VALVULAR DISEASE. Mark Boyko, CCFP-EM R3. One night at the Foot…. 64yo male found down at home… -HR 111 -BP 109/67 -RR 12 -Temp 38.6 -O2 88% -Glucose 22. At first glance…. Moving both sides of body (barely) Not speaking to you GCS 9. Labs. -Hgb 108 -WBC 14 -Lytes N
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Mark Boyko, CCFP-EM R3
64yo male found down at home…
-EKG pacer spikes
REPORT: Multiple ischemic areas consistent with embolic stroke
Which age group is most commonly affected?
a) < 30 yrs
b) 31-60 yrs
c) >60 yrs
Which microbe causes most cases of IE overall?
#1 Streptococcus Viridans (40%)
#2 Staph Aureus (30%)
#3 Enterococci (10%)
#4 HACEK group
*Culture Negative 5% (Coxiella Burnetti, Bartonella)
Can you name at least 3 organisms in the HACEK group?
…. Alternatively…. Which NHL team first drafted famous Czeck goaltender Dominik Hasek?
#5 Fungal (Candida, Apergillis)
#1 Staph Epidermidis (50%)
Which of the following lesions are painful?
a) Osler’s Nodes
b) Janeway Lesions
c) Splinter hemorrhages
d) Roth spots
When is the highest risk for IE after prosthetic valve surgery?
What is Olser’s Triad?
*Okay to perform surgery in acute setting
1. ANY dental work
3. Skin infection & procedure
*99% of our ER procedures are safe, but use in abscess drainage
CP, CHF, Syncope