Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CRRAB 1 > Diebel Week 1 > Flashcards

Diebel Week 1 Flashcards

(88 cards)

Start Studying
1
Q

What are the normal biota of the cardiovascular system?

A

none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the natural defenses found in the cardiovascular system?

A

complement, white blood cells and antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define infectious endocarditis

A

inflammation of the inner lining of the heart (endocardium) typically caused by infection; usually mitral or aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the usual cause of acute endocarditis?

A

results of an overwhelming bloodstream challenge with bacteria with ability to colonize normal heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define vegetations

A

growth on the valves composed of fibrin, WBC, biofilm and bacteria; hampers cardiac function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the usual cause of subacute endocarditis?

A

develops slowly, less pronounced sx, preceded by prior damage to heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of subacute endocarditis

A

fever, anemia, abnormal heartbeat and sometimes abdominal or side pain; may look very ill and may have petechiae, septic emboli, Roth’s spots, splinter hemorrhages under the fingernails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of endocarditis may cause a large spleen?

A

subacute endocarditis; dt chronically fighting bacteria in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Note the temporal evolution of acute endocarditis?

A

hectically febrile to rapidly damages cardiac structures to seeds infection in distal sites through sepsis to death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are largely the causes of acute endocarditis?

A

Staphylococcus aureus and Streptococcus pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are largely the causes of subacute endocarditis?

A

Streptococcal viridans and enterococcal species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the temporal evolution of subacute endocarditis?

A

indolent course of infection to causes structural cardiac damage slowly to rarely seed infection at distal sites to gradually progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What hemolysis is viridans?

A

alpha hemolytic on blood agar plates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the portals of entry for endocarditis?

A

oral cavity, skin and upper respiratory tract are the primary infection sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where is the local infection for endocarditis in the heart?

A

mitral valve, tricuspid valve (injection drug use) and prosthetic valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What two things can give you a presumptive dx for endocarditis?

A

fever and valvular abnormalities (known injection drug use is also helpful)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the range for fever in subacute infectious endocarditis?

A

usually less than 103F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the temperature seen in acute infectious endocarditis?

A

103 to 104F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a positive Duke Criteria for infectious endocarditis?

A

2 major criteria met, 1 major and 3 minor criteria met or 5 minor criteria met

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Can the Duke Criteria dx be overridden

A

Yes-if alternative dx is established, sx resolve and do not recur with less than 5 days of abx therapy or lack of histological evidence of endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What criteria denotes possible endocarditis?

A

1 major and 1 minor or 3 minor criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the 2 Duke Major Criteria?

A
  1. Positive Blood Culture

2. Evidence of endocardial involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What bacteria are included in a positive blood culture for Duke Major Criteria?

A

viridans streptococci or Streptococcus bovis or HACEK group microorganisms or Staph aureus or enterococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How many positive cultures of blood samples drawn how many hours apart for a positive blood culture?

A

2+, more than 12 hours apart or all of 3+ or majority of 4 separate cultures drawn within an hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What if detected in a single blood culture plus a positive IgG antibody titer is a positive blood culture for Duke Major Criteria?
Coxiella bruentii (Q fever)
26
What 3 things are evidences of endocardial involvement for a Duke Major Criteria?
1. oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets or on implanted material 2. abscess 3. new partial dehiscence of prosthetic valve or new valvular regugitation
27
What are the 5 Duke Minor Criteria?
1. predisposition (heart condition of injection drug use) 2. fever above 100.4F 3. vascular phenomena 4. immunological phenomena 5. microbiological evidence
28
Name vascular phenomena in endocarditis that are a Duke Minor Criteria?
arterial emboli, Roth's spots
29
Name immunological phenomena in endocarditis that are a Duke Minor Criteria
Osler's nodes, rheumatoid factor, glomerulonephritis, Janeway lesions
30
Name microbiological evidence that meet the Duke Minor Criteria for endocarditis
positive blood culture but not meeting major criterion
31
Name the organisms that make up HACEK
Haemophilus, Aggregatibacter (Actinobacillus), Cardiobacterium, Eikenella, Kingella
32
Describe the group that the HACEK organisms belong to
group of fastidious gram negative bacteria (won't grow on regular plate--need chocolate agar)
33
Are HACEK a more or less common cause of endocarditis?
less common cause
34
What can cause endocarditis but are a normal part of the human microbiome within the oral-pharyngeal region?
HACEK organisms (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella)
35
What do you use to tx subacute endocarditis?
gear tx towards a strep infection: AMPICILLIN/SUBLACTAM + GENTAMICIN or TOBRAMYCIN; or VANCOMYCIN + CEFTRIAXONE
36
What abx are good for Staph aureus but NOT MRSA?
nafcillin or oxacillin +/-gentamicin or tobramycin (think naf for staph)
37
What abx is good for gram (+) multidrug-resistant bacteria only including MRSA, S.epidermidis, Enterococcus species, Clostridium difficile
Vancomycin
38
What abx is good for severe gram (-) rod infections and works synergistically with beta-lactam antibiotics?
gentamicin (an aminoglycoside); also works on HACEK organisms
39
penicillinase-sensitive penicillin; extended spectrum penicillin
Ampicillin
40
What is used against S. pneumoniae, S.pyogenes, Actinomyces, N. meningitidis, T. pallidum?
Penicillin (G or V)
41
a beta-lactamase inhibitor; often added to penicillin antibiotics to protect the penicillin from destruction
sublactam
42
3rd generation cephalosporin; used for serious gram (-) infections including N. gonorrheae, N. meningitidis and disseminate Lyme disease
Ceftriaxone
43
If pt. has a penicillin allergy what do you use to treat endocarditis?
cephalosporins (3rd to 5th generation) or carbapenems or vacomycin
44
what is the most common cause overall of endocarditis?
Staphylococcus aureus
45
gram positive facultative anaerobe
Staphylococcus aureus
46
What are the virulence factors of Staphylococcus aureus?
biofilm formation, capsule, adhesins, secreted enzymes and hemolysins, and pathogenicity islands for methicillin resistance
47
bacteria, gram +, cocci, catalase +, cogaulase +
Staph aureus
48
most common infectious agent of the skin; superficial infections like boils or abscesses, can produce several toxins that lead to serious toxin-mediated diseases
Staphylococcus aureus
49
Describe the clinical presentation of Staphylococcus aureus
localized skin/subq infection (impetigo, cellutlitis, folliculitis, furuncles, carbuncles; common infectious agent of surgical wounds
50
What does Staph aureus use to colonize the skin?
protein A (binds Fc portion of IgG), coagulase (forms fibrin coat around the organisms), hemolysins and leukocidins (destroy RBCs and WBCs)
51
How does an infection reach the blood stream?
neutrophils localize to the infection site and purulent abscesses form, then skin/subq infections may more deeply invade and reach blood stream
52
What are the virulence factors for deep tissue invasion of Staphylococcus aureus?
hyaluronidase (breaks down connective tissue), staphylokinase (lyses formed clots), lipase (breaks down fat)
53
What is the 2nd major cause overall of endocarditis?
Streptococcal species (viridians); several oral Streptococcal species possible
54
What species usually involves underlying mitral valve damage (rheumatic fever, etc) which provides the site for bacterial colonization?
Streptococcal species (viridans); often S. mutans
55
What can viridans species of Streptococcus produce to assist in colonization?
dextran for glycocalyx formation and surface adhesion proteins
56
What is the 3rd major overall cause of endocarditis?
Enterococcus species
57
What cause of endocarditis is most frequently found following genitourinary procedures in older men and obstetric procedures in younger women?
enterococcus species (preceded by bacteremia)
58
Name the virulence factors of enterococcus species?
pili, surface proteins, extracellular enzymes like proteases and hyaluronidases
59
What causes endocarditis but is usually resistant to penicillin and carbepenems?
Enterococcus species
60
Describe the clinical presentation of Streptococcus pyogenes
1. localized skin/subcutaneous infection=impetigo, erysipelas, cellulitis 2. toxin-mediated=toxic shock syndrome, necrotizing fasciitis
61
What bacteria can colonize the skin (following trauma) leading to colonization to inflammation to pustular lesions and honeycomb-like crusts (impetigo)?
Streptococcus pyogenes
62
What do deeper infections of Streptococcus pyogenes cause?
erysipelas and cellulits
63
Invasion from skin infections of Streptococcus pyogenes can lead to what? but NOT what?
can lead to glomerulonephritis but not Rheumatic fever
64
Name the important virulence factors for spread and inflammation of Streptococcus pyogenes?
Streptokinase (converts plasminogen to plamsin), M protein (resists phagocytosis), Hyaluronidase (breaks down connective tissue), DNase (digests DNA), Streptolysin O (destroys RBCs), Streptolysin S (destroys WBCs)
65
pathway to toxic shock syndrome from skin (Streptococcus pyogenes)
skin infection (cellulitis) to systemic release of pyrogenic exotoxins A (superantigen) to polyclonal activation of T cells to acute fever, shock, multi-organ failure
66
pathway to Necrotizing fasciitis (Streptococcus pyogenes)
trauma allows for deep seated infection to release of exotoxin B (protease) to rapid necrosis along fascial planes with no damage to muscles
67
cause of Rheumatic Heart Disease
Streptococcus pyogenes pharyngitis (genetically predisposed individuals)
68
What is a definitive clinical indicator of Streptococcus pyogenes?
mitral stenosis following pharyngitis with a rash is a definitive clinical indicator
69
What is the cause of the damage to the heart muscles valves in Rheumatic heart disease?
autoantibodies (antibodies to bacterial antigens cross-react with meromyosin in the heart); a type 2 hypersensitivity
70
Name the risk factors for rheumatic heart disease
strep throat infection (prolonged/untreated); prior case of rheumatic fever; age 5 to 15 years old
71
Symptoms of Rheumatic Heart Disease
usually appear 2 to 4 weeks after strep infection; pain swelling in large joints, fever, weakness, muscle aches, shortness of breath, chest pain, nausea and vomitting, hacking cough, circular rash, lumps under the skin
72
Inflammation of the myocardium (middle layer of the heart wall); usually cuased by a viral infection (coxsackievirus B and adenovirus in children)
Myocarditis
73
possible cause of chest pain, heart failure, and abnormal heart rhythms
Myocarditis
74
name a virus, ssRNA (+), Group IV, nonsegmented, icosahedral nucleocapsid, noneveloped, picornaviridae, enterovirus
Coxsackievirus B
75
Define pericarditis
inflammation of the pericardium (sac-like membrane surrounding the heart)
76
Is pericarditis typically acute or chronic?
acute
77
What is the usual cause of pericarditis
coxsackieviruses A and B, echoviruses and influenza virus; usually during summer months with increase in enterovirus infections
78
chest pain associated with the irritated layers of the pericardium rubbing against each other
pericarditis
79
Name three picornaviruses that cause carditis
coxsackie A virus, cosackie B virus, echovirus
80
What is the cause of Rocky Mountain Spotted Fever ?
bacterium Rickettsia rickettsii
81
What are the symptoms of Rocky Mountain Spotted Fever?
fever, headache, abdominal pain, vomiting, muscle pain, rash starting from extremeties
82
What is the classic triad that can be diagnostic of Rocky Mountain Spotted Fever?
fever, headache, rash and in an area with known ticks (can be later confirmed with lab tests)
83
What is the first line tx of Rocky Mountain Spotted Fever?
Doxycycline (effective is started before teh 5th day of sx)
84
Name two obligate intracellular parasites that need host ATP
chlamydiae and rickettsiae
85
Name three causes of palm and sole rash
RMSF, syphillus, coxsackievirus
86
Where does rickettsia ricettsii proliferate?
in endothelial cells
87
what is the vector for Rickettsia rickettsii?
Dermacentor wood or dog tick
88
What is the cause of the rash in rickettsia rickettsii?
inflammation of endothelial lining of small blood vessels to maculpapular rash from palms and soles spreading to the trunk to vasculitis to headache and CNS, renal damage to death

CRRAB 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions