bobby
Forum Guru
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As a part of your multispecialty group practice’s preventive health care initiative, you are asked to help design guidelines for antimicrobial prophylaxis for bacterial endocarditis. Using the group’s electronic medical records, patients with ICD-9–coded diagnosis warranting antimicrobial prophylaxis can be “tagged” for review by one of the clinic’s RNs, who will make sure patients receive the appropriate medications. Using accepted guidelines for determining who should receive antimicrobial prophylaxis for endocarditis, your job is to determine which conditions warrant follow-up. Once the system is in place, which of the following patient’s is most likely to be called for antimicrobial prophylaxis before invasive dental procedure?
A. A 46-year-old man with a history of three-vessel coronary artery bypass grafting
B. A 19-year old woman with a compensated, surgically treated tetralogy of Fallot
C. A 19-year-old asymptomatic woman with a midsystolic click
D. A 17-year old man with a history of rheumatic fever, treated without complications
E. A 29-year old woman with a distant history of atrial-septal defect repair
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if you haven't any charity in your heart, you have the worst kind of heart trouble.
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| bobby
Forum Guru
Topics: 136
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i will go with B.... but not very sure.
if you think a different ans, please kindly explain.
i constantly forget which cardiac defects warrant prophylaxis, even after treatment.
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if you haven't any charity in your heart, you have the worst kind of heart trouble.
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| Natasa
Forum Elite
Topics: 9
Posts: 291
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I would also go with the B-Previous(current) tetralogy of Falot is considered to be one of the major risks for developing endocarditis(also rostetic valves,previous bact.endocarditis,complex cyanotic congenital heart diseases-transposition,fallot)
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| phuluong2k
Forum Fanatic
Topics: 714
Posts: 2,008
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In Kaplan pediatric, the following situations are not recommended for endocarditis prophylaxis:
- Isolated secondum ASD
- Surgical repair of ASD, VSD & PDA
- Coronary artery bypass
- MVP without regurgitation or thickend valve
- Kawasaki without valvular dysfunction
- Rheumatic fever without valve dysfunction
- Pacemaker & defibrillators
I go for B
C with mid systolic click, i think it is mitral valve prolapse
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