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52 Cards in this Set

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