ID 16 Flashcards
Difference in presentation between chlamydia and gonorrhoa with PID
Chlamydia –> subacute and often undiagnosed.
Gonorrhoeae –> acute.
most common bacterial STI in US?
chlamydia
chandelier sign?
cervical motion tenderness
PID presentation
chandelier sign
purulent cervical discharge
PID may include…
salpingitis
endometritis
hydrosalpinx
*tubo-ovarian abscess
Most common causes of nosocomial infection?
E coli (UTI) S aureus wound infections
C diff presentation
watery diarrhea
*leukocytosis
usual pathogens with aspiration
polymicrobial
*gram negatives
anaerobes
aspiration pneumonia findings
1) right lower lobe infiltrate or right upper/middle lobe if recumbent
2) purulent malodorous sputum
decubitus ulcers usually caused by
1) s aureus
2) gram negative anaerobes
long term IV catheter associated pathogen
s epidermidis
other pathogens associated with IV catheters
s aureus
*enterobacter
pathogens associated with mechanical ventilation, endotracheal intubation?
Late onset: P aeruginosa, klebsiella acinetobacter S aureus
Findings with mechanical ventilation, endotracheal intubation infection?
New infiltrate on CXR.
Increased sputum production.
common nosocomial infection with renal dialysis?
HBV
urinary catheterization pathogens?
E coli
Klebsiella
Proteus
Rash in an unimmunized child think..
Rubella
Measles
epiglottitis presentation
fever with dysphagia, drooling, difficulty breathing.
caveat about h flu type b epiglottitis
can cause epiglottitis in immunized children too
Infection in asplenic patient think…
encapsulated microbes
Infection in neutropenic pt think..
candida
aspergillus
empyema think…
s aureus
infection with traumatic open wound think…
clostridium perfringens
nalidixic acid
quinolone
bacitracin
glycopeptide. inhibits peptidoglycan synthesis.
streptogramins?
quinupristin
dalfopristin
monobactams?
aztreonam
1st generation cephalosporin?
cefazolin
2nd generation cephalosporin?
cefoxitin
3rd generation cephalosporin?
ceftriaxone
4th generation cephalosporin?
cefepime
5th generation cephalosporin?
ceftaroline
Penicillin clinical uses
Gram positives (S pneumo, s pyogenes, actinomyces) Gram negatives (n mengitidis) spirochetes (t pallidum)
penicillin bacteriostatic/cidal?
usually bactericidal
penicillin resistance
penicillinase in bacteria cleaves beta-lactam ring
penicillinase?
Type of beta-lactamase
What are step penicillinase-sensitive penicillins?
amoxicillin, ampicillin; aminopenicillins
point of adding clavulanic acid?
protect against beta-lactamse
amoxicillin vs. ampicillin
amoxicillin has greater oral bioavailability
penicillinase-sensitive penicillins use
H flu H pylori E coli Listeria Proteus Salmonella Shigella Enterococci
amoxicillin/ampicillin AE’s
1) Hypersensitivity reactions
2) rash
3) C diff
penicillinase-sensitive penicillins resistance
penicillinase cleaves beta lactam ring
What are penicillinase-resistant penicillins?
Nafcillin
Oxacillin
*Dicloxacillin
How do penicillinase-resistant penicillins resist penicillinase?
Bulky R group blocks access of beta-lactamase to beta-lactam ring
penicillinase-resistant penicillin uses
S aureus (EXCEPT MRSA; resistant because of altered penicillin-binding protein target site) (Use naf for staph)
penicillinase-resistant penicillin AE’s
1) hypersensitivity reactions
2) interstitial nephritis
What are the antipseudomonal penicillins?
Piperacillin
Ticarcillin
Spectrum of penicillinase-resistant penicillins?
narrow
Spectrum of antipseudomonal penicillins?
broad spectrum
antipseudomonal penicillins uses
pseudomonas
gram negative rods
antipseudomonal penicillins resistance
penicillinase
antipseudomonal penicillins caveat
usually used with beta-lactamase inhibitors
antipseudomonal penicillins AE’s
hypersensitivity reactions
Beta-lactamase inhibitors
Clavulanic acid
Sulbactam
tazobactam
hydrosalpinx
Distally blocked fallopian tube filled with serous or clear fluid.
tuba-ovarian abscess
Late complication of PID. Capsule pocket of pus occurring during infection of fallopian tube and ovary.
