Meningitis and Endocartitis Flashcards

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1
Q

what is endocarditis?

A

infection of endocardia surface of heart (usually valves)

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2
Q

who is most susceptible to endocarditis?

A

people with prosthetic valves or other foreign material

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3
Q

what organisms usually cause acute endocarditis?

A

highly virulent organisms

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4
Q

what is the process of endocarditis?

A

colonization on skin/mucous membrane
bacteremia in blood (through trauma)
adhere to roughened endocardia surfaces
platelet fibrin deposition
bacterial division
cauliflower vegetations develop (with dormant organisms inside)

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5
Q

what the heart consequences of endocarditis?

A

impair normal valve functions (eventually destroy)
small emboli can enter arteries and cause myocardial infraction
abscesses may develop in heart muscle that impair electric conduction

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6
Q

what are the brain consequences of endocarditis?

A

brain cortex showered with micro-emboli = confusion and coma
large emboli can cause stroke or brain abscesses

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7
Q

what other consequences of endocarditis are there?

A

large emboli can obstruct renal artities
immune complexes may cause renal damage
emboli may go to spleen, extremities, eyes, other organs
involved blood vessels will weaken stretch and burst

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8
Q

what are common pathogens that cause endocarditis?

A

high virulence = S. aureus, S. pneumonia
low virulence = viridans, streptococci species

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9
Q

how is endocarditis diagnosed?

A

risk factors (surgeries, heart disease, IVDU, indwelling caths)
blood cultures
echo (to see vegetation)

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10
Q

how is endocarditis treated?

A

combination antibiotics for at least four weeks

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11
Q

how is endocarditis prevented?

A

prophylactic antibiotics for surgery

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12
Q

what is meningitis?

A

inflammation of membranes covering brain and spinal cord

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13
Q

what are the types of meningitis?

A

acute or chronic (rare - can complicate preexisting conditions

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14
Q

what bacteria is meningitis caused by?

A

strep pneumo
neissaria meningitis
h. influenzae
listeria monocyogens

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15
Q

what viruses can cause meningitis?

A

enteroviruses (usually mild during summer)
arboviruses (areas with mosquitos)

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16
Q

who does strep pneumo meng effect?

A

children and adults
doesn’t cause outbreaks

17
Q

who does neisarria meng effect?

A

mostly infants, children teens
sporadic and outbreaks
vaccine!!!!

18
Q

who does h influenzae meng effect?

A

3 months to 5 years
vaccine!!!!

19
Q

who does listeria meng effect?

A

the very young and very old
most related to food
outbreaks may occur

20
Q

how does meng invade the body?

A

nasopharyngeal colonization, local invasion, bacteremia, meningeal invasion, bacterial replication and release

21
Q

how does the body respond to meng?

A

activation of macrophages to release cytokines
subarachnoid space inflammation
increased CSF outflow resistance
cerebral vasculitis
increased blood-brain permeability
increased brain edema
confusion
coma

22
Q

how is meng diagnosed?

A

clinical features
CT scan
cerebral spinal fluid
gram stain
CSF culture
PCR

23
Q

how is meng treated empirically?

A

empirically - ceftriaxone/vancomycin and ampicillin

24
Q

how is strep pneumo meng treated?

A

vancomycin

25
Q

how is neissaria and h. influenzae meng treated?

A

ceftriazone

26
Q

how is listeria meng treated?

A

ampicillin