Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CRRAB 1 > Diebel Week 1 > Flashcards

Diebel Week 1 Flashcards

1
Q

What are the normal biota of the cardiovascular system?

A

none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the natural defenses found in the cardiovascular system?

A

complement, white blood cells and antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define infectious endocarditis

A

inflammation of the inner lining of the heart (endocardium) typically caused by infection; usually mitral or aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the usual cause of acute endocarditis?

A

results of an overwhelming bloodstream challenge with bacteria with ability to colonize normal heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define vegetations

A

growth on the valves composed of fibrin, WBC, biofilm and bacteria; hampers cardiac function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the usual cause of subacute endocarditis?

A

develops slowly, less pronounced sx, preceded by prior damage to heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of subacute endocarditis

A

fever, anemia, abnormal heartbeat and sometimes abdominal or side pain; may look very ill and may have petechiae, septic emboli, Roth’s spots, splinter hemorrhages under the fingernails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of endocarditis may cause a large spleen?

A

subacute endocarditis; dt chronically fighting bacteria in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Note the temporal evolution of acute endocarditis?

A

hectically febrile to rapidly damages cardiac structures to seeds infection in distal sites through sepsis to death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are largely the causes of acute endocarditis?

A

Staphylococcus aureus and Streptococcus pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are largely the causes of subacute endocarditis?

A

Streptococcal viridans and enterococcal species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the temporal evolution of subacute endocarditis?

A

indolent course of infection to causes structural cardiac damage slowly to rarely seed infection at distal sites to gradually progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What hemolysis is viridans?

A

alpha hemolytic on blood agar plates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the portals of entry for endocarditis?

A

oral cavity, skin and upper respiratory tract are the primary infection sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where is the local infection for endocarditis in the heart?

A

mitral valve, tricuspid valve (injection drug use) and prosthetic valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What two things can give you a presumptive dx for endocarditis?

A

fever and valvular abnormalities (known injection drug use is also helpful)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the range for fever in subacute infectious endocarditis?

A

usually less than 103F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the temperature seen in acute infectious endocarditis?

A

103 to 104F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a positive Duke Criteria for infectious endocarditis?

A

2 major criteria met, 1 major and 3 minor criteria met or 5 minor criteria met

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Can the Duke Criteria dx be overridden

A

Yes-if alternative dx is established, sx resolve and do not recur with less than 5 days of abx therapy or lack of histological evidence of endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What criteria denotes possible endocarditis?

A

1 major and 1 minor or 3 minor criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the 2 Duke Major Criteria?

A
  1. Positive Blood Culture

2. Evidence of endocardial involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What bacteria are included in a positive blood culture for Duke Major Criteria?

A

viridans streptococci or Streptococcus bovis or HACEK group microorganisms or Staph aureus or enterococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How many positive cultures of blood samples drawn how many hours apart for a positive blood culture?

A

2+, more than 12 hours apart or all of 3+ or majority of 4 separate cultures drawn within an hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What if detected in a single blood culture plus a positive IgG antibody titer is a positive blood culture for Duke Major Criteria?

A

Coxiella bruentii (Q fever)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What 3 things are evidences of endocardial involvement for a Duke Major Criteria?

A
  1. oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets or on implanted material 2. abscess 3. new partial dehiscence of prosthetic valve or new valvular regugitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 5 Duke Minor Criteria?

A
  1. predisposition (heart condition of injection drug use) 2. fever above 100.4F 3. vascular phenomena 4. immunological phenomena 5. microbiological evidence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Name vascular phenomena in endocarditis that are a Duke Minor Criteria?

A

arterial emboli, Roth’s spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Name immunological phenomena in endocarditis that are a Duke Minor Criteria

A

Osler’s nodes, rheumatoid factor, glomerulonephritis, Janeway lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Name microbiological evidence that meet the Duke Minor Criteria for endocarditis

A

positive blood culture but not meeting major criterion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Name the organisms that make up HACEK

A

Haemophilus, Aggregatibacter (Actinobacillus), Cardiobacterium, Eikenella, Kingella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe the group that the HACEK organisms belong to

A

group of fastidious gram negative bacteria (won’t grow on regular plate–need chocolate agar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Are HACEK a more or less common cause of endocarditis?

A

less common cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What can cause endocarditis but are a normal part of the human microbiome within the oral-pharyngeal region?

A

HACEK organisms (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What do you use to tx subacute endocarditis?

A

gear tx towards a strep infection: AMPICILLIN/SUBLACTAM + GENTAMICIN or TOBRAMYCIN; or VANCOMYCIN + CEFTRIAXONE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What abx are good for Staph aureus but NOT MRSA?

A

nafcillin or oxacillin +/-gentamicin or tobramycin (think naf for staph)

37
Q

What abx is good for gram (+) multidrug-resistant bacteria only including MRSA, S.epidermidis, Enterococcus species, Clostridium difficile

A

Vancomycin

38
Q

What abx is good for severe gram (-) rod infections and works synergistically with beta-lactam antibiotics?

A

gentamicin (an aminoglycoside); also works on HACEK organisms

39
Q

penicillinase-sensitive penicillin; extended spectrum penicillin

A

Ampicillin

40
Q

What is used against S. pneumoniae, S.pyogenes, Actinomyces, N. meningitidis, T. pallidum?

A

Penicillin (G or V)

41
Q

a beta-lactamase inhibitor; often added to penicillin antibiotics to protect the penicillin from destruction

A

sublactam

42
Q

3rd generation cephalosporin; used for serious gram (-) infections including N. gonorrheae, N. meningitidis and disseminate Lyme disease

A

Ceftriaxone

43
Q

If pt. has a penicillin allergy what do you use to treat endocarditis?

A

cephalosporins (3rd to 5th generation) or carbapenems or vacomycin

44
Q

what is the most common cause overall of endocarditis?

A

Staphylococcus aureus

45
Q

gram positive facultative anaerobe

A

Staphylococcus aureus

46
Q

What are the virulence factors of Staphylococcus aureus?

A

biofilm formation, capsule, adhesins, secreted enzymes and hemolysins, and pathogenicity islands for methicillin resistance

47
Q

bacteria, gram +, cocci, catalase +, cogaulase +

A

Staph aureus

48
Q

most common infectious agent of the skin; superficial infections like boils or abscesses, can produce several toxins that lead to serious toxin-mediated diseases

A

Staphylococcus aureus

49
Q

Describe the clinical presentation of Staphylococcus aureus

A

localized skin/subq infection (impetigo, cellutlitis, folliculitis, furuncles, carbuncles; common infectious agent of surgical wounds

50
Q

What does Staph aureus use to colonize the skin?

A

protein A (binds Fc portion of IgG), coagulase (forms fibrin coat around the organisms), hemolysins and leukocidins (destroy RBCs and WBCs)

51
Q

How does an infection reach the blood stream?

A

neutrophils localize to the infection site and purulent abscesses form, then skin/subq infections may more deeply invade and reach blood stream

52
Q

What are the virulence factors for deep tissue invasion of Staphylococcus aureus?

A

hyaluronidase (breaks down connective tissue), staphylokinase (lyses formed clots), lipase (breaks down fat)

53
Q

What is the 2nd major cause overall of endocarditis?

A

Streptococcal species (viridians); several oral Streptococcal species possible

54
Q

What species usually involves underlying mitral valve damage (rheumatic fever, etc) which provides the site for bacterial colonization?

A

Streptococcal species (viridans); often S. mutans

55
Q

What can viridans species of Streptococcus produce to assist in colonization?

A

dextran for glycocalyx formation and surface adhesion proteins

56
Q

What is the 3rd major overall cause of endocarditis?

A

Enterococcus species

57
Q

What cause of endocarditis is most frequently found following genitourinary procedures in older men and obstetric procedures in younger women?

A

enterococcus species (preceded by bacteremia)

58
Q

Name the virulence factors of enterococcus species?

A

pili, surface proteins, extracellular enzymes like proteases and hyaluronidases

59
Q

What causes endocarditis but is usually resistant to penicillin and carbepenems?

A

Enterococcus species

60
Q

Describe the clinical presentation of Streptococcus pyogenes

A
  1. localized skin/subcutaneous infection=impetigo, erysipelas, cellulitis 2. toxin-mediated=toxic shock syndrome, necrotizing fasciitis
61
Q

What bacteria can colonize the skin (following trauma) leading to colonization to inflammation to pustular lesions and honeycomb-like crusts (impetigo)?

A

Streptococcus pyogenes

62
Q

What do deeper infections of Streptococcus pyogenes cause?

A

erysipelas and cellulits

63
Q

Invasion from skin infections of Streptococcus pyogenes can lead to what? but NOT what?

A

can lead to glomerulonephritis but not Rheumatic fever

64
Q

Name the important virulence factors for spread and inflammation of Streptococcus pyogenes?

A

Streptokinase (converts plasminogen to plamsin), M protein (resists phagocytosis), Hyaluronidase (breaks down connective tissue), DNase (digests DNA), Streptolysin O (destroys RBCs), Streptolysin S (destroys WBCs)

65
Q

pathway to toxic shock syndrome from skin (Streptococcus pyogenes)

A

skin infection (cellulitis) to systemic release of pyrogenic exotoxins A (superantigen) to polyclonal activation of T cells to acute fever, shock, multi-organ failure

66
Q

pathway to Necrotizing fasciitis (Streptococcus pyogenes)

A

trauma allows for deep seated infection to release of exotoxin B (protease) to rapid necrosis along fascial planes with no damage to muscles

67
Q

cause of Rheumatic Heart Disease

A

Streptococcus pyogenes pharyngitis (genetically predisposed individuals)

68
Q

What is a definitive clinical indicator of Streptococcus pyogenes?

A

mitral stenosis following pharyngitis with a rash is a definitive clinical indicator

69
Q

What is the cause of the damage to the heart muscles valves in Rheumatic heart disease?

A

autoantibodies (antibodies to bacterial antigens cross-react with meromyosin in the heart); a type 2 hypersensitivity

70
Q

Name the risk factors for rheumatic heart disease

A

strep throat infection (prolonged/untreated); prior case of rheumatic fever; age 5 to 15 years old

71
Q

Symptoms of Rheumatic Heart Disease

A

usually appear 2 to 4 weeks after strep infection; pain swelling in large joints, fever, weakness, muscle aches, shortness of breath, chest pain, nausea and vomitting, hacking cough, circular rash, lumps under the skin

72
Q

Inflammation of the myocardium (middle layer of the heart wall); usually cuased by a viral infection (coxsackievirus B and adenovirus in children)

A

Myocarditis

73
Q

possible cause of chest pain, heart failure, and abnormal heart rhythms

A

Myocarditis

74
Q

name a virus, ssRNA (+), Group IV, nonsegmented, icosahedral nucleocapsid, noneveloped, picornaviridae, enterovirus

A

Coxsackievirus B

75
Q

Define pericarditis

A

inflammation of the pericardium (sac-like membrane surrounding the heart)

76
Q

Is pericarditis typically acute or chronic?

A

acute

77
Q

What is the usual cause of pericarditis

A

coxsackieviruses A and B, echoviruses and influenza virus; usually during summer months with increase in enterovirus infections

78
Q

chest pain associated with the irritated layers of the pericardium rubbing against each other

A

pericarditis

79
Q

Name three picornaviruses that cause carditis

A

coxsackie A virus, cosackie B virus, echovirus

80
Q

What is the cause of Rocky Mountain Spotted Fever ?

A

bacterium Rickettsia rickettsii

81
Q

What are the symptoms of Rocky Mountain Spotted Fever?

A

fever, headache, abdominal pain, vomiting, muscle pain, rash starting from extremeties

82
Q

What is the classic triad that can be diagnostic of Rocky Mountain Spotted Fever?

A

fever, headache, rash and in an area with known ticks (can be later confirmed with lab tests)

83
Q

What is the first line tx of Rocky Mountain Spotted Fever?

A

Doxycycline (effective is started before teh 5th day of sx)

84
Q

Name two obligate intracellular parasites that need host ATP

A

chlamydiae and rickettsiae

85
Q

Name three causes of palm and sole rash

A

RMSF, syphillus, coxsackievirus

86
Q

Where does rickettsia ricettsii proliferate?

A

in endothelial cells

87
Q

what is the vector for Rickettsia rickettsii?

A

Dermacentor wood or dog tick

88
Q

What is the cause of the rash in rickettsia rickettsii?

A

inflammation of endothelial lining of small blood vessels to maculpapular rash from palms and soles spreading to the trunk to vasculitis to headache and CNS, renal damage to death

CRRAB 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions