Endocarditis - Ix, Duke Criteria, Complx, Mx

Question 1

Ix
3 bloods?
? - ? sets at different times
ECG - at ? intervals, may be ?? due to emboli or ? defects
CXR - look for evidence of heart ?, or ?/emboli
? echo - in all pts, negative echo does not rule out

Answer 1

FBC, inflam markers raised, U+E
cultures 
3
regular
MI
conduction
failure
abscesses
transthoracic

Question 2

Duke criteria
Dx can be made with ? major or ? major and ? minor

Duke Major Criteria

• ? culture - typical organisms grown in ? cultures
• ? involvement on echo (?, abscesses, new ?)

Answer 2

2
1
3

positive
two
endocardial
vegetations
regurgitation

Question 3

Duke Minor Criteria

• ?
• fever >?
• ?/immunological signs
• ?/? positive but not sufficient for ? criteria

Answer 3

predisposition
38
vascular
echo
culture
major

Question 4

Acute inf endo

-? proliferation in valve leads to ? of the valve tissue, with rapid ? or the valves, leading to acute cardiac failure

Answer 4

bacterial
necrosis
perforation

Question 5

Subacute inf endo

• as infective organisms are poorly ?, there is a very ? onset of valve destruction
• stimulation of ? formation leads to ? embolisation and the persistent low grade ? leads to ? phenomena

Answer 5

virulent
gradual
thrombus
systemic
inflam
immunological

Question 6

Complx

• systemic ? (or ? ? in right sided disease)
• valvular incompetence -> ???
• ? (something to do with kidney)

Answer 6

emboli
pulm abscesses
ccf
glomnephritis

Question 7

Mx

• if suspected, consult a ? early
• empirical therapy is with ?, ? and ? if acute, ? for ? weeks
• subsequent therapy is dependent on the ? and ?

(if prosthetic valve minimum of 6 weeks apparently)

Answer 7

microbiologist
benpen, fluclox, gent
IV
4
organisms 
sensitivities