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Human Diseases > Infective Endocarditis - Clinical diagnosis and antibiotic cover > Flashcards

Infective Endocarditis - Clinical diagnosis and antibiotic cover Flashcards

1
Q

How does infective endocarditis occur? (pathogenesis)?

A

Bacteraemia (bacteria in the blood stream)
Causes erosion on defective endocardium
Causes collection of more bacteria on this surface
Vegetations form on endocardium

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2
Q

Toxic features of infective endocarditis? 5

A 
Pyrexia
Sweats
Malaise, weight loss
Chronic anaemia
Splenomegaly
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3
Q

Features of the heart in infective endocarditis?

A

Arrhythmia

Deteriorating valves function

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4
Q

What is a septic emboli?

A

An embolus that breaks away from the heart and becomes infected in circulation

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5
Q

Where can septic emboli lodge and effect?

A

Limbs, brain, heart

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6
Q

List 5 signs of endocarditis?

A

Oslers node, skin rash finger clubbing, splinter haemorrhage, janeway lesion

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7
Q

Describe Osler’s nodes?

A

Red/purple lumps on fingers/toes

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8
Q

Describe Janeway lesions?

A

Lesions of proximal part of finger

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9
Q

How is infective endocarditis diagnosed?

A

Clinical features
Blood cultures
Imaging

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10
Q

What will you observe in an examination of infective endocarditis?

A 
Earthy look, pallor
Pyrexia
Tachycardia
Skin lesions
Absent pulses
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11
Q

How is infective endocarditis treated?

A

Antimicrobial treatment
Surgery
Management and prevention of complications

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12
Q

How is the choice and length of antimicrobial treatment dictated?

A

By pathogen isolated from culture

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13
Q

What are the arguments for antibiotic prophylaxis in patients susceptible to infective endocarditis?

A 
IE is life threatening
Follows bacteraemia
Some dental procedures cause bacteraemia
IE can be caused by dental organisms
These organisms are sensitive to antibiotics
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14
Q

What features cause someone to be at high risk of IE?

A

Previous IE
Any form of prosthetic heart valve/material used in valve repair
Any type of congenital heart disease

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15
Q

What features cause someone to be at a moderate risk of IE?

A

Previous rheumatic fever
Valvular heart disease
Unrepaired congenital anomalies of heart vales

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16
Q

Arguments against prophylaxis for IE?

A

No consistent association between having an interventional procedure and the development of IE
Regular tooth brushing presents greater risk of IE than single dental procedure
Effectiveness of prophylaxis not proven
Not cost effective

17
Q

What advice about prevention of IE should be given to a patient?

A

Benefits and risks of antibiotic prophylaxis
Importance of good oral health
Symptoms that may indicate IE
Risk of undergoing invasive procedures

Human Diseases (37 decks)

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