<prompt> Roths spot is seen in?Infective endocarditisTyphoidCRAORheumatic carditis  <response>: ANSWER: A Infective endocarditisREF: Harrisons Principles of Internal Medicine 17th ed-chapter 118Roth spots are flame shaped hemorrhages with central cotton wool spots. They are caused by immune complex deposition and are seen in subacute bacterial endocarditisIn the case of leukemia, the Roth spot is composed of a hemorrhage with a central aggregation of white blood cellsFeature of infective endocarditis:Fever Chills and sweatsAnorexia, Weight loss, Malaise, Myalgias, arthralgias, Back painHeart murmur, Newworsened regurgitant murmurArterial emboliSplenomegalyClubbingPeripheral manifestations Osier s nodes, subungual hemorrhages, Janeway lesions, Roths spotsPetechiaeLaboratory7 manifestations: Anemia, Leukocytosis, Microscopic hematuria, Elevated erythrocyte sedimentation rate 90, Elevated C-reactive protein level 90, Rheumatoid factor, Circulating immune complexes, Decreased serum complementCauses of Roth spots:Subacute bacterial endocarditisAcute leukemiaPernicious anemiaScurvyCO poisoningPost cardiac bypass surgery 