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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
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)
26
how would u dx shigella?
stool culture first 48 hours of sx seorlogy (for studies)
27
what is the tx for shigella?
Treat even if its AXS fluids + electrocutes ABX resistant is high: ceftriaxone, ciprofoxacine, azithromycin, bactrim
28
what bacteria is aerobic, non motile, non sporing forming ?
shigella
29
what bacteria is highly mucoid colonies whcih inhibits phagocyotsis?
klebsiella
30
what is the dx and tx for klebseilla?
DX: string test ! TX: ABX resistance o Empiric therapy: ceftriaxone, ciprofloxacin (resistance) beta lactase inhibitors
31
which bacteira is highly contagious via droplet transmission and close contact?
Neisseria Meningitis
32
where do u see Neisseria Meningitis m/c?
crowded living like dorms, barracks, prisons, HIV-MSM, asplenia, travel Africa?
33
what is the imp serogroups for meningitis?
A B C W135 X Y
34
what are the s/x for n.meningitis?
- SX: fever HA +/- AMS, leukocytosis, petechial rash/purpura, shock/death (meningococcemia)
35
how would you dx n.meningitis?
blood agar plate (BAP) and chocolate agar plate (CAP
36
how would u tx n.meningities?
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
which bacteria is ass with urethritis/cervicitis (discharge), pelvic inflame disease, epididymitis (in men), prostatitis ?
N. Gornnorhoease
38
what traid do u see with n.gonnor?
o TRIAD: dermatitis, polyarthralgia, tenosynovitis
39
whats the M/C/C for spetic arthiris in young adutls knees?
Neisseria Gonorrhoeae
40
how would u dx and tx Neisseria Gonorrhoeae?
dx: NAAT, grain stain, urinalysis TX: Ceftraixone + azithro/doxy to cover chalmtydia
41
what are the atypical and typicla pathogens?
atypical: MCL (mycoplasma, chalmydia, legionella) typical: SPSA, HM (strep penumonia, staph,aureus, h.inflcuenza, moraxella cata)
42
how would you tx in pt typical and atypical dx ?
typical - ceftriaxone IV moxi or levo atypical - azitrho or doxy moxi or levo
43
how would you tx NORMAL out pt typical and atypical dx ?
typical - azithro or doxy atypical - azithro or doxy
44
how would you tx BAD out pt in atypical and typical?
typical - amoxicillin or clavulanate ++ cefuroxime moxi or levo atypical - azithro or doxy moxi or levo
45
what is post shigella reactive arthritis sx?
arthritis, conjunctivas, urethritis
46
which baterica has TYPE B group that is pathogenic?
H.influenza
47
what bacteria has the M/C cause of epiglottisitis?
H.influenza
48
how would u tx the bacteria realted to epiglottisis otitis media, meningitis, COPD, trahceobronchitis?
H.influzea TX: TYPICAL CAP MED
49
how would u dx h.influencza
HEMIM (F10) and NAD (F5) on chocolate agar
50
which bacteira is high contagious and causes URI and rarely pneuomia?
moraxella catarrhalis
51
how would u dx and tx Moraxella catarrhalis?
DX: grows EASILY on choclate agar :) TX: typical CAP medds
52
what bacteira is ATYPICAL intracellualr pathogen that is asscoiated w water towwers and air conditioners?
Legionella
53
what are the RF for Legionella ?
COPD, smoking, ages >>> 50, immunosuppresed pt
53
what SX would u see with legionella?
CXR: lobar pathy or intersitiaol infiltrates GI - gi sx *pontiac fever - flu like sx without pneumonia
53
how would u dx and tx Legionella ?
dx: urianary antigen test, PCR, buffered charcaol yeast extract TX: azithro or fluoquinolone
54
which bacteria is called the whooping cough and how would u dx and tx it ?
bordetella pertussis dx: culture of the nasopharynx tx: azithro and TDAP for prevention
55
what are the stages for B.pertussies?
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
is B.pertussis contagious?
YES!!!!!! incudation of 5-12 days
57
what bacteira is non sporing forming and VERY CONTAGIOUS?
shigellosis
58
pt has explosive water diarerhea with BLOOD and post shigella reactive arthtiirs? what bacteiria is it? how would u tx it?
Shigellosis azithro cipro if severe
59
which bacteria cna casue febrile seziures in children if severe?
Shigellosis
60
how would u dx Shigellosis ?
stool culture since its water diareheha w blood scary!! and do leukocyte reaction to see whats up
61

Clin med 2 (7 decks)

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