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cardiovascular system > Infective Endocarditis > Flashcards

Infective Endocarditis Flashcards

1
Q

what layer of the heart does endocarditis effect

A

endocardium

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2
Q

who is more likely to get endocarditis men or women

A

men

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3
Q

who has a worse prognosis of the disease, men or women

A

women

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4
Q

what are cardiac risk factors that increase the chance of someone having infective endocarditis

A 
prosthetic heart valve
rheumatic heart disease 
prior native IE
Aortic stenosis
Ventricular septal defect
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5
Q

what are the classifications of endocarditis

A

acute
subacute
chronic

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6
Q

what are the two clinical manifestations that will present in nearly all cases of infective endocarditis

A

fever

murmur

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7
Q

what clinical findings would give a high index of suspicion that a patient has IE

A 
pyrexia of unknown origin 
know IE causative agent
prosthetic material 
new murmur 
new conduction disorder
congenital heart disease
immunocompromised/IVDA
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8
Q

what investigations would you do for IE

A 
FBC
U+E
blood cultures
urinalysis
ECG
CXR
Echo
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9
Q

if a patient has IE what might you find in urine

A

blood

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10
Q

if a patient has IE what might the ECG show

A

conduction delay

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11
Q

85% of IE can be put down to what 3 microorganisms

A

streptococci
enterococci
staphylococcus

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12
Q

what Duke criteria’s give a definite diagnosis of IE

A

2major findings or
1 major & 3 minor or
5 minor

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13
Q

what Duke criteria give a possible diagnosis of IE

A

1 major or 3 minor findings

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14
Q

what is the treatment of endocarditis

A

antibiotics

possible surgery

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15
Q

how do you decide what antibiotics to treat a patient that has IE

A

depends on the;
microorganism isolated
sensitivities
resistance

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16
Q

Now compared to a few decades ago, who are the patients that get infective endocarditis

A 
those with prosthetic valves
MVP
bicuspid aortic valve 
congenital heart disease
IVDA
immunocompromised
17
Q

what are non-cardiac risk factors for IE

A 
IVDA
indwelling medical device
diabetes mellitus
chronic skin infections
GI infections
alcoholic cirrhosis
18
Q

what can cause disruption of valve endothelium which in turn can lead to IE

A 
turbulent blood flow
electrodes
catheters
inflammation
rheumatic carditis 
degenerative diseases
19
Q

what symptoms would create high suspicion of IE

A 
fever
new murmur
new conduction disorder
pyrexia
prosthetic material
exposure to a IE organism
previous IE
congenital heart disease 
immunocompromised
20
Q

what investigations would you do for IE

A 
full bloods
-CRP
-ESR
blood cultures
urinalysis
U+E
CXR
ECG 
Echo
21
Q

what organisms are 85% of IE cases due to

A

stretococci
enterococci
staphylococcus

22
Q

name two types of enterococci

A

faecalis

faecium

23
Q

what is the Duke criteria used for

A

to diagnose IE

24
Q

what are the two requirements in the major criteria

A

identifying organism

providing evidence of infection anywhere within the heart

25
Q

what does the duke minor criteria focus on

A

clinical findings that could present in endocarditis

26
Q

how long would you continue antibiotic treatment for native valve IE

A

4 weeks

27
Q

what organisms commonly infect native valves in IE

A

staphylococci
streptococci
HACEK species
Bartonella spp

28
Q

how long would you continue antibiotic treatment for prosthetic valves

A

6 weeks

29
Q

what antibiotics would be used for native valve IE

A

IV gentamicin

and IV amoxycillin (or IV vancomycin)

30
Q

what antibiotic would be used for native valve septis IE

A

Gentamicin

vancomycin

31
Q

what antibiotics would you use for prosthetic valve IE

A

gentamicin
vancomycin
and rifampiein

32
Q

what groups of patients are most likely to get fungi IE

A

PV
IVDA
immunocompromised

33
Q

what is the treatment for fungi IE

A

dual anti-fungals

valve replacement

34
Q

what two fungi can cause IE

A

candida

aspergillus

35
Q

what is the most seer form of IE

A

PVE

36
Q

what are the cardiac conditions at highest risk of IE

A 
acquired valvular heart disease 
valve replacement 
structural congenital heart disease
hypertrophic cardiomyopathy
previous IE
37
Q

taking blood cultures is an essential investigation in IE. How many blood cultures are taken

A

3 sets
at different sites
less than 6 hrs between each culture

cardiovascular system (34 decks)

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