Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CVS clinical conditions > Infective endocarditis > Flashcards

Infective endocarditis Flashcards

1
Q

What can cause damage to the endothelial lining of a valve?

A 
Turbulent blood flow
Electrodes
Catheters
Inflammation (rheumatic IE)
Degenerative disease (Aortic stenosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is infective endocarditis?

A

infection affecting the endocardial surface of the heart

usually the valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the risk factors for infective endocarditis of a native valve?

A 
Mitral valve prolapse
Congenital heart disease
Rheumatic heart disease
Asymmetrical septal hypertrophy
IV drug abusers
Alcohol misusers
Diabetics
Medical devises such as catheters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what age group does IE mostly affect?

A

older patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe the pathophysiology of how infective endocarditis occurs.

A

Mechanical endothelial disruption exposes extracellular matrix protein which releases tissue factors.
This causes deposition of fibrin and platelets resulting in non bacterial throb endocarditis.
NBTEC facilitates bacterial adherence and infection resulting in vegetations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what percentage of cases of IE are due to endothelial inflammation without valve lesion?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe the pathophysiological process of how IE occurs with endothelial inflammation without endothelial valve lesions.

A

Inflammation of endothelial cells causes expression of interns B1 family.
the interns are Transmembrane proteins which binds circulating fibronectin to proteins on their surface
Staph aureus carry fibronectin therefore binds to the surface resulting in vegetations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are causes of bacteraemia which can bring about IE?

A

Invasive procedures such as dental procedures requiring manipulation and perforating oral mucosa
GU and GI surgery
IV catheters
Extra cardiac infections
Non-invasive activities i.e. chewing and brushing teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Brushing teeth and chewing is a high/low grade bacteraemia of short/long duration but with high/low incidence

A

low grade
short duration
high incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

name some of the organisms responsible to IE.

A 
strep viridans
staph aureus
enterococci
Staphylococci (coagulase -ve)
haemophillus parainfluenzae
actinobaccilus
strep bovis
fungi
coxiella burnetii
brucella species
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what patients may have an atypical presentation of IE?

A

elderly and immunosuppressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the subacute presentation of IE?

A

fever
non-specific symptoms
palpitation and immunologic/vascular phenomena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the acute presentation of IE?

A

fever
embolic signs/symptoms
or decompensated Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the common/non-sepcific symptoms of IE?

A 
fever
night sweats, malaise, fatigue, weight loss
weakness
arthralgia
headache
SOB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the clinical signs of IE?

A 
cardiac murmor (regurgitant murmor) with signs of heart failure
Janeway lesins
Osler nodes
Roth spot (eyes)
Meningeal signs
Splinter haemorrhages
Cutaneous infarcts
Vasculitic rash
Immune complex deposition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are janeway lesions?

A

Haemorrhage painless plaques

Occur mostly in the palms and soles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are osler nodes?

A

small painful nodular lesion

Found on pads of fingers and toes

18
Q

a woman present with painless lesions on her soles of her feet. what are these most likely to be?

A

Janeway lesions

19
Q

a patinet presents with painful lesions on the pads of her fingers. what are these most likely to be?

A

osler nodes

20
Q

what is the most frequent sign of IE?

A

pyrexia

21
Q

what investigations are carried out for IE?

A 
blood culture
FBC
U+E's (renal failure)
Urinalysis
ECG
CXR
Echo (transthoracic or transesophageal)
MRI, PET-CT, Leucoyte SPECT/CT
22
Q

why are U+E’s carried out?

A

to detect renal failure

23
Q

why are FBC and CRP tests carried out?

A

for detection of elevated inflammatory markers

24
Q

what may be observed in an ECG with someone with IE?

A

prolonged PR interval >200ms

4th degree heart block

25
Q

why is a CXR carried out?

A

to check for pulmonary congestion or access

26
Q

do you carry out a transthoracic or transeophageal echocardiogram first?

A

transthoracic echo then if t is positive then do a transesophageal

27
Q

what are the imaging modalities for patients with suspected IE with native and prosthetic valves

A 
native:
1. repeat ECHO
2. Imaging for embolic events
3. cardiac CT
prosthetic:
1. repeat ECHO
2. F-FDG labelled PET/CT or leukocyte labelled SPECT/CT
3. cardiac CT
4. Imaging for embolic events
28
Q

how are paravalvular lesions detected for diagnosis of IE?

A

cardiac CT

29
Q

fever is defined as what?

A

temperature >38

30
Q

what is the modified duke criteria for diagnosis of definite IE?

A

2 major criteria or
1 major criteria + 3 minor criteria or
5 minor criteria

31
Q

what is the modified duke criteria for diagnosis of possible IE?

A

1 major criteria + 1 minor criterion or

3 minor criteria

32
Q

before initiating IV antibiotics, how many sets of blood cultures have to be done and with what time apart?

A

3 sets of blood cultures taken 30 mins apart

33
Q

what patient characteristics are predictors of poor outcomes?

A

old age
diabetes
prosthetic valve
co-morbidity i.e. renal or pulmonary disease

34
Q

what are the complications of IE?

A 
heart failure
renal failure
brain haemorrhage
ischameic stroke
septic shock
35
Q

what valve IE results in greater risk of heart failure?

A

Aortic IE

36
Q

give an example of an uncontrolled infection from IE?

A

perivalvular abcess

37
Q

pulmonary embolism are a complication from what side IE?

A

right sides IE

38
Q

what organism is most commonly responsible for native valve IE?

A

strep. viridans

39
Q

what organism is most commonly responsible for IE in IV drug abusers?

A

staph. aureus

40
Q

what organism is most commonly responsible for prosthetic valve IE?

A

strep. epidermidis

CVS clinical conditions (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions