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Gen Pathology > Ischemic Heart Disease & Ineffective Endocarditis > Flashcards

Ischemic Heart Disease & Ineffective Endocarditis Flashcards

1
Q

NBTEs are

A

platelets and fibrin

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2
Q

Empiric antibiotic treatment for acute native heart valve endocarditis

A

vancomycin plus beta-lactam

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3
Q

Heparin is only successful when it used in combination with

A

cardiac catheterization

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4
Q

The intact endocardium releases these substances that inhibit platelet action.

A

-NO and prostacyclin

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5
Q

Common venous graft used in CABG.

A

-saphenous vein

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6
Q

P2y12 receptor blockers.

A

-blocks ADP binding

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7
Q

Prinzmetal’s angina is a rare form of angina characterized by extreme chest pain as a result of

A

coronary artery vasospasms

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8
Q

The following are modifiable risk factors, except:
-gender, narcotic use, malnourishment, sedentary lifestyle

A

gender

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9
Q

Characteristics are: unstable plaque, ischemia, increase O2 demand, and chest pain at rest.

A

-unstable angina

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10
Q

True or False
± if gentamycin is working no need to give rifampin, if gentamycin is taking too long to effect give rifampicin

A

True

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11
Q

Classification for Empiric Antibiotic (1) (2)

A

(1) Native Heart Valve Ineffective Endocarditis
(2) Prosthetic Heart Valve Ineffective Endocarditis

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12
Q

Empiric Antibiotic for Acute Native IE ________ & if allergic ____

A

(1) Vancomycin + Beta Lactam
(2) Cefazolin, Naphazoline

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13
Q

Empiric Antibiotic for Subacute Native IE ________ & if allergic ____

A

(1) Vancomycin + Ampicillin / Sulbactam
(2) Vancomycin + Ceftriaxon

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14
Q

Empiric Antibiotic for Acute Prosthetic IE ________ or ____

A

(1) Vancomycin + Ceferine or
(2) Gentamycin ± Rifampicin

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15
Q

Empiric Antibiotic for Subacute Prosthetic IE ________ & if allergic ____

A

(1) Vancomycin + Ampicillin / Sulbactam
(2) Vancomycin + Ceftriaxone or Gentamycin ± Rifampicin

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16
Q

_____ direts the causative agent when blood culture is not done

A

Empiric Antibiotic

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17
Q

In preventive measure consider the _____ and give _____

A

(1) px history
(2) antibiotic prophylaxis (Amoxicillin) 30-60 mins prior to dental procedure

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18
Q

Surgery is done if px is in _____ state or _____

A

(1) Refractory state
(2) Valves are totally damages

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19
Q

If damaged heart valve _________; If heart valve can be repaired _____

A

(1) Prosthetic HV or Valve Replacement Surgery
(2) Valvular repair

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20
Q

Treatment Regime for IE (1) (2) (3)

A

(1) Surgery
(2) Preventive Measures
(3) Antibiotic

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21
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Streptococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

high affinity in prosthetic devices or pacemaker

A

8 Staphylococcus Epidermis (+)

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22
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Streptococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

Bac present in indiv w gastrointestinal disease, inflammatory bowel disease (Crohn’s disease)

A

7 Streptococcus Bovis/Gallolyticus

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23
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Streptococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

Bac can enter thru any form of dental procedure, Chain like structures, vulnerable ppl w poor dentition, subacute IE

A

3 Streptococcus Viridians

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24
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Streptococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

Bac present in urinary tract, inflammation of renal pelvis or genital procedure

A

6 Enterococcus (+)

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25
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Streptococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

First discovered as primary cause of subacute IE, Bac can enter thru any form of dental procedure, Rug shaped

A

5 HACEK groups (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, & Kingella)

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26
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Streptococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

colonize prosthetic heart valve
seen in immunocompromised px (HIV, AIDS)
the only fungi, infective nonbacterial yeast
that causes endocarditis

A

4 Candida (+)

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27
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Streptococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

S. aureus enter thru penetration causes CUS (_____)

A

2 Bacteremia
C - Catheters, Prosthetic HV
U - Use of dirty IV needles
S - Skin boils or pigsa

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28
Q

Choose:
1 Staphylococcus Aureus (+)
2 Bacteremia
3 Stephtococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

arranged in clusters; can directly cause IE if colonized heart valve the only bac that can colonized endo despite no history of abnormal heart valve

A

1 Staphylococcus Aureus (+)

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29
Q

advance state of S. Auerus infection in skin | a rare bac infection, spreads quickly in the body & can cause death

A

Necrotizing fasciitis

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30
Q

Organisms involved in IE (SBS CHESS)

A

1 Staphylococcus Aureus (+)
2 Bacteremia
3 Stephtococcus Viridians
4 Candida (+)
5 HACEK groups
6 Enterococcus (+)
7 Streptococcus Bovis/Gallolyticus
8 Staphylococcus Epidermis (+)

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31
Q

Acute IE caused by _______l Subacute IE caused by _____

A

(1) Staphylococcus Aureus
(2) Streptoccocus Virdians

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32
Q

symptoms/signs of Subacute IE (1) (2) (3)

A

(1) Fatigue
(2) Diff breathing
(3) Low grade fever

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33
Q

symptoms/signs of Acute IE (1) (2) (3) (4)

A

(1) Sepsis
(2) Murmurs
(3) Very sick indiv
(4) Very high fever

34
Q

NBTEs is short for __________, after formation of this it can cause ______

A

(1) Non Bacterial Thrombo Endocarditis
(2) Bacterial Colonization

35
Q

Heart valves: ______; Bicuspid Aortic Valves: _____

A

(1) prone to infection
(2) 30% develop endocarditis

36
Q

How does IE start? px should/have (1) (2) (3) (4)

A

(1) Bicuspid heart valve or Prosthetic heart valve
(2) RHD Rheumatic Heart Disease
(3) Abnormal heart valve
(4) History of IE

37
Q

Procedures to increase revascularization (PC)

A

(1) Percutaneous Coronary Intervention
(2) Coronary Artery Bypass Graft

38
Q

Aftercare treatment for PCI

A

(1) Angioplasty
(2) DAPT Dual Anti Platelet Theraphy
(3) After 1 yr Aspirin

39
Q

True of False

CABG category/qualification
1. main vessel or coronary artery is affected.
2. if there are multiple sites for reperfusion

A

True

40
Q

True or False

There is no possibility of re-thrombosis and it is a combination of angioplasty + stunt

A

First false, Second is true

41
Q

The treatment regime for RHD is considered the gold standard

A

Increase Revascularization of Vessel

42
Q

(1) ______Method that gives Tissue Plasminogen Activator, inc activity of plasma & disollves clot.
Not commonly used SE & should be only used w (2) _______

A

(1) Thrombolysis
(2) PCI: Percutaneous coronary intervention

43
Q

Choose: (1) Nitroglycerin, (2) Beta Blockers (3) Morphine

both dilator of veins & arteries;

A

(1) Nitroglycerin

44
Q

Choose: (1) Nitroglycerin, (2) Beta Blockers (3) Morphine

reduces contractility of heart
= reduce HR

A

(2) Beta Blockers

45
Q

Choose: (1) Nitroglycerin, (2) Beta Blockers (3) Morphine

Reduces POSA _______

A

(3) Morphine
P - preload | O - oxygen demand | S - SV | A - Afterload

46
Q

_____ anti cholesterol drugs; _____ anti hypertensive drug

A

(1) Statin; (2) Ace Inhibitors

47
Q

_____ blocks thromboxane A2; ______ blocks ADP

A

(1) Aspirin; (2) P1Y12 Receptor Inhibitor

48
Q

____ reduce LDL & increase HDL

A

Statins

49
Q

Ace Inhibitors reduces _______

A

cardiac remodeling

50
Q

______ inhibits clotting factor X & thrombin; * both involved in formation of fibrin monomers, form on the surface of platelet & form reticulum of clot

A

Anti Thrombin III

51
Q

Why do platelets clamp together?

A

Due to SAT (Serotonin, ADP, Thromboxane A2) attract platelet & clamp them together

52
Q

Anti Platelet Drugs are (1-5)

A

(1) Statins
(2) Heparin
(3) Aspirin
(4) P1Y12 Receptor Inhibitor
(5) Ace Inhibitors

53
Q

Drugs that Reduce Oxygen Demand (1-3)

A

(1) Nitroglycerine
(2) Beta blockers
(3) Morphine

54
Q

Increase Revascularization of Vessel (1-2)

A

(1) Percutaneous Coronary Intervention
(2) Coronary Artery Bypass Graft

55
Q

time between atrial depolarization and ventricular depolarization, suggestive of AV conduction time

A

PR Interval

56
Q

____ stimulate vasoconstriction, blocked ok

A

Alpha & Beta 1 Receptor

57
Q

Beta 2 Receptors stimulate _______ and ______

A

(1) Vasodilation (2) blocked not ok

58
Q

Treatment for Prinz Metal Angina

A

(1) Give Calcium Channel Blockers
(2) Give Nitroglycerin

BUT do not give Beta Blocker

59
Q

EXAMINATION or SYMPTOMS for Prinz Metal Angina

A

(1) Px similar symptoms IHD
(2) Normal BMI or BP
(3) No familial history or diabetes
(4) Young female w alcohol abuse, narcotic use and long term smoking
(5) Px has migraines from taking triptanes (cause vasospasm CA & lessens lumen

60
Q

Diagnosis for PMA

A

(1) EC no ST Elevations
(2) Blood Chem: 0 or (-) tropnin

61
Q

Stable Angina: _______; Unstable & Subendocardial Infarction: ______ and Transmural Infarction _____

A

(1) 70% Occlusion, 30% Lumen
(2) 90% Occlusion, Near Total Occlusion
(3) 100% Occlusion, Total Occlusion of BV

62
Q

_______ stable plaque, Encapsulated w fibrous capsule, COE ______ and angina is ____

A

(1) Stable Angina
(2) Ischemic but not dead
(3) Exertion

63
Q

______ is unstable plaque, Fibrous capsule very weak, ruptures or fissures exposing plaque, Platelets converge = thrombus but COE ______

A

(1) Subendocardial Infarction
(2) Infarction, Dead & No oxygen supply

64
Q

NSTEMI _______; STEMI ______

A

(1) Non ST Elevation Myocardial infarction
(2) ST Elevation Myocardial Infarction

65
Q

In transmural infraction:
Plaque ______; Platelets: _____l Blood chem _____, ____ is affected, dead, infarction & Angine is felt at rest with _____

A

(1) unstable (2) occlude entire lumen (3) hi level of troponin (4) Walls of the heart -epi,myo, endo (4) compressing

66
Q

_____ is due to to vasospasm or vasoconstriction, no _____ & ____. Affected area _______ & Angina: at rest with _______

A

(1) Prinz Metal Angina
(2) Relation to ischemia or angina
(3) Plaque formation
(4) Compressing pain left shoulder, head & neck

67
Q

The (1) (2) (3) are categorized as ______ syndrome

A

(1) Unstable angina
(2) Subendocardial Infarction
(3) Transmural Infarction
(4) Acute Coronary

68
Q

Instances that require HIGH OXYGEN demand (4)

A

(1) Inc Heart Rate
(2) Left ventricle hypotrophy
(3) Inc thyroid hormone prod (indiv ppl w hyperthyroidism
(4) Exercise

69
Q

Instances that require LOW OXYGEN demand (3)

A

(1) Formation of EMBOLI or THROMBUS in major CA
(2) VASCULITIS: Inflamm CV
(3) VASOSPAMS: constrtion CA

70
Q

RISK FACTORS for Atherosclerosis or IHD

A

(1) BMI equal or more than 30 (obese)
(2) Age equal or more than 60 (elderly)
(3) Diabetes
(4) Familial
(5) Alcohol use
(6) Tobacco or Vaping
(7) Hyperlipidemia

71
Q

Hyperlipidemia is ______ & _____

A

(1) Inc LDL (Low-Density Lipoprotein)
(2) Dec HDL (High Density Lipoprotein)

72
Q

______ cant be changed; _____ can be changed

A

(1) Non modifiable risk factors
(2) Modifiable risk factors

73
Q

Treatment for Atherosclerosis

A

Angioplasty

74
Q

most or main cause of CAD/IHD | “plaque formation”

A

Atherosclerosis

75
Q

fatty or cholesterol deposits,
reduces the diameter of blood vessel therefor less blood is moving into the tissues distal where the plaque is

A

Plaque

76
Q

coronary artery forms plaque that occludes lumen of blood vessels

A

Atherosclerosis

77
Q

Hospital Term for IHD

A

Coronary Artery Disease (CAD)

78
Q

Less blood = Less oxygenation = _______ = Ischemia = _____

A

(1) Hypoxemia
(2) Infarction

79
Q

____ is triggered when not enough oxygen in heart tissue

A

SNS

80
Q

occlusion on coronary artery & low oxygen supply

A

ischemic heart disease

Gen Pathology (5 decks)

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