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Systems 1 > Infective Endocarditis > Flashcards

Infective Endocarditis Flashcards

1
Q

What is the critical information in infective endocarditis?

A

Where the infection is?
Acute or subacute?
How it is acquired?

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2
Q

What are the major pathogens in IE?

A

Viridans strep
Streptococcus pyogenes
Staphylococcus aureus
Staphylococcus epidermidis

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3
Q

Which invasive procedures increase the risk of IE?

A

Dental procedures
GI surgery
Vascular catheters

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4
Q

Risk factors for IE?

A 
MV prolapse 
Rheumatic HD
Congenital HD
Degenerative HD
IVDA
Alcohol/DM
Indwelling devices
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5
Q

How does IE occur?

A 
Mechanical endothelial damage
Turbulent flow (venturi effect)
Inflammation
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6
Q

Symptoms of IE

A 
Fever/Chills
Night sweats, malaise, fatigue
Weight loss
Arthralgia
Headache
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7
Q

Signs of IE?

A 
Prolonged PR
Murmur
Patechial haemorrhage
Splinter haemorrhage 
Janeway lesions (palms)
Osler nodes (painful, fingers)
Roth spots (eyes)
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8
Q

Investigations for IE?

A 
Bloods culture BEFORE AntiB
(3 sets and sites, 30m apart)
FBC, CRP, U+E
Urinalysis
ECG
Transthoracic echo
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9
Q

Most likely prosthetic valve IE?

A

Staphylococcus epidermidis

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10
Q

Most likely Native valve IE?

A

Viridans alpha-haemolytic streptococci

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11
Q

Most likely pathogen IVDA IE?

A

Staphylococcus aureus

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12
Q

Expected PR interval in IE?

A

> 0.2s

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13
Q

How is definite infective endocarditis diagnosed?

A

Dukes Criteria

2maj, 1maj3min, 5min

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14
Q

What are the major criteria for IE?

A

Positive blood cultures

Positive imaging for IE

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15
Q

What are the minor criteria for IE?

A 
Predisposition
Fever >38C
Vascular phenomena 
Immunological phenomena
Microbiological evidence
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16
Q

What must be known for treatment to take place?

A

Previous AntiB therapy

Native valve or prosthesis?

17
Q

Antibiotic therapy for community acquired native valve/late prosthetic IE?

A

Ampicillin
Flucloxacillin
Gentamicin

18
Q

Antibiotic therapy for community acquired native valve/late prosthetic IE? (penicillin allergy)

A

Vancomycin

Gentamicin

19
Q

Antibiotic therapy for early prosthetic valve endocarditis and healthcare associated?

A

Vancomycin
Gentamicin
Rifampicin

20
Q

Indications for surgery in IE?

A

Heart failure (valve regurge)
Uncontrolled infection
Prevention of systemic emboli

21
Q

How can IE be prevented?

A

Antibiotic prophylaxis in patients at risk of IE
At risk undergoing dental treatment
Good oral hygiene
Aseptic measures during venous catheter manipulation

22
Q

Preventative measures for IE?

A 
Dental/skin hygiene
Disinfecting wounds
Decrease chronic carriage
AntiB for any infection
No self medicating antiB
No piercing/tattoos
Limiting catheter use/invasive procedures

Systems 1 (25 decks)

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