CVD II - IE

Question 1

what is infective endocarditis

Answer 1

infection of inner layer of heart - usually affects cardiac valves

Question 2

IE was almost always fatal until development of:

Answer 2

penicillin

Question 3

what is the etiology and pathophysiology of IE

Answer 3

• precipitated by an infectious agent
• turbulent cardiac blood flow and damaged endothelium or heart valves permit congregation of and infection by the microbes
• morbidity accrue from thrombus formation and emboli, valvular dysfunction

Question 4

prophylactic antibiotics are recommended for people in ____ cateogry

Answer 4

high risk

Question 5

describe low risk for IE

Answer 5

• innocent heart murmurs
• mitral valve prolapse without regurgitation
• CAD
• people with pacemakers/defribrillators

Question 6

describe moderate risk for IE

Answer 6

• valve repair without prosthetic material
• hypertrophic cardiomyopathy
• mitral valve prolapse with regurgitation
• acquired valvular dysfunction

Question 7

describe high risk for IE

Answer 7

• mechanical prosthetic heart valve
• natural prosthetic heart valve
• prior IE
• valve repair with prosthetic material
• most congenital heart diseases

Question 8

what conditions require AB prophylaxis

Answer 8

• prosthetic cardiac valve or material
• previous relapse or recurrent IE
• unrepaired cyanotic congenital heart defect or repaired heart defect
• cardiac transplant with valve regurgitation due to a structurally abnormal valve

Question 9

what conditions do not require AB prophylaxis

Answer 9

• heart murmur
• mitral valve prolapse
• mitral valve prolapse with regurgitation
• rheumatic fever
• stent or cabg
• anesthetic injection
• radiographic imaging
• placement of RPD, removable ortho, ortho brackets
• adjustment of ortho appliances
• exfoliation of primary dentition
• bleeding for lip or oral mucosa trauma
• simple impression- alginate
• optical scans

Question 10

when would a heart murmur need AB prophylaxis

Answer 10

if it is due to a specific cardiac condition

Question 11

are prophylactic AB recommended prior to dental procedures for prosthetic joint implant patients

Answer 11

no

Question 12

AB prophylaxis regiments for dental procedures recommended only at risk patients who have procedures that:

Answer 12

• manipulate the gingival tissue
• manipulate the periapex of teeth
• perforate the oral mucosa

Question 13

what is OBS

Answer 13

if the dosage of antibiotic is inadvertently not administered before the procedure the dosage may be administered up to 2 hours after the procedure

Question 14

is clindamycin recommended for AB prophylaxis and why

Answer 14

no due to gastric SE

Question 15

what is the oral med for AB prophylaxis

Answer 15

amoxicillin 2g in adults 50mg/kg in children

Question 16

if a patient is taking a beta-lactam (penicillin, amoxicillin) for an active, existing infection:

Answer 16

resistance strains have likely been selected

Question 17

if urgent/emergency tx is necessary in patients already taking ABs prescribe:

Answer 17

azithromycin or clarithromycin

Question 18

if dental treatment is elective in patients already taking ABs:

Answer 18

wait 10 days after completion of the antibiotic for their active infection, then prescribe amoxicillin

Question 19

what is the script for amoxicillin one appointment dose prophylaxis

Answer 19

500mg
- dispense 4 tabs
- take 4 tabs PO one hour prior to dental appointment

Question 20

what are the procedures likely to induce bleeding and bacteremia and do they require AB prophylaxis

Answer 20

• manipulate the gingival tissue
• manipulate the periapex of teeth
• perforate the oral mucosa
• yes

Question 21

why are the procedures that do not require AB prophylaxis not require them

Answer 21

• they are unlikely to:
• manipulate the gingival tissue
• manipulate the periapex of the tooth
• perforate the oral mucsoa

Question 22

what are predictors of IE chances

Answer 22

size of bacteremia or bacteria number

Question 23

is IE always caused by bacterial infection

Answer 23

no

Question 24

what are likely the cause of most cases of IE

Answer 24

daily exposure to bacteremias during everyday activities such as toothbrushing and chewing