[20] Infective Endocarditis Flashcards Preview

[OS 213] CVS Module > [20] Infective Endocarditis > Flashcards

Flashcards in [20] Infective Endocarditis Deck (31):
1

Definition: Infective Endocarditis

Microbial infection of the endothelium of the heart

2

Why are heart valves prone to IE?

Valves do not receive dedicated blood supply
No defensive immune mechanisms

3

Characteristic Lesion of IE

Vegetation

4

Define: Nosocomial IE

Infection gained through the hospital stay

5

[Acute vs. Subacute IE]

Valves Affected

A: Normal Valves

SA: Typically affects only abnormal valves

6

[Acute vs. Subacute IE]

Course and Time

A: Aggressive course over days

SA: Indolent course over months

7

[Acute vs. Subacute IE]

Causative Agents

A: S. Aureus and B Streptococci

SA: Enterococci and A Hemolytic Streptococci

8

[Early PVE vs. Late PVE]

Causative Agents

E: Staph. Epi Coagulase Negative and due to Intraoperative Contamination or Postop Bacterial Contamination

L: Staphylococci, Alpha Hemolytic Streptococci and Enterococci

[IMPORTANT]

9

Intravenous Drug Abuse IE usually affect which valve?

50% involve the Tricuspid Valve

10

Most common causative organism of IVDA IE

S. aureus

11

In Adults over 60 years old, IE is commonly associated with?

>30% with Calcific Aortic Stenosis

[IMPORTANT]

12

How many days do we use for "early" or "late" post op for Prothetic Valve IE?

60 Days

13

What causes 30-65% of Native Valve Endocarditis (NVE) unrelated to drug abuse?

Viridans streptococci

14

How do you treat Enterococcal IE?

Penicillin (cell-wall active agent) + Gentamycin (Aminoglycoside)

15

Most commonly associated Etiologic Agent for IE in all populations especially with drug use?

Staphylococcus

16

Major Cause of PVE during Initial Year After Valve Surgery?

Staphylococcus epidermidis

17

Gram ( - ) Bacteria Associated with IE

HACEK Organisms

Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella

18

Pathogenesis Pathway of Infective Endocarditis

1. Endothelial Injury
2. Hemostasis
3. Platelet-Fibrin Complex
4. Non-Bacterial Thrombotic Endocarditis
5. Bacteremia
6. Colonization and Infection of NBTE (Maranthic Endocarditis)

19

What is the most common Gram (-) Bacteria that Causes IE?

Pseudomonas, with a very high mortality rate

20

Where are Bacteria and NBTE Vegetation Deposited during IE?

On the sides of the low pressure sink that lie beyond the narrowing or stenosis

21

Most Common Clinical Features of IE?

Fever 80-90%

Followed by Murmurs 80-85%

22

Describe: Janeway Lesion

Macular
Blanching
Nontender Lesion

23

Describe: Osler's Lesion

Tender
Erythematous

24

Describe: Roth's Spots

Retinal hemorrhages with a pale white center

25

Common Peripheral Manifestations of IE?

Petechiae
Janeway Lesion
Osler's Lesion
Roth's Spots

26

Major Criteria for Duke's Criteria

1. 2 blood cultures positive for organisms found in patients with IE

2. Echocardiogram

27

Are you allowed to wait for blood cultures to come for patients who have been sick for a long time?

Yes, it is not incorrect since they are stable

28

Prophylaxis/Prevention for IE Mainly Focuses On?

Prevention of Bacteremia to attach to the NBTE

29

IE Prophylaxis is recommended for?

Dental Procedures that penetrate the mucosa
Any incision involving the respiratory mucosa

30

IE Prophylaxis is no longer recommended for?

GI or Genitourinary Tract Procedures

31

Who should receive IE Prophylaxis during Dental Procedures?

Patients with prosthetic cardiac valves
Patients with previous IE
Patients with unrepaired cyanotic CHD
Patients with completely repaired CHD during the first 6 months
Post transplant patients with valve regurgitation