Chapter 11: Life Threatening Infections

Question 1

Septic shock criteria

Answer 1

Sepsis with hypotension requiring vasoactive drugs to maintain MAP of 65 and lactate >2 despite adequate fluid administration

Question 2

How many hours after surgery should you think infection if there is a new fever

Answer 2

96 hours (in first 48 probably not)

Question 3

Temperature probes on ____ catheters are most accurate to measure core temp

Answer 3

urinary

Question 4

If source of infection is not obvious on initial exam where should you reconsider as source (2)

Answer 4

abdomen and lungs

Question 5

Meningitis coverage normal healthy adult

Answer 5

3rd gen cephalosporin and vanc

Question 6

What to add on to abx for meningitis

Answer 6

dexamethasone .15 mg/kg iv q6 for 2-4 days

Question 7

what do you add on for listeria coverage meningitis

Answer 7

ampicillin

Question 8

blood in CSF and temporal lobe involvement indicate likely

Answer 8

HSV encephalitis

Question 9

tx for HSV encephalitis

Answer 9

14-21 days of acyclovir

Question 10

TX for CMV encephalitis

Answer 10

ganciclovir or forscarnet

Question 11

Brain abscess initial antimicrobials

Answer 11

vanc, metronidazole, 3rd gen cephalosporin , and tmx/smp if toxo is suspected

Question 12

Initial abx for PNA to patents admitted to the ICU

Answer 12

Beta lactam (3rd gen ceps of amp-sulbactam) + macrolide or respiratory fluoroquinolone

Question 13

What PNA causing organism should get steroids added on if significant hypoxemia is present

Answer 13

PJP

Question 14

Nosocomial/ VAP tx

Answer 14

3rd or 4th gen ceph, B lactam, or carbapenem, add vanc in MRSA is likely

Question 15

MSRA PNA and Vanc allergy/ intolerance

Answer 15

give linezolid

Question 16

Abdominal source of infection abx

Answer 16

B-lactam, and carbapenems or cephalosporins with metronidazole

Question 17

What organism do you worry about for UTI in patients with urinary catheters in place for a long time or who have had recent manipulation of urinary tract and what abx to treat

Answer 17

Enterococcal, tx ampicillin, piperacillin, or vanc.

Question 18

Candida UTI lab finding and tx

Answer 18

glycosuria, fluconazole

Question 19

What classes of abx needed for necrotising soft tissue infection

Answer 19

vanc, b lactam, carbapenem, and fluoroquinolones or ahminoglycosides

Question 20

C diff metronidazole dose

Answer 20

500 mg TID for 10-14 days.

Question 21

Van dose c diff

Answer 21

125 mg 4 times daily for 10-14 days

Question 22

tx for aspergillus

Answer 22

Voriconazole