MCQ 1 Infective Endocarditis (IE)

Tujuan pemberian ubatan penicillin kepada pesakit infective endocarditis sebelum mencabut gigi adalah untuk mengurangkan risiko

• Jangkitan

• Kesakitan

• Pendarahan

• Kebengkakan

Answer explanation

Penicillin or other antibiotics are given before a tooth extraction in a patient with infective endocarditis (IE) to prevent bacteria from the mouth entering the bloodstream and causing an infection in the heart, a practice known as antibiotic prophylaxis, according to the Harvard Health and American Heart Association guidelines. This prophylactic treatment reduces the risk of bacteremia, which is the presence of bacteria in the blood, particularly from procedures that involve manipulation of gum tissue or the tooth's roots. 

Semasa ujian echocardiogram, terdapat vegetation pada injap pada En. R. Ini menunjukkan En. R mungkin mengalami

• Pericarditis

• Mitral stenosis

• Myocardial infarction

• Infective endocarditis

Answer explanation

In "echo finding," a vegetation is an infected mass, or lesion, on the heart's lining (endocardium) detected by echocardiography, which is an ultrasound of the heart. These lesions are composed of bacteria, fibrin, and platelets and can appear as an oscillating mass on heart valves or other structures. While a hallmark of infective endocarditis, vegetations can also be non-infectious masses, and their detection by echocardiography has significant prognostic implications

Pesakit yang menghidapi infective endocarditis berisiko mendapat stroke akibat dari kejadian

• Mitral incompetence

• Myocardial necrosis

• Ventricular hypertrophy

• Vegetative lesion

Answer explanation

The risk of stroke in infective endocarditis (IE) stems from the embolization of fragments from heart valve vegetations or mycotic aneurysms traveling to the brain. Risk factors include vegetation size and mobility, mitral valve involvement, and the presence of Staphylococcus aureus. The high risk period is at the time of diagnosis and initial antibiotic treatment, which can lead to ischemic stroke, brain abscess, or hemorrhagic transformation. 

Vegetation characteristics:

Larger and more mobile vegetations are associated with a higher risk of embolization.

Spesies bakteria manakah yang biasanya menyebabkan infective endokarditis?

• Staphylococcus

• Helicobactor Pylori

• Bacilus

• Kelbseilla

Answer explanation

Staphylococcus is the correct answer because it is the most common species of bacteria that causes infective endocarditis. This bacterium is commonly found on the skin and in the nasal passages, making it more likely to enter the bloodstream and infect the heart valves. Staphylococcus can cause severe infections in individuals with weakened immune systems or those who have undergone invasive medical procedures. Helicobacter is primarily associated with gastrointestinal infections, while Bacillus is more commonly associated with food poisoning. Therefore, neither of these bacteria are typically responsible for causing infective endocarditis.

Bahagian jantung yang paling biasa terjejas dalam infective endocarditi (IE) adalah bahagian

• valve leaflets

• chordae

• chamber walls

• Periprosthetic tissue

Answer explanation

Infective Endocarditis (IE) primarily affects the heart valves, particularly the valve leaflets. The infection typically leads to the formation of vegetations, which are clumps of platelets, fibrin, microorganisms, and inflammatory cells. These vegetations can cause significant damage to the valve leaflets, leading to complications such as valve stenosis or regurgitation. Chordae tendineae, chamber walls, and periprosthetic tissues can also be involved, but the valve leaflets are the most commonly and severely affected.