Infective Heart Disease and HEart Failure Flashcards Preview

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Flashcards in Infective Heart Disease and HEart Failure Deck (22)
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1

What is teh most common s for infectious endocarditis?

staph aureus
staph epidermidis(coag neg)
virdan strep
enterococci

2

What are properties of successful IE pathogens?

survive antimicrobial components of serum
able to adhere to endocardium

3

What allows viridan strep to bind endocardium?

dextran(exopolysaccharide) and adhesins that mediate attachment to platelets and fibrin

4

What allows staph aureus to bind endocardium?

s. aureus, fibrinogen-binding adhesins

5

what is the life in a vegetation for infectious endocarditis?

-heterogenous matrix of deposited stuff
protection from immune cells
bacteria can achieve high density

6

What type of antibiotic therapy do you need for infectious herat disease

bactericidal activity
parental admin for sustained activity
long term tx

7

What is the mechanism of action of vancomycin?

binds to D-ala-Dala at the petpide size of peptidoglycan

8

What does daptomycin mechanism of action and spectrum?

bacteriaicidal, narrow spectrum
bind and disrupt cyctoplsmic membrane, possibly via loss of membrane potential

9

What does rifampin target adn mechanism of action?

binds to and inhibits RNA pol
bacteriacidal, gram pos

10

Gentamicin works well in combination with what?

30S inhibitor that works well with cell wall disrupters.

11

What are the predisposing procedures for endocarditis?

dental work or poor hygene, skin dsirupsttion
hemodialysis
IVDU
focal infection with typical organism

12

What is the clinical presentation of endocarditis?

acute or subacute onset
fever large majority
heart murmur80%
chills sweats 40-75%
anorexia malaise weight loss 25-50%
lab abnormalities

13

What are noncardiac manifestations of endocarditis?

embolic events
splenomegaly
clubbing
petechiae

14

What are the lab abnormalities associated with endocarditis?

anemia 70-90%
leukocytosis 20-30%
microscopic hematuria
elevated sed rate and c reactive protein

15

What are the most common causes of endocarditis in different pts pop?

strep and staph aureus for acute
coag neg staph for prosthetic
enterococcus in elderly

16

What are the culture negative endocarditises?

HACEK
Haemophilus aphrophilus
Actinobacillus
cardiobacterum hominis
eikenella corrodens
Kingell kingae

+ others

17

Diagnosis of endocardtisi is made how?

two major, one major plus 3 minor of Duke criteria

18

What are the major indications in the duke criteiria?

typical organism from 2 sep blood cx
organism from persistently pos blood cx
posserology for c. burnetti
evidence of endocardial involvment
-new valvurla regurgitation
-+echo

19

What are the minor indications of the duke criteria?

predisposition to infective endocarditis
fever
vascular phenomena
immunologic phenomena
microbologic not meeting major criteria

20

What are the indications for surgery in endocarditis?

CHF
prosthetic valve endocarditis
valve perforation or rupture
heart block
mutliple emoblicevent
uncontrolled infection on appropiate Rx
uncertain pathogen poorly tx (fungi)

21

What are compications of endocarditis?

cardiac -CHF,, Heart block, vlave failure, absecess or fistur
neurologic, embolic stroke, myotic aneurysm, menigintis
septic emboli abscesses

22

What are mycotic anuerysms?

usually silent until bleed, most common pperipheral MCA, most common with viridians strep