Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardiovascular II > Microbiology of Heart Disease Hersh DSA > Flashcards

Microbiology of Heart Disease Hersh DSA Flashcards

1
Q

serous pericarditis

A

produced by noninfectious infl diseases (rheumatic fever, SLE, scleroderma), tumors, uremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

fibrinous and serofibrinous pericarditis- composed of? causes?

A
  • most frequent types of pericarditis!
  • serous fluid mixed with fibrinous exudate
  • acute MI
  • postinfarction (Dressler) syndrome (autoimmune response days/wks after MI)
  • uremia
  • chest radiation
  • rheumatic fever, SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

fibrinous and serofibrinous pericarditis- symptoms

A
  • pain (sharp, pleuritic, position dependent) and fever!!

- loud pericardial friction rub- most striking finding!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

purulent or suppurative pericarditis- caused by? outcome?

A
  • active infection caused by microbial invasion of pericardial space (via direct extension, blood, lymph, cardiotomy)
  • serosal surfaces are reddened, granular, coated with exudate
  • outcome- scarring- frequently produces constrictive pericarditis?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hemorrhagic pericarditis- composed of? caused by?

A
  • exudate of blood mixed with fibrinous or suppurative effusion
  • caused by malignant neoplasm spread to pericardial space
  • also found in bacterial infections, in pts with bleeding diathesis and tb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

caseous pericarditis- caused by?

A
  • tb!! and fungal infections
  • spread from tb foci within tracheobronchial nodes
  • common antecedent of disabling, fibrocalcific, chronic constrictive pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

chronic or healed pericarditis

A
  • plaque-like fibrosis thickenings of serosal membranes
  • thin, delicate lesions
  • adhesive pericarditis- fibrosis in mesh-like stringy adhesions-obliterates the pericardial sac
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

adhesive mediastinopericarditis- after? effects?

A
  • after infectious pericarditis, cardiac surgery, or mediastinal irradiation
  • obliterated pericardial sac- adherence of external aspect of parietal layer to surround structures- strains cardiac fxn!!
  • hearts pulls against parietal pericardium and surround structures
  • systolic retraction of rib cage and diaphragm- pulsus paradoxus
  • cardiac hypertrophy and dilatoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

constrictive pericarditis- effects? signs?

A
  • heart encases in a dense, fibrous or fibrocalcific scar that limits diastolic expansion and CO
  • fibrous scar obliterates the pericardial space and sometimes calcifying- if extreme resembles a plaster mold (concretio cordis)
  • dense enclosing scar- cardiac hypertrophy cannot occur
  • CO reduced at rest- heart cannot inc its output in response to inc demands
  • signs- muffled heart sounds, elevated jugular venous P, peripheral edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

acute pericarditis- diagnosis

A
  • anterior pleuritic chest pain, worse supine
  • pericardial rub
  • fever common
  • erythrocyte sedimentation rate usually elevated
  • ECG- diffuse ST-segment elevation, PR depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pericarditis- treatment?

A
  • NSAIDs
  • colchicine- helps prevent recurrences
  • ibuprofen (600-800 mg 3x daily for 1-2 wks) or indomethacin (50 mg 3x daily)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

post-MI pericarditis- treatment

A
  • aspirin and colchicine (instead of NSAIDs)
  • aspirin (650-1000 mg 3x daily for 1-2 wks)
  • colchicine (3 months)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pericarditis treatment- if colchicine therapy fails?

A

-immunosuppression (cyclophosphamide or methotrexate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Picornaviridae- 2 subtypes

A 
1- Enteroviridae (infect intestinal epit and lymphoid cells- excreted in feces and spread fecal-oral route):
-poliovirus
-coxsackie A and B
-echovirus
2- Rhinoviridae (common cold)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Coxsackie B- causes?

A
  • pleurodynia (resp infection)

- myocarditis/pericarditis (50% of cases!!)- self-limited chest pain or serious arrhythmias, cardiomyopathy, HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mycobacterium tb- morphology

A
  • 40% of total cell dry weight is lipid
  • mycolic acids
  • thin rods
  • non-motile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mycobacterium tb- metabolism

A
  • aerobic
  • catalase-positive
  • slow growth rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Mycobacterium tb- virulence

A
  • mycosides- cord factor, sulfatides, wax D
  • iron siderophore
  • facultative intracellular growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mycobacterium tb- clinical

A
  • primary- asymptomatic, overt disease involving lungs or other organs
  • reactivation/secondary- pulm, pleural or pericardial, LN, kidney, skeletal joints, CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mycobacterium tb- diagnositcs

A
  • acid-fast stain
  • RAPID CULTURE
  • PPD skin test
  • IGRA (interferon gamma release assay)
  • chest xray
  • Gene Xpert MT/Rif
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

mycobacterium endocarditis- treatment

A
  • isoniazid
  • rifampin
  • pyrazinamide
  • ethambutol
  • streptomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

infective endocarditis

A

-microbial infection of heart valves- leads formation of vegetations composed of thrombotic debris and organisms, often assoc with destruction of underlying cardiac tissues

23
Q

acute infective endocarditis- caused by?

A
  • prev normal heart valve by a highly virulent organism (staph aureus)- rapidly produces necrotizing lesions
  • difficult to cure with antibiotics; need surgery
  • death can occur within days/wks
24
Q

subacute infective endocarditis- caused by?

A
  • organisms with lower virulences (viridans streptococci)- infections of deformed valves with less destruction
  • course days/wks; cured with antibiotics
25
risks of developing infective endocarditis
- rheumatic heart disease with valvular scarring - mitral vavle prolapse - degenerative calcific valvular stenosis - bicuspid aortic valve - artifiial valves
26
endocarditis of prev damaged/abnormal valves- caused by?
streptococcus viridans (50%)
27
endocarditis of healthy valves- caused by??
-S aureus (20-30%)- major in IV drug abusers
28
endocarditis- other bacterial causes
- Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella
29
prosthetic valve endocarditis- caused by?
S epidermidis (coagulase-neg)
30
IE- morphology
- vegetations on heart valves!- friable, bulky, destructive lesions containing fibrin, infl cells, bacteria - aortic and mitral valves most common - prone to embolization
31
acute endocarditis- clinical features
- fevers, chills, weakness, lassitude - fever- most consistent sign!! - murmurs- 90% of pts with left-sided IE
32
acute endocarditis- complications
- GN (glomerular ag-ab complex deposition) - microthromboemboli - erythematous or hemorrhagic nontender lesions on palms/soles (Janeway lesions) - subcutaneous nodules in pulp of digits (Osler nodes) - retinal hemorrhages in eyes (Roth spots)
33
4 major forms of vegetative endocarditis- morphology
- RHD- small, warty vegetations along closure lines of valve leaflets - IE- large, irregular masses on valve cusps that extend onto chordae - NBTE (nonbacterial thrombotic endocarditis)- small,bland vegetations attached at line of closure - LSE (libman-sacks endocarditis)- medium vegetations on either/both sides of valve leaflets
34
Duke criteria- pathologic
- microorganisms by culture or histologic examination in a vegetation, embolus, or intracardiac abscess - histologic confirmation of active endocarditis in vegetation or intracardiac abscess
35
Duke criteria- clinical- major
- 2 blood cultures + for characteristic organism or persistently + for an unusual organism - echocardiographic ID of valve-related or implant-related mass or abscess - new valvular regurgitation
36
Duke criteria- clinical- minor
- predisposing heart lesion or IV drug use - fever - vascular lesions - immunological phenomena (GN, osler nodes, roth spots) - microbiologic evidence- culture positive for unusual organism - echocardiographic findings- consistent with but not diagnostic of endocarditis- worsening/changing of preexistent murmur
37
Viridans Group Streptococci- 3 main types of infection
- dental infections (streptococci mutans) - endocarditis (viridans streptococcus- slowly/subacute; staph aureus- fast/acute) - abscesses (streptococcus intermedius)
38
Viridans Group Streptococci- virulence, treatment, diagnostics
- normal oral flora and GI tract - extracellular dextran- helps bind to heart valves - penicillin G - gram stain, culture, resistant to optochin
39
Group D streptococci- 2 subtypes
- Enterococci (faecalis, faecium) | - non-enterococci
40
Enterococci
(faecalis, faecium) - normal bowel flora - subacute bacterial endocarditis - 2/3rd most common cause of hospital acquired infection- prosthetic valve endocarditis!! - resistant to ampicillin, vancomycin!
41
staphylococcus aureus- causes? morphology? treatment?
- acute endocarditis- high fever, chills, myalgias- no history of valvular disease; grow rapidly - catalase-positive; coagulase-positive!! - most are penicillin resistant- use nafcillin, dicloxacillin - cephalosporins- cefazolin, cephalexin - clindamycin
42
staphylococcus epidermis- morphology, treatment, infects?
- catalase-positive; coagulase neg!! - vancomycin - lives in our skin- compromised hospital pts withI lines - infections of prosthetic valves!!- most frequent organism from infected prosthetic devices!!
43
HACEK organisms- characteristic
- fastidious, very slow growing - cause endocarditis!! - Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella
44
myocarditis- pathogenesis- most common cause?
- viral infections- most common cause!! - Coxsackie viruses A and B- most cases - CMV, HIV, influenza- other cases - infl cytokines can cause myocardial dysfxn
45
myocarditis- other causes
- nonviral agents- mostly Trypanosoma cruzi (Chagas disease) - Trichinosis (Trichinella spiralis)- most common helminthic disease - Lyme disease (Borrelia burgdorferi) - Diphtheritic myocarditis (Corynebacterium diphtheriae)
46
active myocarditis- morphology
- interstitial infl infiltrate assoc with focal myocyte necrosis - diffuse, mononuclear, predominantly lymphocyte infiltrate
47
infective endocarditis- essentials of diagnosis
- fever - preexisting organic heart lesion - positive blood cultures - evidence of vegetation on echocardiography - new or changing heart murmur - evidence of systemic emboli
48
native valve endocarditis- caused by?
- viridans streptococci - Group D streptococci - S aureus - enterococci - HACEK group
49
endocarditis- symptoms/signs
- fever! - duration- few days/wks - nonspecific symptoms - peripheral lesions- petechiae, subungual (splinter) hemorrhages, osler nodes, Janeway lesions, Roth spots
50
endocarditis- diagnostic studies
- blood cultures | - modified Duke criteria
51
endocarditis- blood cultures
-3 sets at least 1 hr apart before starting antibiotics
52
endocarditis- treatment?
- agents against staphylococci, streptococci, enterococci | - vancomycin (1 gm every 12 hrs) plus ceftriaxone (2 gm every 12 hrs)!!!!
53
enterococci- treatment
- penicillin | - streptomycin or gentamicin

Cardiovascular II (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions