Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Study Notes - Cardiology > *Endocarditis > Flashcards

*Endocarditis Flashcards

1
Q

What 2 symptoms together are endocarditis until proven otherwise?

A

Fever + new murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the main cause of infection on a normal valve?

A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Does endocarditis on a normal valve tend to run an acute or subacute course?

A

Acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Does endocarditis on an abnormal valve tend to run an act or subacute course?

A

Subacute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the common types of bacteria that cause native valve endocarditis? (4)

A

Staph aureus
Viridans streptococci
Enterococcus
Staph. epidermidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the difference between bacteraemia and septicaemia?

A 
Bacteraemia = presence of bacteria in the blood
Sepcticaemia = multiplication of bacteria in the blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is bacteraemia/ septicaemia tested for?

A

Blood samples are taken and put in blood culture machines - this incubates the bottles at 37 degrees and detects the production of CO2 indicating growth
If CO2 is detected, the bottle is promptly removed and a small sample cultured and looked at under the microscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the presence of bacteria in the blood usually indicate?

A

That there is a focus of infection elsewhere in the body (can be a skin contaminant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is infective endocarditis?

A

Infection of the endothelium of the heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the categories of endocarditis based on time of onset?

A

Acute

Subacute (over weeks/ months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the mean age of getting infective endocarditis?

A

Majority greater than 50 years old but can occur in children with congenital heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Predisposing factors for endocarditis?

A

Heart valve abnormality e.g. calcification/ sclerosis in elderly, congenital heart disease, post rheumatic fever
Prosthetic heart valve
iv drug users
Intravascular lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does endocarditis form?

A

Heart valve damage causes turbulent blood flow over roughened endothelium
Platlets and fibrin are deposited
Bacteraemia occurs (may be very transient)
Organisms settle in fibrin/ platelet thrombi becoming a microbial vegetation
Infected vegetations are friable and break off becoming lodged in the next capillary bed they encounter causing abscesses or haemorrhage (can be fatal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What side of the heart is usually affected by endocarditis?

A

Left side (mitral and aortic valves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the unusual organisms causing endocarditis?

A

Atypical organisms (Bartonella, Coxiella burnetti, Chlamydia, Legionella, Mycoplasma, Brucella)
Gram negatives
Fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What microorganism causes Q fever?

A

Coxiella burnetti

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the usual presenting symptoms of acute endocarditis?

A

Overwhelming sepsis

Cardiac failure

18
Q

Symptoms of subacute endocarditis?

A 
Fever
Malaise
Weight loss
Tiredness
Breathlessness
19
Q

Signs of subacute endocarditis?

A 
Fever
New or changing heart murmur
Finger clubbing
Splinter haemorrhages
Splenomegaly
Roth spots, Janeway lesions, Osler nodes
Microscopic haematuria
20
Q

What are Janeway lesions?

A

non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles

21
Q

Roth spots?

A

A hemorrhage in the retina with a white center.

22
Q

What are osler nodes?

A

painful, red, raised lesions found on the hands and feet

23
Q

Diagnosis of endocarditis?

A

Take 3 sets of blood cultures (taken at different times at different sites before antibiotics are started)
If blood culture negative, consider serology for atypical organisms
Echocardiogram (transoesophageal more sensitive than transthoracic)

24
Q

What are the 2 different types of prosthetic valve endocarditis and what usually causes each?

A

Early (within 60 days of placement) = usually infected at time of valve insertion = staph aureus or staph epidermis
Late = many years later valve insertion due to co-incidental bacteraemia
Wide range of possible organisms

25
Q

Where is endocarditis in IV drug users usually seen?

A

In the right side - tricuspid valve

26
Q

What is the usual organism that causes endocarditis in drug users?

A

Staph aureus - often presents as a staph aureus “pneumonai” - this is usually secondary to the endocarditis

27
Q

Initial Antibiotics for native valve indolent (subacute) endocarditis?

A

IV amoxicillin and gentamicin

28
Q

Initial Antibiotics for native valve severe sepsis (acute) endocarditis?

A

Flucloxacillin

29
Q

Initial Antibiotics for prosthetic valve or suspected MRSA endocarditis?

A

Vancomycin + Rifampicin + gentamicin

Valve replacement is usually required

30
Q

Initial Antibiotics for native valve endocarditis with risk factors for resistant pathogens?

A

Vancomycin

Meropenem

31
Q

Initial Antibiotics for endocarditis in drug users?

A

Flucloxacillin

32
Q

Antibiotics given when we known viridian’s streptococci is causing the endocarditis?

A

Benzylpenicillin

Gentamicin

33
Q

Antibiotics given when we know enterococcus is causing the endocarditis?

A

Amoxicillin/ vancomycin

Gentamicin

34
Q

Antibiotics given when we know staphylococcus epidermidis is causing the endocarditis?

A

Vancomycin
Gentamicin
Rifampicin

35
Q

Treatment lengths for endocarditis?

A

IV antibiotics usually given for 4-6 weeks

If failing on antibiotic therapy, consider referral for surgery early

36
Q

When are prophylactic antibiotics used for endocarditis?

A

When patients with hear valve lesions, congenital heart defects or prosthetic heart valves are having GI or GU procedures if infection is suspected

37
Q

What is myocarditis?
Age?
Symptoms?
signs?

A 
Inflammation of cardiac muscle
Younger people
Fever, chest pain, shortness of breath, palpitations
Arrhythmia
cardiac failure
38
Q

What is the main causes of myocarditis?

A

Usually enteroviruses e.g. Coxsackie A and B, echovirus, but other viruses possible e.g. influenza

39
Q

How is myocarditis diagnosed?

A

Viral PCR
Throat swab and stool for enteroviruses
Throat swab for influenza
Supportive therapy

40
Q

What is pericarditis?
What does it often occur with?
What is the main symptom?

A

Inflammation of pericardium
Myocarditis
Chest pain

41
Q

What is the main cause of pericarditis?

A

Viruses

Can be caused by bacteria e.g. after cardiothoracic surgery

42
Q

How is pericarditis treated?

A

Supportive treatment unless bacterial cause (in which it needs antibiotics and drainage)

Study Notes - Cardiology (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions