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MSK 1 > Infection - post operative infection > Flashcards

Infection - post operative infection Flashcards

1
Q

what pathogen is the prime for a superficial surgical site infection?

a. staph aereus
b. strep pneumonia
c. e coli

A

a.staph aureus

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2
Q

which of these increases specific risk of deep surgical site infection?

a. lack of ventilation
b. deep placed foreign bodies
c. non sterile conditions

A

b.deep placed foreign bodies

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3
Q

what does deep surgical site refer to?

a. skin
b. soft tissues
c. skin and soft tissues

A

c.skin and soft tissues

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4
Q

in clean contaminated surgery what is the most likely cause of infection?

a. the microbiome of the breached epithelium
b. external microorganisms
c. deep placed objects

A

a.microbiome of breached epithelium

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5
Q

which of these is considered a clean surgery area?

a. GI tract
b. upper reps tract
c. peritoneal cavity

A

c.peritoneal cavity

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6
Q

infection in skin and subcutaneous tissue is classified as ?

a. superficial
b. deep
c. organ/space

A
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7
Q

which organism most commonly causes PVC infection?

a. staph areus
b. strep pneumonia
c. e coli

A

a.staph areas

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8
Q

what is The VIP score used for?

a. to assess pain
c. to assess visible inflammation at device site so likelihood of infection
d. liklehood of infection
d. risk of infection developing post operatively

A

c.to assess inflammation at device site so liklehood of infection

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9
Q

how often should a VIP score be taken ?

a. hourly
b. daily
c. twice daily
d. every half hour

A

b.daily

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10
Q

a biofilm is a community of bacteria existing in a ECM. which of these is the correct components of a biofilm ECM?

a. glucose, lipids
b. proteins and carbohydrates
c. proteins, polysaccharides and lipids

A

c.proteins, polysaccharides, lipids

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11
Q

patient with IV cannula showing signs of inflammation what course of action should be taken?

a. adminster flucloxacillin
b. remove device
c. clean area
d. dress wound

A

b.remove device

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12
Q

why does anaesthesia increase chances of respiratory tract?

a. resp muscles suppressed, secretions pool at bottom of lungs, organisms grow here
b. exogenous bacteria present on the equipment used to administer anaesthetic
c. immune system compromised foreign pathogens not destroyed as effectively

A

a.resp muscles suppressed, allows secretions to pool, provides nutritious environment for organisms

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13
Q

which of these organisms is most likely to be the cause of an upper resp tract infection ?

a. staph areas / haemophilus influenzae
b. strep pneumoniae/ haemophilias influenzae
c. staph aureus/ Staph pneumoniae
d. e coli / enterococci

A

b.strep pneumoniae / haemophilus influenzae

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14
Q

patient bed bound post surgery. infection of the skin of the upper body. which of these groups of bacteria most likely to be causing the infection?

a. enterobactericeae and enteric strep
b. staph aureus
c. strep pneumoniae
d. influenzae

A

a.eneterobactericeae and enteric strep

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15
Q

which of these organisms is an example of an enterobacteriaceae?

a. staph areus
b. strep pneumoniae
c. eneterococci
d. e.coli

A

d.e coli

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16
Q

which of these organisms is an example of an enterobacteriaceae?

a. staph areus
b. strep pneumoniae
c. eneterococci
d. klebsiella

A

d.klebsiella

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17
Q

which of these organisms is an example of an enteric streptococci?

a. staph areus
b. strep pneumoniae
c. eneterococci
d. e.coli

A

c.enterococci

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18
Q

enterococci is an example of what type of organism?

a. eneteric strep
b. staph
c. enterobacteriaceae

A

a.eneteric strep

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19
Q

klebsiella and e coli are an example of what type of organism?

a. eneteric strep
b. staph
c. enterobacteriaceae

A

c.eneterobacteriaceae

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20
Q

which bacteria are likely to be present in post operative UT?

a. staph aureus/ e coli
b. e.coli/ enterococcus
c. e.coli/enetric strep

A

b.e coli and enterococcus

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21
Q

in an early resp tract infection which bacteria is most likely to be the cause?

a. strep pneumoniae and haemophilus influenza
b. E. coli and klebsiella
d. e coli and enterococci

A

a.strep pneumoniae and haemphilus influenza

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22
Q

in an late resp tract infection which bacteria is most likely to be the cause?

a. strep pneumoniae and haemophilus influenza
b. E. coli and klebsiella
d. e coli and enterococci

A

b. e coli/ klebsiella

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23
Q

patient with post surgical UTI. most appropriate course of action?

a. administer empirical antibiotic
b. administer flucloxacillin
c. remove catheter
d. clean area

A

c.remove catheter

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24
Q

how often should a catheter be reviewed?

a. daily
b. hourly
c. twice daily
d. every other day

A

a.daily

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25
Q

what organisms most likely present in a GI tract infection?

a. staph aureus
b. C diff
c. eneterocci
d. e coli

A

b. c diff

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26
Q

what are the 3 risk factors for c diff?

a. old age, hospitalisation, prescription of antibiotics
b. old age, smoking, prescription of antibiotics
c. old age, diet, finishing a course of antibiotics early

A

a.old age, hospitalisation, prescription of antibiotics

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27
Q

what is the main symptom of a c difficile infection?

a. vomiting
b. constipation
c. diarrohoea
d. cough

A

c.diarrohea

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28
Q

what type of bacteria is c difficile?

a. gram negative, spore forming, anaerobic
b. gram positive, spore forming, anaerobic
c. gram positive, spore forming, aerobic
d. gram positive, spore forming, aerobic

A

b. gram positive, spore forming, anaerobic

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29
Q

what is the most common route of infection with c diff?

a. endogenous bacteria from patients skin
b. air in healthcare environments
c. insertion of a catheter
d. anaesthesia

A

b.air in healthcare settings (spores)

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30
Q

how does c diff lead to diarrhoea?

A

toxins, damage epithelium of GI tract
loss of function and increased secretions of fluid in lumen of gut
diarrhoea

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31
Q

any patient in hospital receiving antibiotics is at risk of infection by which bacteria?

a. staph aureus
b. c.diff
c. e coli
d. enterococci

A

b. c diff

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32
Q

what bacteria are patients screened for prior to surgery? if present they are administered a nasal topical antibiotic and specific body wash.

a. e coli
b. MRSA
c. staph aureus
d. c. diff

A

b. MRSA

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33
Q

which of these is the correct definition of sterile conditions?

a. complete absence of microorganisms including viruses and bacterial spores
b. complete absence of bacteria
c. less than 5% of bacteria can survive the conditions

A

a.complete absence of microorganisms including ciruses and bacterial spores

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34
Q

what is the skin at the surgical site cleaned with?

a. saline water
b. chlorohexidine in alcohol
c. alcohol
d. antibiotic cream

A

b.chlorohexidine in alcohol

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35
Q

which of these is a risk factor for surgical site infection?

a. old
b. hypertension
c. diabetes
d. marfans

A

c.diabetes

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36
Q

what must an aenesthetist maintain in a patient during surgery to prevent SSI?

a. blood oxygen temperature
b. temperature blood glucose
c. blood oxygen, respiratory rate
d. temperature, WCC

A

b.temperature, blood glucose

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37
Q

what is the focus of post op measure to prevent infection on?

a. antibiotics
b. wound care
c. observation and monitoring

A

b.wound care

38
Q

what should happen to a wound dressing post op to reduce risk of infection?

a. redressed regularly
b. redressed as little as possible

A

b.redressed as little as possible

39
Q

what technique is used when redressing wounds?

a. AMTT
b. AMTR
c. ANTT
d. ANRT

A

c.ANTT - aseptic non touch technique

40
Q

what is the general rule for antibiotics that admin of preoperative prophylactics breaks ?

a. only give when patient has signs of symptoms of infection
b. finish full course
c. empirical given before specific
d. only give after culture results

A

a. only give when patient has signs and symptoms

41
Q

what bacteria are all preoperative prophylactic antibiotics effective against?

a. c diff
b. MRSA
c. staph aureus
d. e coli

A

c.staph aureus

42
Q

patient having clean surgery no object placement should prophylaxis be administered ?

A

no

43
Q

patient having clean surgery, object placement should prophylaxis be administered ?

A

yes

44
Q

patient having clean contaminated surgery no object placement should prophylaxis be administered ?

A

yes

45
Q

patient having contaminated surgery no object placement should prophylaxis be administered ?

A

yes

46
Q

patient has infected surgery eg empyema no object placement should prophylaxis be administered ?

A

give treatment not prophylaxis

47
Q

patient has breast surgery no object placed should prophylaxis be given ?

A

no

48
Q

patient has breast surgery object placed should prophylaxis be given ?

A

yes

49
Q

patient has bowel resection should prophylaxis be given?

A

yes

50
Q

patient has surgery on trauma wound and is given prophylaxis what type of surgery is this?

a. clean contaminated
b. contaminated
c. infected

A

b.contaminated

51
Q

patient has surgery with empyema and is given antibiotics what is the purpose of these?

a. prophylaxis
b. treatment

A

b.treatment

52
Q

patient has surgery with empyema and is given antibiotics what is the type of surgery ? ]

a. clean
b. clean contaminated
c. contaminated
d. infected

A

d.infected

53
Q

what is the main emphasis of surgical wound infection management?

a. treatment
b. prevention

A

b.prevention

54
Q

what is the first stage of management of suspected surgical site infection?

a. sample wound with swab if swelling remove staples or sutures to drain
b. redress
c. give antibiotics

A

a.sample wound with swab if swelling remove staples or sutures to drain

55
Q

primary intervention of superficial surgical site infection

A.antibiotics

b. appropriate wound care
c. prevention

A

b.appropriate wound care

56
Q

appropriate wound care includes:

a. redressing as often as possible
b. topical antibiotics
c. irrigation, occlusive dressing with antiseptics

A

c. irrigation, occlusive dressing with antiseptics

57
Q

which of these lifestyle factors can optimise wound healing?

a. quitting smoking
b. good diet
c. reducing alcohol intake
d. antibiotics

A

a. good diet

58
Q

an empirical antibiotic for a SSSI would need to cover?

a. staph aureus, MRSA, strep pyogenes
b. heamophilus influenzae, c difiicule , strep pneumoniae
c. staph aureus, E. coli, enterocci, MRSA

A

a.staph aureus, MRSA, strep pyogenes

59
Q

which bacteria most commonly cause infection at prosthetic joints?

a. enterococci
b. e coli
c. staph epidermidis
d. strep pyogenes
e. MRSA

A

c.staph epidermis

60
Q

after wound cleaning course of action for SSSI?

a. prescribe empirical antibiotic
b. redress as often as possible

A

a.empirical antibiotic

61
Q

what should a empirical antibiotic for a deep resp tract infection cover?

a. staph aureus
b. enterocci
c. strep pyogenes
d. heamophilus influenza

A

d.haemophilus influenza

62
Q

what type of empirical antibiotic used to treat a deep surgical site infection in GI tract?

a. narrow spectrum
b. wide spectrum

A

b.wide spectrum

63
Q

what enzyme is responsible for penicillin resistance in staph aureus?

a. beta lactamase
c. alkaline phosphatase
d. transpeptidase

A

a.beta lactase

64
Q

what is the action of beta lactamase?

a. prevents formation of peptidoglycan wall
b. breaks down beta lactam ring of antibiotic
c. inhibits resistance gene in bacteria

A

b.breaks down beta lactam ring of antibiotic

65
Q

what antibiotic is the default choice for non severe skin infections?

a. flucloxacillin
b. co amoxiclav
c. amoxicillin
d. vancomycin

A

a.flucloxacillin

66
Q

infection with gram positive cocci in clusters what bacteria present?

a. c difficile
b. neisseria meningitis
d. klebsiella
e. staph aureus

A

e, staph aureus

67
Q

infection with gram positive cocci in chains what bacteria most likely?

a. c difficile
b. neisseria meningitis
c. strep pneumoniae
d. klebsiella
e. staph aureus

A

c, strep pneumoniae

68
Q

infected with gram positive rods which bacteria most likely ?>

a. c difficile
b. neisseria meningitis
d. klebsiella
e. staph aureus

A

a. c difficile

69
Q

what colour do gram positive show

a. red
b. purple

A

b. purple

70
Q

what colour do gram negative show

a. red
b. purple

A

a.red

71
Q

culture shows gram negative cocci. what organism most likely present?

a. c difficile
b. neisseria meningitis
c. haemophilus influenzae
d. klebsiella
e. staph aureus

A

c. haemophilus influenzae

72
Q

culture shows gram negative rods. which organism most likely presents?

a. c difficile
b. neisseria meningitis
c. haemophilus influenzae
d. klebsiella
e. staph aureus

A

d. klebsiella

73
Q

how often is flucloxacillin administered ?

a. daily
b. every 12 hours
c. every 6 hours
d. every 48 hours

A

c. every 6 hours

74
Q

how is flucloxacillin administered?

a. PO/IV
b. IM/IV
c. topical/PO

A

a.PO/IV

75
Q

patient has endocarditis what antibiotic should be given?

a. vancomycin
b. co-amoxiclav
c. fluclocxacillin

A

c. flucloxacillin

76
Q

patient with bone and joint infection what drug should be given?

a. vancomycin
b. co-amoxiclav
c. fluclocxacillin

A

c.flucloxacillin

77
Q

what two drugs make up co amoxiclav?

A

amoxicillin and clavulanic acid (beta lactam nd beta lactamase inhibitor)

78
Q

what is the effect of combining a beta lactam with a beta lactamase inhibitor?

a. less resistance
b. increased spectrum
c. decreased spectrum

A

b.increased spectrum

79
Q

what bacteria is most targeted with co amoxiclav?

a. staph aureus
b. shaemophilus influenzae
c. c difficile
d. strep pneumoniae

A

a.staph aureus

80
Q

what bacteria is most targeted with flucloxacillin?

a. staph aureus
b. shaemophilus influenzae
c. c difficile
d. strep pneumoniae

A

d.strep pneumoniae

81
Q

how is co amoxiclav administered?

a. IV/PO
b. IV/IM
c. topical

A

a.IV/PO

82
Q

patient with intra abdominal infection what antibiotic prescribed?

a. flucloxacillin
b. co amoxiclav
c. vancomycin

A

b. co amoxiclav

83
Q

patient with clean contaminated surgery what antibiotic most appropriate for preoperative prophylaxis?

a. flucloxacillin
b. vancomycin
c. co amoxiclav

A

c. co amoxiclav

84
Q 
patient with complicated ear/ nose 
/throat/ paxrasinal infection. which antibiotic most apprpriate?
a.flucloxacillin
b.vancomycin
c.co amoxiclav
A

c.co amoxiclav

85
Q

patient given. glycopeptide antibiotic. which one most likely?

a. amoxicillin
b. vancomycin
c. co amoxiclav

A

b.vancomycin

86
Q

how does vancomycin kill bacteria?

a. inhibits transpepdidase
b. embed in cell membrane to block transport of peptidoglu=ycan monomers from cytoplasm to cell wall

A

bb. embed in cell membrane to block transport of peptidoglu=ycan monomers from cytoplasm to cell wall

87
Q

patient with MRSA. which antibiotic most appropriate?

a. flucloxacillin
b. amoxicillin
c. co amoxiclav
d. vancomycin

A

d.vancomycin

88
Q

patient with penicillin allergic which antibiotic most appropriate?

a. amoxicillin
b. vancomycin and gram negative drug
c. flucloxacillin
d. co amoxiclav

A

b.vancomycin

89
Q

how is vancomycin administered?

a. PO/IV
b. IV
c. IM

A

a.IV/po

90
Q

patient with red man syndrome. fast admin of which drug causes this?

a. flucloxacillin
b. co amoxiclav
c. vancomycin

A

c. vancomycin

91
Q

patient with c diff infection which drug given?

a.co amoxiclav
b. vancomycin
c,flucloxacillin

A

b.vancomycin

92
Q

what is the only case in which vancomycin is given orally?

a. red man syndrome
b. c diff diarrhoea
c. side effects
d. penicillin allergy

A

b.c diff diarrhoea

MSK 1 (23 decks)

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