Infection

Question 0

Proximal small bowel bacteria

Answer 0

10^5 bacteria

GPC

Question 1

Bacteria in stomach

Answer 1

Almost sterile
Some GPC
Some yeast

Question 2

Distal small bowel bacteria

Answer 2

10^7 bacteria

GPC, GNR, GPR

Question 3

Colon bacteria

Answer 3

10^11 bacteria
Mostly anaerobes
Some GNR, GPC

Question 4

Most common anaerobe in the colon (anaerobic)

Answer 4

Bacteroides fragilis

Anaerobe

Question 5

Most common bacteria in the colon aerobic

Answer 5

E. Coli

Question 6

Most common cause of gram negative sepsis

Answer 6

E. Coli

Question 7

Reason for gram negative sepsis

Answer 7

Endotoxin (lipopolysaccharide A) is released
Causes release of TNF alpha
Activates compliment and coag cascade

Question 8

Types of wound infections

Answer 8

Clean- hernia
Clean contaminated- elective colon w/prep
Contaminated- Gsw to colon w/repair
Gross contaminated- abscess

Question 9

Most common organism in surgical wounds

Answer 9

Staph aureus
Coagulase positive

Most common GNR - E. Coli
Most common anaerobe - bacteroides fragilis->recovery from tissue indicates necrosis

(Staph epidermidis- coagulase negative)

Question 10

Bacteria amount needed for infection

Answer 10

> 10^5

Less needed if foreign body present

Question 11

Surgical infection within 48hours of procedure

Answer 11

1) injury to bowel with leak

2) invasive soft tissue: Clostridium Perfringes or beta hemolytic strep (gp a strep)

Question 12

Most common nonsurgical infection

Answer 12

UTI - E. Coli

Question 13

Leading cause of infectious death after sx

Answer 13

Nosocomial PNA

Most common in ICU PNA: S. Aureus #2 pseudomonas

Question 14

MRSA resistant infections treated with…..

Answer 14

Linezolid (zyvox) protein synthesis inhibitors
Good for gram +
Resistant skin infections

Question 15

Number 1 organism in line infections

Answer 15

Staph epidermidis
#2 staph aureus
#3 yeast

Culture- need >15 colony forming units

Question 16

Bacteria in necrotizing skin infections

Answer 16

Beta hemolytic group a strep

Clostridium Perfringes

Question 17

Most common bug in line infections

Answer 17

Staph epidermidis - biofilm: exoslime = resistant to abx

#2 -s.aureus
#3- yeast

Question 18

Most common cause of infected AAA

Answer 18

Salmonella

S.aureus

Question 19

Most common cause of acute lymphangitis

Answer 19

Group A strep (streaking)
Chronic- s.schenckii

Tx: PCN

Question 20

Clostridium Perfringes infections

Answer 20

Necrotic tissue decreases oxidation redux potential
Has alpha toxin
Pain out of prop to exam
Gas gangrene & myonecrosis
Farming injury
Tx: debride, PCN

Question 21

Sbp- spontaneous bacterial peritonitis

Answer 21

Protein < 1g/dl in peritoneal fluid
Monobacterial- 50%ecoli
Many fluid Cx negative
PMNS > 500 cells/cc
Tx: ceftrisxone or 3rd gen cephalo
Need to r/o intra-abd cause
Flouroquino- short term prophylaxis

Question 22

Secondary bacterial peritonitis

Answer 22

Due to intra abdominal source- transmucosal migration or perforated viscous

Polymycrobial - most common Bacteroides fragilis, ecoli, enterococcus

Tx: need laparotomy to find source

Question 23

Brown recluse spider bites treatment

Answer 23

Dapsone

May need resection and skin graft if large area

Question 24

Acute septic arthritis is due to…..

Answer 24

Gonococcus
Staph
H. Influenza
Strep

Tx: 3rd generation cephalosporin and vanco

Question 25

Cat/dog/human bites organism

Answer 25

Human: eikenella
Cat/dog: pasturella multocida

Tx: broad spect abx- augmentin

Question 26

Components of SIRS - systemic inflammatory response syndrome

Answer 26

Tachycardia
Tachypnea
Fever
Wbc elevated

Question 27

SIRS to Sepsis

Answer 27

Meet all SIRS criteria + source of infection