endocarditis 1

Question 1

what can cause endothelial damage that results in colonization by bacteria

Answer 1

1. jet lesions due to turbulent blood flow
2. electrodes or catheters (pacemakers)
3. IV drug abuse

Question 2

what sites of involvement are included in left sided infective endocarditis?

Answer 2

mitral valve or aortic valve

Question 3

left sided endocarditis has a higher risk of what

Answer 3

high risk of CNS stroke (strait shot to brain)

Question 4

what sites of involvement are included in right sided infective endocarditis?

Answer 4

tricuspid valve  
pulmonary valve (rare)

Question 5

who as at higher risk for right sided infective endocarditis

Answer 5

IV drag abusers

Question 6

what are the risk factors for infective endocarditis

Answer 6

1. chronic IV access
2. heart failure
3. IV drug abuse
4. previous endocarditis
5. prosthetic valves/ devises
6. exposure in health care setting
7. diabetes
8. heart disease
9. acquired valvular dysfunction
10. mitral valve prolapse with regurgitation

Question 7

what are the 3 main organisms that cause infective endocarditis

Answer 7

1. staphylococci (most common)
2. streptococci
3. enterococci

Question 8

what is the most common cause of infective endocarditis

Answer 8

MRSA

Question 9

what is the most likely organism involved in infective endocarditis in children

Answer 9

strep

Question 10

what is the most likely organism involved in infective endocarditis following a GI or urinary procedure

Answer 10

enterococci

Question 11

what is the name of the diagnostic standard for infective endocarditis

Answer 11

modified duke criteria

Question 12

what type of data is integrated in the modified duke criteria

Answer 12

1. clinical
2. lab
3. micro
4. echocardoigraphic

Question 13

what are the two major criteria that must be met to diagnose endocarditis

Answer 13

1. positive blood culture

2. evidence of IE in TTE or TEE

Question 14

what amount of criteria are needed to get a definite diagnosis of IE

Answer 14

2 major criteria
or 
1 major and 3 minor
or 
5 minor criteria

Question 15

what are the major criteria of diagnosing IE

Answer 15

1. positive blood culture

2. evidence of IE in TTE or TEE

Question 16

what are the minor criteria of diagnosing IE

Answer 16

1. predisposing heart condition
2. IV drug use
3. fever of 104
4. vascular phenomenon (emboli)
   5 aneurisms
5. eye spots
6. janway lesions (lesions on foot)

Question 17

what amount of criteria are needed to get a possible diagnosis of IE

Answer 17

1 major and 1 minor criteria
or
3 minor criteria

Question 18

what are 4 ways the modified duke criteria can reject a diagnosis of IE

Answer 18

1. firm alternative diagnosis
2. resolution of IE syndrome with antibiotics for less than four days
3. no pathologic evidence of IE at surgery or autopsy with antibiotic therapy of less than four days
4. does not meet possible criteria requirements