Infective Endo

Question 0

How common is IE?

Answer 0

Rare
2-6/100 000
M same as F

Question 1

What it infective endocarditis?

Answer 1

This is a bacterial or fungal infection of the heart valves or endocardium

Question 2

What is the mortality rate if IE?

Answer 2

20%

Question 3

What are the four types of IE?

Answer 3

Native valve
Prosthetic Valve
IVDU IE
Nosocomial IE

Question 4

Which diseases and problems are associated with native valve IE?

Answer 4

Congenital heart diseases
Rheumatic Herat disease
Mitral valve prolapse
Degenerative lesions

Question 5

Which organisms are assorted with native valve IE?

Answer 5

Strep viridans

Question 6

What are the two types of prosthetic heart valve IE?

Answer 6

Early and late

Early within 2 months of surgery

Question 7

Which organisms predominate in prosthetic heart valve?

Answer 7

Staphylococci

Question 8

Which side of the heart is re commonly affected in IVDU and which organisms associated with this type of IE?

Answer 8

Right sided 
Staph aureus (sometimes fungi)

Question 9

What predisposes to nosocomial IE?

Answer 9

IV lines and invasive procedures

More common in those older than 60

Question 10

Which side of the heart is affected in nosocomial IE?

Answer 10

Right sided dud to CVP lines and pulmonary artery Catherters

Question 11

What is the pathogenesis to IE?

Answer 11

Heart defect which creates pressure gradient across valve
Then you get and fibrin platelet clot
If you then get a bacteraemia the bacteria colonise the clot causing further fibrin deposition leading to a vegetation

Question 12

What is the key problem with IE with regards to the located of the organisms?

Answer 12

Once they are located inside the endocardium immune cells cannot reach them

Question 13

What host factors are associated with an increased risk of IE?

Answer 13

Rheumatic fever 
Invasive procedure 
Congenital abnormalities causing turbulent blood flow 
Cardiac conditions : 
Acquired valvular disease with stenosis and regurgitation
Valve replacement 
Structural Congenital heart disease 
Hyoertrophic cardiomyopathy

Question 14

What are the common organisms involved in IE?

Answer 14

Staph aureus
HACEK group
Culture negative group eg chlamydiaye

Question 15

What things can cause a transient bacteriaemia?

Answer 15

Tooth brushing
Dental procedures
Medial and surgical procedure

Question 16

What are the symptoms of IE?

Answer 16

Oilers nodes
Jane way lesions 
Roth spots 
splinter heamorrage 
Pyrexia
Haematuria
Splenomegaly

Question 17

What are oslers nodes?

Answer 17

Lesions on hand and fingers PAINFUL

Question 18

What are janeways lesions?

Answer 18

Painless spots on foot

Question 19

What are Roth spots?

Answer 19

Flame shaped retinal haemorrhage

Question 20

Diagnosis of IE is made based on what?

Answer 20

Major and minor criteria

Question 21

What major criteria exist for diagnosis of IE?

Answer 21

Positive blood culture and evidence of endocardium involvement

Question 22

What ,minor criteria exist?

Answer 22

Fever
Predisposition
Echocardiogram positive

Question 23

Which tests would you consider in IE?

Answer 23

FBC
Echocardiogram
Urine
ESR raised

Question 24

What would the FBC show?

Answer 24

Normocytic normochro mic anaemia

Question 25

What are the complication from IE?

Answer 25

Cardiac failure Death Emboli (pulmonary or cerebral) Renal failure

Question 26

Which heart defects are NOT associated with an increased risk if IE?

Answer 26

Isolated atrial septal defects Repaired ventricular septal defects Repaired patent ductus arteriosis Closure devices that have been endothelialised

Question 27

How can we prevent IE?

Answer 27

``` Inform patients re Tattoos Body piercing Improve access to oral care Prompt treatment for episodes of infection Educate on symptoms ```