Quiz II Flashcards
(35 cards)
infectious endocarditis begins..
on lines of closure/greatest pressure
atrial sirface of AV valves, ventricular surfaces of semilunar valves
what labs do you run if suspect infectious endocariditis?
blood culture! CBC, echo
Community acquired endocarditis organisms…
1/3 come back negative
S. aureus (30-50%)
alpha hemolytic strep/ S. viridans (10-35%)
enterococci (5-10%)
Staph epidermis
misc (E coli, Klebsiella, corynebacterium; if nutritional def)
fungi (<5%, if immunocompromised)
Nosocomial endocarditis organisms…
S. aureus (60-80%, majority MRSA)
alpha hemolytic strep (<5%)
Misc (E coli, Klebsiella, corynebacterium, 5-10%)
if culture is negative…
do a full work up and find a causal agent in 75%
Fungi is #1 cause of infectious endocarditis that shows up negative
risk factors for infectious endocarditis
poor dental health/deep dental work *GU infection, instrumentations (esp of GU tract) *impetigo pulmonary infections IV drug use RHD pts w artificial valve immunocompromised alcoholics (nutritional def) vascular grafts
** if immunocompromised
Acute endocarditis
high virulent organism: 1/2 die days-weeks even w tx
new murmur, intense sxs, dramatic onset, vegetations embolize
Sub-acute endocarditis
if already damaged valve. can have full recovery. Sxs: FROM JANE
endocarditis of native valves organism
strep viridens
endocarditis organism w prosthetic valve
Staph epidermidis
endocarditis organism w IV drug users
Staph aureus
endocarditis organism w alcoholics
anaerobes and oral cavity bugs
endocarditis organism after cytoscopy, prostatectomy, catheter
Gram neg, E. coli
endocarditis organism w colon carcinoma
Strep bovis
negative blood culture w endo might indicate
inflammatory/marantic: cancer (lung, pancreatic), SLE (Libman Sacks), hypercoaguable (Trosseau’s syndrome)
fungal
(marantic=non bacterial)
Myocarditis number 1 infectious organism
Coxsackie virus B
1 cause valve dz
aging
1 location of valve dz
aortic valve
least common=pulmonary
1 cause of RHD in the world
RHD
most frequent noted valvular abnormalities (2/3)
aortic and mitral valve stenosis
of these: Aortic stenosis most common
mitral valve prolapse affects what %?
3+% of adults in US, mostly women 20-40 yrs
mitral valve prolapse what kind of finding?
incidental. may –> serious complications in small minority
Sequelae of MVP
infective endocarditis
mitral insufficiency
stroke, systemic infarct
arrhythmias–> sudden death
Rheumatic fever is rare seq of what
group A beta hemolytic Strep pyrogenes pharyngitis. probably due to autoimmune response anti-streptococcal M protein antibodies which cross-react w cardiac myosin
