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harris id > factoids > Flashcards

factoids Flashcards

1
Q

XAMA

A

oppotunistic grows in neutropenic pts with lots of ppx

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2
Q

PSAR sepsis similar other bugs with the exception that it also causes…

A

ecthyma gangrenosum

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3
Q

What is ecthyma gangrenosum

A

small or large, painful, reddish, maculopapular lesionw with a geographic margin. initially pink and then darken to purple finally necrotic

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4
Q

Ecythma gangrenosum pt pop

A

neutropenic and AIDS

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5
Q

Is monotherapy with an aminoglycoside optimal.

A

No.

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6
Q

Some of the aminoglycosides

A

tobra, gent, garamycin, amikacin, kanamycin, neomycin

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7
Q

Toxicites of aminogycosides

A

kidney and vestibular

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8
Q

What drugs are aminoglycosides synergistic with?

A

beta lactams and vanc

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9
Q

What do aminoglycosides target?

A

30s ribosome, protein synthesis

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10
Q

polymixin E

A

colistin

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11
Q

NNT PSAR pneumonia/ bacteremia mono tx

A

cepepime of ceftazidime

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12
Q

NNT PSAR combo tx bacteremia/ pneumonia

A

pip/taz or imi or mero or dori
plus
amikacin

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13
Q

NT PSAR bacteremia/ PNA

A

cefepime 2g q8 IV

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14
Q

PSAR UTI

A

cipro 500mg q12 PO
or
levo 750mg q24h
or any aminoglycoside

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15
Q

MDRO PSAR

A

colistin 100mg q12h IV for shortest possible period

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16
Q

XAMA tx

A

TMP-SMX 1600/320 mg q12 IV x14d

levo or tigecyclince alternates

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17
Q

BCEP

A

mero 1 g q8 IV
or
TMP-SMX (1600/320 mg q12 IV x 14 days

dont use these in combo bc of antagonism

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18
Q

Meliodiosis (pseudomallei), glanders (mallei)

A

ceftazadime
followed by
tmp-smx for 3 months

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19
Q

asian chroninc PSAR colonization

A

happens is some people from childhood

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20
Q

Most endocarditis

A

right sided

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21
Q

IVDU endocarditis

A

left side

22
Q

PSAR endocartitis can embolize to the

A

lungs

23
Q

Vertebral osteomyelitis in elderly can come from origninnaly having a PSAR

A

uti

24
Q

Puncture wound

A

PSAR and Ctet

25
Q

PSAR high csf conc drugs

A

ceftazidime
mero
cefepime

26
Q

green nail sydrome

A

submerging hands water repeatedly

pyocyanin

27
Q

PSAR PNA

A

no lobar predisposition. high frequency is cavitary.

28
Q

XAMA

A

must have disruption of normal flora to become infectious

29
Q

XAMA reistance due to

A

abx efflux pumps

two beta lactamases L1 and L2

30
Q

Xams, is it a sig CF pathogen

A

thought is no

31
Q

most XAMA infc from

A

resp or central line

32
Q

what abx xama typically ss

A

ticaracillin/clav
sxt
levo
tige

33
Q

First line empiric for B cep

A

sxt
mero
doxy

34
Q

Can use mero and sxt together

A

no may be antagonistic

35
Q

B psudomallei causes

A

meliodosis

36
Q

B pseudomallei geographics

A

SE asia
northern australlia
sometimes india and china
(think people returning or military)

37
Q

Meliodis can be

A

latent

38
Q

Meliodosis contracted by

A

inoculation, inhalation or ingestion

rarely person to person

39
Q

Most virulent pseudomonads

A

b pseudomallei, infects immunocompotent

40
Q

mortality of meliodosis

A

44%

41
Q

ds of meliodosis

A

PNA community aqcuired,

septimcemia

42
Q

B. mallei (glanders)

A

equine ds in aftrica, asia and south America. Erradicated from NA and europe decades ago

43
Q

Is us last case of glander was in 2001 in a

A

lab worker

44
Q

B mallei

A

from horses
not from contaminated soil
risk for horse handler, butchers of horse, veterinarians

45
Q

B mallei

A

from horse to human trhough skin puncture
regional lymphadenopathy

from horse to human through inhalation
can be latent

46
Q

Procalcitonin

A

can be used to see if abx are working (at least for legionella)

47
Q

Legionella urinary antigen

A

detects about 80%
only for serogroup 1
detectable 3 days to 2 months onset

48
Q

Legionella is intracetlluar so abx that penetrate cells best including…

A 
macrolide 
quinolone
ketolide (telithromycin)
tetracycline group
sxt
rifampin

best choices are macrolide and quinolone

49
Q

why are quinolones preferred in transplant patient

A

bc macrolide and rifampin interact with cyclosporine and tacrolimus

50
Q

how long should give FQ for legionella

A

3-5 days IV

rest PO for total of 10-14d

51
Q

critically ill legionella

A

levo
azithro
rifampin

harris id (3 decks)

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