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Cardio - mine > Infective Endocarditis & other infections > Flashcards

Infective Endocarditis & other infections Flashcards

1
Q

What does FROM JANE stand for? and what does it help you remember?

A

It is a list of common/buzzword symptoms for endocarditis

Fever
Roth’s spots
Osler’s nodes
Murmur

Janeway lesions
Anaemia
Nail haemorrhages
Emboli

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2
Q

Common symptoms of acute infective endocarditis

A

Sepsis

Cardiac failure

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3
Q

Common symptoms of subacute infective endocarditis (not including FROM JANE)

A

Malaise, weight loss, tiredness, SOB.

General symptoms of infection.

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4
Q

What are Osler’s nodes?

A

Painful red nodules on the hands and feet

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5
Q

What are Roth’s spots?

A

Retinal haemorrhages

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6
Q

What are Janeway lesions?

A

Non-painful nodules on hands and feet

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7
Q

What investigations must be done?

A

Minimum of 3 blood cultures

Echo

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8
Q

What is used for diagnosis?

A

Duke’s criteria

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9
Q

When is Duke’s criteria used? and what is it?

A

Used to diagnose infective endocarditis

Infective endocarditis can be diagnosed if 2major or 5 minor criteria are reached

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10
Q

What are the major criteria from Duke’s criteria?

A

2 x positive blood culture
Echo evidence
New valve regurgitation

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11
Q

What are the minor criteria from Duke’s criteria?

A 
Temp >38
Heart condition
IVDU
Vascular phenomena
Immunological phenomena
Microbiological evidence (blood culture?)
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12
Q

What are vascular phenomena

A

Emboli

Janeway lesions

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13
Q

What are immunological phenomena

A

Roth’s spots

Osler’s nodes

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14
Q

Risk factors

A 
Heart valve abnormality
Old age (valve calcification)
Congenital Heart Disease
Rheumatic fever
IVDU
Prosthetic valve
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15
Q

What bacteria causes endocarditis in IVDU

A

Staph. aureus

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16
Q

What valve is most commonly affected?

A

tricuspid

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17
Q

What side of the heart is affected in IVDU

A

Right

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18
Q

Atypical causes of endocarditis

A

Coxiella bunetti
Brucella
Gram -ve
Fungi

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19
Q

Empirical treatment of a native valve

A

IV Amoxicillin + IV gentomycin

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20
Q

Empirical treatment of prosthetic valve

A

IV vancomycin + IV gentomycin

add Rifampicin on days 3-5, PO

21
Q

Treatment of staph. aureus

A

Flucloxillin

22
Q

Treatment usually required by IVDU

A

Flucloxillin

23
Q

Treatment of MRSA

A

IV vancomycin + IV gentomycin

add Rifampicin on days 3-5, PO

24
Q

Treatment of Strep. viridans

A

IV Benzylpenicillin + IV gentomycin

25
Q

Treatment of Strep. epidermis

A

IV vancomycin + IV gentomycin

add Rifampicin on days 3-5, PO

26
Q

Pathophysiology of Myocarditis

A

Acute inflammation of the myocardium. Heart becomes “flabby” focal haemorrhages and inflammatory infiltrate

27
Q

“Flabby” heart

A

Myocarditis

28
Q

Focal haemorrhages

A

Myocarditis

29
Q

symptoms of Myocarditis

A

palpitations/ arrhymias
Heart failure
Chest pain
Fatigue (general symptoms of infection)

30
Q

Investigations of Myocarditis

A

1st - viral PCR (throat & stool swab)
ECG = ST abnormality
CXR

31
Q

CXR showing cardiac enlargement

A

Myocarditis

32
Q

CXR of Myocarditis

A

cardiac enlargement

33
Q

ECG of Myocarditis

A

ST abnormality

34
Q

ECG showing ST abnormality

A

Myocarditis

35
Q

Treatment of Myocarditis

A

supportive

ACEI, Beta-blockers, spironolactone,digoxin (rarely given)

36
Q

What often occurs with Myocarditis?

A

Pericarditis

37
Q

Symptoms of Pericarditis

A

chest pain which is relived by sitting forward, SOB

38
Q

Chest pain which is relived by sitting forward

A

Pericarditis

39
Q

Treatment of Pericarditis

A

supportive

drainage + antibiotics

40
Q

Main cause of myocarditis

A

viral

41
Q

What is dressler’s syndrome?

A

Pericarditis 4-6 weeks post MI

42
Q

When does Pericarditis often occur?

A

post-op

43
Q

Secondary spread of endocarditis and pneumonia causes what?

A

Pericarditis

44
Q

Secondary spread of what can cause Pericarditis?

A

Endocarditis

Pneumonia

45
Q

Saddle-shaped ST elevation

A

Pericarditis

46
Q

pathogenesis of endocarditis

A

heart valve is damaged causing turbulent blood flow over roughened endothelium. platelets/fibrin is deposited. organisms settle in the fibrin/platelet thrombi forming microbial vegetation

47
Q

most common organism that causes endocarditis

A

staph.aureus

48
Q

dental surgery is linked to which endocarditis causing pathogen

A

strep.viridians

49
Q

endocarditis after dental surgery would be treated with what

A

Benzylpenicillin IV & Gentamycin IV

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