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Infectious Disease > Disease States and Treatments Test 2 > Flashcards

Disease States and Treatments Test 2 Flashcards

1
Q

Steps in the Pathogenesis of an Infection

A

Encounter –> Colonization –> Evasion of Host Defenses –> Invasion –> Mechanisms of Damage –> Shedding

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2
Q

Bacteriocins

A

when the indigenous flora secrete their own antibiotics that inhibit growth of other org around them so they don’t have to compete for nutrients

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3
Q

Virulence

A

degree of pathogenicity of an org

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4
Q

Virulence factors

A

genetically related factors that demonstrate biochemical evidence of damaging potential
Can be defensive (attachment, recognition, proliferation, change in surface structure to avoid recognition) or offensive (damage, toxin prod, spread)

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5
Q

Exotoxins and Examples

A

substances that, if isolated and injected, would elicit sx of infection
Ex. tetanus, botulinum, diphtheria, anthrax

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6
Q

Endotoxins and Examples

A

substances that are kept w/in bact but that are released upon destruction of bact cell wall
Ex. Almost always refers to LPS!

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7
Q

Tamm-Horsfall mannoproteins

A

normal host defense in bladder to keep substances from adhering to bladder wall; decoy for mannose

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8
Q

Umbrella cells

A

protective barrier for the lining of the bladder; secrete mucin

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9
Q

Cystitis

A

LOWER UTI in females; just involves the urethra and bladder

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10
Q

Pyelonephritis

A

UPPER UTI in females; tend to involve the kidneys as well as urethra and bladder

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11
Q

When do you categorize a UTI as complicated?

A

Male, Age >65, children, pregnancy, diabetes, immunosuppression, indwelling catheter, instrumentation, anatomic abnormality

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12
Q

Main org in UTI?

A

E.coli, Staph saprophyticus

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13
Q

Diagnosis of UTI

A

MADE PRIMARILY BY SX AND SUPPORTED BY DIAGNOSTIC TESTS!

Diagnostic tests: leukocyte esterase, WBC’s >10, nitrite, >5 RBC’s, bacteria

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14
Q

First line for uncomplicated lower UTI

A

TMP/SMZ (Bactrim) bid x 3 days OR

Nitrofurantoin (Macrobid) bid x 5 days

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15
Q

Treatment for complicated lower UTI

A

Quinolones preferred x 7-10 days (Cipro or Levo)

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16
Q

First line for pyelonephritis

A

Upper UTI (always want a urine culture); Ciprofloxacin or Levofloxacin
2nd TMP/SMZ
NEVER USE NITROFURANTOIN IN UPPER UTI!

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17
Q

Treatment of UTI in males (non-prostatitis)

A

Cipro or Levo x 10-14 days

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18
Q

First line for prostatitis in males

A

Cipro or Levo OR TMP/SMZ
Acute= 4 weeks (lots of pain)
Chronic= 6 weeks (low back pain and less severe sx)

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19
Q

Asymptomatic bacteriuria

A

not treated unless there are symptoms EXCEPT IN pregnant women and invasive urologic procedures

20
Q

Nonpurulent Cellulitis

A

Swelling, redness, (erythema and edema at site of infxn); Strep pyogenes

21
Q

Purulent Cellulitis

A

Involves a lesion of some sort (boils, abscesses); Staph aureus; require incisions and drainage!

22
Q

Degree of Severity of Cellulitis

A 
Mild= local only
Moderate= systemic sx (fever, >WBC's, chills, etc)
Severe= SIRS, hypotension, failed initial tx, immune compromised
23
Q

Treatment for mild nonpurulent cellulitis

A

penicillin, diclox, C1, clindamycin

24
Q

Treatment for moderate nonpurulent cellulitis

A

penicillin, cefazolin, penicillinase resistant penicillin, clindamycin

25
Q

Treatment for severe nonpurulent cellulitis

A

Vanc PLUS pip/tazo

26
Q

Treatment for mild purulent cellulitis

A

not necessary! (don’t even need them if you got rid of the boil)

27
Q

Treatment for moderate purulent cellulitis

A

TMP/SMZ, doxycycline

28
Q

Treatment for severe purulent cellulitis

A

Vanc

29
Q

Treatment for necrotizing infections

A

Penicillin + Clindamycin

Polymicrobial: Vanc + pip/tazo

30
Q

Treatment for bite wounds

A

Augmentin or ampicillin/sulbactam x 10-14 days

31
Q

Diabetic Foot Infections Duration and Diagnosis

A

Only valuable cultures are from debridement

Treat for approx 14 days

32
Q

Hematogenous

A

spread through bloodstream

33
Q

Contiguous

A

spread from nearby infection

34
Q

Kernig’s sign

A

pain with extension of the leg (meningitis)

35
Q

Brudzinki’s sign

A

raises the neck and it causes flexion of the knees

36
Q

Diagnosis of meningitis

A

definitive by lumbar puncture; increased opening pressure, increased WBC, decreased glucose (50)

37
Q

Steroids as adjunctive therapy in CNS infections

A

MUST give steroids PRIOR to first dose of antibiotics to be effective (used to prevent new inflammation from the lysing of dead bact from abx)
Usually dexamethasone
Do NOT enhance passage across BBB

38
Q

Treatment for meningitis for <1 month olds

A

ampicillin + -tax OR -triax

Add ampicillin to cover Listeria in the youngin’s

39
Q

Treatment for meningitis for 1 mo-60 years old

A

Vanc + -tax OR -triax

40
Q

Treatment for meningitis for >60 years old

A

Vanc + ampicillin + -tax OR -triax

41
Q

Dosing for meningitis agents

A

Ampicillin: 1 gm Q4H
Cefotaxime: 1 gm Q4H
Ceftriaxone: 1 gm Q12H
Vancomycin: 30-40 mg/kg/day

42
Q

Prophylaxis for meningitis

A

Rifampin

43
Q

5 ways you can get infections from catheters

A

1.) contaminated infusate 2.) contaminated hub 3.) skin organisms 4.) contamination of device prior to insertion 5.) hematogenous

44
Q

Diagnosis for catheter related blood stream infections

A

2 sets of blood cultures (one catheter and one blood)

45
Q

Treatment of catheter related blood stream infections

A

Vanc is first line!

High dose daptomycin alternative

46
Q

De-escalation of therapy in CRBSI

A

Based on culture results=
MSSA/ MSSE: nafcillin/oxacillin
Enterococcus: ampicillin/ Vanc + AG
Gram (-) bacilli: beta-lactams

47
Q

Antibiotic lock therapy

A

instill high conc antibiotic into the catheter and leave 24-48 hours

Infectious Disease (6 decks)

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