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Cardiovascular Medicine-Unit 1 > Microbiology Of Heart Disease-Hersh > Flashcards

Microbiology Of Heart Disease-Hersh Flashcards

1
Q

This org is Gram +, Catalase + and Coagulase +

A

Staphylococcus aureus

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2
Q

This org is a Gram + group A beta-hemolytic that is Catalase - with a virulent M protein

A

Strepcoccus pyogenes

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3
Q

This org is a Gram + alpha hemolytic that is Catalase - and a facultative anaerobes

A

Streptococcus viridans

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4
Q

This is a Gram + org that is Lancefield group D and is Catalase -

A

Enterococcus faecalis

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5
Q

What is empiric tx for a pt with acute infective endocarditis with Staph aureus?

A

Vancomycin and Ceftriaxone

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6
Q

This organism is Gram + coccus in clusters that are catalase + and Coagulase -

A

Staphylococcus epidermidis

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7
Q

What are some risk factors for infective endocarditis?

A

Age > 60
M > F
IV drug use
Poor dentition

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8
Q

What are some predisoposing conditions for infective endocarditis?

A
  • Structural heart disease
  • Valvular heart disease-rheumatic, MV prolapse, aortic valve
  • Congenital heart disease-bicuspid aortic valve, VSD, PDA, coarctation of aorta
  • Prosthetic heart valves
  • Hx of prior IE
  • Intravascular devices
  • Hemodialysis
  • HIV –> orgs such as TB, CMV
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9
Q

A patient with this type of infective endocarditis has an abrupt onset, toxic-appearing, and a rapid course.

A

Acute IE

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10
Q

A patient with this type of IE has a gradual onset, systemic manifestations, appear ill but not toxic

A

Subacute

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11
Q

Which side of the heart tends to be affected more in Acute IE?

A

R > L

Tri > Bi > Aorta > Pulm

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12
Q

Which side of the heart tends to be involved in Subacute IE?

A

L > R

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13
Q

Which organisms tend to be involved in Acute IE?

A

S aureus

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14
Q

Which orgs tend to be involved in Subacute IE?

A

S viridans, HACEK, Enterococcus

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15
Q

What are presenting symtpoms Acute IE?

A 
High fever, chills
SOB
Arthralgias/myalgias
Abdominal pain
pleuritic chest pain
Back pain
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16
Q

What are presenting symptoms of Subacute IE?

A 
Low grade fever
Anorexia
Arthralgias/myalgias
Abdominal pain
Fatigue
N/V
17
Q

What are the ways in which the Duke Criteria can be met?

A 
2 major criteria met
Or
1 major with 3 minor criteria met
Or
5 minor criteria met
18
Q

What are Major Duke criteria for IE?

A

Positive blood cultures for IE (one of the following): Typical microogs consistent with IE from 2 separate cultures –> S aureus, S viridans, S bovis, HACEK, community acquired enterococci; Persistently positive blood culture; SIngle positive blood culture for Coxiella burnetti or Phase I IgG Ab titer > 1:800

Evidence of endocardial involvement (one of the following): ECG positive for vegetation or abscess or new partial dehiscence of prosthetic valve; New valvular regurgitation

19
Q

What are Minor Duke criteria?

A

Predisposition: IV drug use or presence of predisposing heart condition

Fever > 38.0C or 100.4F

Vascular phenomena: Janeway lesions

Immunologic phenomena: Osler nodes

Microbiological evidence

Echocardiographic evidence

20
Q

ABx prophylaxis is recommended for these cardiac conditions associated with high risk of IE:

A

Prosthetic cardiac valve
Prosthetic material used for cardiac valve repair
Previous hx of IE
CHD
Cardiac transplant recipients who develop valvulopathy

21
Q

What is empiric tx for infective endocarditis?

A

Vancomycin 1g q12h IV
+
Ceftriaxone 2g q24h

22
Q

What kind of stain do you want to perform to confirm TB/mycobacterium infx?

A

Acid fast AKA Ziehl-Neelsen stain

23
Q

How would you treat a tuberculis pericarditis?

A

Isoniazid + Rifampin + Ethambutol + Pyrazinamide

24
Q

+ssRNA naked icosahedral virus is known as ___

A

Coxsackie B-Picornavirus

Pt with this infx has symptoms alleviated by sitting upright and leaning forward

25
Q

A pt who is diagnosed with acute pericarditis secondary to a coxsackie virus is started on high dose aspirin and colchicine. Aside from EKG stabilization, which lab can you monitor to ensure tx effectiveness?

A

C-Reactive protein (CRP)

26
Q

What is a major risk of acute pericarditis?

A

Cardiac tamponade

27
Q

What is the most common cause of pericarditis?

A

Viral-Coxsackie B (also echovirus and Flu)

28
Q

A pt who presents with anterior pleuritic chest pain, fever, has a pericardial rub on auscultation, and dyspnea likely has ___

A

Pericarditis

29
Q

Describe the EKG progression of pericarditis:

A

Diffuse ST elevation –> ST normalization –> Inverted T waves –> return to baseline

30
Q

What is tx for acute pericarditis?

A

High dose aspirin + colchicine -tapered

31
Q

You give high dose aspirin and colchicine for tx a pt with acute pericarditis. What do you want to order to track their tx?

A

CRP

Cardiovascular Medicine-Unit 1 (6 decks)

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