Acute infections

Question 1

CDC 7 core elements

Answer 1

Leadership commitment
Accountability
Drug expertise
Action
Tracking
Reporting
Education

Question 2

VRE Vancomycin resistant Enterococci

Answer 2

Serious threat

Question 3

MRSA

Answer 3

Serious threat

One of most common HAI

Significantly more likely to die

Question 4

C diff

Answer 4

URGENT

Infects colon post antibiotics

Risk factors:

• Antibiotic use
• gastric acid suppressants
• NSAIDS

Causes mild to severe diarrhea

Question 5

CRE Carbapenem-resistant Enterobacteriaceae

Answer 5

URGENT threat

Includes Klebsiella and E.coli

Mostly immunocompromised people
Enters via ventilators or catheters

K. pneumoniae major HAI

TREATMENT: COLISTIN

Question 6

Osteomyelitis

Answer 6

Bone infection caused by staph aureus

Risk factors:

• DM
• Sickle cell
• RA
• HIV
• IVDU

Onset in 7-10 days

S/S

• Fever
• Fatigue
• N/V
• Swelling around bone, tenderness/redness
• Low ROM

Need xray, bloods, MRI or biopsy to dx

Tx

• Several weeks antibiotics IV–>oral
• Pain mgmt

Can req. surgery to remove infected tissues
Can lead to stunted growth, gangrene infections

Question 7

Necrotizing fasciitis

Answer 7

MEDICAL EMERGENCY

Group A strep

Risk factors:

• CKD
• Immunocompromised
• ETOH abuse
• Steroid use
• Diabetes

S/S
-Early: flu like, diarrhea, N/V

In 3-4 days: Inflammation, blisters, pain worse than it should be

Dehydration

Critical: Toxic shock, severe BP drop, unconsciousness

Question 8

Necrotizing fasciitis dx and tx

Answer 8

Blood tests
Imaging shows fluid, pus and gas

IMMEDIATE IV ANTIBIOTICS
Tissue biopsy, removal of infected tissue, amputation

Blood transfusions

EARLY DX CRITICAL

Question 9

Infection from bites

Answer 9

S/S

• Intense pain and swelling
• Pus around wound
• Fever/chills/malaise

Risk factors:

• ETOH abuse
• Over 50
• Diabetes

Wash and keep clean, need med attention in 24hrs
May need antibiotics

Irrigation/wound cleansing, primary closure, tetanus vaccine, antibiotics for high risk prophylaxis

Question 10

Autoimmunity

Answer 10

Antibodies and auto sensitized T cells cause tissue damage

HLA (Human Leukocyte antigen types + trigger (viral infection, drugs, hormones)

Question 11

When do immune problems begin in HIV

Answer 11

CD4 T cells under 500 cells/uL

Severe at under 200 cells/uL

Normal range: 800-1200 cells/uL

Question 12

HIV infection timeline

Answer 12

Acute: 1-3 weeks

Asymptomatic infection (HIV test now positive): 3 weeks to 3 months

Symptomatic infection: 8-10 years

AIDS: 10+years

Question 13

Acute HIV infection manifestations

Answer 13

Symptoms like mono

Fever, swollen lymph nodes, malaise, N/Diarrhea

Highly infectious

Question 14

Symptomatic AIDS infection

Answer 14

Persistent fever, night sweats, diarrhea, headaches, fatigue

At risk for infection by:

• shingles
• Candidas infections
• Herpes
• Bacterial infections

Question 15

AIDS diagnostic tests

Answer 15

Low WBC

• lymphopenia
• neutropenia

Thrombocytopenia

Anemia

Liver issues

Question 16

Goals w/ aids patients

Answer 16

Decrease viral load
Increase CD4 t cell count
Prevent infection of other disease
Prevent transmission

Question 17

Drug interactions between AIDS antiretrivirals and St Johns wort, Antacids/PPI

Answer 17

St John’s Wort increases metabolism of drug- less effective

Antacids can decrease effectiveness- wait 2 hours to admin

Question 18

HIV PrEP

Answer 18

Pre-Exposure Prophylaxis

Reduce chances of HIV infection in at risk populations

Involves taking HIV antiretroviral medications daily

Question 19

Covid treatments

Answer 19

Remdesivir: antiviral, only approved drug

Question 20

Differences between flu and covid

Answer 20

COVID:
More gradual onset
One virus
Loss of taste/smell
Lasting damage to multiple organs

FLU:
Fast onset
Multiple strains of influenza
No loss of senses
Complications include bacterial infections (pneumonia)