cvm Flashcards
Early Prosthetic Valve Endocarditis Organisms (less than 1 yr)
1 Staph epidermis (Coagulase Negative Staphylococcus )
#2 Staph aureus
Late Prosthetic Valve Endocarditis Organisms - After 1 year of replacement
Staphylococcus spp.(epidermidis/ aurus)
*Streptococcus spp.(vidurians sanginis)
Enterococcus spp.
-potential fungi, parasites, intracellular bacteria
Native Valve endocarditis Organisms
*Staphylococcus spp. (epidermidis/ **aurus)
*Streptococcus spp. (vidrians/sangunis)
Enterococcus spp.
HACEK organisms(community acquired)
-potential fungi, parasites, intracellular bacteria
recent oral invasion procedure
strep vidrians
Optochin resistant
Viridans Streptococci
alpha hemolytic
most common cause of infective endocarditis due to strep
S. sanguinis
alpha hemolytic
primary etiological agent of dental caries
and dental plaques
S. mutans, S. Sanguinis
alpha hemolytic
AND HACKE -Haemophilus aphrophilus
novobiocin test
strep epideridis
Thickening or hardening of artery, loss of elasticity
Arteriosclerosis - umbrella term
calcification of tunica media of arteries
Monckeberg medial
calcific sclerosis (types of arteriosclerosis, not clinically singinifcant bc it doesnt spread to Intima)
Arteriosclerosis of the small arteries is due to what
Arteriolosclerosis due to hypertension
atheromas
Atherosclerosis, type of Arteriosclerosis
which vessels are most involved in artheromas
- The lower abdominal aorta and iliac arteries
- The coronary arteries
- The popliteal arteries
- The internal carotid arteries
- The vessels of the circle of Willis
Rheumatic heart disease
Strep. pyogenes (GAS)
GI procedure, colonoscopy, antibiotic resistance
Enterococcus (enteric microbiota)
- most commonly isolated, and causes 85-90% of
enterococcal infections - Particularly intensive care unit infections(highly resistant)
E. faecalis
- Responsible for 5 -10% of enterococcal infections *Displays event higher levels of antibiotic resistance
E. faecium
HACEK
- H aemophilus spp. #1
- A ggregatibacter #2
actinomycetemcomitans - C ardiobacterium hominis
- E ikenella corrodens
- K ingella kingae
all G-
Colonies with star shaped interior on solid media
Aggregatibacter actinomycetemcomitans
G- bacilli
myocarditis differential diagnoisis
Acute Coronary Syndrome – ECG, cardiac biomarkers
microbial causes of myocarditis
*enterovirus(Coxsackievirus B) and other viruses are most common. bacteria is uncommon, parasites prominent in low income countries (Trypanosoma/Chagas, Toxoplasma)
Fungal, systemic mycoses: candida, aspergillus (immunocompromized)
microorganisms responsible for pericarditis
*Coxsackievirus A and B and other viruses. Sometime G+/- bacteria, not mycobacterium. Fungi in the immunocompromised(Blasto dermatitidis, Candida spp., Histoplasma capsulatum)
arterioles commonly effected in benign and malignant HTN
benign/chronic : hyaline artiolosclerosis-ischemic changes
malignant/sudden: hyperplastic- fibrioid necrosis
thickened reduplicated basemement membrane and smooth muscle cell hyperplasia
hyperplasia arteriolosclerosis
will have a strong PAS stain, onion skin
necrotizing arteriolitis
hyperplasia arteriolosclerosis
kindey, brain, and retina damages from which type of arteriolosclerosis
kidney both (benign or malignant nephrosclerosis)
brain both (HTN intraparynchimal hemoraghes)
retina is just hyperplastic= cotton wool spots
cystic medial degeneration
loss of structural integrity of arterial media causing aneurysm
abdominal aortic aneurysm caused by
caused by atherosclerosis
ascending aortic aneurysm caused by
caused by HTN
ascending/thoracic aorta aortitis
syphillic aneurysm(tertiary stage)
obliterative/ obstructive endarteritis of the vasa vasorum of the aorta
syphillic aneurysm
treebank appearence
syphillic aneurysm
-from fibrosis of the vascular walls, seen form the inside tunica intima
cystic medial degeneration
marfan syndrom
marfan syndrom aneurysm location
located at ascending aorta and arch of aorta
gene for fibrillin-1
marfan
required for normal elastic tissue development and irresistant to normal stress
circle of willis
berry aneurysm (small saccular)
autosomal dominant polycystic kidney disease
berry aneurism
pulsating hematoma
false aneurysm
locations and features of the type A and type B aortic dissections
type A/ proximal is ascending aorta with high mortality and rapid tx. DOUBLE sided separation
type B/ distal is descending aorta distal to L subclavian artery. better prognosis. SINGLE sided separation
chest pain that is beginning in the anterior chest and radiating to the back scapulae
aortic dissection
pain moves downward
aortic dissection
chest pain with absent peripheral pulse
aortic dissection
double barrel aorta
aortic dissection
block above the bundle of his
second degree block- mobitz type 1-Wencheback
Progressive prolongation of the PR-interval
until a QRS is dropped
second degree block- mobitz type 1-Wencheback
Increased PR interval
First Degree block
sinus bradychardia
dec automaticity
block below the bundle of his
Second Degree Block Mobitz Type II
All-or-nothing conduction, in which QRS complexes are dropped without prolongation of the PR-interval
Second Degree Block Mobitz Type II
Complete Heart Block with AV dissociation. Atria and ventricles are driven by independent pacemakers
Third Degree Block Complete AV-block
atrial rate of atrial flutter and atrial fibrulation
flutter= 250-300
fib= 400+
ventriculat rate is normal ~75
“Retrograde” p wave
Orthodromic AVRT
allan test
Buergers disease
pulseless disease
Takayasu Arteritis
also comes with vision problems and neurological sx
hepatits B
Polyarteritis Nodosa
