elderly man with cough Flashcards
a gram negative rod that releases green diffusible pigment in culture is most likely
pseudomonas aeruginosa
best treatment for pseudomonas aeruginosa
piperacillin + tazobactam
p is a semisynthetic penicillin
t is a beta-lactamase inhibitor
what has been successfully used to increase the immunogenicity of the Streptococcus pneumoniae vaccine in humans?
conjugation of bacterial polysaccharides with an immunogenic protein
legionella is tested for by
urine antigen test
left shift in WBC
neutrophils or lymphocytes increased
immature neutrophils being released = bacterial
increased lymphocytes = viral
gram positive is colored
blue/purple
thicker membrane retains more purple dye
strep pneumoniae is
treat with
GRAM + diplococci
fluoroquinolone (moxifloxacin, levofloxacin) or
beta-lactam (amoxicillin), or
cephalosporin for resistant strep pneumo (ceftriaxone)
plus a macrolide (or doxycycline)
Z pack
azithromycin as 5 day course
given for walking pneumonia (mycoplasma)
ribavirin
used for RSV or HepC
Oseltamivir (Tamiflu)
used to treat influenza/flu
treat MRSA with
vancomycin
What is the most likely cause for patient’s fever?
A. A direct effect of endotoxin on the hypothalamic temperature regulation center
B. An increased blood supply to the hypothalamus caused by vasoactive mediators
C. The generation of pyrogenic complement fragments by macrophage proteases
D. The release of C-reactive protein by the liver
E. The release of TNF, IL-1 and IL-6 by activated macrophages
E
Which of the following is the major indication that this patient requires immediate initiation of therapy?
A. Deterioration of his mental status
B. Possible malignant nature of his prostatic enlargement
C. Possible urinary tract infection
D. Signs and symptoms suggestive of bacteremia and likely sepsis
E. Signs and symptoms suggestive of dehydration
D
UTI caused by pseudomonas
gram -
oxidase +
grows on mcconkey agar
occurs with catheter/foley use
serious complicstion from strep pneumo as cause of mortality?
meningitis
influenza B…to prevent outbreak what drug class should be applied?
neuraminidase inhibitor
consolidating pneumonia of right lung is most likley
strep pneumoniae
usually see mycoplasma in
xray shows
ASYMPTOMATIC WALKKING PNEUMONIA
NO consolidation, maybe diffuse infiltrates
klebsiella is associated with
hemoptysis
pneumocystis carinii is seen with
HIV
antibiotic for strep pneumo — which would be used?
- levofloxacin
- ampicillin
- penicillin
- vancomycin
- SMX-TMP
levofloxacin
a fluoroquinolone!
t/f: the decision to remove life support is easier than the decision to put them on it.
FALSE
harder to remove life support
treatment for pseudomonas
levofloxacin
gentamycin toicity
nephrotoxicity and irreversible ototoxicity
aminoglycosides are TOXIC
fluoroquinolones toxicity?
tendonopathy – affects tendons
and
QT prolongation
white exudate with cotton wool ball appearrance is candida
found where?
endogenous flora
