Infective Endocarditis MCQ Questions And Answers

2.

The majority of organisms in vegetation are

Inactive and non-growing
Inactive metabolically but grow rapidly
Very active metabolically but do not grow
Very active metabolically and grows rapidly

Correct Answer

A. Very active metabolically but do not grow

Explanation

In the vegetation of Infective Endocarditis (IE), the organisms are typically very active metabolically. This metabolic activity is crucial for their survival and pathogenicity, especially as they produce factors that help them adhere to the valve leaflets and evade the immune system. However, despite their metabolic activity, they do not grow or replicate rapidly within the vegetation. This slow growth is partially due to the limited nutrient supply in the blood and the effects of the host's immune responses, which inhibit replication but not metabolic activity. This characteristic makes treating IE challenging, as the bacteria can be less susceptible to antibiotics due to their slow growth and dormancy-like state in the vegetation.

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3.

The clinical manifestations of IE result from

Cytokines
Intracardiac infection
Embolization
Immunological phenomenon
All of the above

Correct Answer

A. All of the above

Explanation

Infective Endocarditis (IE) primarily affects heart valve leaflets, with vegetation formed from clumps of microorganisms and inflammatory cells. These organisms are metabolically active but do not replicate rapidly, complicating antibiotic treatment. Clinical manifestations arise from the infection, embolization of vegetation fragments, immune responses, and cytokine-induced inflammation. These factors collectively contribute to IE's complex symptoms, necessitating comprehensive management strategies.

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2

4.

Modified Duke Criteria for IE

Highly sensitive
Highly specific
Both
Neither

Correct Answer

A. Both

Explanation

The Modified Duke Criteria for Infective Endocarditis (IE) are highly sensitive and specific, designed to accurately diagnose IE using a combination of clinical and echocardiographic findings. These criteria classify IE cases into definite, possible, or rejected categories based on major criteria, including typical microorganisms in separate blood cultures and endocardial involvement on echocardiograms, and minor criteria like predisposition and fever. The precision of these criteria ensures effective identification and minimizes false diagnoses, making them essential for managing IE.

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2

5.

Antimicrobial therapy in IE – True statement

Vegetations are highly vascular
Bacteria in vegetation are rapidly growing
All bacteria in the vegetation need not be killed
None

Correct Answer

A. All bacteria in the vegetation need not be killed

Explanation

In the treatment of Infective Endocarditis (IE), antimicrobial therapy aims to reduce the bacterial load within vegetation to a level manageable by the patient's immune system, rather than achieving complete bacterial eradication. This strategy is necessary because the vegetations have a poor blood supply that impedes antibiotic delivery, and the bacteria present are in a low-growth state, making them inherently less susceptible to antibiotics. Therefore, the objective is to suppress the infection to a point where the body’s immune defenses can effectively control and eliminate the remaining bacteria.

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6.

Which species of bacteria typically causes infective endocarditis?

Staphylococcus
Helicobacter
Bacillus
None of the above

Correct Answer

A. Staphylococcus

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.

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7.

In children with CHD, Group A streptococci rarely cause infective endocarditis.

True
False

Correct Answer

A. True

Explanation

True. In children with congenital heart disease (CHD), Group A Streptococci (Streptococcus pyogenes) rarely cause infective endocarditis. While Group A Streptococci can cause various infections, including strep throat and skin infections, it is not a common causative agent for infective endocarditis in individuals with CHD. Infective endocarditis is more commonly associated with other bacteria, such as viridans streptococci or staphylococci, in individuals with underlying heart conditions.

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8.

______ is effective in diagnosing infective endocarditis in patients with congenital heart disease.

Presence of Janeway lesions
Duke criteria
Electrocardiography
None of the above

Correct Answer

A. Electrocardiography

Explanation

Electrocardiography is effective in diagnosing infective endocarditis in patients with congenital heart disease because it can help identify any abnormal electrical activity in the heart. This can be indicative of an infection in the heart valves, which is a common complication in patients with congenital heart disease. By analyzing the electrical patterns and rhythms of the heart, electrocardiography can provide valuable information to aid in the diagnosis of infective endocarditis.

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9.

Which of the following Duke criteria is a major criteria for infective endocarditis?

Immunologic findings such as glomerulonephritis
Predisposing heart condition or intravenous drug use
Blood cultures positive for typical infective endocarditis organisms
All of the above

Correct Answer

A. Blood cultures positive for typical infective endocarditis organisms

Explanation

Blood cultures positive for typical infective endocarditis organisms is a major criterion for infective endocarditis according to the Duke criteria. This criterion refers to the identification of microorganisms in the blood that are commonly associated with infective endocarditis, such as Streptococcus viridans, Staphylococcus aureus, and Enterococcus species. The presence of these organisms in the blood indicates an active infection involving the heart valves, which is a key diagnostic feature of infective endocarditis. The other options listed, predisposing heart condition or intravenous drug use and immunologic findings such as glomerulonephritis, are not major criteria for diagnosing infective endocarditis.

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10.

Which trial shows the significant benefit of early surgery in patients at high risk for emboli and with large vegetations?

EASE
ICE
ASE
ESE

Correct Answer

A. EASE

Explanation

The trial that shows the significant benefit of early surgery in patients at high risk for emboli and with large vegetations is the EASE trial.

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Infective Endocarditis MCQ Questions And Answers

The most commonly affected in IE is?

Quiz Preview

The majority of organisms in vegetation are

The clinical manifestations of IE result from

Modified Duke Criteria for IE

Antimicrobial therapy in IE – True statement

Which species of bacteria typically causes infective endocarditis?

In children with CHD, Group A streptococci rarely cause infective endocarditis.

______ is effective in diagnosing infective endocarditis in patients with congenital heart disease.

Which of the following Duke criteria is a major criteria for infective endocarditis?

Which trial shows the significant benefit of early surgery in patients at high risk for emboli and with large vegetations?