infective endocarditis

Question 1

major criteria for endocarditis?

3

Answer 1

bacteremia
new murmur
new vegatation on echo

Question 2

minor criteria?

4

Answer 2

fever
risk factors
vascular
rhematologic

Question 3

risk factors for endocarditis? 3

Answer 3

IV drug use
hx of endo
prosthetic valves

Question 4

2 bugs causing acute infective endocarditis?

Answer 4

staph and strep

Question 5

how to diagnose and treat acute infective endo?

Answer 5

blood cultures and then give abx until cultures are negative

Question 6

what bugs cause subacute endo?

Answer 6

hacek

Question 7

big time difference between patient presentation with acute and subacute infective endo

Answer 7

acute is sick as crap and not enough time for rheum stuff. subacute not as sick and given time to have rheum symptoms

Question 8

how to diagnose and treat subacute?

Answer 8

draw blood cultures until positive and dont give abx until you get a positive culture

Question 9

best test to confirm endocarditis and severity?

Answer 9

TEE

Question 10

what empriric treatment for infective endo with native valve?
new valve less than 6o days?
new valve between 60 and 356 days?
new valve over 1 year?
subacute?

Answer 10

vancomycin 
vancomycin and gentamycin cefepime
vancomycin and gentamycin
vancomycin and gentamycin and ceftrixone
gentamycin and ceftrixone 
4-6 weeks

Question 11

When do you need to replace the valve because of infective endocarditis?
5 reasons

Answer 11

CHF
vegetation greater than 15 mm
vegatation greater than 10 mm plus embolism 
abscess
fungus

Question 12

if you cant give vancomycin give what?

if your culture tells you strep bovis do what and why?

Answer 12

dapto

colonscopy, they have cancer

Question 13

what combo do you give prophylaxis for endocarditis and what med?

Answer 13

bad valve and dental procedure or respiratory procedure

amox