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Cardiology > Infections > Flashcards

Infections Flashcards

1
Q

Endocarditis is an infection of the endocardium, usually in what part?

A

Valve leaflets

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2
Q

What are common complications associated with endocarditis?

A

Stroke (15%) and valve surgery (32%)

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3
Q

Who are at high risk of contracting endocarditis?

A

IVDU
Hemodialysis
DM
HIV
Immunosuppression
Dental Procedures
Valvular Heart Disease
Endovascular Hardware

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4
Q

Where is it more common for vegetation to occur in endocarditis?

A

Left side of the heart (mitral or aortic valves) due to more turbulent flow, more O2, and valvular disorders more common

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5
Q

What is the number one bacterial cause of endocarditis?

A

Staph aureus

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6
Q

What are common bugs that cause endocarditis?

A

Staph aureus
Strep viridans
Enterococci

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7
Q

What are Osler’s Nodes?

A

Painful raised red lesions on the hands and feet in endocarditis

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8
Q

What are Janeway lesions?

A

Non-tender, flat, small red lesions on hands or feet in endocarditis

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9
Q

What are splinter hemorrhages?

A

Capillary hemorrhages under the fingernails (seen in endocarditis)

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10
Q

What are Roth Spots?

A

Retinal hemorrhages with pale centers (sign of endocarditis)

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11
Q

What is the work-up for endocarditis?

A

Blood cultures (2-3 sets from 2 different locations)

Echo (TTE with follow-up TEE if positive or high risk)

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12
Q

When should blood cultures be collected in the work-up of endocarditis?

A

Before empiric antibiotic

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13
Q

What is the Duke criteria for endocarditis?

A

2 major
1 major + 3 minor
5 minor

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14
Q

What are the major criteria in the Duke Criteria for diagnosing endocarditis?

A

Positive blood culture
Evidence of endocardial involvement by ECHO

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15
Q

What are the minor criterion in the Duke Criteria for diagnosing endocarditis?

A

Predisposition

Fever

Microbiogic evidence

Vascular phenomena (Janeway lesions, emboli, etc.)

ECHO findings

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16
Q

IVDU’s with endocarditis are at higher risk for developing

A

septic emboli or metastatic infections

17
Q

Prophylaxis antibiotics for the prevention of high risk patients for endocarditis should be given in these situations

A

Significant dental work
Invasive respiratory tract procedures
Procedures involving skin or MSK infections

18
Q

Rheumatic fever is a sequelae of

A

Strep pharyngitis

19
Q

Beta hemolytic strep (strep pyogenes) causes

A

systemic inflammation

20
Q

What is the Jones criteria?

A

Criteria for diagnosing acute rheumatic fever

Joints
Heart
Nodules
Erythema Marginatum
Sydenham chorea

21
Q

What is the criteria for diagnosing rheumatic fever with Jones criteria?

A

History of strep infection
2 major or 1 major + 2 minor

22
Q

What is Sydenham chorea?

A

Random, continuous, involuntary movements

23
Q

What is erythema marginatum?

A

Rapidly enlarging ring or crescent shaped macules with central clearing

24
Q

Who typically is at high risk for myocarditis?

A

Primarily young, and healthy patients

Kids
Pregnant females
Immunocompromised

25
Q

What are non-infectious causes of myocarditis?

A

Autoimmune
Meds
Venoms
Hypothermia
Radiation injury
Extensive list

26
Q

What is the typical infectious agent of myocarditis?

A

Viral most common

27
Q

What is the acute treatment in myocarditis?

A

IV, O2, monitor
Treatment of arrhythmias
Treatment of HF

28
Q

What should be avoided in the treatment of sub-acute or chronic myocarditis?

A

Avoid cardiotoxic agents and NSAIDs

29
Q

What is a pericardial effusion?

A

Build up of fluid in the pericardial space (between pericardium and heart)

30
Q

When pressure within the pericardial space exceeds 15mmHg what will occur?

A

Pericardial Tamponade

31
Q

What is a classic finding in pericardial effusion and tamponade?

A

Beck’s Triangle

32
Q

What is Beck’s Triangle?

A

Hypotension, JVD, muffled heart sounds

33
Q

What is the work up for pericardial effusion and tamponade (if there is time)?

A

CXR
EKG

34
Q

What will be the EKG findings in pericardial effusion and tamponade?

A

Non-specific T wave abnormalities and diffuse low-voltage QRS

Electrical alternans (pathognomonic)

35
Q

What EKG finding is pathognomonic for pericardial effusion and tamponade?

A

Electrical alternans

36
Q

What is electrical alternans?

A

Alternating height of QRS; heart swinging in pericardial sac

Cardiology (15 decks)

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