Crappy Staph (Lec 2) Flashcards
Staph aureus is gram positive, catalase ____, and coagulase ____
positive, positive
Coagulase negative staph =
staph epidermidis and saprophyticus
Rate of colonization of staph is higher in patients with these issues:
diabetes, HIV, skin damage
Classic site of colonization of S aureus
anterior nares
3 toxins produced by staph:
cytotoxins, pyrogenic toxin superantigens, exofoliative toxin mediates
Symptoms of Staph TSS: Fever > \_\_\_\_\_ Hypotension: systolic less than \_\_\_\_\_ \_\_\_\_\_
38.9 (102 F)
90 mm
diffuse maculopapular erythoderma
desquamation
MRSA skin infections are often wrongly attributed to _____
spider bites
______ is the primary treatment of all simple abscess/boils
incision and drainage
MRSA or MSSA causes most purulent ____ tissue infections, as opposed to strep
soft
_____ is a superficial infection of a hair follicle/superficial dermis
folliculitis
_____ are a coalescence of multiple carbuncles and are more likely to lead to ____ symptoms
furuncles, systemic
_____ are infections originating from hair follicles and extending into the epidermis
carbuncles
_____ is a superficial dermal infection of staph, usually seen in _____
impetigo
kids
______ is a follicular infection of the intertriginous area
Hidradenitis suppurativa
Cellulitis, erysipelas, and fasciiits are infection of the ______ tissues
subcutanoues
_____ is an infection of skeletal muscle
pyomyositis
_____ are a collection of pus in the dermis and deeper tissues
skin abscesses
Staph sepsis is typically preceded by ______
bacteremia
_____ is the empiric treatment of MSSA
Nafcillin
Protracted fever or sweats may indicate ____ caused by staph bacteremia
endocarditis
What do you use to look at heart valves in patients with S. Aureus bacteremia?
echocardiography–>typically trans-esophageal
Valve replacement should be considered in patients with ____ > 10 mm
vegetations
Treatment of MRSA bacteremia is typically:
vancomycin (or daptomycin)
Antibiotic treatment of MRSA bacteremia should be for at least _____ days
14
What is typically the safest area for central line placement?
subclavian
_____ is a clinical syndrome complicating a noninfecious insult; ie pancreatitis
SIRS (systemic inflammatory response syndrome)
Diagnostic criteria for SIRS include:
HR __ 90 bpm
Respiration rate __ 20 breaths/min or PaCO2 __ 32 mm Hg
>
>;
SIRS:
WBC is typically > ____ or less than _____
Temp > 38 C or less than 36
12,000; 4,000
Sepsis requires at least ___ components
2
______ is sepsis induced hypotension persisting despite adequate fluid resuscitation (vasodilation)
septic shock
_____ is the main cause of fungal sepsis
candida (from central lines)
Vasopressors should be given after administration of ____
IV fluids
MRSA is mediated by PBP-2a, a ______ binding protein encoded by the ____ gene
penicillin;
mecA
The mecA gene is located on a ______ genetic element
mobile
USA300 and USA400 strains of MRSA are associated with __ associated MRSA; presentation of disease is typically:
community;
skin/soft tissue infections
USA100 and 200 strains are associated with ___ associated MRSA. presentation of disease is typically ______
healthcare
severe invasive disease
Younger patients are more likely to have ___ associated MRSA; older patients usually have _____
community;
hospital associated
