Infectious Disease Flashcards
What is immune senescence?
Immune response decline with age
What is the cause of immune senescence? (2)
Depressed T cell responses and depressed T cell/macrophage interactions
B cells produce lower affinity antibodies
True or false: age has a greater influence on immune senescence than the impact of comorbidities and host resistance
false–other way around
True or false: fever may be absent in 30-50% of frail older adults with serious infections?
True
What are the three different ways a fever can be redefined in old age?
Temp >2 F above baseline
Oral temp >99 F
Rectal temp >99.5
True or false: renal function declines with aging, regardless of any renal pathology
True
What is the most common causative agent of UTIs?
E.coli
What are the minimum criteria to diagnose a UTI without a catheter?
Fever AND some other common signs of UTIs
What are the minimum criteria to diagnose a UTI with a catheter?
Fever OR some other common signs of UTIs /psych symptoms
What are the minimum criteria to diagnose skin and soft tissue infections in the elderly?
Fever OR redness, TTP, warmth etc
What is the earliest sign of geriatric pneumonia?
Tachypnea
What are the minimum criteria to diagnose a respiratory tract infection in the elderly?
Fever w/ productive cough
Fever, AND tachycardia
How do the minimum criteria to diagnose respiratory infections changes with a pt what has COPD?
No fever needed–just increased purulent cough
What are the tracts that are more common sites of sepsis infections for older adults than younger?
GI and GU
What is the strongest independent predictor of mortality in elderly pts with pneumonia?
Comorbidities
True or false: mortality from pneumonia in older adults is 3x to 5x that of younger adults
true
What is the most common causative agent of pneumonia? The other two
- Strep pneumoniae
- Gram negatives
- Staph aureus
What is the first line therapy for pneumonia in elderly adults?
Beta-lactam + beta lactamase inhibitor
What is the treatment for MRSA?
Vancomycin
What are the four ways to reduce the risk of pneumonia?
- Immunization
- Stop smoking
- Treat comorbidities
- Control sources of infx
What is asymptomatic bacteriuria?
Chronic colonization of the urinary tract in some women–no need to treat. In fact, don’t
What is the cause of cystitis in men?
Prostatic disease or tract disease
What is the treatment for all pts with TB?
Isoniazid x9 months
What are the two indications for treatment of TB?
- Never have been treated in the past
2. Active disease is excluded
New heart murmur + fever = ?
Infective endocarditis
What is the most likely pathogen for septic arthritis?
Staph Aureus
What is the most likely pathogen for osteomyelitis?
Staph Aureus
What are the common causes of osteomyelitis?
DM foot ulcers
Decubitus ulcers
True or false: the response of older adults to HAART (highly aggressive antiretroviral therapy) is not as good as those in young adults
False-actually similar response to the meds
What is the MOST treatable cause of dementia?
HIV
What infections are associated with Bell’s palsy?
Herpes zoster–lyme’s disease
ABdominal pain in old age demands what?
Good PE
Surgical consult
True or false: you treat infectious diarrhea in elderly pts as you would for adults?
true
What should you order if you suspect an intra-abdominal infection?
CT or labled WBC study
What should you order if you suspect a cholecystitis, appy, or abscess?
US
What should you order if you suspect ischemic bowel?
Angiography or sigmoidoscopy
What are the two abx for c.diff infections?
Metronidazole
Vanco
