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MICRO Exam 7 > Infective Endocarditis > Flashcards

Infective Endocarditis Flashcards

1
Q

Infective Endocarditis- Epidemiology Predisposing

A 
Rheumatic Fever
Calcific aortic stenosis
Cogenital Heart Disease
Prosthetic Valves
Residual damage from previous IE
Mitral valve prolaspse
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2
Q

Acute Native Valve Endocarditis

A

Abrupt Onset
Fever always
Complications one 1 wekk
S. aureus maybe

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3
Q

Subacute Native Valve Endocarditis

A 
Fever
subtl and nonspecific  symptoms
flu like/ anorexia
onset to dx 6 wks
Etiology: HACEK or viridans
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4
Q 
Site of infection and etiology
S. aureus
viridans stept
enterococci
s epidermidis
s gallolyticus
other strept
Non HACEK
FUNGI
HACEK
A

ACUTE
Subacute

Major PVE

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5
Q 
H
A
C
E
K
A 
Haemophilus aphrophilus
actinobacillus actinomycetes
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae
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6
Q

HACEK

A

most common sub acute gram neg

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7
Q

Non bacterial thrombotic Vegetation

A

Aggregation of platelets and fibrin

  • trauma
  • defective Valves
  • Changes endocardium
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8
Q

Stage 2 Bacteremia

A 
organism adheres
seeds
begins to replicate
aggregation of fibrin & platelets
infections avascular
Surface-- Active
internal Depp-- inactive/stationary
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9
Q

Formation of Vegetations

A 
pressure gradient 
fibrin platelet
colonized fibrin platelet
further  deposits of thrombus
Vegetations
increase in size and break away
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10
Q

MSCRAMMS Virulence Factors

A

MSC- extracellular polysaccharide, lipteichoic acid, FimA
Recognize:Platelet Fibrin aggregates
Adherence: Fibronectin adhesion, clumping factor

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11
Q

Clinical Syndrome

A 
Symptoms of left side heart disease
signs of pulmonary= right side
Fever
Petechiae
subungual hemorrhages
Specific= Osler, janeway, roth, glomerularnephritis
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12
Q

Janeway Lesion

A

On palm and soles
macular painless
Vascular Phenomena

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13
Q

Immunologic Phenomena

A

Glomerulonephritis, flea bitten kidneys
Osley Nodes- painful, tips of hands, more subacute
Roth Spots- exudative lesions of retina

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14
Q

Subconjuctival petechiae-

A

Vascular Phenomena

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15
Q

NOT DUKE CRITERIA

A

Subungual hemorrhages

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16
Q

IE Diagnosis

A

Certainty only: micro or hist o view

Duke criteria: clin laboratory and Echo

17
Q

IE Therapy and prophylaxis

A

no spontaneous cure
Parental Antibiotics
Bactericidal
Monitor treatment

18
Q

If no response to Abx treatment

A

surgical removement of vegetation

19
Q

Bacteremia

A

NOT DISEASE STATES
Transient- Not clinical (like brushing teeth)
Intermittant
Continuous

20
Q

Transient

A 
Swiftly cleared
brush teeth
normal childbirth
 endoscopy
Defecation
21
Q

Transient Etiology

A

Viridans streptococci

Virulence determines ability to colonize

22
Q

Intermittant

A

Repeated blood cultures, monitor treatment

abscess, UTI infection

23
Q

Continuous

A

IV catheter surgery, underline disease leak in gi or endocarditis ( bovis or galoliticus)

24
Q

Common isolates

A

most frequent staphylococci

Gram negative

25
Q

Unusual Pathogens

A

Bacteroides, below diaphragm

26
Q

Diagnosis bacteremia

A

blood is sterile,differentiation

27
Q

Treatment

A

What abx is working in the area good point of reference

28
Q

Systemic Inflammatory Response Syndrome

A 
2 or more
• fever
•Heart Rate
•Breathing Rate
•WBC
29
Q

SEPSIS

A

Clinical Syndrome

Presence of infection & systemic manifestation

30
Q

Sever Sepsis

A 
Tissue hypoperfusion
Organ dysfunction
hypotension
elev lactate
oliguria
hypotension
31
Q

Septic Shock

A

Reduced resistance

increase in cardiac output

32
Q

Multiple Organ Dysfunction

A

progressive organ dysfunction
acutely ill patient
Intervention required to maintain homeostasis

33
Q

3 steps to tx of septic shock

A
  1. Resusitate
  2. Identify
  3. maintain organ function

MICRO Exam 7 (14 decks)

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