NMNC 4510 FINAL EXAM 2025
QUESTIONS AND ANSWERS
Infective Endocarditis? (3) - ANS 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) - ANS - 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? - ANS 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.
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,Common pathogens in IE? (3) - ANS - staphylococcus aureus
- streptococcus virudans
- staphylococcus epidermidis
untreated streptococcus infections can cause rheumatic fever.
Most common valve affected by IE? - ANS 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) - ANS - 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? - ANS L Sided:
- brain
- limb
- kidney
- liver
- spleen
R sided:
- lungs
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, Acute IE? (3)
Causes? (2) - ANS - 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) - ANS - 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) - ANS - high risk for developing IE.
- not as common as acute and subacute types.
- causes: trauma, hypercoagulability.
S/S of IE? (4) - ANS - 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)
COPYRIGHT © 2025 BRAINBARTER ALL RIGHTS RESERVED 3
QUESTIONS AND ANSWERS
Infective Endocarditis? (3) - ANS 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) - ANS - 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? - ANS 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.
COPYRIGHT © 2025 BRAINBARTER ALL RIGHTS RESERVED 1
,Common pathogens in IE? (3) - ANS - staphylococcus aureus
- streptococcus virudans
- staphylococcus epidermidis
untreated streptococcus infections can cause rheumatic fever.
Most common valve affected by IE? - ANS 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) - ANS - 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? - ANS L Sided:
- brain
- limb
- kidney
- liver
- spleen
R sided:
- lungs
COPYRIGHT © 2025 BRAINBARTER ALL RIGHTS RESERVED 2
, Acute IE? (3)
Causes? (2) - ANS - 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) - ANS - 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) - ANS - high risk for developing IE.
- not as common as acute and subacute types.
- causes: trauma, hypercoagulability.
S/S of IE? (4) - ANS - 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)
COPYRIGHT © 2025 BRAINBARTER ALL RIGHTS RESERVED 3
