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Microbiology > Circulatory, RES, & Lymphatics > Flashcards

Circulatory, RES, & Lymphatics Flashcards

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Biology 101 flashcards
1
Q

bacteria in the blood

A

bacteremia

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2
Q

a broad term that includes bacterial toxins or fungi

A

septicemia

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3
Q

Most common sources of bacteremia

A

UTI, respiratory tract infection, infections of skin or soft tissues

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4
Q

Sepsis=

A

SIRS + suspicion or proof of an infectious cause

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5
Q

Sources of SIRS other than infection

A

pancreatitis, burns, trauma, PE, myocardial infarction, anaphylaxis and drug overdose

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6
Q

SIRS required two or more of the following

A

temperature elevated or decreased, increased HR, increased RR, significantly elevated or decreased WBCs OR 10% immature neutrophils

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7
Q

immature neutrophils

A

bands

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8
Q

sepsis assoc. w/ organ hypoperfusion

A

severe sepsis

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9
Q

indicators of organ hypoperfusion

A

reduction in urine output, mental status changes, systemic acidosis and/or hypoxemia

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10
Q

hypotension not responsive to fluid and pharmacologic treatment

A

refractory septic shock

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11
Q

sepsis+ hypotension (systolic pressure < 90 mm Hg)

A

septic shock

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12
Q

throwing clots in many different parts of the body

A

disseminated intravascular coagualation

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13
Q

death from septic shock is usually caused by

A

multi-organ failure

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14
Q

fatality rate of septic shock

A

40-60%

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15
Q

septic shock is classically induced by

A

gram - bacteria in the bloodstream-LPS

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16
Q

Gram + bacteremia causes septic shock via

A

peptidoglycan or exotoxins

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17
Q

release of vasoactive substance such as histamine can cause

A

arterial hypotension

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18
Q

TNF can affect cardiac muscle via

A

depression of cardiac muscle contractility-decreases organ perfusion

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19
Q

cell function is affected rather than organ destruction

A

cellular stasis

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20
Q

Tx septic shock-hypotension:

A

IV fluids (1-2L of normal saline over 1-2 h)

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21
Q

Tx septic shock-hypoxia:

A

ventilator therapy

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22
Q

Tx septic shock-DIC:

A

transfusion of fresh-frozen plasma and platelets to stop bleeding OR heparin to prevent thrombi formation

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23
Q

Tx septic shock-bacterial infection:

A

antibiotics

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24
Q

In septic shock patients what was the major determinant of outcome?

A

the interval between the onset of hypotension and the administration of antibiotics

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25
Q

What happens when you run out of clotting components during DIC

A

start to hemorrhage-need to give plasma/platelets

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26
Q

Early in DIC Tx

A

Heparin to prevent thrombi formation

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27
Q

Septic shock Tx for unknown bacterium

A

Vancomycin and gentamicin to cover both gram-positive, and gram-negative infections

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28
Q

Septic shock with generalized erythroderma

A

toxic shock syndrome-Staph. aureus, Strep. pyogenes

29
Q

Septic shock with petechiae in skin

A

Neisseria meningitidis

30
Q

Septick shock with petechial skin lesions in person who has been bitten by a tick in an endemic area

A

Rocky Mountain spotted fever

31
Q

Septic shock with hemorrhagic skin lesions with history of consuming raw oysters

A

Vibrio vulnificus

32
Q

Main method of diagnosing sepsis

A

blood cultures

33
Q

% of infective endocarditis yielding + blood cultures

A

95%

34
Q

When do you not do a blood culture for diagnosing sepsis

A

if the patient is already on antibiotic therapy

35
Q

most common cause of septic shock

A

bacteria (gram +/ gram -)

36
Q

Predisposing factors to pericarditis

A

pericardial effusion, immunosuppression, chronic diseases, cardiac surgery, chest trauma

37
Q

common causes of pericarditis

A

streptococci, staphylococci, gram-negative rods, anaerobic bacteria, haemophilus influenzae, early complication of lyme disease (borrelia burgdorferi)

38
Q

Tx of pericarditis

A

surgical drainage, systemic antibiotics

39
Q

Dx: of pericarditis

A

very high fever, WBC count, and cardiac tamponade

may test pericardial fluid

40
Q

fatality rate: pericarditis

A

untreated: fatal, treated: 40% mortality

41
Q

Dx: mycobacterial pericarditis

A

bacilli observed in pericardial fluid or a biopsy of the site

42
Q

acute infectious myocarditis should be suspected in patients with

A

dynamically evolving changes in ECG, echocardiography, and serum creatine kinase levels

43
Q

infectious myocarditis most commonly associated with

A

non-bacterial pathogens (viruses-coxsackie B, trypanosoma cruzi protozoa, endomyocardial fibrosis-parasite)

44
Q

bacterial causes of myocarditis

A

borrelia burgdorferi, orientia tsutsugamushi, rickettsia rickettsii, coxiella burnetii, mycoplasma pneumoniae, chlamydia pneumoniae, corynebacterium diphtheriae

45
Q

high fever (103-104F), acutely ill, rapid damage to cardiac structures

A

acute bacterial endocarditis

46
Q

acute bacterial endocarditis if untreated

A

progresses to death within weeks

47
Q

mycotic aneurysm may result from

A

acute bacterial endocarditis

48
Q

subacute bacterial endocarditis presentation

A

low-grade fever, night sweats, weight loss, vague constitutional complaints, indolent course (slow damage to the heart)

49
Q

bacterial causes of acute bacterial endocarditis (ABE)

A

staph. aureus, beta-hemolytic streptococci, pneumococci

50
Q

subacute bacterial endocarditis-bacterial causes

A

viridans streptococci, enterococci, coagulase-negative staph, HACEK group (normal oropharyngeal flora)

51
Q

native valve endocarditis bacterial agents

A

staph. aureus, viridans streptococci, group D streptococci, enterococci, HACEK

52
Q

injection drug users-endocarditis bacterial agents

A

staph. aureus, enterococci and streptococci

53
Q

Prosthetic valve endocarditis early infections (within 2 months of implant) caused by

A

staphylococci, gram - organisms, fungi

54
Q

Prosthetic valve endocarditis late infections caused by

A

mainly streptococci, but staphylococci also

55
Q

transvenous pacemaker or implanted defribrillator-associated endocarditis causes

A

nosocomial, staph. aureus or coagulase- staph.

56
Q

Most common causes of endocarditis

A

STAPH AUREUS!

57
Q

clinical manifestations of endocarditis

A

fever, valve destruction, peripheral purpura, embolisms

58
Q

nontender erythematous macules on palms or soles usually seen in ABE

A

Janeway lesions

59
Q

painful, purplish nodules of the fingers, toes or feet usually seen in SBE

A

Osler nodes

60
Q

dark, linear discolorations under the nails usually seen in SBE

A

Splinter hemorrhages

61
Q

Embolisms in the heart and brain may result in

A

infarctions

62
Q

predisposing factors to endocarditis

A

degenerative valve disease, prosthetic heart valves, IV drug abuse, and intracardiac devices

63
Q

present in 50% of endocarditis cases

A

disease of the heart valves

64
Q

how does disease of heart valves predispose to endocarditis

A

alters blood flow-disrupts endothelial surface-provides a focus for direct attachment and colonization of the bacterium

65
Q

Common sources of bacteria causing endocarditis

A

transient bacteremia from dental, upper respiratory, urologic, and lower gastrointestinal diagnostic and surgical procedures

66
Q

continuous bacteremia with endocarditis is caused by

A

continuous shedding of bacteria from vegetations

67
Q

vegetation is composed of

A

platelets, fibrin, microcolonies of bacteria and inflammatory cells

68
Q

Dx: of bacterial endocarditis

A

fever, positive blood cultures, peripheral emboli, visualization of vegetative growth on echocardiography

69
Q

Tx of bacterial endocarditis

A

b/f blood culture results: vancomycin and gentamicin (covers staph, strep, enterococci) prolonged therapy (> 4 weeks), surgical vegetectomy and valve replacement in some cases

Microbiology (8 decks)

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