Subacute bacterial endocarditis is an indolent disease that may not be recognized for several months. Acute bacterial endocarditis is, however, life-threatening and may require surgery. The diseases are rare, although the incidence is increasing, especially in the elderly. At current frequencies, primary care physicians are likely to see only one or two cases during their career. Chapter 7, pp 212 to 231, of Infectious Diseases in 30 Days by F.S. Southwick (McGraw-Hill, 2003) introduces you to some basic concepts about endocarditis and will help you understand the pathogenesis of this rare but important disease. After reading this you should be able to answer the following questions.
Question 1 - Single Best Answer
Is endocarditis more frequent in males or females?
A) males
B) females
Question 2 - Single Best Answer
Which of the following is a defining characteristic of bacterial endocarditis?
A) bacterial exotoxin damaging the heart muscle
B) intracellular bacteria growing in the heart muscle
C) bacteria growing on a heart valve
D) bacteria growing in blood clots that occlude coronary arteries
Question 3 - Single Best Answer
Which of the following are symptoms of bacterial endocarditis?
A) Low grade fever and anorexia
B) High fever and myalgia
C) Chest pain and low back pain
D) Cough and skin rash
Question 4 - Single Best Answer
What are two conditions that occur together that result in all cases of endocarditis?
A) congenital heart disease and intravenous drug use
B) prosthetic valve and Staphylococcal infection in the body
C) NBTE and bacteremia
D) coronary artery thrombosis and exposure to someone with endocarditis
Question 5 - Single Best Answer
Some causes of NBTE are?
A) rheumatic heart disease
B) congenital heart disease
C) calcific aortic valve disease
D) mitral valve prolapse
E) all of the above
Question 6 - Single Best Answer
Fill in the blank? The bacteria found in most cases of subacute bacterial endocarditis are_____________________?
A) coagulase-negative Staphylococci
B) viridans Streptococci
C) Beta-hemolytic Streptococci
D) Candida albicans
E) E. coli
Question 7 - Single Best Answer
What are some things that can lead to bacteremia and then to endocarditis (in the predisposed)?
A) brushing one's teeth
B) difficulty in passing stools
C) dental extraction
D) colonoscopy
E) pulmonary intubation
F) all of the above
Question 8 - Single Best Answer
Diseases that might be confused with subacute bacterial endocarditis are?
A) Rocky Mountain Spotted Fever and measles
B) cancer and tuberculosis
C) pneumonia and influenza
D) peridontal disease
E) secondary syphilis
Question 9 - Single Best Answer
Pieces of the vegetation on the heart consisting of a collection of platelets, fibrin and bacteria can break off and become lodged in arteries and arterioles throughout the body. These are manifested as?
A) splinter hemorrhages
B) Osler nodes
C) petechiae in the conjunctiva
D) Janeway lesions
E) all of the above
Question 10 - Single Best Answer
The bacteremia in subactute bacterial endocarditis is described as?
A) intermittent and high level
B) constant and high level
C) intermittent and low level
D) constant and low level
Question 11 - Single Best Answer
Along with blood cultures, what test is done to diagnose endocarditis?
A) anti-vegetation antibody
B) CAT scan
C) MRI
D) Echocardiography
Question 12 - Single Best Answer
True or False ......Bacteriostatic antibiotics are OK in the treatment of bacterial endocarditis because neutrophils penetrate the vegetation and kill the bacteria?
A) True
B) False