Crappy Staph (Lec 2)

Question 1

Staph aureus is gram positive, catalase ____, and coagulase ____

Answer 1

positive, positive

Question 2

Coagulase negative staph =

Answer 2

staph epidermidis and saprophyticus

Question 3

Rate of colonization of staph is higher in patients with these issues:

Answer 3

diabetes, HIV, skin damage

Question 4

Classic site of colonization of S aureus

Answer 4

anterior nares

Question 5

3 toxins produced by staph:

Answer 5

cytotoxins, pyrogenic toxin superantigens, exofoliative toxin mediates

Question 6

Symptoms of Staph TSS:
Fever > \_\_\_\_\_
Hypotension: systolic less than
\_\_\_\_\_
\_\_\_\_\_

Answer 6

38.9 (102 F)
90 mm
diffuse maculopapular erythoderma
desquamation

Question 7

MRSA skin infections are often wrongly attributed to _____

Answer 7

spider bites

Question 8

______ is the primary treatment of all simple abscess/boils

Answer 8

incision and drainage

Question 9

MRSA or MSSA causes most purulent ____ tissue infections, as opposed to strep

Answer 9

soft

Question 10

_____ is a superficial infection of a hair follicle/superficial dermis

Answer 10

folliculitis

Question 11

_____ are a coalescence of multiple carbuncles and are more likely to lead to ____ symptoms

Answer 11

furuncles, systemic

Question 12

_____ are infections originating from hair follicles and extending into the epidermis

Answer 12

carbuncles

Question 13

_____ is a superficial dermal infection of staph, usually seen in _____

Answer 13

impetigo

kids

Question 14

______ is a follicular infection of the intertriginous area

Answer 14

Hidradenitis suppurativa

Question 15

Cellulitis, erysipelas, and fasciiits are infection of the ______ tissues

Answer 15

subcutanoues

Question 16

_____ is an infection of skeletal muscle

Answer 16

pyomyositis

Question 17

_____ are a collection of pus in the dermis and deeper tissues

Answer 17

skin abscesses

Question 18

Staph sepsis is typically preceded by ______

Answer 18

bacteremia

Question 19

_____ is the empiric treatment of MSSA

Answer 19

Nafcillin

Question 20

Protracted fever or sweats may indicate ____ caused by staph bacteremia

Answer 20

endocarditis

Question 21

What do you use to look at heart valves in patients with S. Aureus bacteremia?

Answer 21

echocardiography–>typically trans-esophageal

Question 22

Valve replacement should be considered in patients with ____ > 10 mm

Answer 22

vegetations

Question 23

Treatment of MRSA bacteremia is typically:

Answer 23

vancomycin (or daptomycin)

Question 24

Antibiotic treatment of MRSA bacteremia should be for at least _____ days

Answer 24

14

Question 25

What is typically the safest area for central line placement?

Answer 25

subclavian

Question 26

_____ is a clinical syndrome complicating a noninfecious insult; ie pancreatitis

Answer 26

SIRS (systemic inflammatory response syndrome)

Question 27

Diagnostic criteria for SIRS include:
HR __ 90 bpm
Respiration rate __ 20 breaths/min or PaCO2 __ 32 mm Hg

Answer 27

>

>;

Question 28

SIRS:
WBC is typically > ____ or less than _____
Temp > 38 C or less than 36

Answer 28

12,000; 4,000

Question 29

Sepsis requires at least ___ components

Answer 29

2

Question 30

______ is sepsis induced hypotension persisting despite adequate fluid resuscitation (vasodilation)

Answer 30

septic shock

Question 31

_____ is the main cause of fungal sepsis

Answer 31

candida (from central lines)

Question 32

Vasopressors should be given after administration of ____

Answer 32

IV fluids

Question 33

MRSA is mediated by PBP-2a, a ______ binding protein encoded by the ____ gene

Answer 33

penicillin;

mecA

Question 34

The mecA gene is located on a ______ genetic element

Answer 34

mobile

Question 35

USA300 and USA400 strains of MRSA are associated with __ associated MRSA; presentation of disease is typically:

Answer 35

community;

skin/soft tissue infections

Question 36

USA100 and 200 strains are associated with ___ associated MRSA. presentation of disease is typically ______

Answer 36

healthcare

severe invasive disease

Question 37

Younger patients are more likely to have ___ associated MRSA; older patients usually have _____

Answer 37

community;

hospital associated