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Cardio Week 5 > Pathology: Endocarditis, Myocarditis and Pericarditis > Flashcards

Pathology: Endocarditis, Myocarditis and Pericarditis Flashcards

1
Q

Why are about 10% of all infective endocarditis cases extremely difficult to treat?

A
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2
Q

Pericarditis

  • Primary Pericarditis
    • How common is it?
    • What is it usually due to?
  • Secondary Pericarditis
    • What conditions is it usually secondary to?
    • Where does pain radiate to?
    • Are other structures usually involved?
  • What is the most common systemic disorder associated with pericarditis?
A
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3
Q

Describe the mortality rates for infective endocarditis caused by

  • Low-virulence organisms, eg, Streptococcus viridans or Streptococcus bovis
  • Enterococci and S. aureus infections
  • Aerobic gram-negative bacilli or fungi
A
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4
Q

Clinical Features of Infective Endocarditis

  • What is the most consistent sign of infective endocarditis?
    • What patient population would result in the absence of a fever?
      • What manifestations would occur in this group of PTs instead?
A
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5
Q

In viral myocarditis

  • How do you ID pathogens?
  • What is the reason for cardiac injury?
A
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6
Q

How can organisms even get into the body so that endocarditis can occur?

A
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7
Q

What are the histological features of Chagas myocarditis?

A
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8
Q

For infective endocarditis, what are the poor prognostic indicators?

A
  • Septicemia
  • Arrhythmias
    • Suggesting extension to the underlying conduction system
  • Systemic embolization
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9
Q

Non Infective Vegetations (Nonbacterial thrombotic endocarditis [NBTE])

  • What is this disease characterized by?
  • Do the lesions from this condition destroy the cardiac tissue?
  • Describe the vegetations associated with NBTE?
A
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10
Q

Where do sterile platelet-fibrin deposits occur, and how do they relate to infective endocarditis?

A
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11
Q

Morphology of Infective Endocarditis

  • What can occur because of the friable nature of the vegetations?
  • Of acute and subacute endocarditis, which is associated with valvular destruction?
A
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12
Q
  • This shows acute endocarditis on an aortic valve.
    • Because this is the acute form and this heart is from an IV drug user, what organism would most likely cause it?
    • What is odd about this aortic valve?
      • What valve is associated with IV drug use and infective endocarditis?
    • What is the arrow pointing to?
A

Tricuspid valve a frequent target in the setting of IV drug abuse.

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13
Q

Morphology of Infective Endocarditis

  • What occurs in both acute and subacute forms?
  • What valves are usually affected? How does IV drug use affect this?
  • What is a ring abscess?
A
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14
Q

This shows Nonbacterial thrombotic endocarditis (NBTE) on a mitral valve.

  • What is indicated at the arrows?
  • What condition(s) are precursors to NBTE?
A
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15
Q

Morphology of Pericarditis

  • In acute viral pericarditis or uremia,
    • What does the exudate usually look like?
  • In acute bacterial pericarditis,
    • What does the exudate usually look like?
      • What is noted about Tuberculous pericarditis?
A
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16
Q

Clinical Features of Pericarditis

  • What symptoms does Pericarditis classically manifests with?
  • What can acute pericarditis cause when associated with significant fluid accumulation?
  • What does Chronic constrictive pericarditis produce in terms of heart function?
A
17
Q

Define the following

  • Roth spots
  • Janeway lesions
  • Osler nodes
A
  • Retinal hemorrhages (Roth spots)
  • Painless palm or sole erythematous lesions (Janeway lesions)
  • painful fingertip nodules (Osler nodes).
18
Q

In NBTE, the local effect on the valve is usually benign. How then, does this condition become clinically significant?

A
19
Q

Morphology of Myocarditis

  • Microscopically, what is myocarditis characterized by? What is the most common microscopic feature of myocarditis?
  • How does the myocardial injury heal?
A
20
Q

Pericarditis

  • What are the immediate hemodynamic complications associated with pericarditis?
  • What can this eventually progress into?
A
21
Q

This shows Infective endocarditis. What valve seems to be affected, and what are the arrows pointing to?

A
22
Q

Pathogenesis of Myocarditis

  • What viruses are usually associated with Myocarditis?
A
23
Q

Acute endocarditis

  • What does it refer to?
  • What organisms are generally responsible for it?
  • What kind of patient outcomes is it associated with?
A
24
Q

This is Lymphocytic myocarditis. How can you tell?

A

Lymphocytic myocarditis, with edema and associated myocyte injury.

25
Q

Pathogenesis of Infective Endocarditis

  • What organism accounts for most infections that occur on damaged or deformed valves?
  • What organism is associated with infective endocarditis in IV drug abusers?
  • What makes the HACEK group, and where are they found in the body?
A
26
Q
A
27
Q

Clinical Features of Myocarditis

  • Describe the broadness of the clinical features of Myocarditis
A
28
Q
  • What organism is responsible for Chagas disease?
  • Where does this organism live?
  • What happens to about 10% of people who have this disease?
  • What can happen to patients 10 to 20 years after getting Chagas?
A
29
Q

Describe the prognosis and adverse sequelae of Infective Endocarditis

A

Untreated IE is generally fatal.

30
Q
  • Infective Endocarditis is a microbial infection of the heart valves or the mural endocardium.
    • What forms because of this infection, and what is it made of?
    • What is usually destroyed in this condition?
    • Why does the classification of subacute and acute endocarditis sometimes not make sense?
A
31
Q

Clinical Features of Infective Endocarditis

  • How does acute endocarditis manifest?
  • When do murmors typically manifest?
  • What happens when patients are not treated properly?
  • How do you diagnosis this condition?
A
32
Q
  1. What bacteria is responsible for Lyme disease?
    • How often does this cause myocarditis? How is it treated?
  2. What other bacteria can cause myocarditis?
  3. What helminth can cause myocarditis?
A
33
Q

This is a photomicrograph of an NBTE lesion

  • What does the t and C stand for?
  • What do you notice about any inflammation in this photo?
A
34
Q

What host factors are associated with increased risk for infective endocarditis?

A
35
Q

This is Chagas myocarditis. How can you tell?

What is at the arrow?

A
36
Q
  • What is Pericarditis due to malignancy often associated with?
  • Describe how chronic pericarditis occurs
A
37
Q

Pathogenesis of Infective Endocarditis

  • Infective endocarditis can develop on previously normal valves, but cardiac abnormalities predispose to such infections. What abnormalities does this include?
    • What accounts for 10-20% of all cases of IE?
A
38
Q

How are acute and subacute endocarditis separated?

A
39
Q

Subacute endocarditis

  • What does it refer to?
  • What organisms are generally responsible for it?
  • What kind of patient outcomes is it associated with?
A

Cardio Week 5 (10 decks)

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