CVD II - IE Flashcards

1
Q

what is infective endocarditis

A

infection of inner layer of heart - usually affects cardiac valves

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2
Q

IE was almost always fatal until development of:

A

penicillin

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3
Q

what is the etiology and pathophysiology of IE

A
  • 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
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4
Q

prophylactic antibiotics are recommended for people in ____ cateogry

A

high risk

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5
Q

describe low risk for IE

A
  • innocent heart murmurs
  • mitral valve prolapse without regurgitation
  • CAD
  • people with pacemakers/defribrillators
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6
Q

describe moderate risk for IE

A
  • valve repair without prosthetic material
  • hypertrophic cardiomyopathy
  • mitral valve prolapse with regurgitation
  • acquired valvular dysfunction
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7
Q

describe high risk for IE

A
  • mechanical prosthetic heart valve
  • natural prosthetic heart valve
  • prior IE
  • valve repair with prosthetic material
  • most congenital heart diseases
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8
Q

what conditions require AB prophylaxis

A
  • 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
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9
Q

what conditions do not require AB prophylaxis

A
  • 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
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10
Q

when would a heart murmur need AB prophylaxis

A

if it is due to a specific cardiac condition

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11
Q

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

A

no

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12
Q

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

A
  • manipulate the gingival tissue
  • manipulate the periapex of teeth
  • perforate the oral mucosa
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13
Q

what is OBS

A

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

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14
Q

is clindamycin recommended for AB prophylaxis and why

A

no due to gastric SE

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15
Q

what is the oral med for AB prophylaxis

A

amoxicillin 2g in adults 50mg/kg in children

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16
Q

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

A

resistance strains have likely been selected

17
Q

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

A

azithromycin or clarithromycin

18
Q

if dental treatment is elective in patients already taking ABs:

A

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

19
Q

what is the script for amoxicillin one appointment dose prophylaxis

A

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

20
Q

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

A
  • manipulate the gingival tissue
  • manipulate the periapex of teeth
  • perforate the oral mucosa
  • yes
21
Q

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

A
  • they are unlikely to:
  • manipulate the gingival tissue
  • manipulate the periapex of the tooth
  • perforate the oral mucsoa
22
Q

what are predictors of IE chances

A

size of bacteremia or bacteria number

23
Q

is IE always caused by bacterial infection

A

no

24
Q

what are likely the cause of most cases of IE

A

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

25
Q
A