6. Intro to Infectious Disease MT2

Question 1

what are the different pathogenic microorganisms

Answer 1

• bacteria
• virus
• parasite
• fungi

Question 2

what are the four ways pathogens are spread

Answer 2

• person to person
• vector to person
• environment to person
• persons own flora

Question 3

this is a s/s of infection; is lower in the morning and higher in the night. may also be caused by malignancy, autoimmune disease, physiological distress, medications especially antipsychotics

Answer 3

fever

Question 4

this is a s/s of infection; due to the fact that infections can cause mobilization of lymphocytes and granulocytes. may also Bec aused by inflammatory disorders, physiological stress, malignancy, and drugs especially corticosteroids

Answer 4

increased WBCs

Question 5

acute phase reactants is a s/s of infection: what are the three acute phase reactants

Answer 5

erythrocytes sedimentation rate (ESR)
c- reactive protein (CRP)
procalcitonin

Question 6

this acute phase reactant can show inflammatory activity in the body, measures the distance RBCs fall in a test tube within an hours.

Answer 6

ESR

Question 7

true or false: the farther the RBCs have fallen the greater the inflammatory response of the immune system

Answer 7

true

Question 8

this acute phase reactant is made in the liver and levels increase when there is inflammation in the body

Answer 8

CRP

Question 9

this acute phase reactant is a biomarker that is release in response to bacterial infections. can be used to differentiate the etiology of infectious processes.

Answer 9

procalcitonin

Question 10

is this a gram positive cocci or gram positive bacilli?
enterococcus (e.g. E. faecalis, E. faecium)

Answer 10

gram positive cocci

Question 11

is this a gram positive cocci or gram positive bacilli?
listeria

Answer 11

gram positive bacili

Question 12

is this a gram positive cocci or gram positive bacilli?
streptococci (e.g. pneumonococcus, viridans)

Answer 12

gram positive cocci

Question 13

is this a gram positive cocci or gram positive bacilli?
staphylococci (e.g. s. aureus, s. epidermidis)

Answer 13

gram postive cocci

Question 14

is this a gram positive cocci or gram positive bacilli?
corynebacterium

Answer 14

gram positive bacili

Question 15

what is used to treat MSSA

Answer 15

cloxacillin, cephalexin, cefazolin

Question 16

what is used to treat hospital acquired MRSA

Answer 16

vancomycin, daptomycin, linezolid

Question 17

what is used to treat community acquired MRSA

Answer 17

clindamycin, TMP/SMX, doxycycline

Question 18

what is used to treat penicillin-susceptible S. pneumoniae

Answer 18

penicillin or ampicillin

Question 19

what is used to treat penicillin-resistant S. pneumoniae

Answer 19

3rd gen cephalosporins(not ceftazidime), vancomycin, Fas (not cipro)

Question 20

what is used to treat enterococcus

Answer 20

ampicillin or vancomycin

Question 21

is this a gram negative cocci or gram negative bacilli?
serratia, salmonella, shigella

Answer 21

gram negative bacilli

Question 22

is this a gram negative cocci or gram negative bacilli?
enterobacter, citrobacter, proteus

Answer 22

gram negative bacilli

Question 23

is this a gram negative cocci or gram negative bacilli?
E. coli and klebsiella

Answer 23

gram negative bacilli

Question 24

is this a gram negative cocci or gram negative bacilli?
pseudomonas

Answer 24

gram negative bacilli

Question 25

is this a gram negative cocci or gram negative bacilli?
moraxella

Answer 25

gram negative cocci

Question 26

is this a gram negative cocci or gram negative bacilli?
mogranella and Providencia

Answer 26

gram negative bacilli

Question 27

is this a gram negative cocci or gram negative bacilli?
camphylobacter

Answer 27

gram negative bacilli

Question 28

is this a gram negative cocci or gram negative bacilli?
heliobacter

Answer 28

gram negative bacilli

Question 29

is this a gram negative cocci or gram negative bacilli?
legionella

Answer 29

gram negative bacilli

Question 30

is this a gram negative cocci or gram negative bacilli?
neisseria (e.g. N. meningiditis, N. gonorrhoea)

Answer 30

gram negative cocci

Question 31

is this a gram negative cocci or gram negative bacilli?
haemophilus

Answer 31

gram negative bacilli (coccobacilli)

Question 32

what is used to treat easy to kill gram negative cocci/bacilli

Answer 32

amoxicillin, amoxi/clav, macrolides, 2nd gen cephalosporins

Question 33

what is used to treat hard to kill gram negative cocci/bacilli (SPACE organisms)

Answer 33

pip/tazo, 3rd/4th gen cephalosporins, carbapenems

Question 34

what group do these pathogens fall under?
peptococcus, peptostreptococcus, bactericides, fusobacterium and prevotella

Answer 34

anaerobes

Question 35

this is the presence of organisms without an inflammatory response

Answer 35

colonization

Question 36

this is the presence of organisms usually acquired during specimen sampling without the evidence of host inflammatory response

Answer 36

contamination

Question 37

this is the presence of one or more organisms that initiate a host inflammatory response

Answer 37

infection

Question 38

why should a blood culture be done in acutely ill febrile patients BEFORE antibiotics are given

Answer 38

if administer antibiotics before blood culture, the blood culture will become inaccurate

Question 39

true or false: the skin, oropharynx, nose, ears, throat and perineum are heavily colonized with a variety of bacteria

Answer 39

true

Question 40

this is the lowest anticrobial concentration that prevents visible growth of an organism after approx 24 hours of incubation on a specific growth medium

Answer 40

minimal inhibitory concentration (MIC)

Question 41

how is antimicrobial therapy selected before the cultures come back

Answer 41

empiric therapy is given to cover all the bases before the culture results become available

Question 42

what are some important things to keep in mind regarding antimicrobial selection for a patient

Answer 42

• patient history: previous Abx use (switch agent and class from last 3 months to minimize resistance), site of infection
• host factors: abx allergy, age, pregnancy, organ function, concomitant drugs, medical conditions
• drug factors: pharmacodynamics (drug does to body) and pharmacokinetics (body does to drug), tissue penetration, PAE, time/conc. dependant

Question 43

this kind of drugs exert optimal bactericidal effect when drug concentrations are maintained above the MIC; higher concentrations do not result in greater kill of an organism; tend to have little to none PAE

Answer 43

time dependant ABx

Question 44

this kind of drug achieve increased bacterial killing with increased concentration of drug. these agents have PAE therefore effect occurs even when concentration goes below MIC.

Answer 44

concentration dependant ABx

Question 45

this is persistent suppression of bacterial growth that occurs after the drug has been removed in vitro or cleared by drug metabolism in vivo. often seen in ahminoglycosides

Answer 45

post antibiotic effect (PAE)

Question 46

this type of antibiotic inhibits bacterial growth; killing of the organism depends on host defence mechanisms

Answer 46

bacteriostatic

Question 47

this type of antibiotic depends less on host factors and are preferred in immunocompromised patients. necessary in severe and life-threatening infections

Answer 47

bactericidal