Infective Endocarditis

Question 1

Define Infective Endocarditis

Answer 1

infection of the endothelium of the heart valves

Question 2

Biggest cause of the rise of endocarditis in hospital

Answer 2

Staphylococcus Aureus

Question 3

Endocarditis Risk Factors

Answer 3

Heart valve abnormality
Prosthetic Heart Valve
IV Drug User

Question 4

Heart valve abnormality examples

Answer 4

calcification/sclerosois (elderly)
congenital heart disease
post rheumatic fever

Question 5

Pathogenesis of Infective Endocarditis

Answer 5

Heart valve damage
Turbulent blood flow to valve endothelium
Platelets/fibrin deposited
Bacteria
Organism settle in fibrin/platelet thrombi –> MICROBIAL VEGITATION

Question 6

Side of the heart most commonly affected by endocarditis

Answer 6

Left

Question 7

Endocarditis causative organisms

Answer 7

Staphylococcus Aureus
Viridians Streptococci
Enterococcus SP
Staphylococcus Epidermidis

Question 8

Native Endocarditis presenting symptoms

Answer 8

sepsis and heart failure

Question 9

Native endocarditis investigations

Answer 9

3 x blood culture

Echo

Question 10

Prosthetic Valve Endocarditis Early Presentation

Answer 10

(

Question 11

Prosthetic Valve Endocarditis Late Presentation

Answer 11

(years)

co-incidental bacteria

Question 12

IV Drug User Endocarditis

Answer 12

RIGHT sided –> tricuspid valve
STAPHYLOCOCCUS AUREUS
Present with staphylococcus aureus pneumonia

Question 13

Endocarditis Treatment (empirical)

Answer 13

HIGH DOSE FREQUENT ANTIBIOTICS

Question 14

Native Endocarditis Treatment

Answer 14

AMOXICILLIN

GENTAMICIN IV

Question 15

Prosthetic Endocarditis Treatment

Answer 15

VANCOMYCIN
GENTAMICIN IV
RIFAMPICIN PO
(valve replacement)

Question 16

Drug User Endocarditis Treatment

Answer 16

Flucloxacillin IV

Question 17

Staphylococcus Aureus

Answer 17

FLUCLOXACILLIN IV

Question 18

MRSA

Answer 18

VANCOMUCYCIN IV

RIFAMPICIN PO

Question 19

Viridian’s Streptococci

Answer 19

BENZYLPENICILLIN

GENTAMICIN IV

Question 20

Enterococcus SP

Answer 20

AMOXICILLIN
VANCOMYCIN
GENTTAMICIN IV

Question 21

Staphylococcus Epidermidis

Answer 21

VANCOMYCIN
GENTAMICIN IV
RIFAMPICIN PO

Question 22

Endocarditis Monitoring

Answer 22

IV antibiotics for 4-6 weeks

Cardiac function, temperature, serum C-reactive protein (CPP)

Question 23

Myocarditis

Answer 23

Inflammation of the cardiac muscle

Question 24

Myocarditis buzz words

Answer 24

Young people
fever, chest pain, SOB, palpitations
arrhythmia, cardiac function

Question 25

Myocarditis main cause

Answer 25

ENTEROVIRUSES (throat swab + stool)

Coxsackie A&B, echovirus

Question 26

Pericarditis

Answer 26

Inflammation of the pericardium

Question 27

Pericarditis buzz words

Answer 27

MYOCARDITIS

Chest Pain

Question 28

Pericarditis main cause

Answer 28

VIRAL AETIOLOGY

but can also be caused by bacteria after cardiothoracic surgery

Question 29

NAG

Answer 29

for Native endocarditis the treatment is Amoxicillin and Gentamicin