carditis

Question 1

inflammation of the heart muscle

Answer 1

myocarditis

Question 2

most commonly affected in IE

Answer 2

heart valves

Question 3

how does IE occur

Answer 3

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

Question 4

how does IE cause a leaky valve

Answer 4

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

Question 5

Intracardiac effects include severe valvular

insufficiency, which may lead to:

Answer 5

• intractable congestive heart failure

- myocardial abscesses (foci of infection

Question 6

prototypic lesion of IE

Answer 6

vegetation

Question 7

what are vegetations

Answer 7

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

Question 8

Febrile illness that rapidly damages cardiac

structures

Answer 8

acute endocarditis

Question 9

what is mycotic aneurism

Answer 9

ballooning of blood vessel due to bacteria

Question 10

bacteria that cause acute endocarditis

Answer 10

S aureus

Question 11

bacteria that cause subacute endocarditis

Answer 11

S. viridans

Question 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

Answer 12

transient bacteremia

Question 13

HACEK

Answer 13

Haemophilus
Actinobacillus
Cardiobacteria
Eikenella
Kingella

Question 14

this causes Q fever

Answer 14

Coxiella burnetti

Question 15

most common cause of early prosthetic valve infections

Answer 15

Staphylococci

Question 16

how does NBTE develop?

Answer 16

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)

Question 17

conditions which lead to endothelial cell damage

Answer 17

RHD
CHD
MVP
Degenerative HD
Prosthetic valve replacement

Question 18

where does bacteria and platelets accumulate to produce NBTE

Answer 18

downstream or low-pressure side of valvular lesion

Question 19

this help bacteria colonize NBTE

Answer 19

Surface adherence factors

Question 20

this binds to platelet receptors

Answer 20

Strep sanguis

Question 21

this binds to fibronectin

Answer 21

S aureus

Question 22

where does S sanguis bind

Answer 22

platelet receptors

Question 23

where does S aureus bind

Answer 23

fibronectin

Question 24

four outcomes in the formation of vegetations

Answer 24

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

Question 25

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

Answer 25

abscess

Question 26

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

Answer 26

acute

Question 27

most common symptom of subacute IE

Answer 27

low grade fever

Question 28

manifestations seen in both types of endocarditis

Answer 28

``` murmurs roth spots petechial hemorrhages janeway lesions osler nodes ```

Question 29

changing murmur occurs when

Answer 29

valve leaflet is destroyed or chordae tendinae ruptures

Question 30

murmurs are less common in ____

Answer 30

R-sided endocarditis

Question 31

these are retinal hemorrhages with pale centers

Answer 31

roth spots or flame shaped hemorrhages

Question 32

Painless hemorrhagic plaques on the palms and | soles

Answer 32

janeway lesions

Question 33

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

Answer 33

osler nodes

Question 34

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

Answer 34

myocardial abscess formation extravascular site infection acute endocarditis

Question 35

test for the confirmation of IE

Answer 35

2D echo

Question 36

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

Answer 36

distinct round cannonball like pulmo emboli in R-sided endocarditis

Question 37

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

Answer 37

to rule out transient bacteremia which lasts abt 30 min

Question 38

doppler color flow allows assessment of

Answer 38

valve function myocardial contractility chamber volume

Question 39

Definite endocarditis accdg to duke criteria

Answer 39

2 major 1 maj 3 min 5 min

Question 40

possible endocarditis accdg to duke criteria

Answer 40

1 maj 1 min | 3 min

Question 41

therapy for IE must be

Answer 41

bactericidal and given for long periods

Question 42

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

Answer 42

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

Question 43

most important infectious agent for myocarditis

Answer 43

viruses

Question 44

single most important group of viruses for myocarditis

Answer 44

enteroviruses

Question 45

bacterial causes of myocarditis

Answer 45

legionella chlamydia borrelia burgdorferi

Question 46

fungal causes of myocarditis

Answer 46

aspergillus caandida cryptococcus

Question 47

parasitic causes of myocarditis

Answer 47

trypanosoma cruzi | trichinella spiralis

Question 48

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

Answer 48

skin infection

Question 49

if the pericardium is involved this sign may be present

Answer 49

friction rub

Question 50

ekg in myocarditis may present

Answer 50

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

Question 51

why echo is used in the diagnosis fo myocarditis

Answer 51

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

Question 52

why contrast enhanced MRI is used in the diagnosis fo myocarditi

Answer 52

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

Question 53

contraindicated in the treatment of myocarditis

Answer 53

Glucocorticosteroids and immunosuppresive drugs

Question 54

treatment for fulminant disease

Answer 54

cardiac transplant