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ABSITE Review > ABSITE Review - Infection > Flashcards

ABSITE Review - Infection Flashcards

1
Q

What is the MC immune deficiency?

A

Malnutrition

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2
Q

What is the microflora in the stomach?

A

Virtually sterile; some GPCs, some yeast

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3
Q

What is the microflora in the proximal small bowel?

A

10^5 bacteria, mostly GPCs

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4
Q

What is the microflora in the distal small bowel?

A

10^7 bacteria, GPCs, GPRs, GNRs

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5
Q

What is the microflora in the colon?

A

10^11 bacteria, almost all anaerobes, some GNRs, GPCs

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6
Q

What is the MC organisms in the GI tract?

A

Anaerobes

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7
Q

What is the MC anaerobe in the colon?

A

Bacteroides fragilis

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8
Q

What is the MC aerobic bacteria in the colon?

A

Escherichia coli

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9
Q

What is the MC organism in gram-negative sepsis?

A

Escherichia coli

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10
Q

What is the endotoxin of gram-negative organisms? What it triggers?

A

Lipopolysaccharide lipid A

Triggers the release of TNF-alpha (from macrophages), activates complement and coagulation cascade

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11
Q

How clostridium difficile can be diagnosed? What is the treatment?

A

Dx - Fecal leukocytes in stool, C.difficile toxin

Tx - oral or IV flagyl, oral vancomycin, lactobacillus

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12
Q

How you classify the wound of an elective colon resection with prepped bowel?

A

Clean-contaminated = 3-5% risk of wound infection

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13
Q

How you classify the wound of GSW to colon with repair?

A

Contaminated = 5-10% risk of wound infection

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14
Q

How many bacteria are needed for a wound infection?

A

10^5 bacteria

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15
Q

Mention some risk factors for wound infection.

A

Long operations, hematoma or seroma formation, advanced age, chronic disease (COPD, renal failure, liver failure, DM), malnutrition, immunosuppressive drugs

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16
Q

Which are the agents involve with invasive soft tissue infection?

A

Clostridium perfringens and beta-hemolytic strep

17
Q

What are the MC agents in ICU pneumonia?

A 
#1 - Staph aureus
#2 - Pseudomonas
18
Q

What are the MC agents in ICU pneumonia?

A 
#1 - Staph epidermidis
#2 - Staph aureus
#3 - yeast
19
Q

What are the MC agents in necrotizing soft tissue infection?

A

Beta-hemolytic, Streptococcus (group A), C.perfringens and mixed organism

20
Q

Mention signs and symptoms of necrotizing soft tissue infection.

A

WBC 20, thin gray drainage, marked induration, edema of entire limb, hypoNa (<135), skin blistering/slougihng, skin necrosis, crepitus/soft tissue gas on x-ray, pain out of proportion, sepsis

21
Q

What is the treatment for necrotizing fasciitis?

A

Early debridement, high-dose penicillin or broad spectrum abx if polyorganismal

22
Q

What is the toxin of C.perfringens?

A

Alpha-toxin

23
Q

What is the MC presentation of C. perfringens? Describe the gram stain.

A

Myonecrosis and gas gangrene

Gram stain - GPRs without WBCs

24
Q

C. perfringens is common in __________ injuries.

A

Farming

25
Q

What is Fournier’s gangrene? Mention some risk factors.

A

Severe infection in perineal and scrotal region

RFs - DM, immunocopromised state

26
Q

What are common symptoms of Actinomyces? What is the treatment?

A

MC - Pulmonary symptoms, tortous abscesses in cervical, thoracic, ad abdominal areas
Tx - drainage and penicillin G

27
Q

What are common symptoms of Nocardia? What is the treatment?

A

Pulmonary and CNS symptoms

Tx - drainage and sulfonamides (Bactrim)

28
Q

What are common symptoms of Histoplasmosis? What is the treatment?

A

Pulmonary symptoms, Mississippi and Ohio River valleys

Tx - amphotericin for severe infections

29
Q

What are common symptoms of Cryptococcus? What is the treatment?

A

CNS symptoms

Tx - amphotericin for severe infections

30
Q

What are common symptoms of Coccidiodomycosis? What is the treatment?

A

Pulmonary symptoms, Southwest

Tx - amphotericin for severe infections

31
Q

What is a risk factor for SBP?

A

Protein < 1g/dLin peritoneal fluid

32
Q

How is SBP diagnosed?

A

PMNs > 500 in peritoneal fluid is diagnostic

33
Q

What is the treatment of SBP? Short-term prophylaxis?

A

Ceftriaxone, prophylaxis with fluoroquinolones

34
Q

What are the 2 MCCs of laparotomy in HIV patients?

A 
#1 - CMV infection
#2 - neoplastic disease
35
Q

Is upper or lower GI bleeding more common in HIV patients?

A

Lower GI bleeding is more common
Upper GI bleeds - Kaposi, lymphoma
Lower GI bleeds - CMV, bacterial, HSV

36
Q

What is the bacteria in cat and dog bites?

A

Pausterella multocida

37
Q

What is the bacteria in human bites?

A

Eikenella

ABSITE Review (32 decks)

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