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Cardiology - ABIM

Endocarditis

QuestionAnswer
Seven indications for surgery in patients with native valve infective endocarditis BBEHAVE: persistent Bacteremia 5-7 d on abx, heart Block, recurrent Emboli, Heart failure 2/2 valve dysfunction, valve Abscess, mobile Vegetation >10mm, left sided Endocarditis 2/2 resistant organisms such as MRSA, fungal, etc
Which high risk procedures should get endocarditis prophylaxis? Dental procedures that have risk of bleeding.
Which high-risk conditions should get prophylaxis for endocarditis? Prophylax The Cute Heart. Prosthetics (valve, patch); Transplant; Congenital heart disease with repair in the last 6 mo; History of endocarditis.
List the conditions that would not warrant endocarditis prophylaxis. (5) s/p CABG, pacemaker, ASD/VSD, HOCM,
Antibiotic for endocarditis prophylaxis – general. When should it be given? Amoxicillin by mouth given one hour prior to procedure.
Antibiotic for endocarditis prophylaxis if the patient is NPO. IV ampicillin given one hour prior to procedure.
Antibiotic for endocarditis prophylaxis if the patient has a penicillin allergy. Azithromycin PO, given one hour prior to procedure
What antibiotic is given after a procedure if the patient got pre procedure endocarditis prophylaxis? Nothing after the procedure.
empiric therapy for native valve endocarditis Vancomycin and gentamicin
empiric therapy for endocarditis in a patient with IV drug usage Vancomycin and gentamicin
Antibiotic for MRSA endocarditis Vancomycin
antibiotic for MSSA endocarditis Ceftriaxone
Antibiotic for Streptococcus endocarditis Ceftriaxone
Antibiotic for Streptococcus endocarditis if the patient is penicillin resistant Ceftriaxone and gentamicin
Empiric antibiotic therapy for endocarditis in a patient with prosthetic cardiac valve Rifampin plus vancomycin plus gentamicin
Antibiotic for MRSA endocarditis in a patient with prosthetic cardiac valve Rifampin plus vancomycin plus gentamicin
Antibiotic for MSSA endocarditis in a patient with prosthetic cardiac valve Rifampin plus ceftriaxone plus gentamicin
Antibiotic for Strep endocarditis in a patient with prosthetic cardiac valve Ceftriaxone
Antibiotic for Strep endocarditis in a patient with prosthetic cardiac valve and has penicillin resistance Ceftriaxone and gentamicin
medication for right-sided endocarditis with septic emboli Daptomycin
If the patient has staph aureus bacteremia, what studies should you do? Do a transesophageal echocardiogram to rule out endocarditis
How long do you treat Staph aureus bacteremia in the general population? Two weeks if blood cultures become negative in less than 72 hours after start of antibiotics.
For which populations would you treat Staph aureus bacteremia for four weeks? Patients that have positive blood cultures for greater than 72 hours after starting antibiotics; immunocompromised patients; patients with cardiac prosthetic valves; patients with prosthetic joints
If a patient has a prosthetic valve and staph aureus bacteremia, what should you do for the patient? Remove the prosthetic valve
For which population would you treat staph aureus bacteremia for 6 to 8 weeks? Patients who have a positive transesophageal echocardiogram, denoting that they have endocarditis.
Created by: christinapham