ID exam 1 Flashcards

1
Q

whats the old defintion of sepsis ? SIRS

A

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

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2
Q

what is the new defintion of sepsis? qSOFA?

A

score less than 2 with poor outcome due to spesis

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3
Q

what is septic shock? what do you need as meds?

A

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

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4
Q

pt come in with high procalcitonin and lipopolysaccharide. what is the dx

A

septic shock

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5
Q

how would u tx septic shock?

A

remove infection soruce, IV fluids, vasopressors

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6
Q

what gram negative bacteria do u found in soil/water/surfaces?

A

Pseudomonas aeruginosa

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7
Q

what bacteria would u see ass w nosocomila, IV lines, catheter IV, UTI, otisis media, contact lens?

A

Pseudomonas aeruginosa

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8
Q

what bacteria can casue these RF: DM2, burns, immunsuppression neutropenisa?

A

Pseudomonas aeruginosa

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9
Q

what bacteria is ass w blue-green pigment and fruit order?

A

Pseudomonas aeruginosa

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10
Q

how would u tx Pseudomonas aeruginosa?

A

anti pseudomonal agent like pencillin and cephalopsorn

if sus is high or spetic shock : dual pseudo + ABX

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11
Q

which bacteria is lactose fermenter postive?

A

E.coli

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12
Q

where do u see e.coli most?

A

UTI, cystitis, prostatiis, pylonephritiss, meningitis in infants

you tx AXS bactermia in prengnacty !!

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13
Q

how would u tx enterotoxigenic e.coli?

A

traverlers diareeha

tx w macrolide (azithro) or quinolone (all the foxcin)

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14
Q

what is hemolytic uremic syndrome (HUS) ass with? and what are the s/s

A

ass w enterohemorrhagic e.clo

s/s FAT RN
renal failure, hemolytic anemia, thrombocytopenia, bloody dirarehha, seziiers/stroke

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15
Q

how would u tx e.coli? what do u want to avoid?

A

fluid replacement

avoid ABX (quinolones can enahnce toxicity)
supprotive care
NO ANTIMOTLITY AGENTS

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16
Q

what gram neg bacteria do u see ass with raw poutly and in GI trat of animals?

A

Campylobacter. Jejuni

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17
Q

what bacteira is ass w post infectious gulliam barre syndrome or usage of PPI?

A

Campylobacter. Jejuni

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18
Q

how would you dx someone who is coming in with s/s of acute pendiciites from eating raw chicken?

A

c. jejuni

DX: stool culture gram negative –> S shape or seagul shape

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19
Q

whats the tx for Campylobacter. Jejuni ?

A

azithromycin + fluids mainstay

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20
Q

what bacteria occurs when children handle turble or reptiles?

A

non typhi salmonella

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21
Q

whats the tx for non typhji salmonella? what are RF

A

Self-limited, no tx unless: severe disease, AGE >50, neoplasm, immunosuppressed, valvular heart disease

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22
Q

whats the tx for non typhi salmonella ?

A

o Ceftriaxone (cephalosporin)

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23
Q

what baceteria is ass with unwashed hands, infected water, flying cockroach?

A

Shigella

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24
Q

whats the m/c group in the US for shigella?

A

GROUP D –> S. SONNEI

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25
Q

what are the sx for shigella and post shigella?

A

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)

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26
Q

how would u dx shigella?

A

stool culture first 48 hours of sx

seorlogy (for studies)

27
Q

what is the tx for shigella?

A

Treat even if its AXS
fluids + electrocutes

ABX resistant is high:
ceftriaxone, ciprofoxacine, azithromycin, bactrim

28
Q

what bacteria is aerobic, non motile, non sporing forming ?

A

shigella

29
Q

what bacteria is highly mucoid colonies whcih inhibits phagocyotsis?

A

klebsiella

30
Q

what is the dx and tx for klebseilla?

A

DX: string test !
TX: ABX resistance
o Empiric therapy: ceftriaxone, ciprofloxacin (resistance) beta lactase inhibitors

31
Q

which bacteira is highly contagious via droplet transmission and close contact?

A

Neisseria Meningitis

32
Q

where do u see Neisseria Meningitis m/c?

A

crowded living like dorms, barracks, prisons, HIV-MSM, asplenia, travel Africa?

33
Q

what is the imp serogroups for meningitis?

A

A B C W135 X Y

34
Q

what are the s/x for n.meningitis?

A
  • SX: fever HA +/- AMS, leukocytosis, petechial rash/purpura, shock/death (meningococcemia)
35
Q

how would you dx n.meningitis?

A

blood agar plate (BAP) and chocolate agar plate (CAP

36
Q

how would u tx n.meningities?

A

ABX to cross the BB
- IV pencilin
- ceftraixone!

if close contact w someohe tx them w :
- rifampin 600mg BID

prevention: surgery for asplenia

vaccine!!

37
Q

which bacteria is ass with urethritis/cervicitis (discharge), pelvic inflame disease, epididymitis (in men), prostatitis ?

A

N. Gornnorhoease

38
Q

what traid do u see with n.gonnor?

A

o TRIAD: dermatitis, polyarthralgia, tenosynovitis

39
Q

whats the M/C/C for spetic arthiris in young adutls knees?

A

Neisseria Gonorrhoeae

40
Q

how would u dx and tx Neisseria Gonorrhoeae?

A

dx: NAAT, grain stain, urinalysis

TX: Ceftraixone + azithro/doxy to cover chalmtydia

41
Q

what are the atypical and typicla pathogens?

A

atypical: MCL (mycoplasma, chalmydia, legionella)

typical: SPSA, HM (strep penumonia, staph,aureus, h.inflcuenza, moraxella cata)

42
Q

how would you tx in pt typical and atypical dx ?

A

typical - ceftriaxone IV
moxi or levo

atypical - azitrho or doxy
moxi or levo

43
Q

how would you tx NORMAL out pt typical and atypical dx ?

A

typical - azithro or doxy

atypical - azithro or doxy

44
Q

how would you tx BAD out pt in atypical and typical?

A

typical - amoxicillin or clavulanate ++ cefuroxime

moxi or levo

atypical - azithro or doxy
moxi or levo

45
Q

what is post shigella reactive arthritis sx?

A

arthritis, conjunctivas, urethritis

46
Q

which baterica has TYPE B group that is pathogenic?

A

H.influenza

47
Q

what bacteria has the M/C cause of epiglottisitis?

A

H.influenza

48
Q

how would u tx the bacteria realted to epiglottisis otitis media, meningitis, COPD, trahceobronchitis?

A

H.influzea

TX: TYPICAL CAP MED

49
Q

how would u dx h.influencza

A

HEMIM (F10) and NAD (F5) on chocolate agar

50
Q

which bacteira is high contagious and causes URI and rarely pneuomia?

A

moraxella catarrhalis

51
Q

how would u dx and tx Moraxella catarrhalis?

A

DX: grows EASILY on choclate agar :)

TX: typical CAP medds

52
Q

what bacteira is ATYPICAL intracellualr pathogen that is asscoiated w water towwers and air conditioners?

A

Legionella

53
Q

what are the RF for Legionella ?

A

COPD, smoking, ages&raquo_space;> 50, immunosuppresed pt

53
Q

what SX would u see with legionella?

A

CXR: lobar pathy or intersitiaol infiltrates
GI - gi sx

*pontiac fever - flu like sx without pneumonia

53
Q

how would u dx and tx Legionella ?

A

dx: urianary antigen test, PCR, buffered charcaol yeast extract

TX: azithro or fluoquinolone

54
Q

which bacteria is called the whooping cough and how would u dx and tx it ?

A

bordetella pertussis

dx: culture of the nasopharynx
tx: azithro and TDAP for prevention

55
Q

what are the stages for B.pertussies?

A

CPC
catarahhal stage - cough, NOOOO coryza, milf fever, rhinorreha

paraoxysmal stage - cough with whopping sound after cough fits may have post coughing emesis

convalscent stage: decreases freq and severity oif couhg

56
Q

is B.pertussis contagious?

A

YES!!!!!! incudation of 5-12 days

57
Q

what bacteira is non sporing forming and VERY CONTAGIOUS?

A

shigellosis

58
Q

pt has explosive water diarerhea with BLOOD and post shigella reactive arthtiirs? what bacteiria is it? how would u tx it?

A

Shigellosis

azithro cipro if severe

59
Q

which bacteria cna casue febrile seziures in children if severe?

A

Shigellosis

60
Q

how would u dx Shigellosis ?

A

stool culture since its water diareheha w blood scary!! and do leukocyte reaction to see whats up

61
Q
A