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CVS Respi Case 3

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

Under Modified Duke Criteria, documentation of the following confirms a definite endocarditis? 

a)

One major criteria

b)

Five minor criteria

c)

Two major criterion and Three minor criteria

d)

One major criterion and Two minor criteria

e)

Two of the options

2.

A patient with endocarditis will require a surgical intervention immediately on the same date of admission in  which of the following conditions? 

a)

Progressive paravalvular prosthetic regurgitation

b)

Septal perforation

c)

Valve dysfunction with pulmonary edema

d)

Acute aortic regurgitation with heart failure

e)

Fungal endocarditis

3.

These conditions would require endocarditis prophylaxis before a dental procedure to continue due to a higher risk of cardiac lesions EXCEPT:

a)

Prior endocarditis

b)

Prosthetic heart valves

c)

Mitral valve prolapse

d)

Unpaired cyanotic congenital heart disease

4.

Mr. Hiroshima is diagnosed with subacute endocarditis. Which of the following is/are the most likely cause of the infection?

a)

Viridans streptococci

b)

Enterococci

c)

Pneumococci

d)

Only 2 of the options

e)

All of the above

5.

A 45 year-old female patient was confirmed to have infective endocarditis, her laboratory results would include

a)

Elevated C-reactive protein

b)

Elevated ESR

c)

Anemia

d)

Leukocytosis

e)

All of the above

6.

These surface adhesin molecules are required in order for S. aureus to invade the endothelium:

a)

Ebp pili

b)

Clumping factor

c)

Fibronectin-binding proteins

d)

Only 2 of the options

e)

All of the above

7.

The clinical manifestations of endocarditis arise from the following events EXCEPT:

a)

Tissue injury

b)

Hematogenous infection

c)

Embolization of vegetation fragments

d)

Inadequate venous return

e)

All of the above

8.

A 75 year-old man was admitted to the hospital due to fever, chills,and sweats. He has a previous diagnosis of aortic regurgitation. His blood culture confirms Enterococcus faecalis as the causative agent of his disease. What will be the appropriate treatment for this patient?

a)

Vancomycin + Rifampicin

b)

Penicillin G + Gentamicin

c)

Ampicillin + Ceftriaxone

d)

Doxycycline + Gentamicin

9.

Transesophageal echocardiography is preferred than transthoracic echocardiography because it detects the following EXCEPT:

a)

Myocardial abscesses

b)

Valve perforations

c)

Intracardiac fistulae

d)

Only 2 of the options

e)

None of the above

10.

Rheumatic heart disease is characterized by deforming valvular disease particularly involving the mitral valve. Which anatomic changes of the mitral valve in chronic RHD will occur?

a)

Fusion of tendinous cords

b)

Thickening of the leaflets

c)

Shortening of valve commissures

d)

All of the above

e)

None of the above

11.

The following are true regarding acute rheumatic fever EXCEPT:

a)

Occurs mostly in children 5-15 years old

b)

Appears 3 days after a streptococcal infection

c)

Initial attacks can occur in the middle to later life

d)

Antistreptolysin O antibodies can be detected in ASO titer test

12.

A 10-year- old boy presented with dyspnea and knee pain. He revealed a history of sore throat 5 weeks prior to the onset of symptoms. His ASO titer is high. On PE, he has a systolic murmur at the apex. He eventually died. An autopsy of the heart shows Aschoff bodies in the epicardium, myocardium, and endocardium layers. Which of the following is the underlying cause of death?

a)

Bacterial endocarditis

b)

Scarlet fever

c)

Acute rheumatic fever

d)

Chronic rheumatic fever

13.

A 10-year- old boy presented with dyspnea and knee pain. He revealed a history of sore throat 5 weeks prior to the onset of symptoms. His ASO titer is high. On PE, he has a systolic murmur at the apex. He survived but presented with high-grade fever as well. His blood culture is positive for Streptococcus viridans. Despite appropriate treatment, he died.  An autopsy of the heart shows large, irregular masses on the valve cusps that may extend to the chordae. Which of the following is the underlying cause of death?

a)

Acute infective endocarditis

b)

Subacute infective endocarditis

c)

Acute rheumatic fever

d)

Chronic rheumatic fever

e)

Scarlet fever

14.

hat type of cardiac murmur starts after S1 and ends before S2 heard at 2nd left ICS?

a)

Aortic stenosis

b)

Aortic regurgitation

c)

Mitral stenosis

d)

Mitral regurgitation

e)

Both A & D

15.

Which of the following is TRUE regarding acute infective endocarditis?

a)

Gradually damages cardiac structures

b)

Seeds extracardiac sites

c)

Progresses to deaths within weeks

d)

Only 2 of the options

e)

All of the above