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Patho CVS > Endocarditis > Flashcards

Endocarditis Flashcards

1
Q

Infective Endocarditis is infection of?

A

cardiac valves and/or the endocardium

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2
Q

vegetation ( result of Infective Endocarditis) is formed by

A

mass of thrombus, necrotic debris and micro-organisms

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3
Q

Vegetation of IE is mostly on which side of the heart?

A

Left(on valve leaflets, mostly aortic and mitral valves.)

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4
Q

Right IE is caused by(unusual)

A

IV drugs ( unsterile material use infects the blood which goes back from circulation to right side of heart)

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5
Q

IE types and which one is more dangerous

A

1-Acute( more severe with 50% death )
2-subacute which can’t be treated but antibiotics

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6
Q

Which organism causes IE

A

*ACUTE( High virulent staphylococcus)
*SUBACUTE(Low virulent hemolytic streptococcus)

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7
Q

Which type of IE affects normal valves not just deformed

A

Acute

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8
Q

Hematogenous infection is caused by?

A

*Intravenous drug abusers
*Previous dental, surgical or interventional procedure .

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9
Q

Occult source of bacteremia

A

Small injuries to skin or mucosal surfaces.

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10
Q

Risk Factors of IE

A

1Cardiac abnormalities
•.Prostheticheartvalves(10%to20%).
(Previous two referee to deformed valve mostly)
3.Intravenousdrugabusers

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11
Q

Most common pathogen causing IE

A

-Hemolytic (viridans) streptococci (50-60%)
*attacks deformed valves(subacute)

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12
Q

Major cause of IE in drug abuse

A

Staphylococcus aureus (10-20%)
attacks healthy or deformed valves(acute)

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13
Q

Which organism infects prosthetic valves

A

Coagulase-negative staphylococci (S.epidermidis)

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14
Q

Percent of culture-negative endocarditis

A

10% No organism is isolated from the blood

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15
Q

Gross of vegetation in IE

A

Friable,bulky,and potentially
destructive
* may lead to embolism

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16
Q

What is (ring abscess)

A

When vegetation erodes into the underlying myocardium to produce an abscess cavity

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17
Q

Abscesses development at the sites where emboli lodge leads to

A

septic infarcts and mycotic aneurysms.

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18
Q

most consistent sign of IE

A

Fever ( cause it’s infection)

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19
Q

Clinical sign present in 90% of patients with left- sided lesions

A

Murmur

20
Q

Diagnosis of IE is done through

A

Positive blood cultures and echocardiographic findings.

21
Q

Microemboli ( sign of IE)can give rise to:

A

-Petechia
- Nail bed (splinter) hemorrhages
-Retinalhemorrhages(Rothspots)
- Painless palm or sole erythematous lesions (Janeway lesions)
- Painful fingertip nodules (Osler nodes)

22
Q

Complications of IE

A

• Glomerulonephritis
• Arrhythmias
• Systemic embolization

23
Q

Deposition in Nonbacterial Thrombotic Endocarditis consists of?

A

•Deposition of small (1 to 5 mm in diameter) thrombotic masses composed mainly of fibrin and platelets on previously normal cardiac valves.

24
Q

Marantic endocarditis definition

A

Nonbacterial Thrombotic Endocarditis subtype that Occur in a wide variety of diseases associated with general wasting disease ( like cancer)

25
Q

usual precursor of NBTE

A

Hypercoagulable states

26
Q

The difference in emboli between IE and NBTE

A

In IE it’s septic ( more dangerous cause it froms abscess)

27
Q

Thrombotic vegetation location is described as

A

Nearly complete row of thrombotic vegetations along the line of closure of the mitral valve leaflets.

28
Q

When Systemic lupus erythematoses ( autoimmune diseases) affects heart valve it results in which disease

A

Libman-Sacks Endocarditis

29
Q

Location of vegetation in LSE

A

Canoccuranywhereonthevalve surface, on the cords, or even on the atrial or ventricular endocardium

30
Q

Vegetation in rheumatic heart disease morphology:

A

row of small vegetations along the lines of closure of the valve leaflets.

31
Q

Vegetation morphology in IE

A

large, irregular masses on the valve cusps that extend onto the cords.

32
Q

Majority of myocarditis cases are caused by

A

Coxsackieviruses A and B and other enteroviruses.

33
Q

Can myocarditis be caused by influenza virus?

A

Yes

34
Q

None viral myocarditis is caused by

A

1-protozoan Trypanosoma cruzi
2-Toxoplasma gondii
3-Trichinosis
4-Borrelia burgdorferi (bacterial spirochete)

35
Q

Borrelia burgdorferi (bacterial spirochete) causes which disease

A

Lyme

36
Q

the most common helminthic disease with associated cardiac involvement is

A

Trichinosis

37
Q

protozoan Trypanosoma cruzi is the agent of

A

Chagas disease.

38
Q

Noninfectious causes of myocarditis:

A

-Lesions associated with systemic diseases of immune origin: systemic lupus erythematosus and polymyositis.
-Drug hypersensitivity reactions(hypersensitivity myocarditis)-eosinophilia is noticed

39
Q

Hypersensitivity myocarditis under microscope looks like

A

Interstitial and perivascular infiltrates composed of high proportion of eosinophils.

40
Q
  • Chagas myocarditis under microscope
A

Intracellular organisms (Trypanosoma cruzi) inside a myocyte
• Accompanied by an inflammatory infiltrate of neutrophils, lymphocytes, macrophages, and occasional eosinophils

41
Q

Morphology of inflammatory involvement in myocarditis

A

Patchy

42
Q

End result of surviving acute myocarditis

A

lesions can resolve without significant sequelae or heal by progressive fibrosis.

43
Q

Heart appearance in myocarditis

A

Normal or dilated

44
Q

Edema, myocyte injury,diffuse lymphocytic infiltrate
Are seen in

A

Active myocarditis

45
Q

In hypersensitivity myocarditis the Interstitial and perivascular infiltrates composed of

A

high proportion of eosinophils.

46
Q

Which microorganism is seen in chags myocarditis

A

Intracellular organisms (Trypanosoma cruzi) inside a myocyte
*** Accompanied by an inflammatory infiltrate of neutrophils, lymphocytes, macrophages, and occasional eosinophils

Patho CVS (6 decks)

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