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34 Cards in this Set
- Front
- Back
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what bug is common in transient/spontaneous bacteremia?
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viridans streptococci
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what are the origins of Primary bacteremia?
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IV or arterial line
usually normal flora of skin |
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What are the origins of Secondary bacteremia?
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subsequent to a document infection (lesions/abscess)
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what are the most common isolates in bacteremia?
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staphylococci and gram-negative bacilli
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What is SIRS's?
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Systemic Inflammatory Response Syndrome
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What is the definition of SIRS?
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two or more of
Fever above 100.5, or below 97 HR above 90bpm RR above 20 WBC's above 12,000 or below 4,000 |
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What is the definition of septic shock?
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sepsis plus:
MAP below 60mmHg requires drugs to maintain BP |
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What is the definition of sepsis?
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occurrence of SIRS due to microbes
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What is the definition of severe sepsis?
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sepsis (so SIRS + microbes) AND a sign of hypoperfusion or dysfunction
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What are the three goals of treating septic shock?
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resuscitate pt from shock
identify and treat source of infxn maintain organ function |
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What are the general characteristics of infective endocarditis
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valvular insufficiency
lots of infective emboli immune complexes |
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Who usually gets infective endocarditis ?
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men more commonly than women
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What are some of the predisposing factors to infective endocarditis ?
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Previous IE.
mitral valve prolapse rheumatic fever Calcific aortic stenosis Prosthetic valves |
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How does ACUTE infective endocarditis present?
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abrupt onset
FEVER complications within one week- dyspnea, fatigue, wide spectrum of complications |
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What is the most common bug in acute infective endocarditis ?
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staph aureus
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what is the presentation of Subacute infective endocarditis ?
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low grade fever
long onset to diagnosis about 6 weeks |
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what is the most common bug of subacute infective endocarditis ?
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viridans strep (from the mouth)
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what things lead to subacute infective endocarditis ?
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indiscriminate use of antibiotics
immunosuppressed pts |
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What is the morphology of Strep Bovis?
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G+, catalase -, non hemolytic
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Where are HACEK organisms found and what do they cause?
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these are typically upper respiratory bug
and they cause subacute infective endocarditis |
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What are the clinical manifestations of infective endocarditis ?
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petechiae
subungual hemorrhages* Osler nodes Janeway lesions Roth spots |
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What is the first step in infective endocarditis ?
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the heart endothelium must be damaged before bacteria can attach.
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What things causes the first stage of infective endocarditis ?
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trauma, defective valves or septum, other random changes due to stress, renal failure, malnutrition, neoplasia
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What are janeway lesions indicative of?
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acute infective endocarditis
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What are janeway lesions? where are they located?
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flat painless red-blue macules on the Palms and Soles
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What are splinter petechiae?
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these are linear hemorrhages in the middle of the nail bed
associated with infective endocarditis |
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What causes flea-bitten kidneys?
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this is glomerulonephritis due to circulating immune complexes in infective endocarditis
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What are Oslers Nodes?
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these are red painful nodules in the pads of fingers of toes.
made up of immune complexes |
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What does Oslers indicate?
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infective endocarditis
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What causes Roth spots in infective endocarditis ?
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circulating immune complexes
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What are the major criteria for infective endocarditis ?
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positive blood culutre
evidence of endocardial involvement |
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What are the minor criteria for infective endocarditis ?
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predisposed
fever vascular stuff immune stuff microbes echocardiograph is NOT major |
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how do you treat infective endocarditis
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long term IV bacteriaCIDAL drugs
up to 4-6 weeks |
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if antibiotics fail, how do you treat infective endocarditis ?
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surgery and prosthetic valves
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