MHD: Cardiac infections Flashcards Preview

MHD/Pharm Block 4 > MHD: Cardiac infections > Flashcards

Flashcards in MHD: Cardiac infections Deck (18):
1

List the heart valves in order of most likely to least likely to be affected by endocarditis

Mitral, aortic, tricuspid, pulmonary

2

What are the two types of infective endocarditis?

Subacute: associated with viridans Strep
Acute: associated with Staph aureus

3

What organisms are most likely to infect a native heart valve?

Streptococci (60-80%)
Staphylococci (20-35%)
HACEK

4

What organisms are most likely to infect a prosthetic heart valve

Staph aureus
Staph epidermidis

5

What organisms are most likely to infect a prosthetic heart valve >2 months after surgery?

Viridans strep
Staph epidermidis
Staph aureus

6

What organisms are most likely to cause infective endocarditis in IV drug users?

Staph aureus
G- bacilli (Pseudomonas)
Viridans strep
Candida

7

What is the most common cause of IE in community hospitals?

Staphylococci

8

What are the HACEK organisms?

Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella

9

What are the characteristic lesions associated with IE?

Splinter hemorrhages
Janeway lesions
Osler nodes
Roth Spots

10

What is the mechanism for lesion formation in IE?

Vegetations dislodge from valve surface and embolize to small vessels

11

What are the most common physical exam findings in infectious endocarditis?

Fever (90%)
Murmur (85%)
Peripheral lesions are far less frequent (

12

What is the timing difference between acute and subacute endocarditis?

Acute: rapid onset, 2-5 days
Subacute: 2-5 weeks

13

What is nonbacterial thrombotic endocarditis?

Tissue damage of a valve leads to formation of a thrombus. This thrombus can serve as a site for microorganism attachment

14

What property do organisms that are associated with IE have that non-associated organisms do not?

IE causing organisms adhere more avidly to normal heart valves due to adhesins: dextran, Fim A attach to damaged epithelia

15

What are the major lab studies for confirming diagnosis of infective endocarditis?

Blood cultures: growth from more than 1 sample
Transesophageal echocardiography: valve damage visible

16

What are the minor criteria for diagnosis of infective endocarditis?

1) Predisposing heart disease or IV drug use
2) High body temperature
3) Evidence of vascular phenomena
4) Immunological phenomena
5) Microbiologic evidence

17

General, how is infective endocarditis treated?

Combination antimicrobial therapy for several weeks

18

Describe the synergism in antibiotic treatment of IE

Cell wall synthesis inhibitors enhance the entry of aminoglycosides into the bacteria