Cardiovascular: infective endocarditis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Cardiovascular: infective endocarditis

Sample item

A 28-year-old man who injects drugs has high fever and pleuritic chest pain. Chest radiograph shows multiple peripheral cavitating nodules, and echocardiography shows a large vegetation on a heart valve. Which valve and organism are most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Tricuspid valve with Staphylococcus aureus

Intravenous drug use introduces skin organisms to the right heart, so acute endocarditis of the tricuspid valve caused by Staphylococcus aureus is typical. Fragments embolise to the lungs as septic emboli that form cavitating nodules. Viridans streptococci cause subacute disease on previously damaged left-sided valves.

Option by option

  • A. Mitral valve with viridans streptococci

    Viridans streptococci cause subacute left-sided disease on abnormal valves and would not give septic pulmonary emboli.

  • B. Tricuspid valve with Staphylococcus aureus (correct)

    Correct. Right-sided disease with septic pulmonary emboli points to tricuspid S. aureus infection.

  • C. Aortic valve with Streptococcus gallolyticus

    Streptococcus gallolyticus is linked to colonic neoplasia and left-sided valve infection, not to intravenous drug use.

  • D. Mitral valve with Staphylococcus epidermidis

    Coagulase-negative staphylococci cause prosthetic valve endocarditis rather than disease on native right-sided valves.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Tricuspid valve with Staphylococcus aureus. Intravenous drug use introduces skin organisms to the right heart, so acute endocarditis of the tricuspid valve caused by Staphylococcus aureus is typical.

Why is "Mitral valve with viridans streptococci" not the answer?

Viridans streptococci cause subacute left-sided disease on abnormal valves and would not give septic pulmonary emboli.

Why is "Aortic valve with Streptococcus gallolyticus" not the answer?

Streptococcus gallolyticus is linked to colonic neoplasia and left-sided valve infection, not to intravenous drug use.

Why is "Mitral valve with Staphylococcus epidermidis" not the answer?

Coagulase-negative staphylococci cause prosthetic valve endocarditis rather than disease on native right-sided valves.

What concept does this question test?

It tests Cardiovascular: infective endocarditis in Pathology. Fragments embolise to the lungs as septic emboli that form cavitating nodules. Viridans streptococci cause subacute disease on previously damaged left-sided valves.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular: infective endocarditis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.