Exam 4 - Endocarditis

Question 1

how to diagnose endocarditis

Answer 1

-2 major criteria
-1 major + 3 minor
-5 minor

Question 2

what are the major criteria

Answer 2

blood cultures
imaging
surgical

Question 3

what are the general treatment considerations and goals for endocarditis

Answer 3

eradicate the infection!
start high dose empiric therapy w/ bactericidal activity

Question 4

-Viridans group strep and strep gallolyticus
-native valve
-highly pen susceptible

Answer 4

-pen g or ceftriaxone x4 weeks
-pen g or gent x 2 weeks
-ceftriaxone + gent x 2 weeks
-vanc x 4 weeks

Question 5

-Viridans group strep and strep gallolyticus
-native valve
-pen resistant

Answer 5

pen g + gent x4+2 weeks
ceftriaxone + gent x 4 + 2 weeks
vanc x4 weeks

Question 6

-Viridans group strep and strep gallolyticus
-prosthetic valve
-highly pen susceptible

Answer 6

pen g x6 weeks +/- gent x2 weeks
ceftriax x6 weeks +/- gent x2 weeks
vanc x6 weeks

Question 7

when should gent be avoided

Answer 7

CrCl < 30

Question 8

-Viridans group strep and strep gallolyticus
-prosthetic valve
-pen resistant

Answer 8

same as susceptible options but for 6 weeks duration

Question 9

staphylococci
native valve
MSSA

Answer 9

naf or ox x 6 weeks

Question 10

staphylococci
native valve
MSSA
pen allergy

Answer 10

cefazolin x 6 weeks

Question 11

staphylococci
native valve
MRSA

Answer 11

vanc or dapto x6 weeks

Question 12

staphylococci
native valve
MRSA
last ditch effort

Answer 12

ceftaroline

Question 13

staphylococci
prosthetic valve
MSSA

Answer 13

Naf or ox >6 weeks +
Rifampin >6 weeks +
gent >2 weeks

Question 14

staphylococci
prosthetic valve
MSSA
allergy

Answer 14

cefazolin to replace gent

Question 15

staphylococci
prosthetic valve
MRSA

Answer 15

Vanc >6 weeks + Rifampin >6 weeks + Gent 2 weeks