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52 Cards in this Set
- Front
- Back
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most common cause of cardiac disease in pts<50years old worldwide
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acute rheumatic fever
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ARF is secondary to infection with ______
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Group A Strep
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major manifestations of ARF
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carditis
polyarthritis chorea |
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characs of strep bacteria
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gram-pos cocci in pairs or chains
faculatative anaerobes (most) ferment carbs, produce lactic acid catalase and oxidase negative |
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species of group A strep
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streptococcus pyogenes
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3 categories of diseases cuased by GAS
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1) suppurative: pharyngitis, skin lesions
2) non-suppurative: ARF, acute glomerulonepritis 3) toxic: TSS, scarlet fever |
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charac of GAS
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--Beta-hemolytic (total), encapsulated colonies
--Many strains (>80) differentiated by antigenic diffs in M proteins |
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location and function of M protein
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fimbriae
func: adhesin, anti-phagocytic |
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what makes up capsule of GAS
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hyaluronic acid
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virulence factors of s. pyogenes
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capsule - antiphagocytic
lipoteichoic acid M and F protein pyrogenic exotoxins streptolysin S, O, streptokinase DNase C5a peptidase |
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how are strains of s.pyogenes distiguished?
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antigenic differences in M protein
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SSx of ARF
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fever, joint pain, general weakness, SOB, easy tiring, new murmur, Hx of fever and pharyngitis in preceding weeks
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epitopes of M protein of rheumatogenic strains share antigenic determinants with _______
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cardiac myosin, sarcolemma membrane proteins, synovium and articular cartilage
(leads to autoimmune prob) |
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how is antecedent strep infection tested for?
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antibodies to streptolysin O
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Jones criteria for ARF diagnosis
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2 major manifestations or 1 major and 2 minor
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major manifestations of ARF
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carditis, arthritis, chorea, subcutaneous nodules, erythema marginatum
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minor manifestations of ARF
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fever, arthroalgia, elevated ESR, elevated CRP, prolonged PR interval
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leading cause of mitral valve stenosis and valve replacement in US
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Chronic Rheumatic HD
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SSx of infective endocarditis (subacute)
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insidious: fever, chills, night sweats, malaise, weakness, dyspnea, cough, heart murmur
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glue produced by organisms causing endocarditis
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dextran and adhesins (fimbriae)
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microbes assoc with subacute endocarditis
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viridans streptococci
enterococci HACEK group others |
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microbes assoc with acute endocarditis
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staph aureus
Beta-hemolytic strep others |
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microbes assoc with prosthetic valve endocarditis
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Staph epidermidis
Staph aureus candida sp |
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microbes assoc with endocarditis in IV drug users
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S. aureus
Group A strep Pseudomonas aeruginosa |
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types of viridans group strep
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S. mutans
S. mitis S. bovis S. sanguis |
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what does HACEK stand for?
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Haemophilus,
Actinobacillus, Cardiobacterium, Eikenella, Kingella |
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Where are HACEK bacteria?
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oral cavity
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NBTE
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What;s this?
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most common fungi causing endocarditis
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candida spp, aspergillys spp
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is aspergillus normal flora of body
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no
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how to treat fungi in the heart
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amphotericin B or one of the azoles
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most common cause of myocarditis when a cause can be identified
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coxsackievirus B and
adenovirus serogroups 2 and 5 |
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coxsackieviurses are what type of virus?
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small, nonenveloped ssRNA viruses
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where does coxsackievirus get in?
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intestinal epithelium via fecal/oral route
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What effect do TNF and IL-1 have on cardiac function?
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NO production by myocytes --> decreased contractility of myofibers
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anti-heart antibodies found in viral myocarditis and dilated cardiomyopathy
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anti-cardiac myosin
anti-beta adrenoreceptor anti-cardiac mitochondrial proteins |
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important bacterial cause of myocarditis
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corynebacterium diphtheria and
borrelia burgdorferi |
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vaccine for diphtheria
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DPT - DP toxoid
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characs of corynebacteria
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gram pos bacilli
irreg shape aerobe or facultative anaerobe non-motile |
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action of diphtheria toxin
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inhibits protein synthesis
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spirochete causing myocarditis
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borrelia burgdorferi
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reservoir and vector of B. burgdorferi
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res: mice
vec: ticks |
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myocarditis caused by lyme disease is manifest as varying degrees of ________
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heart block
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protozoa assoc with myocarditis in Chagas disease
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Trypanosoma cruzi
(parasites invade myocytes) |
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Reservoir and vector of T. cruzi
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Res: armadillo, rodents, dogs
Vec: reduviid bugs |
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SSx of pericarditis
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retrosternal chest pain, pericardial friction rub, dyspnea, tachycardia, fever, flu-like illness
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enteroviruses involved in pericarditis
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coxsackievirus B and A and Echovirus
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Where are HACEK bugs
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oral cavity
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pathogens found in endothelial cells in atherosclerotic lesions
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chlamydia and CMV
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inflammatory mediators involved in atherosclerotic plaque formation
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NO
CC-chemokins IL-1 TNF IL-8 |
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infiltrating macrophages in vessel intima ingest lipids and are transformed into ______
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foam cells
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foam cells form lesions called fatty ______
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streaks
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