MRCP cardio

Question 1

Poor prognostic factors associated with infective endocarditis

Answer 1

Staph aureus infection, prosthetic valve, culture negative endocarditis, low complement levels

Question 2

Mortality according to organism with Infective endocarditis

Answer 2

staphylococci - 30%
bowel organisms - 15%
streptococci - 5%

Question 3

Intial blind therapy for IE

Answer 3

Native valve - amox + low dose gent
If pen allergic - vanc + low dose gent
If prosthetic valve - vanc + rifampicin + low dose gent

Question 4

Native valve endocarditis - staphylococci - abx guidelines

Answer 4

Flucloxacillin

If pen allergic or MRSA - vanc + rifampicin

Question 5

Prosthetic valve endocarditis - staphylococci - abx guidelines

Answer 5

Fluclox + rifampicin + low dose gent

If pen allergic or MRSA - vanc + rifampicin + low dose gent

Question 6

Streptococci (fully-sensitive) endocarditis

Answer 6

Benzylpenicllin

Vanc + low dose gent if pen allergic

Question 7

Streptococci (less-sensitive) endocarditis

Answer 7

Benzylpenicillin + low dose gent

Vanc + low dose gent if pen allergic

Question 8

Indications for surgery with infective endocarditis

Answer 8

Severe valvular incompetence, 
aortic abscess (lengthening PR interval), infections resistant to abx, fuangal infections, cardiac failure refractory to standard medical rx, recurrent emboli after abx therapy