Cardiology: infective endocarditis: practice question

A Pediatrics 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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Pediatrics · Cardiology: infective endocarditis

Sample item

A child with a VSD has fever for 2 weeks, new murmur, splinter haemorrhages and Roth spots. What is the most common causative organism in this setting?

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

The answer and the reasoning

A. Viridans streptococci

Subacute bacterial endocarditis on congenitally abnormal valves or defects is most commonly caused by viridans streptococci. Diagnosis uses modified Duke criteria, with at least 2 or 3 blood cultures before antibiotics. Staphylococcus aureus is the leading cause in acute disease.

Option by option

  • A. Viridans streptococci (correct)

    Correct. Viridans streptococci are the commonest.

  • B. Staphylococcus epidermidis

    Coagulase-negative staphylococci typically infect prosthetic material.

  • C. Candida albicans

    Candida occurs in immunocompromised patients and in IV drug use.

  • D. Escherichia coli

    E. coli is rare in endocarditis.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Viridans streptococci. Subacute bacterial endocarditis on congenitally abnormal valves or defects is most commonly caused by viridans streptococci.

Why is "Staphylococcus epidermidis" not the answer?

Coagulase-negative staphylococci typically infect prosthetic material.

Why is "Candida albicans" not the answer?

Candida occurs in immunocompromised patients and in IV drug use.

Why is "Escherichia coli" not the answer?

E. coli is rare in endocarditis.

What concept does this question test?

It tests Cardiology: infective endocarditis in Pediatrics. Diagnosis uses modified Duke criteria, with at least 2 or 3 blood cultures before antibiotics. Staphylococcus aureus is the leading cause in acute disease.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Cardiology: infective endocarditis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.