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test 2 > Infection > Flashcards

Infection Flashcards

1
Q

Types of infections that lead to sepsis

A

Bacterial>fungal>parasitic>viral>others

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2
Q

Non-septic infections include

A

Cystitis, local cellulitis, osteomyelitis, Upper Resp Infection, early onset fungal or viral

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3
Q

Diagnosis of sepsis includes

A

Infection plus greater than or equal to 2 SIRS

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4
Q

Diagnosis of severe sepsis

A

Infection plus 2 or more SIRS plus diminished perfusion, correct with fluids

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5
Q

First line for treatment of sepsis

A

Fluids

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6
Q

Diagnosis of septic shock??

A

Infection plus 2 or more SIRS

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7
Q

Treatment for septic shock

A

Give fluid with vasopressors

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8
Q

What is a Quick SOFA (qSOFA)

A

A new bed side assessment to providing criteria to identify patients with suspected infection who likely will have poor outcomes

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9
Q

How many qSOFA criteria are needed to predict prolonged ICU stay and death

A

2 or more criteria

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10
Q

What are the qSOFA criteria

A

Altered mentation
systolic blood pressure less than 100
Respiratory rate greater than 22

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11
Q

patient with suspected infection and positive qSOFA should be assess further for? Treat? Lab?

A

Assess using SOFA for sepsis,
Treat sepsis using fluids, vasopressors to keep MAP >65
Serum lactate should be <2mmol/L (normal 0.6 to1.2)

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12
Q

Management of skin and soft tissue infections

Treatment of mild non-purulent necrotizing infection, cellulitis, or erysipelas

A 
Oral antibiotics:
Penicillin 
Cephalosporins 
Dicloxacillin
Clincamycin
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13
Q

Management of skin and soft tissue infections

Treatment of moderate non-purulent necrotizing infection, cellulitis, or erysipelas

A 
IV antibiotics:
Penicillin 
Ceftriaxone
Cefazolin
Clindamycin
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14
Q

Management of skin and soft tissue infections

Treatment of severe non-purulent necrotizing infection, cellulitis, or erysipelas

A

Emergency surgical inspection and debridment inspecting for any necrotizing process
Start empirically on vancomycin and piperacillin/tazobactam (zosyn)
THEN
Culture and sensitivity
Look for monomicrobial or polymicrobial

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15
Q

SIRS criteria

A

increased WBC, fever, increased heart rate, lower bp

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16
Q

Purulent abcess Mild (no systemic signs of infection) treatment

A

I and D

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17
Q

Treatment for Purulent infection in patient with: SIRS, >100.4 F, >24 RR, >90 HR, WBC >12,000 cells/mcL

A

Treat for moderate infect:

I and D
C and S
Empiric 
Doxcycline or bactrium
Define;
MRSA (BACTRIUM)
MSSA (Dicloxacilin or cephalexin
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18
Q

Treatment for Purulent infection in patient with: SIRS plus hypotension, WBC <400 cells/mcL, who has went through one round of abx.

A

Severe treatment:

i and D
C and S
Empiric rx
Vanc or Daptomycin
linezolid
televacin
ceftaroline
Define rx
Mrsa
MSSA
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19
Q

celluiltis caused by

A

Beta hemolytic strep

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20
Q

Patient obese asking for antibiotis for bilateral lower extremity edema and erythema, dark pigmentation. Patient says its been going on for a long time. The lesions are nontender with bound down plaques, you look closely and see some serous drainage. what do you tell patient

A

Explain to the patient this is due to venous stasis, antibiotics will not help.

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21
Q

Why is culturing cellulitis not recommeded

A

staph will grow in culture because of virulent and growth

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22
Q

Duration of treatemtn for cellulities

A

5 days

23
Q

Number one treatment for skin condition

A

wound care

24
Q

Recurrent cellulitis risk factors

A

(edema, obesity, eczema, venous insufficiency,

interdigital toe space abnormalities

25
Q

Recurrent cellulitis tx

A

3 to 4 episodes per year despite preventive measures:
Antimicrobial prophylaxis:
- pcn, cephalosporin or erythromycin bid x 4–52 wks
- intramuscular benzathine penicillin every 2–4 weeks

26
Q

Abscess Signs and Symptoms

A 
Redness
• Heat
• Swelling
• Pain
• Loss of function
• Fluctuant upon palpation

treat for staph

27
Q

Abscess >5cm

A

needs draining

28
Q

pantsvalentivne isolated and susceptible to bactrim,

TCN/Doxicillin, arithromycn clithromycin

A

CA MRSA

29
Q

Recurrent abscess

A

culture
5-10 day course of abx
topical decolonization
family sterilized

30
Q

clostridial myonecrosis

A

cellulitis

gangren

31
Q

Diabetic foot

A

cellulitis

32
Q

What is a SOFA and what 6 areas are assessed

A 
Sequential (sepsis related) organ failure assessment
6 areas studied
circulation (MAP)
coagulation (platelet)
central nervous system (GCS)
Liver function (bilirubin)
respiratiory (FiO2/PaO2)
Renal (creatinine/urine volume)
33
Q

normal bilirubin levels

A

0.1 to 1.2 mg/dL

34
Q

Normal creatinine levels

A

0.6 to 1.2mg/dL

35
Q

normal serum lactate level

A

0.5 to 1 mmol/L

36
Q

Treatment of Severe Nonpurulent infection with Streptococcus pyogenes

A

penicillin plus clindamycin

37
Q

Treatment of Severe Nonpurulent infection with Clostridial sporogenes

A

penicillin plus clindamycin

38
Q

Treatment of Severe Nonpurulent infection with Vibrio vulnificus

A

doxycycline plus ceftazidime

39
Q

Treatment of Severe Nonpurulent infection with Aeromonas Hydrophila

A

doxycycline plus ciprofloxacin

40
Q

Treatment of Severe Nonpurulent infection with polymicrobial infection

A

vancomycin plus piperacillin/tazobactam

41
Q

Empiric Treatment of Severe purulent infection with?

A 
Vancomycin 
or
ceftaroline
or 
Daptomycin
or 
Linezolid
or
televancin
42
Q

Treatment of Severe purulent MRSA infection with

A 
Vancomycin or
Ceftaroline
Daptomycin
Linezolid
televancin
43
Q

Treatment of Severe purulent MSSA infection with

A

nafcillin
cefazolin
clindamycin

44
Q

Patient obese asking for antibiotics for lower left extremity erythema. Patient says its been going on for a few days. The lesions are tender , you look closely and see some indistinct borders with streaking what do you tell patient

A

explain to the patient they will need antibiotic.

start on penicillin

45
Q

When should cellulitis be covered for MRSA

A 
Patient has; 
nasal colonization
evidence of MRSA elsewhere
hx of iv drug use
traumatic injury
46
Q

Treatment for cellulitis?

A

Treat for Beta hemolytic strep
penicillin
cephalexin and tmp/smx

47
Q

Treat for cellulitis and MRSA?

A 
treating for MRSA and strep
Vancomycin
or 
linezolid
or 
clindamycin
48
Q

What can be used for non-antimicrobial treatment of cellulitis? how long?

A

corticosteroids (in non-DM) for 5 days

49
Q

Predisposing factors causing reoccurring cellulitis

A 
obese
venous stasis
edema
eczema
foot wounds (interdigital toe space abnormalities)
50
Q

Treatment for a patient with reoccurring cellulitis 3 to 4 times a year despite preventive measures should be?

A

antimicrobial therapy:
PCN, cephalosporin, erythromycin BID x 4 to 52 weeks
or
intramuscular benzathine penicillin every 2-4 weeks

51
Q

CA-MRSA is most likely when patient meets what criteria

A

1) MRSA was found 48 hours within admission to hospital
2) no history of admission to any facility or dialysis within last year
3) no medical history of MRSA infection or colonization
4) no indwelling catheter being used
5) Susceptible to >2 non-Beta-lactam antimicrobials

52
Q

Empiric treatment for purulent cellulitis without abscess

with coverage for MRSA

A

Clindimycin plus Trimethprim-sulfamethoxazole plus doxycycline (minocycline)

53
Q

Treatment for necrotizing faciitis? what to suspect in culture?

A

1) surgical debride
2) Culture
3) Emipric treatment Vanc plus Zyson plus ceftriaxzone
4) Confirm with Group A Strep (treat with penicillin plus clindamycin)

test 2 (13 decks)

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