Endocarditis

Question 1

All staphylococci are _ and _

Answer 1

All staphylococci are gram-positive cocci in clusters

Question 2

All staph are gram-postive, and _ positive

Answer 2

All staph are gram-postive, and catalase positive

Question 3

Not all staph are coagulase positive; specifically _ is coagulase positive

Answer 3

Not all staph are coagulase positive; specifically S aureus is coagulase positive

Question 4

S. aureus characteristics

Answer 4

S. aureus
* Gram positive cocci, catalase positive, grows on mannitol salt
* Coagulase positive
* Beta hemolytic
* Yellow/gold hue on plates

Question 5

Gram-positive cocci, gamma-hemolytic, coagulase negative, novobiocin sensitive

Answer 5

Gram-positive cocci, gamma-hemolytic, coagulase negative, novobiocin sensitive: s. epidermidis

Question 6

Gram positive cocci, gamma hemolytic, coagulase negative, novobiocin resistant

Answer 6

Gram positive cocci, gamma hemolytic, coagulase negative, novobiocin resistant: s. saprophyticus

Question 7

Associated with colonization of foreign objects due to biofilm formation

Answer 7

Associated with colonization of foreign objects due to biofilm formation: S epidermidis

Question 8

Normal inhabitant of GU and GI tracts and common cause of UTI

Answer 8

Normal inhabitant of GU and GI tracts and common cause of UTI: s saprophyticus

Question 9

Gram positive cocci in chains, catalase negative, alpha hemolytic

Answer 9

Gram positive cocci in chains, catalase negative, alpha hemolytic: strep. pneumoniae, strep. viridans

Question 10

Gram positive cocci in chains, catalase negative, beta hemolytic

Answer 10

Gram positive cocci in chains, catalase negative, beta hemolytic: strep. pyogenes, strep. agalactiae

Question 11

Gram positive cocci in chains, catalase negative, gamma hemolytic

Answer 11

Gram positive cocci in chains, catalase negative, gamma hemolytic: e. faecalis

Question 12

S. pyogenes (Group A strep) is novobiocin (sensitive/ resistance)

Answer 12

S. pyogenes (Group A strep) is novobiocin- sensitive

Question 13

Rheumatic fever develops because of antibodies to _ cross-react with _

Answer 13

Rheumatic fever develops because of antibodies to GAS “M” protein cross-react with myosin

Question 14

Within the viridans family, _ , _ , and _ are all associated with subacute infective endocarditis following dental procedures

Answer 14

Within the viridans family, s. mutans, s. sanguinis and s mitis are all associated with subacute infective endocarditis following dental procedures

Question 15

_ is the most common cause of acute infection of native, healthy heart valves; associated with IV drug use

Answer 15

S. aureus is the most common cause of acute infection of native, healthy heart valves; associated with IV drug use

Question 16

_ is the most common cause of subacute infection of damaged heart valves; can travel from oral cavity during dental procedures

Answer 16

Viridans is the most common cause of subacute infection of damaged heart valves; can travel from oral cavity during dental procedures

Question 17

_ is most common infection of prosthetic heart valves

Answer 17

S. epidermidis is most common infection of prosthetic heart valves

Question 18

The most common sx of infective endocarditis is _

Answer 18

The most common sx of infective endocarditis is fever

Question 19

IE post dental procedure but the causative organism takes 4 days to grow on plates:

Answer 19

IE post dental procedure but the causative organism takes 4 days to grow on plates: HACEK

Question 20

Pathogenesis of IE on a healthy, normal valve

Answer 20

(Endothelial) injury to the valve –>
Fibrin thrombus –>
Transient bacteremia –>
Bacteria adhere and colonize fibrin –>
Acute inflammation
Necrosis of the valve is possible

Question 21

Criteria for making IE diagnosis

Answer 21

Question 22

Nonbacterial thrombotic endocarditis is likely caused by increased _ in patients with conditions such as _

Answer 22

Nonbacterial thrombotic endocarditis is likely caused by increased hypercoagulability in patients with conditions such as Lupus, APS syndrome, Cancer
* Sterile fibrin vegetations form
* Can get infarctions from emboli
* Treatment: anticoagulate

Question 23

Nonbacterial thrombotic endocarditis usually targets _ valves

Answer 23

Nonbacterial thrombotic endocarditis usually targets mitral and aortic valves

Question 24

How do we diagnose rheumatic fever?

Answer 24

Jones criteria
J: joints (polyarthritis)
A: heart (pancarditis)
N: nodules
E: erythema marginatum
S: sydenham chorea

Question 25

Sx of infective endocarditis:

Answer 25