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Y4R6 - Pediatrics II 👶 > L8: Infective Endocarditis > Flashcards

L8: Infective Endocarditis Flashcards

1
Q

IE refers to …….

A
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2
Q

Etiology of Infective Endocarditis

A
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3
Q

Etiology of Infective Endocarditis

  • Pathogens
A
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4
Q

Etiology of Infective Endocarditis

  • most common bacteria causing IE
A

Streptococcus Viridians

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5
Q

Etiology of Infective Endocarditis

  • most common fungus causing IE
A

Candida albicans

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6
Q

The most common microbiologic etiologic agents causing IE change over time.

A

…

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7
Q

Etiology of Infective Endocarditis

  • RF
A
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8
Q

Pathogenesis of Infective Endocarditis

A
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9
Q

Pathogenesis of Infective Endocarditis

  • endothelial Damage
A
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10
Q

Almost all patients with congenital heart defects are complicated by IE except …..

  • Due to low pressure gradient between both atria so no turbulent flow and no endocardial damage
A
  • secundum ASD
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11
Q

Pathology in Infective Endocarditis

A
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12
Q

CP of Infective Endocarditis

A
  • Hx
  • Symptoms
  • Signs
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13
Q

CP of Infective Endocarditis

  • Hx
A
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14
Q

CP of Infective Endocarditis

  • Symptoms
A
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15
Q

CP of Infective Endocarditis

  • Signs
A
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16
Q

Signs of Infective Endocarditis

  • Manifestations of the disease are due …..
A

Manifestations of the disease are due to:

  • Toxemia
  • Cardiac damage
  • Embolization
  • Immune complexes
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17
Q

Signs of Infective Endocarditis

  • Cardiac
A

Heart murmur is almost always present (85 - 90 %)

  • Development of a new heart murmur or change in a pre-existing one
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18
Q

Signs of Infective Endocarditis

  • Spleen
A

Splenomegaly is common (70%)

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19
Q

Signs of Infective Endocarditis

  • Embolic & Immunologic

Rare in Chidren

A
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20
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Skin
A
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21
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Most Common
A
  • Petechiae on the skin, mm, or conjunctivae
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22
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Petechiae
A
  • Petechiae on the skin, mm, or conjunctivae
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23
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Osler’s Nodes
A

Painful, pea-size pink nodes at the Pulps of fingers or toes

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24
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • janeway Lesions
A

small, painless, hemorrhagic areas on the palms or soles

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25
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Splinter Hemorrhage
A

linear hemorrhagic streaks beneath the nails

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26
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Lung & Spleen
A

Pulmonary & Splenic emboli

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27
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • CNS
A

CNS emboli → Seizures and hemiparesis occur in 20% of cases.

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28
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Kidney
A

Glomerulonephritis (Hematuria) and renal failure

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29
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • Eye
A

Roth’s spots (oval, retinal hemorrhages with pale centers located near optic disc)

  • Occur in < 5% of patients.
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30
Q

Embolic & Immunologic Signs of Infective Endocarditis

  • toxemia
A
  • Fever associated with systemic symptoms
  • Clubbing fingers in absence of cyanosis
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31
Q

INvx for Infective Endocarditis

A
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32
Q

INvx for Infective Endocarditis

  • Labs
A
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33
Q

Blood Culture in Infective Endocarditis

A
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34
Q

Blood Culture in Infective Endocarditis

  • Indications
A
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35
Q

Blood Culture in Infective Endocarditis

  • Technique
36
Q

Blood Culture in Infective Endocarditis

  • Results
37
Q

Blood Culture in Infective Endocarditis

  • Special Situations
38
Q

Labs in Infective Endocarditis

  • CBC
39
Q

Labs in Infective Endocarditis

  • APR
A

Increased ESR unless there is polycythemia

40
Q

Labs in Infective Endocarditis

  • Urinalysis
A

Microscopic hematuria (in 30% of patients)

41
Q

Rads in Infective Endocarditis

42
Q

Rads in Infective Endocarditis

  • MSCT
A

May be used in recent embolic events and paravalvular lesions

43
Q

Rads in Infective Endocarditis

  • MRI
A

For detection of cerebral lesion

44
Q

Rads in Infective Endocarditis

  • ECHO
45
Q

ECHO in Infective Endocarditis

46
Q

ECHO in Infective Endocarditis

  • Types
47
Q

ECHO in Infective Endocarditis

  • Uses
A

Detects the site and extent of valvular damage

48
Q

ECHO in Infective Endocarditis

  • Findings
49
Q

ECHO in Infective Endocarditis

  • false -ve
A
  • vegetations are small
  • Have already embolized
50
Q

ECHO in Infective Endocarditis

  • Notes
A
  • Echo evidence of vegetation may persist for up to years.
  • The absence of vegetation on echo does not in itself rule out lE.
51
Q

Dx of Infective Endocarditis

52
Q

Dx of Infective Endocarditis

  • Modified Duke Criteria
53
Q

Modified Duke Criteria

  • Major Clinical Criteria
54
Q

Major Clinical Criteria

  • Blood Culture
55
Q

Major Clinical Criteria

  • Imaging
56
Q

Modified Duke Criteria

  • Minor Clinical Criteria
57
Q

Minor Clinical Criteria

  • Predisposition
A

predisposing heart condition or injection drug users.

58
Q

Minor Clinical Criteria

  • Fever
A

temperature > 38° C

59
Q

Minor Clinical Criteria

  • Vascular Phenomena
A
  • Major arterial emboli
  • septic pulmonary infarct
  • Janeway lesions
  • Mycotic aneurysm
  • Conjunctival
  • Intra-cerebral hemorrhage
60
Q

Minor Clinical Criteria

  • Immunologic Phenomena
A

As mentioned Before

61
Q

Minor Clinical Criteria

  • Microbiologic Evidence
A

Positive blood culture but doesn’t meet a major criterion

62
Q
  • Modified Duke Criteria

Pathological Criteria

63
Q

Pathological Criteria

  • Microorganisms
64
Q

Pathological Criteria

  • Pathological Lesions
A
  • vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis
65
Q

Diagnostic MDC

66
Q

Diagnostic MDC

  • Definite
67
Q

Diagnostic MDC

  • Possible
68
Q

Diagnostic MDC

  • Rejected
69
Q

Management of Infective Endocarditis

A
  • Blood Culture
  • Medical
  • Surgical
70
Q

Management of Infective Endocarditis

  • Blood Culture
A

Previosly Mentioned

71
Q

Management of Infective Endocarditis

  • Initial empiric Therapy
72
Q

Initial Empiric Therapy in Management of Infective Endocarditis

  • Community Acquired
73
Q

Initial Empiric Therapy in Management of Infective Endocarditis

  • Nosocomial
74
Q

Management of Infective Endocarditis

  • Specific Antibiotics
75
Q

Specific Antibiotics in Management of Infective Endocarditis

  • Streptococci
76
Q

Specific Antibiotics in Management of Infective Endocarditis

  • Staphylococci
77
Q

Management of Infective Endocarditis

  • Surgery
78
Q

Management of Infective Endocarditis

  • Indication of Surgery
79
Q

Prevention of Infective Endocarditis

80
Q

Prevention of Infective Endocarditis

  • Conditions Requiring Prophylaxis
81
Q

Conditions Requiring Prophylaxis in Infective Endocarditis

  • CHD
82
Q

Procedures Requiring Prophylaxis in Infective Endocarditis

83
Q

Procedures Requiring Prophylaxis in Infective Endocarditis

  • Dental procedures
84
Q

Procedures Requiring Prophylaxis in Infective Endocarditis

  • Respiratory Tract Procedures
85
Q

Procedures Requiring Prophylaxis in Infective Endocarditis

  • GI & GU Procedures
86
Q

Procedures Requiring Prophylaxis in Infective Endocarditis

  • Skin / MSK Tissue

Y4R6 - Pediatrics II 👶 (10 decks)

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