Infectious Disease Emergencies Flashcards
This is one of the most common presenting sx and should prompt infectious and non-infectious DX?
Fever
When a PT presents to the ED with fever, what are five HX, SX, or medication questions you should ask? (i can pick five from any category)
SX: headache, neck pain, N/V/D, abdominal PX
Drugs: Immunosuppressive drugs; ABX; recreational drugs
HX: recent travel; diabetes; HIV; sick contacts
What are the two gram negative ABX that should be used in the ED?
cephalosporin or pip/taxo
What are the 3 gram positive pathogens likely to cause sepsis?
s. pneumoniae; S. aureus; GAS
What are the 3 gram negative pathogens likely to cause sepsis?
pseudomonas, Klebsiella, Enterobacter
A PT presents to the ED with fever, headache, dysuria, N/V/D, back pain, cold mottled skin, a low body temp, and AMS. What is the likely dx?
sepsis
When a PT presents with sepsis, which type of antibiotics should be giver first?
Cephalosporins and Pip/Tazo for gram negative pathogens which will kill pt sooner
Presentation: Fever; stiff neck; AMS;
nuchal rigidity; petechiae; rash?
Neurologic meningitis
What is the management for a pt dx with neurologic meningitis?
Admit/isolation
Ceftriaxone & vancomycin
Presentation: Pronounced AMS; seizure, neuro deficit; requires lumbar puncture, MRI, and viral PCR studies?
neurologic encephalitis
Most common pathogen of neurologic encephalitis?
HSV
Treatment for neurologic encephalitis?
Acyclovir
Presentation: New cough with sputum, dyspnea, chest px, back px, hypoxia, weird breath sound
respiratory pneumonia
Treatment for community acquired pneumonia
azithromycin
Presentation: fever most common, chills, weakness, dyspnea, chest px, Janeway lesions
infective endocarditis
Most common pathogen causing infective endocarditis?
staph aureus
Presentation: urinary urgency, frequency, dysuria, can have fever, CVA, abd tenderness
UTI
Treatment for complicated UTI?
ceftriaxone and pip/tazo (zosyn)
Presentation: Dysuria, pelvic px, scrotal px, discharge, itching, postcoital bleed
STI
Treatment for gonorrhea?
ceftriaxone 500mg IM
treatment for chlamydia?
doxycycline
Presentation: Erythema, tenderness, induration, fever, chills
cellulitis
Treatment for cellulitis without MRSA?
cephalexin or Augmentin
treatment for cellulitis with MRSA?
bactrim (TMP/SMX) or clindamycin
Presentation: feel like rice crispies in skin; rapid growing infection; extreme px; discoloration?
necrotizing fasciitis
Pathogens of necrotizing fasciitis?
GAS & Staph aureus
Treatment for necrotizing fasciitis?
Surgical debridement;
Vancomycin + meropenem
What is the dx for ANC <500 + fever?
Neutropenic fever
Animal reservoir presentation: GI sx and rash ankle and rash on wrist
rocky mountain spotted fever
Microorganism responsible for RMSF?
Rickettsia rickettsii
treatment for RMSF
doxycycline
Zoonotic reservoir presentation: lymph enlargement and ulcers caused by aerobic gram negative pathogen?
Tuleremia
What does SIRS stand for and what is the definition?
Systemic inflammatory response syndrome
Sepsis that has an identifiable pathogen/microorganism