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Acute PNP > Infectious Disease Part 1 > Flashcards

Infectious Disease Part 1 Flashcards

1
Q

Leukocytosis signals what kind of infection

A

Bacterial

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2
Q

Leukopenia signals what kind of infection

A

Viral

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3
Q

What phase is thrombocytosis active in acute infection?

A

Active phase

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4
Q

What are nonspecific acute-phase reactants during acute inflammation?

A

C-Reactive protein
Pro-inflammatory cytokines
Erythrocyte sedimentation rate

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5
Q

What biomarker is elevated in bacteremia?

A

Procalcitonin

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6
Q

What diagnostic lab is helpful with a fever of unknown origin (FUO)?

A

Erythrocyte sedimentation rate

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7
Q

DTaP, Tdap, Polio (IPV), Haemophilus influenzae type B, hepatitis B, human papillomavirus, influenza, meningococcal, and pneumococcal vaccine are all ___ vaccines

A

Inactive Vaccines

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8
Q

Bacille Calmette-Guerin, MMR, Varicella, Post-exposure prophylaxis for varicella, rotavirus, smallpox are all _____ vaccines

A

Active Vaccines

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9
Q

Strep, stab, enterococcus, listeria, mycobacteria, pneumococcus, corynebacteria, bacillus, nocardia are all gram-______ aerobic organisms

A

Gram-Positive

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10
Q

E.coli, pseudomonas, klebsiella, acinetobacter, neisseria, enterobacter, haemophlius infleunza, legionella, salmonella are all gram-______ aerobic organism

A

Gram-Negative

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11
Q

Bacteroides, fusobacterium, porphyromonas, prevotella are all gram-______ anaerobe organisms

A

Gram-Negative

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12
Q

Actinomyces, clostridia, peptostreptoccus, and propionibacterium are all gram-_____ anaerobe organisms

A

Gram-Positive

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13
Q

Most common organism for intra-abdominal infections

A

Bacteroides

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14
Q

Most common organism for abscesses, wound infections, and pulmonary and intracranial infections

A

Fusobacterium

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15
Q

Most common organism for aspiration pneumonia and periodontitis

A

Porphyromonas

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16
Q

Most common organism for intra-abdominal infections and soft-tissue infections

A

Prevotella

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17
Q

Most common organism for head, neck, abdominal, and pelvic infections and aspiration pneumonia

A

Actinomycosis

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18
Q

Common causes necrotizing enteritis, botulinum, tetanus, clostrioides difficile-induced diarrhea

A

Clostridia

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19
Q

Beta Lactam Antimicrobials

A

Penicillin
Cephalosporins
Monobactams
Carbapenems

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20
Q

Bactericidal

Gram +, Gram = cocci, non-beta-lactamase-producing anaerobes

A

Penicillin

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21
Q

Antimicrobial used to treat bacterial prophylaxis, UTI, sinusitis, otitis media, and lower respiratory tract infection

A

Penicillin

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22
Q

Bactericidal

Coverage increases with each generation

A

Cephalosporins

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23
Q

1st generation is used for surgical prophylaxis
3rd generation is used for meningitis and sepsis
4th generation is used for sepsis and febrile neutropenia

A

Cephalosporins

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24
Q

Beta-lactam

Treats Gram - only

A

Monobactams/Aztreonam

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25
Q

Beta-Lactam
Gram +, Gram -, anaerobic
Used to treat mixed aerobic/anaerobic coverage, febrile neutropenia

A

Carbapenems/meropenem

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26
Q

Gram +, Gram -, Atypical
Limited to anaerobic
Treats UTIs, bacterial diarrhea, soft tissue/bone infections

A

Fluoroquinolones

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27
Q

What are common fluoroquinolones?

A

Cipro

Levaquin

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28
Q

Gram + and Gram -

Poor anaerobic

A

Sulfonamides

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29
Q

What are common sulfonamides?

A

Bactrim

Sulfa

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30
Q

Gram -

Used for sepsis, endocarditis, UTIs

A

Aminoglycosides

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31
Q

Gram + anaerobic coverage

A

Lincosamides/Clindamycin

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32
Q

Gram + (pneumococci, staph, strep)
Gram -
Atypicals (mycoplasma, legionella)

A

Macrolide/Azithromycin

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33
Q

What is classified as a fever as a neonate (28 days)?

A

More than 100.4 taken rectally

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34
Q

What are the most common bacterial infections in neonates?

A

Bacteremia, meningitis, UTI, pneumonia

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35
Q

What is treatment for fever in neonate?

A

Ampicillin and gentamycin
OR
Ampicillin and cefotaxime/ceftriaxone

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36
Q

What are the most common bacterial organisms for bacteremia, meningitis, UTI, pneumonia in a neonate?

A 
GBS
E. Coli
Listeria monocytogenes
Staph aureus
Enterococcus species
HSV
CMV
Varicella-zoster virus
RSV
Candida species
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37
Q

Fever > 101F/38.3C lasting for at least 8 days and up to 3 weeks with no apparent clinical diagnosis

A

Fever of Unknown Origin

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38
Q

Bacteremia, meningitis, and UTI

A

most common differentials for infants 1-3 months of age with fever of unknown origin

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39
Q

What is the common management for infants 1-3 months of age with suspected meningitis?

A

Ampicillin + Cefotaxmine + Acyclovir

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40
Q

What is the common management for infants >3 months with suspected meningitis?

A

Vancomycin + Ceftiaxone

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41
Q

Meningitis, pneumonia, toxic shock, urosepsis

A

Most common differentials for fever of unknown origin in children 3 months to 2 years

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42
Q

Antimicrobial choice for meningitis in children 3 months-2 years

A

Vancomycin + ceftriaxone

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43
Q

Antimicrobial choice for pneumonia in children 3 months-2 years

A

Ampicillin/Cefuroxime/ceftriaxone + Clindamycin/Vancomycin

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44
Q

Toxic shock, meningitis, pneumonia

A

Common etiologies of fever of unknown origin in children 2-18 years

45
Q

Pneumonia in 2-18 years old antimicrobials

A

Azithromycin + Cefuroxime or Ceftriaxone

Clindamycin/Vancomycin

46
Q

Meningitis in 2-18 years old antimicrobials

A

Ceftriaxone and Vancomycin

47
Q

Risk factors include:
Prematurity, invasive lines, catheters, ECMO, dialysis, parenteral nutrition, invasive ventilation, transplant, burns, neonates, and neoplasms

A

Healthcare-Associated Infections

48
Q

Treatment for Healthcare-Associated Infections

A 
Prevention
Handwashing
Broaden antimicrobials
Wound Ostomy and Continence Nurse (WOCN)
Evaluate the necessity of interventions daily
49
Q

Can get exposure from older homes or abandoned buildings, cutting firewood, tree stumps, gardening, barns, caves, hollow trees

A

Histoplasmosis (fungal infections)

50
Q

Pulmonary/Disseminated; prolonged weight loss, fatigue, fever, dry cough, chest discomfort, hepatosplenomegaly, lymphadenopathy, pallor/petechiae, ulcers, molluscum-like papules

A

Histoplasmosis

51
Q

Spore-folding mold; with 60% asymptomatic and self-limiting, characteristic erythema nodosum or multiforme

A

Coccidioidomycosis

52
Q

What is the treatment for coccidioidomycosis?

A

Long-term azoles

53
Q

Blastomyce dermatitidis with broad, non-descript, insidious presentation; can infect skin and bone

A

Blastomycosis

54
Q

What is the treatment for blastomycosis?

A

amphotericin B

Itraconazole

55
Q

What medical issues require antifungal prophylaxis to prevent systemic candidemia?

A

Solid organ transplant, chemo-induced neutropenia, stem cell transplant with neutropenia

56
Q

What antifungal prophylaxis is used to prevent systemic candidemia?

A

Fluconazole

57
Q

Most common opportunistic infection in immunocompromised patients

A

Pneumocystis carinii pneumonia (PCP)

58
Q

What is the peak incidence of PCP in HIV patients?

A

3-6 months of age

59
Q

Nonspecific, chest pain, fever, tachypnea

A

Pneumocystis carinii pneumonia (PCP)

60
Q

What is required for diagnosis of PCP?

A

Microscopy/stain from BAL/sputum

Chest x-ray

61
Q

Chest x-ray shows bilateral, diffuse, ground-glass appearance

A

Pneumocystis carinii pneumonia (PCP)

62
Q

What is the treatment for Pneumocystis carinii pneumonia (PCP)?

A

Bactrim
Pentamidin
Dapson + trimethoprim

63
Q

Nonspecific symptoms for weeks prior to acute illness with night sweats, abdominal pain, fatigue, diarrhea, anemia, neutropenia

A

Mycobacterium avium complex (MAC)

64
Q 
Strep pneumo
MRSA
VRE
Haemophilus infleunzae
Extended spectrum beta-lactamase (ESBL), E.coli, Klebsiella
A

Most common resistant organisms

65
Q

Borrelia bugdorferi spirochete is the organism for which vector-borne disease

A

Lyme Disease

66
Q

What is the vector for Lyme Disease?

A

Ixodes ticks

67
Q

What is the treatment for uncomplicated Lyme disease?

A

Doxycycline

68
Q

What is the treatment for complicated Lyme disease?

A

IV ceftriaxone or Penicillin

69
Q

Arthritis, carditis, meningitis/encephalitis

A

Complications of Lyme disease

70
Q

Rickettsia rickettsii is the organism for which vector-borne disease

A

Rocky Mountain Spotted Fever

71
Q

What is the vector for Rocky Moutain Spotted Fever?

A

Dermancentor tick

72
Q

Fever, severe headache, myalgia, rash on wrists, ankles, palms, and soles which spreads to the trunk, thrombocytopenia

A

Rocky Mountain Spotted Fever

73
Q

What is the treatment for Rocky Mountain Spotted Fever?

A

Doxycycline until afebrile for 72 hours

74
Q

Steeple sign on x-ray

75
Q

What is the treatment for mild croup?

A

supportive, humidified air, antipyretics, PO dexamethasone 0.6 mg/kg x 1

76
Q

What is the treatment for moderate/severe croup?

A

Oxygen, nebulized epinephrine (observe for rebound), PO/IV dexamethasone, Heliox, and intubation may be required

77
Q

Rapid onset, toxic presentation, high fever (>102), muffled voice, drooling, tripoding

A

Epiglottitis

78
Q

Thumb sign

A

Epiglottitis

79
Q

What antimicrobial is used to treat epiglottis?

A

3rd generation cephalosporin +/- vancomycin

80
Q

Risk factors for ____:
<4 years (exclude neonates), overcrowded populations, complement deficient, SLE< liver disease, HIV, asplenia, Ig deficiencies, nephrotic syndrome

A

Meningococcemia

81
Q

Resuscitation with fluid, vasoactive medications, intubation, FFP, cryoprecipitate, factor VII, PRBC, platelets, hydrocortisone, high dose dexamethasone, broad-coverage for 5-7 days (penicillin G, cephalosporin, vancomycin)

A

treatment for meningococcemia

82
Q

Common organisms for peritonsillar/retropharyngeal abscess

A

Strep pyogenes, staph aureus, haemophilus, MRSA, some anaerobes

83
Q

Sore throat usually unilateral, dysphagia, new onset snoring, neck swelling, drooling, hot potato voice, chest/ear pain

A

peritonsillar/retropharyngeal abscess

84
Q

AIRWAY PROTECTION, avoid agitation, airway expect, surgical drainage, culture
Ampicillin-sulbactam/unasyn or clindamycin +/- vancomycin

A

peritonsillar/retropharyngeal abscess treatment

85
Q

Most common sites for tuberculosis

A

Lung parenchyma/intrathoracic lymph nodes

86
Q

Hx of travel to endemic areas, jails, prisons, group homes, shelters, IV drug users, family hx of TB

A

tuberculosis

87
Q

New-onset fever

Escalating ventilator setting without lung disease

A

Hospital Acquired Infections

88
Q

Not present upon admission, but develops within__ hours of admission in acute care setting

A

48 hours

CLASBI

89
Q

Not present at discharge, but apparent within __ days after discharge

A

10 days

CLASBI

90
Q

Coagulase-negative staphylococci, gram-negative bacteria, Staph. aureus, and Candida sepcies

A

Common causes of CLASBI

91
Q

Fever, chills, hypotension

Neonates: hypothermia, apnea, bradycardia

92
Q

Diagnosis of CLASBI

A

2 blood cultures (at least one drawn peripherally)
Catheter tip cultures, CBC with differential, CRP, ESR
Urine, sputum, respiratory viral cultures

93
Q

Ventilator-associated condition: period of baseline stability or improvement on mechanical ventilation; >2 calendar days of stable or decreasing FiO2 or PEEP values followed by at least one of the following indicators of deteriorating status

Increase in FiO2 > 0.20 from baseline period, sustained for >2 calender days
Increase in PEEP level of >3 cm H2) from baseline period, sustained for >2 calendar days

94
Q

Fever, leukopenia, or leukocytosis
Increased respiratory secretions or change in sputum character
New-onset or worsening apnea, tachypnea, dyspnea, wheezing, rales, rhonchi, cough, bradycardia, oxygenation

Two or more serial chest radiographs with new or progressive and persistent infiltrate, consolidation, cavitation, or pneumatoceles (<1 year)

95
Q

Chest x-ray
CBC with differential, CRP, ESR
Blood and bacterial cultures, and Gram-staining for endotracheal aspirate
Bronchoalveolar lavage with protected specimen brush collection specimen
Pleural fluid or lung biopsy
respiratory viral culture/viral panel

A

VAE/VAP diagnosis

96
Q

Management for VAE/VAP

A

Increase oxygen and other settings
Hemodynamic support
Broad-spectrum antibiotic administration

97
Q

UTI in which an indwelling catheter was in place for > 2 calendar days when all elements of CDC UTI infection criteria are present

A

Catheter-Associated Urinary Tract Infection (CAUTI)

98
Q

E.coli, P. aeurginosa, Candida species, Enterococcus species, K. pneumoniae

A

common organisms for Catheter-Associated Urinary Tract Infection (CAUTI)

99
Q

Fever; urinary frequency, urgency, dysuria; costovertebral pain or suprapubic tenderness; positive urine culture, pyuria, positive dipstick for leukocytes and/or nitrates

Infants-hypothermia, apnea, bradycardia, lethargy, vomiting

A

Catheter-Associated Urinary Tract Infection (CAUTI)

100
Q

Symptoms of lower respiratory tract infection and RSV antigen >72 hours after admission

A

Nosocomial Respiratory Syncytial Virus

101
Q

What is the median hospitalization for nosocomial RSV compared to RSV?

A

10 days versus 5 days

102
Q

Infection occurring within 30 or 90 days after an operative procedure involving skin, subcutaneous tissue, or deep soft tissue of incision; associated with clinical signs of infection or associated positive wound culture

A

Surgical Site infection

103
Q

Staph. aureus, coagulase-negative staphylococci, P. aeruginosa

A

common causes of surgical site infection

104
Q

Toxin-mediated, multisystem febrile illness caused by bacteria staph. aureus and strep. pyogenes

A

Toxic Shock Syndrome

105
Q

Begins with lethargy, myalgia, sore throat, abdominal pain, diarrhea, and rash

Quickly develop fever and hypotension

A

Toxic Shock Syndrome

106
Q

Fever >102F
Diffuse macular erythroderma
Desquamation 1-2 weeks following rash
Hypotension (S. BP <90 for adults or less than 5th percentile for <16 yr)

Multisystem involvement:
Vomiting/diarrhea
Severe myalgias or creatinine phosphokinase at least 2x upper limit of normal
Hyperemia of conjunctiva, oropharynx, or vagina
BUN and creatinine at least 2x normal; urinary sediment with pyuria
Total bilirubin, AST, or ALT at least 2x normal
Platelet <100,000
Altered mental status without focal neurologic signs in absence of fever or hypotension

A

Toxic Shock Syndrome

107
Q

Differentials for toxic shock syndrome

A

sepsis, acute viral infection, bacterial meningitis, meningococcemia, and RMSF

108
Q

Aggressive hemodynamic and respiratory support; removal/debridement of localized site of infection, and antibiotic therapy

A

Toxic shock syndrome treatment

109
Q

What antibiotic therapy for toxic shock syndrome?

A

3rd generation cephalosporin (Ceftriaxone) and vancomycin + clindamycin

Acute PNP (8 decks)

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