Infectious Disease Flashcards
How do B and T cells differ in neonates?
Normal and quantity but less efficient
There are some gram negative organisms?
Gram-negative bacilli, e coli, club Cielo, pseudomonas
List foir gram positive organisms?
Streptococcus staphylococcus and taro caucus listeria myobacteria
What is the hallmark right of symptoms and older kids with viral meningitis?
Fever, headache, altered LOC
What can be given for PCP prophylaxis
Bactrim or pentamidine
How do steroids affect your CRP?
Lowers it
The most common bacterial organisms in bacterial meningitis of neonates?
Group B strip, e coli, listeria
What is the treatment for CMV in immunocompromised patients?
Valgancyclovir which is the prodrug for ganciclovir
When are amino glycosides used?
Sepsis, endocarditis, UTIs
What is the antibiotic treatment for meningococcemia?
Third generation cephalosporins such as subtraction or cephalexin
What is used to treat strep pneumonia?
High doses amoxicillin
What is the treatment for bacterial meningitis and neonates?
Ampicillin and gentamicin or cephfotaxim with acyclovir
What are four antibiotics that can be used to treat MRSA?
Bactrim, clindamycin, doxycycline, vancomycin
What occurs to the CSF WBC’s in a viral and bacterial infection?
Bacteria there will be greater than 1,000, viral less than 500
Concern of increased ICP what should you do prior to the lumbar puncture?
CT scan
What is vancomycin used to treat?
MRSA or MRSE
Supportive treatment is used for dente but what agents need to be avoided?
Aspir in and or NSAID due to the risk of DIC
What cephalosporin is used for surgical prophylaxis?
First generation such as cephalexin
What is the treatment for typhoid?
Ceftriaxone or ciprofloxacin
What is an example of a glycopeptide?
Vancomycin
What differentiates CMV from EBV?
CMV does not have pharyngitis, tonsillitis or splenomegaly
What is the most common cause of community acquired pneumonia?
Strep pneumonia
To qualify as SIRS patients need two or more of what four qualities?
Temperature greater than 38 or less than 36
Tachycardia greater than 2 cm above age norm
New respiratory rate greater than two standard deviations above age norm or mechanical ventilation for an acute process
Leukocyte count elevated or depressed for age
What is used to treat otitis media?
Amoxicillin
What antibiotic is used for bacterial prophylaxis, UTIs, otitis media, lower respiratory tract infections?
Penicillins
What test to text presence of macrolide inducible resistance to clindamycin?
D test
What is diagnostic for disseminated intravascular coagulation?
D- dimer presence
When should you add acyclovir in the treatment of neonatal sepsis?
CSF pleocytosis, maternal prolonged rupture of membranes, primary maternal HSV infection, seizures
What is used to treat skin and softer shoe infections?
First generation cephalosporin, clindamycin, bactrim, vancomycin
What is the pathophysiology of typhoid?
Widespread bacteremia and endotoxin release
What are the most common organisms to cause skin and soft tissue infections?
Staph aureus and group a strep
What medication should be avoided when a patient has influenza?
Solicitor containing medications such as aspirin due to the risk of reye’s syndrome
What disorder presents with bleeding followed by thrombosis and tissue ischemia
Disseminated intravascular coagulation
What is an example of a sulfonamide?
Bactrim
What is the second most common STI in the US?
Necessaria gonorrhea
What is an example of a fluoroquinolone?
Cipro, levofloxacin
What is the treatment for Lyme disease?
Amoxicillin for children younger than eight doxycycline for children greater than eight
14 to 21 days or 21 to 28 days for severe disease
Comment on the infection presentation of CMV
Primary infection or virus goes to organs of kidney, lungs, liver, brain followed by secondary infection which is a reactivation scene in the setting of immunodeficiency
Christmas common cause of bacterial meningitis and children greater than 2 years of age?
And meningitides, s pneumonia, h influenzae
Just the ESR or CRP rise faster in response to infection?
CRP
Who needs prophylaxis after exposure to a patient with meningococcemia? What is the prophylactic treatment?
Close contacts and healthcare workers
Ciprofloxacin or rocephin
What are patients with untreated Rocky mountain spotted fever at risk for?
D i c and septic like picture
Define fever of unknown origin?
Fever greater than 38.3, lasting for at least 8 days and up to 3 weeks with no apparent clinical diagnosis
In high risk patient with fever and neutropenia what do you need to be sure to cover with antibiotics?
Gram negative organisms, strep viridans and pseudomonas
When managing septic shock what is your goal CVP?
10 to 12
What does CMV cause in neonates when pass congenitally from mother to infant?
Hearing loss, ocular damage, ocular motor dysfunction
What are the most common organisms causing sepsis in the neonate?
Group B strep, listeria monocytogenes, e coli
Who’s the most common source of infection in young infants? In fever without a source
Group B strep the stereo monocytogenes, salmonella, e coli
What is Kehr’s sign?
Sign of splenic rupture
To be classified as severe sepsis what needs to be seen?
Cardiovascular organ dysfunction, acute respiratory distress syndrome, two or more other organ dysfunctions
What is a normal glucose and what happens during a viral or bacterial infection in the CSF?
Normal is 50 to 75
Normal to low in viral
Low in bacterial
What is most commonly causing otitis media?
Struck pneumonia, h influenza
What kind of illness is dengue?
Viral
What’s cephalospotin is used for meningitis or sepsis? Why
Third generation such as cephalexin or ceftriaxone as it crosses the blood brain barrier
What is Malaria caused by?
Plasmodium
What is the most common antibiotic therapy in bone and joint infections?
Cefazoline or clindamycin
What is the treatment for syphilis?
Penicillin g
What what malignancy is our associated with EBV?
Lymphoma, B cell tumors
What are the two antibiotic combos that can be used in the treatment of neonatal sepsis?
Gentamicin and ampicillin or ampicillin and cephalexin
There’s most common cause of bacterial meningitis in young children?
Streptococcus pneumoniae, N meningititidis, groupie strip, H. influenza
What are examples of macrolides?
Erythromycin or clarithromycin
What should be used in a community acquired pneumonia if MRSA is suspected?
Add staff coverage using vancomycin or clindamycin
What is the first line therapy for HSV?
Acyclovir
What causes typhoid?
Salmonella enterica
What is the most common organism in viral meningitis?
Enterovirus
What is a synonym for the target lesions associated with Lyme disease?
Erythema migrans
When is Cipro used?
UTIs, bacterial diarrhea, soft tissue or bone infections
What is the severe outcome of mononucleosis?
Uncontrolled proliferation of B cells and lymphobliferative disease
What qualifies as septic shock?
An adult’s severe sepsis with refractory hypotension, and children sepsis in the presence of cardiovascular dysfunction
What is the treatment for gonorrhea?
Intramuscular ceftriaxone plus azithromycin or doxycycline
What is an example of a beta-lactam?
Penicillins, cephalosporins, monobactams, carbapenems
Where’s the most common STI in the US?
Chlamydia
When should vancomycin or linezolid be used in a patient that is febrile and neutropenic?
Cellulitis or pneumonia
What bacterial infection has a rapid onset of severe symptoms such as fever, altered mental status, poor perfusion, purpura, irritability?
Neisseria meningititidis
What are examples of amino glycosides?
Gentamicin, tobramycin, amikacin
But it’s most common source of infection in a patient with fever without a source in the older infant or toddler?
Salmonella, neisseria meningititides streptococcus pneumonia
What are the clinical criteria for toxic shock syndrome?
Fever greater than 39, diffuse fresh, desquamation of palms and souls wanted two weeks after onset, hypotension, multisystem involvement of at least three organ systems
What is the antibiotic treatment for toxic shock syndrome?
Broad spectrum with ceftriaxone and vancomycin
How is dengue transmitted?
Mosquitoes
What is the treatment of meningitis in an older child?
Ceftriaxone and vancomycin
What unique tick born disease causes a rash on the wrist ankles palms and soles that spreads to the trunk?
Rocky mountain spotted fever
What cephalosporin is used in sepsis and febrile neutropenia?
Cefepime or other fourth generation cephalosporin
What antibiotic monotherapy can be used in a fever and neutropenia patient?
Penicillin, fourth generation cephalosporum, or cartapenum
What is the treatment for Rocky mountain spotted fever?
Doxycycline
What is the prophylaxis for malaria?
Doxycycline, tetracycline, clindamycin
How is malaria diagnosed?
Blood smears repeated every 12 to 24 hours if test is negative
What is the most common organism causing bone and joint infections?
Staph aureus
What causes syphilis?
Spirochete treponema pallidum
What should be used if a resistant organism is suspected in an infected fever and neutropenia patient?
Gram positive and anaerobic coverage such as gentamicin and or zosyn
What is criteria for diagnosis of fever with neutropenia?
Single temperature greater than 38.3 or 38.0 for greater than 1 hour with an ANC ess than 500
When do you need inotropic support?
Cold or warm shock
What is a normal protein and what happens when a viral or bacterial is present in the CSF?
Normal protein is 15 to 45 becomes elevated when infected
List 3 gram negative bacteria?
E coli, pseudomonas, neisseria, salmonella, haemophilus influenza B
When do we see fungal infections?
Immunocompromised hosts, neonates and critically ill children on long-term antibiotics
What are the three stages of Lyme disease?
Early dissemination, late disease, latent dissemination
What three kinds of infections will cause fever without other symptoms and can be serious?
Bactoremia, UTI, pneumonia
What bacteria causes meningococcemia?
Neisseria meningititidis
What is a negative outcome of administering cipro?
Tendon rupture
What bacteria are responsible for toxic shock syndrome?
Staph aureus and strep pyrogenes
What is the difference between sepsis and SIRS or systemic inflammatory response syndrome?
Sepsis is s i r s nope with a known or suspected infection
What does significant RBC’s on a good lumbar puncture indicate?
HSV
What are some systemic infections most commonly associated with fever of unknown origin in children?
Salmonella, tuberculosis, syphilis, Lyme disease, cat scratch disease, , mono, CMV, viral hepatitis, malaria, toxoplasmosis
What are the two meningial signs?
Kernig and brudzinski
What balactam is used to treat mixed aerobic / anaerobic infections, ESBL infections, febrile neutropenia?
Meropenem and other carbapenems
How is chlamydia treated?
Azithromycin or doxycycline
When should antifungal coverage be added in a patient that is febrile and neutropenic?
Fever persisting for 4 to 7 days after starting broad spectrum antibiotics
What is given to address coagulation issues associated with DIC?
Vitamin k, cryo precipitate, FFP, platelets
In what patients is parvovirus particularly dangerous?
Risk of transient aplastic crisis in patients with sickle cell, sphero cytosis, G6PD deficiency
What does severe disease of malaria look like?
Hypotension, renal failure, hypoglycemia, metabolic acidosis
What is the treatment for meningitis in infants?
Vancomycin and ceftriaxone with acyclovir
