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House AMP > Infective Endocarditis > Flashcards

Infective Endocarditis Flashcards

1
Q

Infective Endocarditis

This is an _______, _______ disease of the heart

Characterized by ___________ of the _______ or the _______ by microbiological agents with the formation of ______,______ ———- laden with microbiologic agents

A

infectious; inflammatory

colonization or invasion

heart valves ; mural endothelium

bulky, friable vegetations

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2
Q

Infective Endocarditis

May also affect the _____,_________ and other sites

A

aorta, aneurysmal vessels

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3
Q

Infective Endocarditis

There are 2 clinical subtypes
- _____
- __________

A

Acute

Subacute

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4
Q

Infective Endocarditis

There are 2 clinical subtypes

In both cases, the organism affects the _______ causing _________ (called ______)

A

tissue

thrombus formation

vegetations

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5
Q

Infective Endocarditis

-Acute: a destructive infection on a previously (normal or damaged?) valve. The organisms are (mildly or highly?) virulent (eg ______).

Death occurs in _____% of cases

A

normal

highly; staph aureus

50

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6
Q

Infective Endocarditis

-Subacute: this is common in previously (normal or damaged?) heart.

Causative organisms are (more or less?) virulent (eg ________).

It pursues a ______ course and patient recovers after _____________

A

damaged

Less

S.viridans

protracted; appropriate antibiotic therapy.

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7
Q

PATHOGENESIS of infective endocarditis

1) Predisposing cardiac conditions

-________ heart disease
-________ heart disease
-___________ disease
- ___________________________ stenosis

A

Rheumatic

Congenital

Myxomatous mitral

Degenerative calcific valvular

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8
Q

PATHOGENESIS of infective endocarditis

2) Systemic conditions
- ______aenia
-__________ states (eg HIV)
-____________
- Chronic __________
- indwelling ________ (intracardiac/intravascular)
-____________ (injection)

A

Neutrop

Immunodeficiency

Diabetes Mellitus

alcoholism; catheters

Drug abusers

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9
Q

PATHOGENESIS of infective endocarditis

Implicated organisms include,
Bacteria-_____,_____,_____,______

-Gram ____.organisms (_______)
Viruses
fungi

A

S.viridans, S.faecalis
-Staph
-S.pneumoniae

neg; E.coli

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10
Q

MORPHOLOGY of infective endocarditis

•______,______ vegetations on heart valves

•___________ of the valves

•Organization and ______

A

Friable , bulky

Ring abscess

fibrosis

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11
Q

CLINICAL COURSE of infective endocarditis
Usually (specific or non-specific?)

Fever, malaise, loss of weight, _____ haemorrhage, _____ haemorrhage

A

non-specific

petechieal

subungal

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12
Q

CLINICAL COURSE of infective endocarditis

___________- embolism of the central arteries of the ______ may cause ____ shaped haemorrhagic spot with a _______

A

Roth’s spot

retina; canoe

pale centre

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13
Q

COMPLICATIONS of infective endocarditis : CARDIAC

______ insufficiency with ________

————— abscess with perforation

A

Valvular; cardiac failure

Myocardial ring

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14
Q

COMPLICATIONS of infective endocarditis : CARDIAC

________ pericarditis (as opposed to the ‘__________’ seen in rheumatic heart disease.

_________ of artificial valves

A

Suppurative

bread and butter

Dehiscence

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15
Q

COMPLICATIONS of infective endocarditis : RENAL

•________ ———-

•(Focal or diffuse?) glomerulonephritis leading to ________ and _______

A

Embolic infarcts

Focal

nephrotic syndrome and renal failure

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16
Q

COMPLICATIONS of infective endocarditis : RENAL

•Diffuse glomerulonephritis due to _________________

•Multiple ______ with ______ bacteria

A

Ag-Ab complex formation

renal Abscess

staphylococci

17
Q

NON-BACTERIAL THROMBOTIC ENDOCARDITIS
(NBTE)
Also called _________

A

Marantic Endocarditis

18
Q

NON-BACTERIAL THROMBOTIC ENDOCARDITIS
(NBTE)

Are ______ seen in patients with _______

A

Vegetations

debilitating illness

19
Q

NON-BACTERIAL THROMBOTIC ENDOCARDITIS
(NBTE)

Associated with _______ ———carcinoma

Also associated with ________ leukaemia

A

mucinous adeno

promyelocytic

20
Q

mucinous adenocarcinoma: Mucin has a ______ effect

promyelocytic leukaemia: ________ state

A

pro-coagulant

Hyperestrogenic

21
Q

NBTE : MORPHOLOGY

Deposition of (small or large?) (sterile or non-sterile?) _____ masses in _____ that are (normal or abnormal?) and vegetations do not contain _________

A

Small

Sterile

Fibrin; valve leaflets

Normal; micro-organisms

22
Q

NBTE: MORPHOLOGY

Mostly occurs in ______ and _____ valves

A

aortic and mitral

23
Q

NBTE May cause embolism

T/F

A

T

24
Q

Infective endocarditis in pre-existing NBTE is usual

T/F

A

F

unusual

25
Q

LIEBMAN-SACKS DISEASE

_____ and _______ valvulitis occuring in _____

A

Mitral & Tricuspid

SLE

26
Q

LIEBMAN-SACKS DISEASE

Morphology
Lesions are (small or large?) (1-4mm)

Lesions are (Sterile or non-sterile?) and (Granular or Agranular?)

A

Small

Sterile

Granular

27
Q

LIEBMAN-SACKS DISEASE

Morphology

Lesions are Located in _____ surface of _______

Lesions Consist of ______ material that contains ________ bodies

A

under

AV valves

eosinophilic; haematoxylin

28
Q

LIEBMAN-SACKS DISEASE

Morphology

Intense ______ with _________

Vegetations rarely ______ but often become ______

A

valvulitis; fibrinoid necrosis

embolises; fibrosed

29
Q

Differentiate between Rheumatic fever, NBTE, LSE, and infective endocarditis

In terms of lesions

A

Small, warty Firm, Friable

Small, warty Friable

Medium sized (small) Flat, verrucous Irregular

Large Bulky Irregular

30
Q

Differentiate between Rheumatic fever, NBTE, LSE, and infective endocarditis

In terms of sterility

A

Sterile

Sterile

Sterile

Non-Sterile

31
Q

Differentiate between Rheumatic fever, NBTE, LSE, and infective endocarditis

In terms of embolization

A

Embolization is uncommon

Embolization is uncommon

Embolization is uncommon

Embolization is common

32
Q

Differentiate between Rheumatic fever, NBTE, LSE, and infective endocarditis

In terms of conditions where it is found

A

In rheumatic heart disease

In Cas (M3-AML, pancreatic CA, DVT, TS

In SLE

In IE

33
Q

Differentiate between Rheumatic fever, NBTE, LSE, and infective endocarditis

In terms of location

A

Along lines of closure

Along lines of closure

Both surfaces of cusp but more of the under surafce…less commonly mural endocardium

Vegetations on the valve cusps.Less often on mural endocardium

34
Q

_______ is the most common overall cause of infectious endocarditis

A

Streptococcus viridans

35
Q

_______ is the most common cause of infectious endocarditis in IV drug users

A

Staphylococcus aureus

36
Q

Staphylococcus aureus most commonly infects ______ valve

A

Tricuspid

37
Q

Staphylococcus epidermidis is associated with endocarditis of _________

Streptococcus bovis is associated with endocarditis in patients with underlying ___________

A

prosthetic valves.

colorectal carcinoma.

38
Q

_________ organisms are associated with endocarditis with negative blood cultures.

A

HACEK

39
Q

HACEK organisms (______,_______,______,______,______)

A

Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella

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