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Cardiovascular > Endocarditis > Flashcards

Endocarditis Flashcards

1
Q

Define bacteraemia

A
  • the presence of bacteria in the bloodstream
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2
Q

What are the expected bacteria for an implantable electronic device?

A
  • skin organisms
  • staph aureus
  • staph epidermidis
  • corynebacterium sp
  • propionibacterium acnes
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3
Q

What does biofilm mean?

A
  • slow growing community of bacteria
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4
Q

Risk factor for ICED infections

A
  • pre procedure prophylaxis
  • if the procedure is complex
  • heart and renal failure
  • haematoma post procedure
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5
Q

Staph aureus may cause?

A
  • septic shock
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6
Q

What does secondary foci mean?

A
  • as the infection is in the blood, it can spread to other areas of the body, such as the spine or lungs
  • secondary foci
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7
Q

When should blood cultures be taken?

A
  • prior to starting antimicrobial therapy
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8
Q

If suspicion of an ICED infection what should be done to test?

A
  • suspicion of ICED infection - 3 blood cultures > 6hrs between
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9
Q

Define infective endocarditis

A
  • infection of the endothelium of the heart valves

- can be life threatening

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10
Q

subacute meaning?

A
  • slowly increasing infection
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11
Q

Predisposing factors for infective endocarditis?

A
  • heart valve abnormality
  • prosthetic heart valve
  • Intravenous drug uses
  • Intravascular lines
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12
Q

Pathogenesis of endocarditis?

A
  • heart valve damages
  • turbulent blood flow over roughened endothelium
  • platelets deposited
  • bacteraemia
  • organisms settle
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13
Q

Negative blood cultures, but other symptoms. what bacterias?

A
  • coxiella burnetti (Q fever)

- bartonella

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14
Q

Meaning of hacek organisms?

A
  • difficult to grow bacteria

- may come back with negative blood culture at first - take longer to grow

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15
Q

What is the classification system used for endocarditis?

A
  • Duke’s criteria
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16
Q

Sign for infective endocarditis on the hands?

A
  • Osler nodes
  • och - sore
  • Janeways lesions
  • not sore
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17
Q

Gram positive and in clusters?? suggestive of?

A
  • staphylococci
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18
Q

What test is used to distinguish between gram positive and negative staph?

A
  • coagulase test
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19
Q

What is the most common coagulase negative staphylococcus?

A
  • staphylococcus epidermis

* BE AWARE - if the patient has prosthetic material (e.g. iv line, heart valves e.t.c)

20
Q

Presenting symptoms of acute endocarditis?

A
  • overwhelming sepsis

- cardiac failure

21
Q

Presenting symptoms of subacute endocarditis?

A
  • fever
  • new or changed heart murmurs
  • finger clubbing
  • splinter haemorrhages
  • laneway lesions
  • Osler nodes
22
Q

Viridans group streptococci are what colour?

A
  • green
23
Q

examples of alpha haemolytic step?

A
  • strep mitis

- strep sanguinis

24
Q

After a blood test what should you perform if you suspected endocarditis?

A
  • trans thoracic echo (from skin)

- transoseophageal echo (down throat)

25
Q

Complications of endocarditis

A
  • spread of infection through blood
26
Q

Most common side of heart effected by endocarditis for those who do not inject drugs

A
  • left side
27
Q

Where would endocarditis likely effect in people who inject drugs?

A
  • right tricuspid valve

- staph aureus

28
Q

Drug treatment for endocarditis straight away (empirical choices)

A
  • high doses
  • IV to start off with
  • streptococcus –> amoxicillin
  • prosthetic valve –> vancomycin & gentamicin
  • drug users –> flucloxacillin
29
Q

How long on average would you treat endocarditis for with antibiotics?

A
  • 4- 6 weeks
  • refer for surgery if failing
  • repeat blood culture every 2-3 days
30
Q

If lab results come back with a fungi infection endocarditis what would you do next?

A
  • refer for surgery
31
Q

Prevention of endocarditis

A
  • case by case

- may do antibiotic prophylaxis in some cases

32
Q

Define myocarditis

A
  • viruses!

- infection of the cardiac muscle

33
Q

Pericardis usually bacteria or viruses?

A
  • viruses
34
Q

Symptoms of myocarditis?

A
  • fever
  • chest pain
  • shortness of breath
  • palpitations
35
Q

How is myocarditis diagnosed?

A
  • viral PCR
36
Q

Define pericarditis?

A
  • inflamed pericardium
  • often occurs with myocarditis
  • Positional
37
Q

Symptoms of pericarditis?

A
  • pain when breathing in and out

- pain when moving forward and backwards

38
Q

Define cardiomyopathy

A
  • any disease of the cardiac muscle

- change in heart chamber and thicknes

39
Q

Explain dilated cardiomyopathy

A
  • genetic
  • x -linked
  • reduced ejection fraction
40
Q

Explain hypertrophic cardiomyopathy

A
  • big heart, strong, not like dilated cardiomyopathy
  • heart cannot relax
  • may lead to sudden death
41
Q

Explain restrictive cardiomyopathy

A
  • stiff heart

- heart may appear normal

42
Q

What is amyloid?

A
  • abnormal deposition of abnormal protein
  • tends to be in beta sheets
  • restrictive cardiomyopathy pattern
43
Q

Explain arrhythmogenic right ventricular dysplasia?

A
  • autosomal dominant
  • low penetrance
  • syncope
44
Q

What is dresslers syndrome?

A
  • pericarditis post MI

- May lead to pleural effusions and cardiac tamponade

45
Q

What is the most common heart tumour?

A
  • atrial myxoma

Cardiovascular (26 decks)

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