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Block 12 Module 3 > carditis > Flashcards

Flashcards in carditis Deck (54):
1

inflammation of the heart muscle

myocarditis

2

most commonly affected in IE

heart valves

3

how does IE occur

when bacteria and occasionally fungi and other
microbes enter the bloodstream & attack the lining of
the heart or the heart valves

4

how does IE cause a leaky valve

there are vegetations or holes on valves or scarring of the valve tissue that may result in a leaky valve

5

Intracardiac effects include severe valvular
insufficiency, which may lead to:

-intractable congestive heart failure
-myocardial abscesses (foci of infection

6

prototypic lesion of IE

vegetation

7

what are vegetations

mass of platelets, fibrin, microcolonies of mcg and scant InFtory cells

8

Febrile illness that rapidly damages cardiac
structures

acute endocarditis

9

what is mycotic aneurism

ballooning of blood vessel due to bacteria

10

bacteria that cause acute endocarditis

S aureus

11

bacteria that cause subacute endocarditis

S. viridans

12

this usually occurs w/o ill effects but usually leads to IE in patients w/
an underlying CV lesion or w/ a suppressed immune
system

transient bacteremia

13

HACEK

Haemophilus
Actinobacillus
Cardiobacteria
Eikenella
Kingella

14

this causes Q fever

Coxiella burnetti

15

most common cause of early prosthetic valve infections

Staphylococci

16

how does NBTE develop?

Endothelial cells that line the inside of the heart and the
heart valve can become damaged leading to the
accumulation of platelets or uninfected platelet-fibrin
thrombus producing a condition called non-bacterial
thrombotic endocarditis (NBTE)

17

conditions which lead to endothelial cell damage

RHD
CHD
MVP
Degenerative HD
Prosthetic valve replacement

18

where does bacteria and platelets accumulate to produce NBTE

downstream or low-pressure side of valvular lesion

19

this help bacteria colonize NBTE

Surface adherence factors

20

this binds to platelet receptors

Strep sanguis

21

this binds to fibronectin

S aureus

22

where does S sanguis bind

platelet receptors

23

where does S aureus bind

fibronectin

24

four outcomes in the formation of vegetations

1. damage to intracardiac structures
2. embolization of vegetation fragments
3. Hematogenous infection of sites during bacteremia
4. Tissue injury due to the deposition of circulating
immune complexes or immune responses to
deposited bacterial antigens

25

the symptoms of acute IE is similar to the presence of what

abscess

26

which has a rapid onset of symptoms (acute or subacute)

acute

27

most common symptom of subacute IE

low grade fever

28

manifestations seen in both types of endocarditis

murmurs
roth spots
petechial hemorrhages
janeway lesions
osler nodes

29

changing murmur occurs when

valve leaflet is destroyed or chordae tendinae ruptures

30

murmurs are less common in ____

R-sided endocarditis

31

these are retinal hemorrhages with pale centers

roth spots or flame shaped hemorrhages

32

Painless hemorrhagic plaques on the palms and
soles

janeway lesions

33

Small, pea-sized subcutaneous, painful
erythematous nodules that occur in the pads of the
fingers and toes and the thenar eminence

osler nodes

34

In IE lab results, peripheral leukocyte count is not normal in what conditions

myocardial abscess formation
extravascular site infection
acute endocarditis

35

test for the confirmation of IE

2D echo

36

what are the findings in the chest x-ray in IE

distinct round cannonball like pulmo emboli in R-sided endocarditis

37

1 do you need to do an hourly blood culture at different sites of the body

to rule out transient bacteremia which lasts abt 30 min

38

doppler color flow allows assessment of

valve function
myocardial contractility
chamber volume

39

Definite endocarditis accdg to duke criteria

2 major
1 maj 3 min
5 min

40

possible endocarditis accdg to duke criteria

1 maj 1 min
3 min

41

therapy for IE must be

bactericidal and given for long periods

42

High risk cardiac lesions for which endocarditis prophylaxis is advised before dental procedure

prosthetic HV
prior endocarditis
unrepaired cyanotic CHD
completely repaired CHD
valvulopathy after cardiac transplant

43

most important infectious agent for myocarditis

viruses

44

single most important group of viruses for myocarditis

enteroviruses

45

bacterial causes of myocarditis

legionella chlamydia
borrelia
burgdorferi

46

fungal causes of myocarditis

aspergillus
caandida
cryptococcus

47

parasitic causes of myocarditis

trypanosoma cruzi
trichinella spiralis

48

before the heart effects are seen in myocarditis what is usually the manifestation

skin infection

49

if the pericardium is involved this sign may be present

friction rub

50

ekg in myocarditis may present

ST and T wave changes, vent or atrial arrhythmias
conduction defects

51

why echo is used in the diagnosis fo myocarditis

assess cardiac contractility,
chamber size, valve function and wall thickness

52

why contrast enhanced MRI is used in the diagnosis fo myocarditi

detect the extent and degree of IFN
determine parameters that correlate with LV function

53

contraindicated in the treatment of myocarditis

Glucocorticosteroids and immunosuppresive drugs

54

treatment for fulminant disease

cardiac transplant