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RB Y1 Cardiology > Endocarditis > Flashcards

Endocarditis Flashcards

1
Q

risk factors

A

calcification in elderly

congenital heart disease

rheumatic fever

IV drugs

prosthetic heart valve

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2
Q

cause in PWID

A

S.aureus

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3
Q

cause after dental surgery

A

S.viridans

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4
Q

cause in prosthetic valves

A

S.epidermidis

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5
Q

atypical causative organisms

A

Coxiella burnetti

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6
Q

gram negatives

A

HACEK Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella

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7
Q

PWID valve affected

A

tricuspid (R sided)

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8
Q

most common valve affected

A

mitral (L sided)

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9
Q

pathology

A
  • Bacteraemia organisms settle in fibrin or platelet thrombi becoming thrombotic vegetations
  • These are friable and break off causing septic emboli or haemorrhage.
  • Can be fatal
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10
Q

classification

A

dukes

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11
Q

dukes major

A

2 separate positive blood cultures Endocardial involvement

ECHO findings

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12
Q

dukes minor

A

Fever >38 C

IV drug user or predisposing heart condition, and Immunological phenomena (eg Osler’s nodes, Roth’s spots)

Vascular phenomena, e.g. mycolytic aneurysm/Janeway L’s

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13
Q

CF

A

Fever

Roth spots

Osler nodes

Murmur (new)

Janeway lesions

Anaemia

splinter Nail haemorrhage

Emboli

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14
Q

investigations

A

Blood - 3 separate places and 3 cultures

Blood for anaemia

Urinalysis

CXR ECHO - trans thoracic or transesophageal for vegetations

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15
Q

treatment for prosthetic valve or suspected MRSA

A

epidermidis

vancomycin IV and Gentamicin IV and delayed rifampicin PO

valve replacement may be required

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16
Q

treatment for native valve indolent - subacute

A

Enterococcus

Amoxicillin IV and gentamicin

17
Q

treatment for native valve sever sepsis and risk actors for resistant pathogens

A

vancomycin IV and meropenem IV

18
Q

treatment for strep viridans

A

penicillin G (benzylpenicillin) and gentamicin

19
Q

complications

A

Heart failure

Arrhythmia

Abscess formation in cardiac muscle

Embolic formation (stroke, vision loss, infection spread)

RB Y1 Cardiology (34 decks)

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