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11 Endocarditis
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23
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Kindergarten
11/15/2012

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Cards

Term
1. blood culture x 2 from 2 different sites
2. then start empiric antibiotics immediately/
Definition
If you suspect endocarditis from a history what is the next step ?
Term
Acute: aureus, pyogenes, pneumo, gonorrhaeae

subactue: viridans strep
Definition
Acute endocarditis Bacteria vs. Subacute
Term
acute: death < 6 weeks
subactue: death 6 wk - 3 mo
chronic; death >3 mo
Definition
Course of disease difference between acute, subacute, and chronic endocarditis
Term
high fever, systemic toxicity, leukocytosis
Definition
Acute presentation
Term
slow, indolent course
Prior valvular disease
Definition
subacute presentation
Term
Low grade fever, night sweats, wt. loss
Definition
chronic presentation
Term
M>A>M+A>T>P
Definition
Valves from increasing rate of infection with endocarditits
Term
1. 2 major
2. 1 major + 3 minor
3. 5 minor
Definition
What Duke criteria is needed for Dx:
Term
1. + blood cultures __> 2 different blood cultures
2. Echocardiogram evidence
Definition
Major Duke criteria
Term
NOT SUFFICIENT
Definition
worsening or changing of preexisting murmur is _______for DUKE criteria of endocarditis.
Term
1. predisposition
2. IV drug use
3. FV or temp >38 C
4. vascular phenomena
5. immunological phenomena
6. Microbio evidence- (1 positive culture )
Definition
Minor Duke criteria
Term
Atrial- AV
Ventricular- Semilunar
Definition
On what surface does pathologic changes occur on AV/Semilunar valves
Term
Right
Definition
What side of the heart will an IV drug user have endocarditis
Term
Left
Definition
Petechia/conjunctival hemorrhages are indicative of what sided heart endocarditis
Term
Abcess
Infarction
Glomerulonephritis
Definition
IF you get an embolus from the mass of bacterial endocarditis to the kidney you can get
Term
stroke, surgery immediately
Definition
CNS emboli leads to
Term
IV drug users
OR CATHETER (both right sided heart begetation)
Definition
Emboli to lungs are from what
Term
TEE- high patient risk (prosthetic, Congenetal Heart disease, previous endocarditis, new murmur, heart failure)

TTE- small children
Definition
TEE vs. TTE
Term
AV replacement with aortic repair. If the mass is big antibiotic probably won't clean it up.
Definition
If a patient has a mechanical valve with severe regurgitiation and + vegetation what do you do:
Term
Nafcillin
Definition
What antibiotic is used when vancomycin can't be for staph
Term
1. staph
2. viridans
Definition
Native valve endocarditis (top two)
Term
pseudomonas
Definition
IV drug user what are you worried about
Term
pts w/unifixed structural heart disease or previous IE

do not use for mitral valve w/ or without murmurs
Definition
When to use prophylaxis in pts
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