NMNC 4510 FINAL EXAM QUESTIONS AND ANSWERS SOLVED CORRECTLY GRADED A+
Infective Endocarditis? (3) - Answers infection w/ inflammation of the endocardium of the heart (lines
the inside of the heart).
- normally smooth but inflammation changes this.
- issues w/ heart fxn: heart's ability to beat, strength of contractions, weakness in septum itself.
Risk factors for infective endocarditis (IE)? (9) - Answers - recent dental work: introducing bacteria can
seep into the bloodstream and affect endocardium, may give prophylactic abx.
- pacemakers
- central lines
- IVDA
- hx of valve disorder-rheumatic fever and congenital defects of the heart
- aging adult
- renal dialysis
- UTI
- surgical procedures
What is rheumatic fever? - Answers autoimmune response that affects valves of the heart and causes
scarring.
- valves cannot open all the way because of the scarring.
- signs: joint pain because it attacks synovial joints, erythema of the skin.
Common pathogens in IE? (3) - Answers - staphylococcus aureus
- streptococcus virudans
- staphylococcus epidermidis
untreated streptococcus infections can cause rheumatic fever.
Most common valve affected by IE? - Answers mitral valve - between LA and LV
- if it's not opening fully, fluid coming from LA can't get to LV and backs up into the lungs.
- s/s: SOB, lung problems - crackles, pulmonary edema, diastolic murmur (maybe)
,- hearing new or worsening murmur is sign of endocarditis, especially mitral stenosis.
What can vegetation on the tricuspid valve lead to?
What can vegetation on the mitral valve lead to? (5) - Answers - tricuspid valve: between RA and RV,
vegetation can break off and flow to the lungs - pt gets PE.
- mitral valve: between LA and LV, vegetation can break off and flow out into the body - pt gets stroke,
renal infarct, sepsis, septic shock, splenomegaly.
L sided heart embolizations affect what? (5)
R sided heart embolizations affect what? - Answers L Sided:
- brain
- limb
- kidney
- liver
- spleen
R sided:
- lungs
Acute IE? (3)
Causes? (2) - Answers - healthy pts, sudden onset.
- sudden high fever.
- body doesn't have time to adjust to infection so compensatory mechanisms are not usually in place.
- causes: trauma (shot, stabbed, blunt force trauma), fast moving infection.
Subacute IE?
Causes? (2)
S/S? (5) - Answers - underlying condition, slow and gradual.
- causes: IVDA, rheumatic fever.
- s/s: malaise, fatigue, signs of decreased CO, low grade fever, micro emboli (back pain, abd discomfort,
clubbing of fingers).
, Non-infective Endocarditis? (2)
Causes? (2) - Answers - high risk for developing IE.
- not as common as acute and subacute types.
- causes: trauma, hypercoagulability.
S/S of IE? (4) - Answers - hallmark is worsening murmur
- fever, chills, fatigue, malaise
- if pt has renal infarct, will see hematuria
- splenomegaly due to back up of blood
S/S of IE:
Osler nodes? (3)
Janeway lesions? (4)
Roth's spots? (2) - Answers osler nodes:
- typically seen on toe pads or fingertips
- pinpoint purplish area tender to palpation
- infected piece of debris lodged itself into one of the tiny capillaries and is causing a localized immune
response
janeway lesions:
- from septic emboli
- more associated w/ bacterial endocarditis
- doesn't look pinpoint, more of a general round spot
- pads of feet, hands
roth's spots:
- seen in 80% of subacute cases
- little white dot in the middle w/ circle around it (retinal hemorrhages)
Infective Endocarditis? (3) - Answers infection w/ inflammation of the endocardium of the heart (lines
the inside of the heart).
- normally smooth but inflammation changes this.
- issues w/ heart fxn: heart's ability to beat, strength of contractions, weakness in septum itself.
Risk factors for infective endocarditis (IE)? (9) - Answers - recent dental work: introducing bacteria can
seep into the bloodstream and affect endocardium, may give prophylactic abx.
- pacemakers
- central lines
- IVDA
- hx of valve disorder-rheumatic fever and congenital defects of the heart
- aging adult
- renal dialysis
- UTI
- surgical procedures
What is rheumatic fever? - Answers autoimmune response that affects valves of the heart and causes
scarring.
- valves cannot open all the way because of the scarring.
- signs: joint pain because it attacks synovial joints, erythema of the skin.
Common pathogens in IE? (3) - Answers - staphylococcus aureus
- streptococcus virudans
- staphylococcus epidermidis
untreated streptococcus infections can cause rheumatic fever.
Most common valve affected by IE? - Answers mitral valve - between LA and LV
- if it's not opening fully, fluid coming from LA can't get to LV and backs up into the lungs.
- s/s: SOB, lung problems - crackles, pulmonary edema, diastolic murmur (maybe)
,- hearing new or worsening murmur is sign of endocarditis, especially mitral stenosis.
What can vegetation on the tricuspid valve lead to?
What can vegetation on the mitral valve lead to? (5) - Answers - tricuspid valve: between RA and RV,
vegetation can break off and flow to the lungs - pt gets PE.
- mitral valve: between LA and LV, vegetation can break off and flow out into the body - pt gets stroke,
renal infarct, sepsis, septic shock, splenomegaly.
L sided heart embolizations affect what? (5)
R sided heart embolizations affect what? - Answers L Sided:
- brain
- limb
- kidney
- liver
- spleen
R sided:
- lungs
Acute IE? (3)
Causes? (2) - Answers - healthy pts, sudden onset.
- sudden high fever.
- body doesn't have time to adjust to infection so compensatory mechanisms are not usually in place.
- causes: trauma (shot, stabbed, blunt force trauma), fast moving infection.
Subacute IE?
Causes? (2)
S/S? (5) - Answers - underlying condition, slow and gradual.
- causes: IVDA, rheumatic fever.
- s/s: malaise, fatigue, signs of decreased CO, low grade fever, micro emboli (back pain, abd discomfort,
clubbing of fingers).
, Non-infective Endocarditis? (2)
Causes? (2) - Answers - high risk for developing IE.
- not as common as acute and subacute types.
- causes: trauma, hypercoagulability.
S/S of IE? (4) - Answers - hallmark is worsening murmur
- fever, chills, fatigue, malaise
- if pt has renal infarct, will see hematuria
- splenomegaly due to back up of blood
S/S of IE:
Osler nodes? (3)
Janeway lesions? (4)
Roth's spots? (2) - Answers osler nodes:
- typically seen on toe pads or fingertips
- pinpoint purplish area tender to palpation
- infected piece of debris lodged itself into one of the tiny capillaries and is causing a localized immune
response
janeway lesions:
- from septic emboli
- more associated w/ bacterial endocarditis
- doesn't look pinpoint, more of a general round spot
- pads of feet, hands
roth's spots:
- seen in 80% of subacute cases
- little white dot in the middle w/ circle around it (retinal hemorrhages)
