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23 Cards in this Set
- Front
- Back
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What is the pathogenesis of CV infections?
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1. Valvular lesions create endothelial injury
2. Platelets accumulate 3. Bacteria latch on here 4. Formation of biofilm 5. Bacteria can't be eradicated |
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What are the clinical manifestations of CV infections?
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Fever
Anorexia Malaise Night sweats New/worsened murmurs Splenomegaly Peripheral findings Back pin |
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What are the typical lab findings of CV infections?
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Leukocytosis
Anemia Elevated sed rate Positive blood cultures |
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What are typical EKG findings of CV infections?
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Sinus tachycardia due to problems with regurgitation
Bradycardias if the infection extends into the conduction system |
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What are cardiac consequences of CV infections?
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CHF
Acute MIs Pericarditis, hemopericardium, tamponade Perivalvular abscess Fistulas |
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What is a major hematologic complication secondary to CV infections?
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Embolism to many different places
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What are the neurologic consequences of CV infections?
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Stroke (esp. in context of fever)
Mycotic aneurysms Meningitis Intracranial hemorrhage |
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What are immunologic consequences of CV infections?
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Splenomegaly
Interstitial nephritis --> hematuria, renal failure |
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What are some skin/eye findings in CV infections?
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Petechiae (eye)
Osler nodes (end of fingers0 Splinter hemorrhages Janeway lesions (in feet) Roth spots (inside the eye) |
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What are the two clinical classifications of endocarditis?
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Acute
Subacute |
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What are the characteristics of ABE?
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Rapid presentation
Occurs in normal hearts |
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What is the normal microorganism responsible for ABE?
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S. aureus
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What are the characteristics of SBE?
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Slower
Less virulent organisms Often in damaged hearts |
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What are the main microbial suspects for endocarditis?
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Gram positives
Streptococci (viridans) Enterococci S. aureus Coag. negative (more in prosthetic valve endocarditis) |
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What are some of the major Duke criteria?
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2 separate + blood cultures
New murmur Veggie on echo Detachment of prosthetic valve Myocardial abscess |
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What are some of the minor Duke criteria?
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IV drug abuse
Febrile Vascular phenomenon Immunologic phemonena Minor echo findings |
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What are the requirements for a positive diagnosis of endocarditis with the Duke criteria?
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Two major criteria
One major, three minor criteria Five minor criteria |
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What is the medical treatment for endocarditis?
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Lots of antibiotics
Prolonged duration! |
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What are the indications for surgical treatment of endocarditis?
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Persistent bacteremia
Recurrent thromboembolism Severe valvular dysfunction Myocardial abscesses Fungal endocarditis |
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What types of people should you give prophylaxis to for endocarditis?
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Prosthetic cardiac valves
Previous endocarditis Congenital heart lesions Transplans |
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To the people who need prophylaxis for endocarditis, when should you give them drugs?
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Dental procedures
Upper respiratory tract procedures ONLY IF it involves incision/biopsy of mucosa GU infections Infected skin, etc. |
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What drugs should you give for endocarditis prophylaxis?
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Oral amoxicillin 1 hr. before procedure
IV ampicillin Other |
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What people are at particularly high risk for CV infections?
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People with foreign material inside the heart
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