Critical care 2 Flashcards

1
Q

5 reasons cirrhotics are at higher risk of infection

A

increased bowel translocation, SIBO, immunocompromised state, alterations of gut microbiome (dysbiosis), and increased risk of resistant infections

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2
Q

Antibiotic regimen for cirrhotic patients with GI bleeds

A

fluoroquinolone or ceftriaxone x 7 days

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3
Q

Which patients are appropriate for PRIMARY SBP ppx?

A

low protein ascites (<1.5 g/dL) + renal or liver impairment

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4
Q

should cirrhotics with asymptomatic candiduria be treated?

A

no (exchange Foley)

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5
Q

Should fungus-positive BAL or sputum cultures be treated?

A

no

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6
Q

When should positive fungal cultures from sputum or urine be treated?

A

when fungus is cultured from 2 or more sites

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7
Q

What drug should be given empirically to start fungal treatment for critically ill patients?

A

micafungin (or caspofungin or anidulafungin [echinocandins])

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8
Q

What drug class should be used as de-escalation for patients with fungal infections?

A

Azoles

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9
Q

Goal fibrinogen level for cirrhotics with active bleeding or going for surgery?

A

> 1.5 g/L

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10
Q

When should TEG be used to guide coagulation mgmt in cirrhotics?

A

during surgery

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