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Cardiovascular > Infectious Processes > Flashcards

Infectious Processes Flashcards

1
Q

Acute bacterial endocarditis is to Staph aureus as Subacute bacterial endocarditis is to _______

A

Viridans Strep (usually Strep mutans)

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2
Q

What type of bacterial endocarditis involves a previously healthy valve?

A

Acute

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3
Q

What are Viridans Strep according to our flowchart?

A

G+ cocci, catalase -, alpha hemolytic (green/partial), Bile Esculin -, Optochin Resistant

(Viridis is Latin for green)

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4
Q

What are Staph aureus on the flowchart?

A

G+ cocci, clusters, catalase +, coagulase + (also mannitol salt +)

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5
Q

What are the characteristics of the bug most associated with prosthetic valve endocarditis?

A

Staph epidermidis

G+ cocci, catalase +, coagulase -, Novobiocin Sensitive

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6
Q

What are the characteristics of the bug most associated with endocarditis in a colon cancer patient?

A

Strep bovis (a group D Strep, with Enterococcus)

G+ cocci, catalase -, nonhemolytic (gamma)

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7
Q

IV drug users typically get endocarditis involving the _______ valve caused by ________

A

Tricuspid

Staph aureus/Pseudomonas/Candida

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8
Q

Round white spots on RETINA surrounded by hemorrhage

A

Roth spots

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9
Q

very TENDER raised nodules on finger pads and toe pads

A

Osler’s nodes

ow=Ostler

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10
Q

small erythematous lesions on palms and soles

A

Janeway lesions

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11
Q

Reddish purple lines on nails

A

Splinter hemorrhages

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12
Q

What is the acronym for the findings of bacterial endocarditis?

A

FROM JANE

fever, roth spots, osler nodes, murmur, janeway lesion, anemia, nail hemorrhages, emboli

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13
Q

Describe the flow of events in subacute bacterial endocarditis

A

dmg to valve/exposed subendothelial collagen/thrombotic vegetation (platelets+fibrin)/bacteria colonize vegetation

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14
Q

Patient presents with fever, tender raised nodules on the finger pads, and splinter hemorrhages. Cultures come back negative. Patient has lots of lots of neutrophils around and a left shift. What could be going on?

A

infection with one of the HACEK bacteria

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15
Q

Describe the characteristics of the HACEK group

A

all fastidious GNRs

Haemophilus parainfluenza (blood, also choc agar)
Aggregatibacter actinomycetemcomitans
Cardiobacterium hominis
Eikanella corrodens (human bites, bleach smell)
Kingella

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16
Q

What is Libman Sacks Endocarditis?

A

nonbacterial, associated with SLE

17
Q

What are the gross findings in endocarditis associated with SLE?

A

sterile vegetations on BOTH SIDES of valve (usu mitral)

result: mitral regurg

18
Q

What are the flowchart characteristics of the causative agent of Rheumatic fever?

A

Strep pyogenes (aka group A Strep)

G+ cocci in chains, catalase - , Beta/complete hemolysis, Bacitraicin sensitive

also pyr +

19
Q

Rheumatic fever is a progression of a basic pharyngitis in kids due to?

A

Molecular mimicry

Type II hypersensitivity

Ab vs bacterial M PROTEIN attack self

20
Q

Complications of a Group A Strep pharyngitis can cause rheumatic fever and/or ?

A

glomerulonephritis

21
Q

How do we diagnose rheumatic fever and what do the letters stand for?

A

Jones criteria

Joints (migratory polyarthritis)
O (think of a heart shape for pancarditis)
Nodules (subq)
Erythema marginatum (rash, red borders)
Syndenham Chorea (rapid invol. mvmt)
22
Q

As part of the Jones criteria, we must have evidence of a previous group A Strep infection. What are the two acceptable methods?

A

ASO titer
or
Anti-DNAse B titer

23
Q

What are the top 2 valves involved in Rheumatic fever endocarditis?

A

Mitral #1

Aortic #2

24
Q

What is the characteristic finding in the myocardium of a rheumatic fever patient?

A

Aschoff body

25
Q

Describe an Aschoff body.

A

Granuloma (eipitheliod histiocytes (macrophages) and fibrosis)

may see Anitschkow cells

26
Q

What are Anitschkow cells?

A

activated histiocytes (macrophages) whose chromatin looks like a CATERPILLAR

27
Q

caterpillar cells =

A

Anitschkow cells found in Aschoff body

28
Q

Describe the effects of rheumatic fever on the 3 layers of the heart.

A

Endocarditis: vegetations, valve regurg or stenosis
Myocarditis: Aschoff bodies, can kill pt
Pericarditis: friction rub

29
Q

How will the glomeruli look on light microscopy in a pt suffering from PSGN?

A

lumpy bumpy (type III hypersensitivity here!)

30
Q

Rheumatic fever: type _______ hypersensitivity

Post-Strep glomerulonephritis: type _______ HS

A

type II

type III

31
Q

Rheumatic fever early valve consequence:

Rheumatic fever late valve consequence:

A

regurgitation

stenosis

32
Q

What infection can lead to aortic dilation by disrupting the vasa vasorum of the aorta, and may calcify the wall?

A

tertiary Syphilis (Treponema pallidum)

33
Q

What is the treatment for syphilis?

A

Still good ol Penicillin G

34
Q

The screen test for syphilis is _______ and can give a false positive in what cases?

A

VDRL test

false + include Viruses/Drugs/Rheumatic fever/Lupus and Leprosy

Cardiovascular (7 decks)

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