Syncope, infection, shock

Question 1

High risk cardiac conditions for bacterial endocarditis prophylaxis

Answer 1

Prosthetic heart valve
Previous endocarditis
Structural heart valve abnormality in transplanted heart
Unrepaired cyanotic heart
Congenital heart disease not fully repaired

Question 2

HACEK organisms causes infective endocarditis

Answer 2

Haemophilus
Aggregatibacter
Cardiobacterium
Eikenella
Kinegella

Question 3

Viridians strep and enterococcus commonly causes what type infective endocarditis

Answer 3

Left-sided: aortic, mitral

Question 4

Culture negative causes of endocarditis

Answer 4

Coxiella burnetti
Bartonella
Tropheryma whipplei

Question 5

Libman-Sacks endocarditis is associated with…

Answer 5

SLE
Antiphospholipid syndrome

Question 6

Causes of non-infective endocarditis

Answer 6

Malignancy- i.e. pancreatic cancer
Hypercoagulability
Previous rheumatic fever
Autoimmune- SLE, APS, RA
Chronic infections

Question 7

Treatment of non-infective endocarditis

Answer 7

Anticoagulation with heparin
Treat underlying cause

Question 8

Empirical agents of IE

Answer 8

Vancomycin
Beta-lactam- i.e. ceftriaxone

Gentamicin + rifampicin (prostethic valves)

Question 9

Rx- staph IE

Answer 9

MRSA
- vancomycin

MSSA
- beta-lactam: naficillin, oxacillin

Question 10

Rx- viridian strep IE

Answer 10

Beta-lactam
- ampicillin/ pen G

Question 11

Rx- enterococcus IE

Answer 11

Ampicillin/ pen G + gentamacin

penicillin resistant= vancomycin + gentamicin

Question 12

Rx- HACEK IE

Answer 12

Ceftriaxone

2nd line= ampicillin, ciprofloxacin

Question 13

Duration of Abx for IE

Answer 13

2-6 weeks after sterile blood cultures.

Question 14

What bacteraemia in IE is associated with colorectal cancer?

Answer 14

Streptococcus gallolyticus

Question 15

Antibiotic prophylaxis for high risk procedures

Answer 15

Oral amoxicillin/ IV ampicillin 30-60 mins before procedure

2nd line- azithromycin