Ix and Mx

Question 1

Name 4 major investigations for IE?

Answer 1

1. Bloods
   FBC, ESR, Culture

• Blood culture - 3 samples in 24 hours
  2. Urine
  3. ECG

4 ECHO - Transthoracic / TOE

Question 2

Result of blood test in IE?

Answer 2

1. Raised ESR and CRP
2. Chronic normocytic anaemia
3. result of culture (x3 12 hours apart)

Question 3

Result of urinalysis

Answer 3

microhaematuria

Question 4

Result of ECG?

Answer 4

New AV block

Question 5

How is diagnosis made?

Answer 5

Duke’s criteria

Question 6

What is the ‘Duke’s criteria’

Answer 6

1. Used to make the diagnosis of IE
   - Blood culture is positive
2. 2 major criteria
3. 1 major and 3 minor criteria
4. 5 minor criteria

Question 7

What is the ‘major criteria’ in Duke’s?

Answer 7

1. 2 positive blood cultures

2. Evidence of endocardial involvement - echo showing abscess/new murmur

Question 8

What is the ‘minor criteria’ in Duke’s?

Answer 8

1. Predespositiion - congenital heart disease/IVDU
2. Fever > 38
3. Vascular phenomena - emboli, clubbing, splinter haem
4. Immunological - osler’s nodes, roth spots