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Endocarditis: Pathology review




Cardiovascular system

Vascular disorders
Congenital heart defects
Cardiac arrhythmias
Valvular disorders
Heart failure
Cardiac infections
Pericardial disorders
Cardiac tumors
Cardiovascular system pathology review

Endocarditis: Pathology review


1 / 10 complete

USMLE® Step 1 style questions USMLE

10 questions

A 67-year-old man presents to the primary care physician with a several week history of worsening fatigue, blurry vision, and rectal bleeding. Medical history is notable for ulcerative colitis, hypertension, and hyperlipidemia. The patient’s last colonoscopy was at age 50. Temperature is 37.6°C (99.7°F), pulse is 96/min, respirations are 18/min, and blood pressure is 122/63 mmHg. BMI is 34 kg/m2. Physical examination demonstrates an obese habitus. The patient’s skin appears pale with noted conjunctival pallor. Cardiopulmonary examination demonstrates a 3/6 holosystolic murmur best at the cardiac apex which was not present at the previous office visit 3 months ago. Retinal examination demonstrates round white spots on the retina surrounded by hemorrhage. Rectal examination is positive for scant blood in the rectal vault. Laboratory values are demonstrated below:  

Laboratory value  Result 
Complete Blood Count, Serum 
Hemoglobin  11.5 g/dL 
 Hematocrit  39.5% 
 Leukocyte count  14,100 /mm3 
 Platelet count  155,000/mm3 
Electrolytes, Serum 
                  Sodium                134 mEq/L 
               Potassium                 3.6 mEq/L 
                 Chloride                 97 mEq/L  
              Bicarbonate                 22 mEq/L 
                 Calcium                8.4 mg/dL 
Blood is drawn and sent for culture. Two days later, 3 of 4 blood cultures obtained grow Streptococcus gallolyticus (Streptococcus bovis biotype I). Which of the following studies is most likely to reveal the etiology of this patient’s infection?  

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