Week 4: Rheumatic Heart Disease & Endocarditis

Question 1

is virtually the only cause of mitral stenosis

Answer 1

Rheumatic Heart Disease (RHD)

Question 2

what infections is associated with RHD

Answer 2

Group A streptococcal (GAS) pharyngitis and cellulitis

Question 3

Why does it take 2-3 weeks for symptoms of acute Rheumatic fever to occur

Answer 3

2-3 week delay because of time needed to generate an immune response

Question 4

what antibodies are generated in acute RF

Answer 4

Streptococcal M protein (cross-reacting antibodies)

Question 5

ID

Answer 5

Aschoff Body

Question 6

ID

Answer 6

Anitschkow/caterpillar cells

Question 7

is there a presence of Streptococcal bacteria in the rheumatic fever (RF) lesions?

Answer 7

NO

Question 8

What is the antibody associated with Group A Streptococcus

Answer 8

Streptolysin O

Question 9

where are vegetations located in Rheumatic Fever (RF)

Answer 9

along lines of closer

Question 10

ID

Answer 10

Mitral Stenosis

Question 11

where do you hear a murmur in mitral stenosis?

Answer 11

mid-diastolic snap

Question 12

JONES criteria requirement

Answer 12

MUST have a preceding GAS infection

Question 13

What are the Major manifestation of JONES Criteria

Answer 13

J - joints: Migratory polyarthritis in joints
O - Pancarditis
N - Nodules: sub Q
E - Erythema marginatum
S - Sydenham chorea

Question 14

What are the Minor manifestation of JONES Criteria

Answer 14

Fever, arthralgia, and elevated blood levels

Question 15

What counts as evidence of antecedent GAS infection

Answer 15

Positive throat culture or rapid strep antigen test and streptococcal antibody titer (Streptolysin O)

Question 16

ID

Answer 16

erythema marginatum

Question 17

A microbial infection of the heart valves or the mural endocardium that leads to the formation of vegetations composed of thrombotic debris and organisms, often associated with destruction of the underlying cardiac tissues

Answer 17

Infective Endocarditis

Question 18

Most common bacterial infections for infective endocarditis

Answer 18

S. aureus and S. viridans
Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella (HACEK)

Question 19

ID

Answer 19

infective endocarditis

Question 20

ID

Answer 20

infective endocarditis (see bacteria)

Question 21

most common valves affective by infective endocarditis

Answer 21

aortic and mitral valve

Question 22

What valve is most commonly affected in infective endocarditis with intravenous drug users/persons who use injection drugs (PWID)?

Answer 22

Tricuspid valve (veins drain to the right side of the heart). By S. aureus

Question 23

what is infective endocarditis most prone to

Answer 23

embolization of vegetation fragments

Question 24

what are complications due to embolizations in infective endocarditis

Answer 24

stroke and abscess