ID exam 1 Flashcards
whats the old defintion of sepsis ? SIRS
need two of the following:
1. temp higher than 38C or less than 36C
2. WBC higher than 12 or less than 4 or higher than 10% bands
3. HR higher than 90 bpm
4. RR higher than 20 or paCO2 less than 32
what is the new defintion of sepsis? qSOFA?
score less than 2 with poor outcome due to spesis
what is septic shock? what do you need as meds?
vasodilation or distrubitive shock
when you dont respond to fluids
arachnoid acid –> into prostagladnins –> peripheral vasodilation
requries vasopressors to maintain MAP > 65
requires serum lactate > 2mmol
pt come in with high procalcitonin and lipopolysaccharide. what is the dx
septic shock
how would u tx septic shock?
remove infection soruce, IV fluids, vasopressors
what gram negative bacteria do u found in soil/water/surfaces?
Pseudomonas aeruginosa
what bacteria would u see ass w nosocomila, IV lines, catheter IV, UTI, otisis media, contact lens?
Pseudomonas aeruginosa
what bacteria can casue these RF: DM2, burns, immunsuppression neutropenisa?
Pseudomonas aeruginosa
what bacteria is ass w blue-green pigment and fruit order?
Pseudomonas aeruginosa
how would u tx Pseudomonas aeruginosa?
anti pseudomonal agent like pencillin and cephalopsorn
if sus is high or spetic shock : dual pseudo + ABX
which bacteria is lactose fermenter postive?
E.coli
where do u see e.coli most?
UTI, cystitis, prostatiis, pylonephritiss, meningitis in infants
you tx AXS bactermia in prengnacty !!
how would u tx enterotoxigenic e.coli?
traverlers diareeha
tx w macrolide (azithro) or quinolone (all the foxcin)
what is hemolytic uremic syndrome (HUS) ass with? and what are the s/s
ass w enterohemorrhagic e.clo
s/s FAT RN
renal failure, hemolytic anemia, thrombocytopenia, bloody dirarehha, seziiers/stroke
how would u tx e.coli? what do u want to avoid?
fluid replacement
avoid ABX (quinolones can enahnce toxicity)
supprotive care
NO ANTIMOTLITY AGENTS
what gram neg bacteria do u see ass with raw poutly and in GI trat of animals?
Campylobacter. Jejuni
what bacteira is ass w post infectious gulliam barre syndrome or usage of PPI?
Campylobacter. Jejuni
how would you dx someone who is coming in with s/s of acute pendiciites from eating raw chicken?
c. jejuni
DX: stool culture gram negative –> S shape or seagul shape
whats the tx for Campylobacter. Jejuni ?
azithromycin + fluids mainstay
what bacteria occurs when children handle turble or reptiles?
non typhi salmonella
whats the tx for non typhji salmonella? what are RF
Self-limited, no tx unless: severe disease, AGE >50, neoplasm, immunosuppressed, valvular heart disease
whats the tx for non typhi salmonella ?
o Ceftriaxone (cephalosporin)
what baceteria is ass with unwashed hands, infected water, flying cockroach?
Shigella
whats the m/c group in the US for shigella?
GROUP D –> S. SONNEI
what are the sx for shigella and post shigella?
fever, abdo cramps, water direahha, tenemus (feeling to pee but not peeing), blood diareeha w mucus,
post shigella reactive arthitirs: reiters syndrome (3 things: arthritis, conjunctiva, urethritis)