Infective Endocarditis Flashcards Preview

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Flashcards in Infective Endocarditis Deck (19):
1

What is the first test you should order to determine the etiologic cause of IE?

Blood culture

2

What are Osler nodes?

Painful nodules on the palms and soles

3

What are Janeway lesions?

non-tender flat lesions on palms and soles

4

What are Roth spots?

Small vegetative emboli to the retina

5

List some symptoms of IE

Fever
New Murmur
Vegetation seen on echo
Osler node
Splinter hemorrhage
Janeway lesions
Roth spots
Conjunctival petechiae
Splenomegaly
Anemia
Hematuria

6

What 4 organisms (or groups of organisms) are most likely to cause bacterial endocarditis?

Viridans streptococci
Staph aureus
HACEK group
Enterococcus spp

7

Name the organisms in the HACEK Group

Haemophilis parainfluenzae
Actinobacillus Aggregatibacter
Cardiobacterium
Eikenella
Kingella

8

What are common reasons for negative blood cultures in endocarditis?

Fastidious organisms (hard to grow -- Anaerobes, HACEK)

Prior administration of antibiotics

Fungal IE

Non infective endocarditis

9

What valve is most commonly infected in IVDA IE?

Tricuspid valve

10

What organism most commonly causes IE in IVDAs?

Staph aureus

11

When should you start antibiotics when IE is suspected?

Wait until the blood cultures are positive

12

Definitive Duke Criteria for IE

Microorganisms shown by culture or histology in a vegetation

pathologic lesions (vegetation of intracardiac abscess present)

13

Major Duke Criteria for iE

Persistently + blood cultures for typical organism

Typical findings on echo

Endocardial damage (new regurgitant murmur)

Serological or cultural evidence of Coxiella burnetti

14

Minor Duke Criteria for IE

Fever
Predisposition
Vascular phenomena (embolism, Janeway lesions)
Immunologic phenomena
Microbiologic

15

What other test in addition to blood cultures could confirm diagnosis?

Transesophageal Echocardiogram

16

Why do we prefer transesophageal echo to transthoracic?

Transesophageal has over 90% likelihood of detecting a vegetation, while transthoracic only has 65%

17

What toxicities should you worry about with aminoglycosides?

Nephrotoxicity and Ototoxicity

18

How long do you treat endocarditis?

Prolonged therapy is indicated (2-6 weeks)
IV Antibiotics

19

How do you manage a patient who has acute aortic insufficiency and develops heart failure due to the damaged valve?

Valve replacement surgery

Decks in MHD Class (57):