Infection And Inflammation Flashcards
Which valve is usually affected in IVDU and endocarditis? And by what organism?
Tricuspid Staph aureus (now commonest bug)
What are the risk factors for endocarditis?
Prosthetic valves
Congenital heart defects
Rheumatic heart heart
IVDU
Bicuspid aortic valves and mitral valve prolapse also are RF
Most common organism in infective carditis in the developing world?
Viridans streptococci
Which bacteria likes prosthetic valves?
Staphylococcus epidermidis
Often contracted in hospital during surgery
What diagnostic tests are used in infective endocarditis?
Blood cultures
Echocardiography
Which type of endocarditis is associated with SLE?
Libman- Sacks endocarditis
Not infective - due to immune complexes
Treatment for native valve endocarditis
Amoxicillin and gentamicin
Treatment for native valve endocarditis with sepsis and RF for gram negative infection?
Vancomycin and meropenem
Treatment for endocarditis of prosthetic valves
Vancomycin, gentamicin and rifampacin
ECG changes in acute pericarditis?
Widespread saddle shaped ST elevations PR depression (most specific marker for pericarditis)
Causes of pericarditis?
Viral (coxsaccie) TB Uraemia Trauma Post MI Connective tissue disease (SLE Libyan-sacks) Hypothyroid
Pericarditis symptoms?
Fever
Chest pain - worse on insipation, better sitting up and leaning forward
Large pleural effusions (progressive to pericardial fibrosis) cause ⬇️ heart sounds, ⬇️ cardiac output, low QRS voltage on ECG or electrical alternans
Friction rub, ECG changes
X-ray - water bottle sign (effusion)
Echo - heart dancing/ stiff and restrictive movement
Rheumatic fever criteria?
Evidence of strep infection (ASOT >200, hx scarlet fever, positive throats swab, increase DNaseB titre)
Major: carditis, polyarthritis, Sydenham chorea, subcutaneous nodules, erthyma marginatum
Minor: fevers, raised ESR/ CRP, arthalgia, prolonged PR
