Acute Infections

Question 1

SIRS criteria

Answer 1

core temp >38.5 C or 101.2 F
or < 36C
tachycardia or bradycardia if less than 1 yo
mean RR >2 SDs above normal
leukocytosis, leukopenia or >10% immature Neutros

Question 2

sepsis

Answer 2

systemic manifestations of infection: SIRs with infection

Question 3

severe sepsis vs sepsis

Answer 3

severe sepsis has hypotension causing organ dysfunction

Question 4

septic shock vs severe sepsis

Answer 4

arterial hypotension causing septic shock organ dysfunction DESPITE fluid resuscitation

Question 5

what causes bacterial meningitis

Answer 5

strep p neumo
H flu
N meningitidis
Salmonella

Question 6

Initial Tx for bacterial meningitis

Answer 6

cefotaxime or ceftriaxone 50 mg/kg and dexamethasone for H fl ue and S pneumo at 0.15 mg/kg/dose

Question 7

Tx for HSV meningitis

Answer 7

Acyclovir 15mg/kg/dose

Question 8

dangerous organism causing encephalopathy in kids

Answer 8

plasmodium falciparum

Question 9

metabolic derrangements that can cause twitching, dec BP, inc HR, inc RR

Answer 9

hypoglycemia
hyponatremia
hypocalcemia

Question 10

bacterial meningitis cause in infants

Answer 10

GBS
E coli
enteric gram neg organismts
listeria and enterococcus

Question 11

ddx for appendicitis

Answer 11

DKA

bowel perforation

Question 12

organisms likely causing peritonitis

Answer 12

gram neg E coli and klebsiella
gram + pneumococcus, staph, alpha hemolytic strep, enterococcus
anaerobes like bacteroides

Question 13

what is treatment for gram + peritonitis

Answer 13

clinda at 10mg/kg/dose with amp 50mg/kg/dse or amp and gent

Question 14

ascaris stronglyloides can cause peritonitis how

Answer 14

perforation

Question 15

what is VAP

Answer 15

ventilator associated pneumonia

Question 16

3 types pneumonia

Answer 16

community acquired
aspiration
healthcare associated

Question 17

Tx community acquired pneumonia in immunocompetent

Answer 17

3rd gen cephalo with macrolid or fluoroquinolone

Question 18

community acquired pneumonia in immunocompromised treatment

Answer 18

TMP SMX and antifungal

to cover pneumocystis jirveci

Question 19

treatment of hospital acquired or ventilator associated pneumonia

Answer 19

3rd or 4h generation cephalosporin with a betalactamase or carbopenem
OR
fluorowuinolone with glycoside

Question 20

Tx gram + pneumonia

Answer 20

linezolid vanco or daptomycin

Question 21

Tx pseudomonas

Answer 21

carbapenems
don't use cipro as single agent. fluoros best for upper airway
or
pip taz
ticarcillin with clavunate

Question 22

Tx for aspiration pneumonia

Answer 22

clinda

Question 23

Treatment choices for immunocompromised empiric therapy for high risk febrile eneutropenia

Answer 23

cefepime or ceftazidime 50 mg/kg/dose
OR
meropenem 20mg/kg/dose
OR
pip tazo 80-100 mg/kg/dose

may add vanco for gram + and either metro or clinda for anaerobes

Question 24

if fever persisting in high risk febrile neutropenia after 24 -48 hours of fever persisting

Answer 24

anti fungal and anti virals

Question 25

most common cause of bacterial skin infections

Answer 25

staph and strep because of exotoxins

Question 26

what causes type 2 NECrotizing fasciitis

Answer 26

beta hemolytic strep

Question 27

treatment for staph and strep exotoxins

Answer 27

beta lactam/vanco/dapto

linezolid if resistance

Question 28

HAART

Answer 28

highly active antiretroviral treatment

Question 29

what is immune reconstitution inflammatory syndrome

Answer 29

when the immune system returns (most likely during HAART therapy) and the immune system attacks all the pathogens that have been adding up causing a inflammatory surge

Question 30

how to manage immune reconstitution syndrome

Answer 30

supportive and controlling causative infection
may need to withdraw HAART
anti inflammatory agents