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Review
of Clinical Signs

Peripheral Signs of Endocarditis

Series Editor and Author: Frank L. Urbano, MD

1. Roth’s spots have been described in all of the following conditions EXCEPT:
  1. Infective endocarditis
  2. HIV disease
  3. Diabetes mellitus
  4. Hematologic malignancies
  5. Peripheral vascular disease
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2. Which of the following statements is true regarding Osler’s nodes?

  1. Osler’s nodes were first described by Canadian physician and educator Sir William Osler.
  2. The pathogenesis of Osler’s nodes is thought to involve septic microemboli that originate from endocardial valvular lesions.
  3. Osler’s nodes appear early in the disease course of infective endocarditis.
  4. Osler’s nodes resolve slowly (ie, 7 to 10 days) during the treatment of endocarditis.
  5. Osler’s nodes have also been seen in patients with scleroderma.
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3. Which of the following statements is FALSE regarding Janeway lesions?
  1. The term "Janeway lesion" was coined by American physician Dr. Emanuel Libman.
  2. Janeway lesions are usually erythematous and nodular, and may appear hemorrhagic.
  3. Janeway lesions are usually painful.
  4. Janeway lesions are usually found on the palms and soles.
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4. Splinter hemorrhages have been described in all of the following patients EXCEPT:

  1. Hemodialysis patients
  2. Healthy patients
  3. Patients with infective endocarditis
  4. Patients with HIV disease
  5. Patients with mitral stenosis
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