Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
26 Cards in this Set
- Front
- Back
|
what is endocarditis? which one is worse, acute or chronic?
|
microbial infection of the endocardium of the heart, predominantly involving the valvular surface.
acute is worse |
|
|
The source of endocarditis is _____, the source of pericarditis is ______
|
bacterial
viral |
|
|
what population has the greatest overall incidence of endocarditis? what population has the greatest individual risk?
|
prosthetic valves
IVDA |
|
|
what are the congenital cardiac anomalies that get endocarditis?
|
PDA
VSD Bicuspid aortic valve |
|
|
what is the most common overall organism of endocarditis in non-traumatic and non valvular diseae? which pathogen is most common associated w/ IVDA in traumatic and valvular dz?
|
S. viridans
S. aureus |
|
|
what bug is most likely the cause of endocarditis within 60 days of valve surgery?
|
s. epidermidis
|
|
|
what is the pathophysiology of endocarditis?
|
injury to the endothelium (high velocity jet impacting on surface, flow form high to low Pressure area, flow through narrow orifice) --> platelet adherence and initiation of the clotting cascade --> bacterial resistance to immunity
|
|
|
what are the four clinical complications of endocarditis?
|
Local destructive effects of bacteria
Embolization of bland or septic fragments Hematologic seeding of remote sites Chronic antibody response with host vs host reaction |
|
|
what are the clinical features of endocarditis?
|
Fever
New Heart Murmur Splenomegaly Petechiae Splinter hemorrhages Osler’s nodes Musculoskeletal symptoms Systemic emboli Neurological symptoms Congestive Heart Failure Renal insufficiency or failure |
|
|
how do you make a definitive diagnosis of endocarditis?
|
positive blood cultures and visible vegetations
or 2 major criteria or one major and 3 minor criteria |
|
|
what bug is most likely the cause of endocarditis within 60 days of valve surgery?
|
s. epidermidis
|
|
|
what is the pathophysiology of endocarditis?
|
injury to the endothelium (high velocity jet impacting on surface, flow form high to low Pressure area, flow through narrow orifice) --> platelet adherence and initiation of the clotting cascade --> bacterial resistance to immunity
|
|
|
what are the four clinical complications of endocarditis?
|
Local destructive effects of bacteria
Embolization of bland or septic fragments Hematologic seeding of remote sites Chronic antibody response with host vs host reaction |
|
|
what are the clinical features of endocarditis?
|
Fever
New Heart Murmur Splenomegaly Petechiae Splinter hemorrhages Osler’s nodes Musculoskeletal symptoms Systemic emboli Neurological symptoms Congestive Heart Failure Renal insufficiency or failure |
|
|
how do you make a definitive diagnosis of endocarditis?
|
2 major criteria
or one major and 3 minor criteria |
|
|
what are the major criteria for diagnosing endocarditis?
|
positive blood cultures (at least 2 drawn 12 hours apart at different sites)
visible vegetative lesion on echocardiogram new valvular regurgitation |
|
|
what are the minor criteria for diagnosing endocarditis?
|
Persistent fever
Vascular phenomena (emboli, stroke, conjunctival hemorrhage) Immunologic phenomena (rheumatoid factor, Roth’s spots, Osler’s nodes, renal inflammation) Thickened valves on echo without clear vegetation |
|
|
how do you tx endocarditis nonsurgically?
|
combo of bacteriocidal and bacteriostatic abs--IV administration for about 6 weeks
|
|
|
when do you surgically tx endocarditis?
|
refractory bacteremia
severe valve distruction major or recurrent emboli very large vegetations perivalvular abcess |
|
|
what situations/ heart conditions warrant antibiotic prophylaxis to prevent endocarditis?
|
valvular stenosis or regurgitation
VSD any valve replacement mitral valve prolapse w/ regurg any prior endocarditis |
|
|
what is the definition of myocarditis?
|
inflammation/infection of the myocardium; injury to the functional myocardial tissue
|
|
|
what are the etiologies of myocarditis?
|
VIRUS- MC
coxsackie but in all viral infections except common rhinoviruses can be caused by parasitic (chagas dz) |
|
|
what does myocarditis often present with?
|
rapidly progressive congestive heart failure
|
|
|
how do you diagnose myocarditis?
|
clinical symptoms
echo to confirm LV involvement testing for particular viral agent |
|
|
how do you tx myocarditis?
|
by txing CHF: Diuretics, ACE-I, B-blocker
|
|
|
what percentage of myocarditis pts spontaneously resolve?
|
50%
|
