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Infective Endocarditis Flashcards

1
Q

microbial infection of heart valve, lining of a cardiac chamber or blood vessel, or a congenital anomaly (e.g. septal defect).

A

Infective endocarditis

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2
Q

Infective endocarditis may affect

A

Both Prosthetic and native valve

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3
Q

What cause Infective endocarditis

A

usually a bacterium

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4
Q

Other causes of Infective endocarditis

A

rickettsia, chlamydia or fungus

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5
Q

What are the bacteria which may cause Infective endocarditis

A

streptococci or staphylococci

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6
Q

avascular valve tissue and presence of fibrin and platelet aggregates , help to

A

protect proliferating organisms from host defense mechanisms.

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7
Q

Extracardiac manifestations such as ……. (2)
Due to ………….

A

vasculitis and skin lesions

emboli or immune complex deposition

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8
Q

Morbidity and mortality in Infective endocarditis are

A

higher

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9
Q

What is the division of Infective endocarditis based on onset and duration of symptoms before diagnosis
(3)

A

Acute bacterial endocarditis (ABE)

Subacute bacterial endocarditis(SBE)

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10
Q

Refers to an abrupt onset of symptoms (infective endocarditis)

A

Acute bacterial endocarditis (ABE)

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11
Q

Insidious, evolves over several weeks or months (infective endocarditis)

A
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12
Q

Embolic events are common

A

Acute bacterial endocarditis (ABE)

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13
Q

cardiac or renal failure may develop rapidly

A

Acute bacterial endocarditis (ABE)

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14
Q

should be suspected when a patient with congenital or valvular heart disease develops:

Persistent fever, Night sweats, Complains of unusual tiredness, Weight loss, and Develops new signs of valve dysfunction or heart failure.

A

Subacute bacterial endocarditis(SBE)

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15
Q

Congenital heart defects

A

Risk factor for infective endocarditis

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16
Q

Artificial heart valves

A

Risk factor for infective endocarditis

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17
Q

History of endocarditis

A

Risk factor for infective endocarditis

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18
Q

Damaged heart valves

A

Risk factor for infective endocarditis

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19
Q

History of intravenous (IV) drug abuse

A

Risk factor for infective endocarditis

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20
Q

Subacute bacterial endocarditis(SBE) should be suspected when a patient with congenital or valvular heart disease develops …………. (5)

A

Persistent fever
Night sweats
Complains of unusual tiredness
Weight loss
Develops new signs of valve dysfunction or heart failure

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21
Q

malaise
confusion
weakness
Fever
weight loss

A

Non specific symptoms and signs

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22
Q

Affects normal valves over days to weeks

A

Acute bacterial endocarditis (ABE)

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23
Q

more likely due to Staphylococcus aureus which has much greater virulence

A

Acute bacterial endocarditis (ABE)

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24
Q

presents as a severe febrile illness with prominent and changing heart murmurs and petechiae

A

Acute bacterial endocarditis (ABE)

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25
Q

Clinical stigmata of chronic endocardia are usually absent

A

Acute bacterial endocarditis (ABE)

26
Q

Most of the patients of SBE have

A

murmur

27
Q

Purpura and petechial hemorrhages on the skin and mucous membrane

A

Sign of Infective Endocarditis

28
Q

Splinter hemorrhages under the fingernails or toe nails

A

Sign of Infective Endocarditis

29
Q

Osler’s nodes are painful tender swellings at the fingertips

A

Sign of Infective Endocarditis

due to vasculitis; they are rare.

30
Q

Janeway Lesions

A

Sign of Infective Endocarditis

31
Q

non tender small erythematous or hemorrhagic macule or nodular skin lseions on the palms or soles, only few millimeter in diameter

A

Janeway Lesions

32
Q

Digital clubbing

A

Sign of Infective Endocarditis

late sign

33
Q

Roth spots

A

Sign of Infective Endocarditis

34
Q

Retinal hemorrhages with small, clear centers; immunological event, rare

A

Roth spots

35
Q

spleen is frequently palpable

A

Sign of Infective Endocarditis

36
Q

liver may be enlarged

A

Sign of Infective Endocarditis

37
Q

Microscopic hematuria

A

Sign of Infective Endocarditis

common

38
Q

Embolic stroke or peripheral arterial embolism

A

Sign of Infective Endocarditis

39
Q

murmur

A

Sign of Infective Endocarditis

40
Q

Skin rashes typically consisting of multiple petechiae, often on the legs and conjunctivae , are due to

A

vasculitis

41
Q

Dark-red to brown or black , linear lesions on the nail

A

Subungual (splinter) haemorrhages
Non specific

42
Q

Tender subcutaneous red spots under the skin of the fingers usually found on the distal pads of the digits

A

Osler nodes
Rare
Specific

43
Q

Nontender maculae on the palms and soles(vascular embolic event)

A

Janeway lesions
Specific

44
Q

Flame-shaped retinal hemorrhages with a ‘cotton-wool’ centre

result from septic emboli

Similar appearances may occur in patients with anemia or leukemia

A

Roth’s spots
Seen by fundiscopical examination

45
Q

(+) blood culture

A

Major criteria

46
Q

Endocardial involvement

A

Major criteria

47
Q

Typical organism from 2 cultures

A

Positive blood culture

48
Q

Persistent positive blood cultures taken > 12 hrs apart

A

Positive blood culture

49
Q

3 or more Positive cultures taken over > 1 hr

A

Positive blood culture

50
Q

Positive echocardiographic findings of vegetations

A

Endocardial involvement

51
Q

New valvular regurgitation

A

Endocardial involvement

52
Q

Predisposing valvular or cardiac abnormality

A

Minor criteria

53
Q

IV drug misuse

A

Minor criteria

54
Q

Pyrexia 38C or more

A

Minor criteria

55
Q

Embolic phenomenon

A

Minor criteria

56
Q

Vasculitic phenomenon

A

Minor criteria

57
Q

Blood cultures suggestive: organism grown but not achieving major criteria

A

Minor criteria

58
Q

Suggestive echocardiographic findings

A

Minor criteria

59
Q

2 major or 1 major + 3 minor or 5 minor

A

Definite endocarditis

60
Q

1 major + 3 minor or 3 minor

A

Possible endocarditis

61
Q

Surgical intervention

A

Management of endocarditis

if there is valvular obstruction,fungal IE, myocardial abscess, unstable infected prosthetic valve

62
Q

Antibiotics: Penicillin/ gentamicin /vancomycin/amoxicillin

A

Management of endocarditis

Choice of antibiotics depends on the organism/severity and sensitivity

Pre (18 decks)

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