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Cardio > Infective Endocarditis > Flashcards

Infective Endocarditis Flashcards

1
Q

What is infective endocarditis?

A

An infection of the heart’s inner lining (endocardium), often involving the heart valves.

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2
Q

What causes turbulence in blood flow in infective endocarditis?

A

Abnormal heart valves or structural defects.

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3
Q

How do platelets and fibrin contribute to infective endocarditis?

A

They form small masses (vegetations) where bacteria can adhere and grow.

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4
Q

What is the role of circulating bacteria in infective endocarditis?

A

Bacteria in the bloodstream can attach to damaged heart valves, causing infection.

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5
Q

What is valve destruction in infective endocarditis?

A

Damage to heart valves due to infection, leading to dysfunction.

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6
Q

What is embolization in infective endocarditis?

A

Pieces of infected tissue (vegetations) break off and travel to other organs, causing blockages.

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7
Q

What are the immunologic responses in infective endocarditis?

A

Immune complex deposition, leading to symptoms like glomerulonephritis and skin lesions.

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8
Q

What are the general symptoms of infective endocarditis?

A

Fever, malaise, anorexia, and arthralgia.

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9
Q

What is toxemia in infective endocarditis?

A

Systemic symptoms caused by bacterial toxins, including fever and fatigue.

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10
Q

What is sub-conjunctival hemorrhage?

A

Bleeding under the conjunctiva, often seen in infective endocarditis.

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11
Q

What is splinter hemorrhage?

A

Linear bleeding under the nails, a sign of infective endocarditis.

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12
Q

What is a petechial rash?

A

Small red or purple spots on the skin caused by bleeding.

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13
Q

What are Janeway lesions?

A

Painless hemorrhagic lesions on the palms or soles.

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14
Q

What are Osler nodes?

A

Painful, raised nodules on the fingertips or toes.

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15
Q

What are Roth spots?

A

Retinal hemorrhages with a pale center, seen in infective endocarditis.

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16
Q

What are the cerebral complications of infective endocarditis?

A

Stroke, brain abscess, or mycotic aneurysms.

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17
Q

What are the symptoms of pulmonary embolism in infective endocarditis?

A

Cough, dyspnea, hemoptysis, and chest pain.

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18
Q

What is digital gangrene?

A

Tissue death in the fingers or toes due to blocked blood flow.

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19
Q

What are the renal complications of infective endocarditis?

A

Hematuria and renal infarction.

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20
Q

What are the Duke criteria for diagnosing infective endocarditis?

A

A set of major and minor criteria used to diagnose the condition.

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21
Q

What are the major Duke criteria?

A

Positive blood cultures and evidence of endocardial involvement on echocardiography.

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22
Q

What are the minor Duke criteria?

A

Fever, predisposing factors, vascular phenomena, and immunologic phenomena.

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23
Q

How many blood cultures are needed for diagnosis?

A

At least 2 positive cultures drawn >12 hours apart.

24
Q

What is the role of echocardiography in diagnosis?

A

To detect vegetations, abscesses, or valve regurgitation.

25
Q

What is the difference between trans-thoracic and trans-esophageal echocardiography?

A

Trans-esophageal echocardiography provides better visualization, especially for prosthetic valves.

26
Q

What are predisposing factors for infective endocarditis?

A

Heart valve abnormalities, prosthetic valves, or recent dental procedures.

27
Q

What are vascular embolic manifestations?

A

Stroke, retinal infarction, or splenic infarction.

28
Q

What are immune complex deposition manifestations?

A

Glomerulonephritis, Roth spots, and Osler nodes.

29
Q

What is the first step in treating infective endocarditis?

A

Starting antibiotic therapy based on blood culture results.

30
Q

What antibiotics are used for staphylococcal endocarditis?

A

Methicillin or vancomycin, often combined with gentamicin.

31
Q

What is the treatment for streptococcal endocarditis?

A

Penicillin G or ceftriaxone for 4 weeks.

32
Q

What is the treatment for fungal endocarditis?

A

Amphotericin B.

33
Q

When is surgery indicated for infective endocarditis?

A

For heart failure, large vegetations, or prosthetic valve involvement.

34
Q

What is the role of bed rest in treatment?

A

To reduce strain on the heart until symptoms improve.

35
Q

What dietary restrictions are recommended?

A

Salt and fluid restriction in heart failure.

36
Q

What is septic embolism?

A

Infected material breaking off and traveling to other organs.

37
Q

What is a mycotic aneurysm?

A

A weakened blood vessel wall caused by infection.

38
Q

What is splenic infarction?

A

Blockage of blood flow to the spleen, causing tissue death.

39
Q

What is glomerulonephritis?

A

Kidney inflammation due to immune complex deposition.

40
Q

What is the mortality rate of infective endocarditis?

A

Approximately 20-30%, depending on complications.

41
Q

What is antibiotic prophylaxis for infective endocarditis?

A

Antibiotics given before dental or surgical procedures to prevent infection.

42
Q

Who should receive antibiotic prophylaxis?

A

Patients with prosthetic valves or congenital heart defects.

43
Q

What antibiotics are used for prophylaxis?

A

Ampicillin or clindamycin for allergic patients.

44
Q

What is the significance of blood cultures in infective endocarditis?

A

They identify the causative organism and guide antibiotic therapy.

45
Q

What is the role of CT scans in infective endocarditis?

A

To detect brain emboli or abscesses.

46
Q

What is the role of fundoscopy in infective endocarditis?

A

To identify Roth spots or retinal hemorrhages.

47
Q

What is the role of chest radiography in infective endocarditis?

A

To detect pulmonary emboli or infiltrates.

48
Q

What is the role of abdominal ultrasound in infective endocarditis?

A

To detect splenic or renal infarctions.

49
Q

What is the recovery rate for infective endocarditis?

A

Approximately 80%.

50
Q

What is the significance of large vegetations (>10 mm)?

A

Higher risk of embolization and need for surgery.

51
Q

What is the role of Doppler ultrasound in infective endocarditis?

A

To detect vascular obstructions.

52
Q

What is the role of blood picture in diagnosis?

A

To identify anemia, leukocytosis, and elevated ESR.

53
Q

What is the significance of CRP in infective endocarditis?

A

It is a marker of inflammation and infection.

54
Q

What is the role of trans-esophageal echocardiography in prosthetic valve endocarditis?

A

It provides better visualization of vegetations and abscesses.

55
Q

What is the role of pulmonary scanning in infective endocarditis?

A

To detect pulmonary emboli.

56
Q

What is the role of chest radiography in infective endocarditis?

A

To detect bilateral infiltrates, nodules, or pleural effusions.

Cardio (10 decks)

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