unique1
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A young IV drug user presents with high fever. On physical examination a loud murmur is present. On echocardiogram large vegetations are found on the aortic valve. Chest radiograph demonstrates findings of pulmonary edema.Which of the following complications of his disease he is most likely to develope ?
1: Cerebral mycotic aneurysm
2: Cardiac myxoma
3: Aortic stenosis
4: Pulmonary infarction
5: Constrictive pericarditis
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| mytime
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| usmlefever
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| new_n_lost
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I have one Doubt An Aortic Valve vegetations is most likely to end up in Kidney,spleen, liver n Brain. Now the MCC of Acute IE is S Aureus in the IV abusers.
SO it cant be A cos its a mycotic aneurysm but if it were a simple aneurysm or abcess that wud have been the Choice.
Its not B cos Myxoma has a diiferent etiology n IE doesnt fit in it.
Its not D cos this is a Left Sided Presentation (aortic) not a Right Sided Presentation (Tricuspid ).
Its not C it mostly results in a Regurge rather than a Stenosis.
Then the Only Option Left is Constirctive PEri which does not have IE as its etiology
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| silver
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u better have the answer once we through racking our brains over this!!!
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| new_n_lost
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Well this is a good one DO Post the Explanation cos its gonna be a good one to know
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| new_n_lost
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1: Cerebral mycotic aneurysm <<< ??
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| silver
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A
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| unique1
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Yup . You got it . It is A.
This is score95.com question which has good questions but pathetic explanations. Anyways the explanation given is as follows:
Infective endocarditis can produce septic embolization , and the bacterial growth with inflammation can produce focal destruction of arterial walls.
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| silver
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ur right, that was a horrible explanation 
found better one on another site
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| new_n_lost
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Mycotic aneurysms result from septic embolization of vegetations to the arterial vasa vasorum or the intraluminal space, with subsequent spread of infection through the intima and vessel wall. Arterial branching points favor the impaction of emboli and are the most common sites of mycotic aneurysms. The clinical presentation of patients with intracranial mycotic aneurysms is quite variable. Some intracranial aneurysms leak slowly before rupture and produce headache and mild meningeal irritation, whereas in other patients, there are no clinically recognized premonitory findings before sudden intracranial hemorrhage.
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| silver
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good ques. unique
thanks for expl. nnl
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| usmlefever
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that was a nice qs.thanks nnl for expl.
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| unique1
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Silver , more qs with lousy explanations will keep coming in future too. Stay tuned. 
NnL , thanx for the explanation.
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| doc179
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nice qns unique1 thanx
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| silver
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unique1 wrote:Silver , more qs with lousy explanations will keep coming in future too. Stay tuned.
Can't wait!
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| Ig F
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good explanation nnl.........
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| SmokyWaters
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here's my explanation...
the most cmmon bacteria is DEFINITELY staph aureus...but pseudomonas can also cause thrombotic complications...TRICUSPID and then on second number AORTIC valve are involved in IV drug users...
MYCOTIC aneurysms as the NAME IS VERY MISLEADING is more commonly caused by
bacterioides, salmonella n pseudomonas
and then aspergillus, mucor and rhizopus...
the answer is definitely A
but the explanation is a bit different...for further explanation and confimation...please check GOLJAN rapid review n see MYCOTIC ANEURYSM portion
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