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ICM Cardio > Endocarditis 1 > Flashcards

Endocarditis 1 Flashcards

1
Q

What is infective endocarditis?

A

Microbial infection of the endocardium of the heart

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2
Q

What can infective endocarditis infect in the heart? (3)

A

Inner lining of the heart (endocardium)
Chordae Tendinae
Valves

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3
Q

What Staph strains cause endocarditis? (2)

A

Staph aureus

Coagulase neg Staph

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4
Q

What Streptococcus strains cause endocarditis? (3)

A

Mutans
Sanguis
Bovis

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5
Q

Mnemonic for remembering infectious organisms for Bacterial endocarditis? (5)

A 
"HACEK" 
Haemophillus
Actinobacillus
Cardiobacterium Hominis 
Eikenella
Kingella kingae
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6
Q

Painful, swollen subcutaneous nodules on the pulp of fingers and toes are called whaT?

A

Osler node

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7
Q

Non-tender nodules on the palms or soles called what?

A

Janeway lesion

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8
Q

How big are Osler nodes?

A

1mm to greater than 1cm

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9
Q

Hoe big are Janeway Lesions?

A

Variable size

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10
Q

What type of endocarditis does Osler nodes signify?

A

Subacute

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11
Q

What type of endocarditis does Janeway lesions signify?

A

Acute

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12
Q

Histologic findings of Janeway lesion?

A

Septic microemboli

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13
Q

Histologic findings of Osler node?

A

Vasculitis

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14
Q

What clinical finding way we see on the nails for infective endocarditis?

A

Splinter hemorrhages

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15
Q

Perivalvular abscesses run the risk of causing what? (3)

A

Valve disfunction
Heart block
Stroke

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16
Q

Major criteria for bacterial endocarditis? (3)

A

1) Laboratory Evidence of IE (blood cultures)
2) Endocardial involvement seen on transthoracic or transesophageal echocardiogram
3) New Valvular regurgitation

17
Q

Minor criteria for bacterial endocarditis? (4)

A

1) Predisposing heart condition
2) Fever
3) Vascular Phenomenon
4) Immunologic Phenomenon

18
Q

How do you treat gram positive IE?

A

Penicillin or Ampicillin if sensitive

If not sensitive then Vancomycin and Amino-glycoside for 2-6weeks

19
Q

Anticoagulation therapy good idea?

A

No, doesn’t prevent embolism and may increase risk of bleeding

20
Q

Endocarditis main presenting symptoms?

A

Fever and murmur

21
Q

Best first test for endocarditis?

A

Blood cultures

22
Q

Most likely eye finding in bacterial endocarditis?

A

Roth Spots

23
Q

Symptom of endocarditis involving the finger nail?

A

Splinter hemorrhage

24
Q

Which skin symptom is also associated with endocarditis?

A

Osler nodes and Janeway lesions

25
Q

Cardiac exam reveals which murmur?

A

Mitral regurgitation

26
Q

Inspiration increases murmurs on which side of the heart

A

Right sided

27
Q

Expiration increases murmurs on which side of the hearT?

A

Left sided

28
Q

Pansystolic murmur that decreases with inspiration best heard where on chest?

A

Left sternal border

29
Q

After blood cultures are performed what is the next best step?

A

Start antibiotics

30
Q

best empiric choice for antibiotics?

A

Vancomycin and gentamycin

31
Q

A patient with redness and flushing at the neck line in response vancomycin and gentamicin should be treated how?

A

Decrease RATE of infusion

32
Q

In endocarditis what is likely found on lab testing?

A

Low compliment levels

33
Q

Strep bovid should trigger you to what exam?

A

Colonoscopy to check for malignancy

34
Q

Equation for sensitivity?

A

Sensitivity = TP/(TP+ FN)

35
Q

Equation for positive predictive value?

A

TP/All positive

36
Q

When do you use transesophageal echocardiogram over transthoracic echocardiogram?

A

When the patient has had a valve replacement

37
Q

Endocarditis caused by Bartonella is associated with who?

A

Alcoholics on the street and flea bites

38
Q

Indication for prophylaxis?

A 
Prosthetic valve
Heart transplant recipient
Previous endocarditis
Uncorrected cyanotic heart disease
PLUS
Dental work with bleeding
Tonsillectomy/adenoidectomy
39
Q

If there is a prosthetic valve involved then what antibiotic can you add?

A

Rifampin

ICM Cardio (5 decks)

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