IF

Question 1

WHATS THE DIFFERENCE BETWEEN ACUTE AND SUBACUTE

Answer 1

A:
- the heart previously normal
- s. aureus and other strep
-organisms are more virulent
- need to treat urgently cant afford to wait for cultur e
- patient looks more ill

subacute - s. virdians

Question 2

time differentiations

Answer 2

acute <6 weeks

subacute >6 weeks

Question 3

symptoms

Answer 3

obviously the mor epathognomic ones

but general systemic signs
fever - most common symptoms
night sweats
abdominal pain - affecting kidneys
arthralgia
myalgia

Question 4

when hsoulld you be very suspcius of IE

Answer 4

patient comes in with fever AND a new murmour

Question 5

physical signs

Answer 5

roth spots
janeway lesions etc
MURMOUR on ausculation
Microscopic haematuria and glomerulonephritis

Question 6

complication of iE

Answer 6

aortic root abscess, bateria go beyond the valve and you see this on ECG as pR prolongation( 1st degree block ) or complete AV block

. heart failure due to the valves regurgitation

seeding of infection to joints, osteomyelitis , abscesses in any organ potentially

embolic complications splenic infarction so palpation may be painful

stroke
mycotic aneurysm

Question 7

p

Question 8

investigatyions

Answer 8

blood culture (but dont have time to wait especcialy in acute)

ECHO-function of valves
ECG

Transthoracic echocardiogram is the first line imaging investigation
Transoesophageal echocardiogram is the most sensitive diagnostic test

Question 9

RULE ABOUT BLOODS

Answer 9

At least 3 sets of blood cultures should be taken at different times from various sites

Question 10

which interetsing organism is assocutiated with IE

Answer 10

coxiella burnetti q fever (interestingly only need just 1 sample )

Question 11

name of criteria for diagnosis and how to we interpret it

Answer 11

DUKES

2 major criteria

1 major +3 minor

5 minor

Question 12

what are the immunological signs

Answer 12

osler nodes , roth spots , glomerulomephritis

Question 13

surgery indications

Answer 13

valve is infected as prosthetic (replaced)

bad heart failure

aortic root abscess - PR prolongation

Question 14

Which valve is most commonly affected in intravenous drug users?

Answer 14

tri

Question 15

dukes major

Answer 15

see pic

Question 16

rukes minor

Answer 16

see pic

Question 17

rukes minor

Answer 17

see pic

Question 18

which organisms are associated with ED

Answer 18

HACEK
S. AUREUS
S. VIDRDANS
S. BOVIS

Question 19

What is the most common AGENT cause of infective endocarditis?

Answer 19

S.AUREUS

Question 20

What is the most common cause of infective endocarditis in patients without a history of cardiac disease?

Answer 20

s. aureus

Question 21

people with marfans are at what risk of cardiovascaular events

Answer 21

mitral valve prolapse/regurgitation
aortic regurg
aortic anuerysm
aortic root dilation
spontaneous pneumothroaces