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MED 4 > Infection Of the Cardiovascular System > Flashcards

Infection Of the Cardiovascular System Flashcards

1
Q

Invasion anf multiplication of micro-organisms on the endocardial surface, withing the endocardium, myocardium or prosthethic materials withi the cardiac structure. Involves vulvular structures and may lead to destruction of these structures, localized or generalizd sepsis or sites of embolism

A

Infective endocarditis

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2
Q

Can be congenital or acquired and majority of the patients have ________________ and ___________

A

Pre-existing heart disease
Prosthetic heart valve in situ

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3
Q

Epidemiology of Infective Endocarditis

A

A rare disease, more common in men, Increasingly a disease of elderly individuals

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4
Q

Two valces that infective endocarditis can affect?

A

Native Valves (Pathogen inflames native valve)
Prosthetic (artificial valves) - Pathogens attaches to prosthetic and grows on them

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5
Q

Native valves can be divided into __________ and __________

A

Healthy native Valves : Caused by virilent organism
Damaged native Valves: Normal flora that are not so virulent

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6
Q

2 main categories of Infective endocarditis _____________ and _____________

A

Acute and Subacute

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7
Q

Highly virulent bacteria common in IVD users? Large lesions and abscesses formation on previously healthy native valves; FULMINANT course

A

Acute Infective endocarditis

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8
Q

Less virulent bacteria: Smaller lesions on damage(Native valve) or artifical valves (Prosthetic Valve) -INDOLENT Course

A

Subacute Infective endocarditis

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9
Q

Abrupt onset, Fulminant course, highly virulent bacteria, duration of onset of symptoms <14 days, Large vegetation

A

Acute ENdocarditis

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10
Q

Insidious onset, Less virulent bacteria, indolent course, small vegetation , duration of onset of symptoims median 5-6 weeks

A

Subacute endocarditis

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11
Q

Causative agents of infective endocardiatis -That usually grow readily in culture

A
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12
Q

Causative agents of culture-negative infective endocarditis (that usually DON’T grow readily in culture)

A
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13
Q

Causes of bacteremoa potentially leading to infective endocarditis

A
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14
Q

What are the predisposing (risk) factors associated with infective endocarditis?

A
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15
Q

Damage to endocardial lining can be due to the following:

A

-Turbulent blood flow to heart damages cardiac endothelium
-Endocardial damage due to intracardiac catheter tips, pacemaker leads
-Valve damage due to Rheumatic heart disease
-Congenital Cardiac valvular defects – bicuspid aortic valve, VSD
-Mitral valve prolapse
-i.v illicit substance use (microscopic solid dust particles can damage tricuspid endothelium)
-Prosthetic valve
-Previous history of infective endocarditis / Marfan’s

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16
Q

Bacteremia & potential pathogens in Infective endocarditis

A
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17
Q

Match Infective Endocarditis Predisposing factor and causal Organism

A
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18
Q

Dextran Production

A

Viridans Streptococci – commensal oro-dental streptococci (alpha hemolytic)

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19
Q

Surface adhesins-FimA

A

Viridans Streptococci

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20
Q

Adherence to specific components of NBTE

A

Streptococcus sanguis – binds to platelet receptor, fibrin
Staphylococcus aureus – binds to fibrinogen & fibronectin

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21
Q

Glycocalyx & Slime layer - Adhesion to prosthetic valves

A

coagulase negative Staphylococci (S. epidermidis)

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22
Q

Match the caridiovascular bugs with their virulent factors

A
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23
Q

Pathogenesis of Infective endocarditis

A
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24
Q

Pathogenesis of Infective Endocarditis -Simplified

A
  1. Bacterial entry
  2. Bacterial adherence to damaged endothelium and microthrombi
  3. Bacterial proliferation, neutophil and macrophage infiltration
  4. Vegetation formation
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25
Q

Pathogenesis of IE _Viridan Streptococci

A
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26
Q

Vegetations in native valve infective endocarditis

A
27
Q

Prosthetic Valve Endocarditis

A
28
Q

Infective Manfestation -Physical Signs

A
29
Q

Criterias for Diagnosis of Infective Endocarditis -Major and Minor Criteria

A
30
Q

Summary of IE

A
31
Q

Septic Emboli vs Immune Complexes in IE

A
32
Q

Laboratory Diagnosis of Infective Endocarditis and Culture Negative Endocarditis

A
33
Q

Identifying characteristics of viridans Streptococci

A
34
Q

IE- Enterococcus Species

A
35
Q

IE- Staphylococcus Aureus

A
36
Q

Infective Endocarditis causal organism of Viridans Streptococci

A

Streptococcus (Sanguinis, Mitis, Mutans, Milleri/Anginosus)

37
Q

HACEK - A subacute Infective Endocardia ( Gram negative bacilli) normal or0-dental flora, Dental procedure is a risk factor, Fastidious and often missed during routine blood cultures for IE.

A

HAECK :
H- Hemophilus
A-Aggregatibacter
C-Cardiobacterium
E-Eikenella
K-Kingella

38
Q

Gram-negative, Causes IE in IVDU (Druggies)-Non-fermenter, Oxidase psoitive, can grow in tap water, soap, antiseptic and disinfectant solutions- Found mostly in moist environment. Produces Blue-green pigment in cuture and has sweet grape-like/fruity odor

A

Pseudomonas Aeruginosa

39
Q

Match the Microbiology characteristics with the bugs

A
40
Q

EI bugs that won’t readily grow in blood culture-negative infective endocarditis

A

-Coxiella Burnetti
-Tropheryma Whipplei
-HACEK
-Bartonella

41
Q

Treatment of Infective Endocarditis

A

**ANTIMICROBIAL THERAPY
-Empiric & targeted antimicrobial Rx
-Bactericidal antibiotics are preferred
-Duration of therapy is long (4-8 weeks) & relapse is not unusual
**SURGERY

42
Q

Valve type, Clinical Presentation, Regimen

A
43
Q

What are the prophylaxis for IE?

A

Prophylactic Abx administered30–60 minutesprior to Dental/ lower GI/ respiratory tract / cutaneous abscess I&D, urethral instrumentation:

Amoxycillin/Amplicillin
Penicillin Allergy- Azithromycin, Clindamycin

Who needs prophylaxis?
-Valvular defect
-History of Endocarditis
-Congenital Heart disease
-Prosthetic valve
-Post cardiac surgery/transplant

44
Q

Decribe Acute Rheumatic Fever & Rheumatic Heart Disease

A
45
Q

Acute Rheumatic Fever and RHD Pathogenesis

A
46
Q

Jones Criteria used in the diagnosis of Acute Rheumatic Fever

A
47
Q

Inflammation of the Myocardium

A

Myocarditis

48
Q

What are the viral causes of Myocarditis?

A
49
Q

Bacterial Causes of Myocarditis

A
50
Q

Protozoa causes of Myocarditis

A

Trypanosoma Cruzi (Chagas disease)
Toxoplasma gondii

51
Q

Helminthic cause of Myocarditis

A

Trichinella Spiralis

52
Q

Mode of spread and Risk groups of Viral Myocardiatis?

A
53
Q

Viral Myocarditis Pathogenesis

A
54
Q

Clinical features and Diagnosis of Viral Myocarditis

A
55
Q

Cardiac Involvement in Chagas Disease

A
56
Q

Physical signes of Chagas Disease

A
57
Q

Cardiac Manifestation of Chagas Disease

A
58
Q

Myocarditis in Lyme Disease

A
59
Q

Myocarditis -Diptheria

A
60
Q

Pericarditis-Viruses, Bacteria (Acute) Purulent Pericarditis , Chronic

A
61
Q

Clinical Features and Diagnosis of Pericarditis

A
62
Q

Examples of Infective Endocarditis, Acute Rheumatic Fever, Myocarditis

A
63
Q

What is Syphilitic Heart Disease and Its Pathogenesis?

A

MED 4 (4 decks)

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