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Therapeutics V > Infectious Disease - Principles in Abx Selection Handout > Flashcards

Infectious Disease - Principles in Abx Selection Handout Flashcards

1
Q

Gram Stain Positive color

A

PURPLE

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2
Q

Gram Positive Cocci in clusters: Coagulase positive

A

S. aureus

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3
Q

Gram Positive Cocci in clusters: Coagulase negative

A 
S. epidermidis
S. lugdunensis
S. hominis
S. saprophyticus
S. haemolyticus
S. capitis
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4
Q

Gram-positive cocci in pairs

A

Streptococcus pneumoniae

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5
Q

Gram-positive cocci in chains:

Viridans streptococci (α-hemolytic):

A 
S. milleri
S. mutans
S. salivarius
S. mitis
S. sanguis
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6
Q

Gram-positive cocci in chains:

Group streptococci (β-hemolytic):

A

Group A (S. pyogenes),

Group B (S.
agalactiae)

Group C (Streptococcus equi)

Group D (S. bovis, S. equinus),

Groups F and G streptococci (S. dysgalactiae)

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7
Q

Gram-positive cocci in pairs & chains

A

Enterococcus spp. (E. faecalis, E. faecium, E. durans, E. gallinarum, E.
avium, E casseliflavus, E. raffinosus)

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8
Q

Gram-positive bacilli classifications

A

non spore forming

spore forming

branching, filamentous

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9
Q

Gram-positive bacilli classifications:

non spore forming

A

Corynebacterium spp. (C. diphtheriae, C. jeikeium, C. striatum, etc.)

Lactobacillus spp.

Listeria monocytogenes

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10
Q

Gram-positive bacilli classifications:

spore forming

A

Bacillus spp. (B. anthracis, B. cereus, etc.)

Streptomyces spp.

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11
Q

Gram-positive bacilli classifications:

branching, filamentous

A

Erysipelothrix rhusiopathiae

Nocardia spp. (N. asteroides)

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12
Q

Gram Stain Negative color

A

red

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13
Q

Gram-negative cocci

A

Neisseria spp. (N. gonorrhoeae, N. meningitidis, etc.)

Moraxella catarrhalis

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14
Q

Gram-negative coccobacilli

A

Haemophilus spp. (H. influenzae, H. parainfluenzae, H. ducreyi, etc.)

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15
Q

Gram-negative bacilli examples

A

lactose-fermenting

non lactose fermenting

other gram negative bacilli

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16
Q

Gram-negative bacilli:

lactose fermenting

A

Aeromonas hydrophila
*Citrobacter spp. (C. freundii, C. koseri)
*Enterobacter spp. (E. cloacae, E. aerogenes [Klebsiella aerogenes])
*Escherichia coli
*Klebsiella spp. (K. pneumoniae, K. oxytoca)
Pasteurella multocida
Vibrio cholerae

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17
Q

Gram-negative bacilli:

non lactose fermenting

A

Acinetobacter spp. (A. baumannii)
Alcaligenes spp.
Burkholderia cepacia
*Morganella morganii
*Proteus spp. (P. mirabilis, P. vulgaris)
*Providencia spp. (P. rettgeri, P. stuartii)
Pseudomonas spp. (P. aeruginosa, P. putida, P. fluorescens)
*Salmonella spp. (S. typhi, S. paratyphi, S. enteritidis, S. typhimurium)
*Serratia marcescens
*Shigella spp. (S. dysenteriae, S. sonnei)
Stenotrophomonas maltophilia

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18
Q

Gram-negative bacilli:

other gram negative bacilli

A 
Brucella spp.
Bordetella spp.
Campylobacter jejuni
Francisella tularensis
Helicobacter pylori
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19
Q

Define gram variable

A

stain both Gram-positive and Gram-negative in the same smear

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20
Q

Gram-variable bacilli example

A

Gardnerella vaginalis

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21
Q

Miscellaneous organisms where Gram stain

is typically not useful: 2 groups

A 
atypical bacteria (Cell walls difficult to stain; Mycoplasma lack a
cell wall)

spirochetes (Motile, corkscrew-shaped organism visualized
using dark field microscopy)

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22
Q

Miscellaneous: atypical bacteria examples

A

Chlamydophila pneumoniae
Chlamydia trachomatis
Legionella pneumophila
Mycoplasma pneumoniae

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23
Q

Miscellaneous: spirochetes

A 
Treponema pallidum (syphilis)
Borrelia burgdorferi (Lyme disease)
Leptospira interrogans
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24
Q

Gram stain positive (anaerobic): gram positive cocci in chains

A 
Peptostreptococcus spp. (P. anaerobius, P. intermedius)
Finegoldia magna (formerly P. magnus)
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25
Q

Gram-positive bacilli (anaerobic): examples

A

non-spore forming

spore forming

branching, filamentous

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26
Q

Gram-positive bacilli (anaerobic):

non spore forming examples

A

Cutibacterium spp. (C. acnes [formerly Propionibacterium acnes])

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27
Q

Gram-positive bacilli (anaerobic):

spore forming

A

Clostridium spp. (C. perfringens, C. tetani, C. botulinum)

Clostridioides difficile

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28
Q

Gram-positive bacilli (anaerobic):

branching, filamentous

A

Actinomyces spp. (A. israelii)

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29
Q

Gram negative (anaerobic) cocci

A

Veillonella spp. (V. parvula)

30
Q

Gram negative (anaerobic) bacilli

A

Bacteroides spp. (B. fragilis, B. thetaiotamicron, B. ovatus, B. distastonis)

Fusobacterium spp.

31
Q

Normal flora: Skin

A

Diphtheriods (e.g., Corynebacterium spp.)

Staphylococci (esp. S. epidermidis)

Streptococci

Propionibacterium spp.

32
Q

Normal flora: Oropharynx

A

Haemophilus spp.

Streptococci (viridans group)

Diphtheriods (e.g., Corynebacterium spp.)

Neisseria spp.

Oral anaerobes

33
Q

Normal flora: gastrointestinal tract

A

Bacteroides spp.

Enterobacteriaceae

Enterococci

Fusobacterium spp.

Peptostreptococcus spp.

Clostridium spp.

34
Q

Normal flora: Genital tract

A

Corynebacterium spp.

Enterobacteriaceae

Lactobacillus spp.

Mycoplasma spp.

Staphylococci

Streptococci

Anaerobes

Candida spp.

35
Q

Fever is a ________ of infection

A

hallmark

36
Q

Fever significant if oral temperature

A

> 38.0°C (100.4°F)

37
Q

Rectal temperature generally 0.6°C (1°F) ______;

axillary temperature generally
0.6°C (1°F) ______

A

higher

lower

38
Q

non-infectious causes of fever

A

Malignancy, collagen vascular disease (autoimmune)

Drug fever – fever coincides temporally with administration of the offending
agent and disappears promptly with withdrawal of the offending agent

Blood transfusions

39
Q

Drug fever offending agents

A

β-lactam antibiotics, anticonvulsants, allopurinol, hydralazine,
nitrofurantoin, sulfonamides, phenothiazines, methyldopa

40
Q

Absence of fever in a patient with signs and symptoms consistent with an
infection (false-negatives) EXAMPLES

A

Antipyretics – discourage during treatment of infection (may mask poor
therapeutic response)

Corticosteroids

Antimicrobial therapy (partial)

Overwhelming infection

41
Q

Signs and symptoms of infection

A

Fever (temp > 38°C)

Increased white blood cell count

Chills, rigors

Tachycardia (> 90 beats/min)

Tachypnea (> 20 breaths/min)

Hypotension (SBP < 90 mmHg or MAP < 70)

Malaise

Mental status changes

42
Q

Normal WBC count

A

4,500 to 10,500/mm3

43
Q

Mature neutrophil (PMNs, polys, segs) normal range

A

50 - 70%

44
Q

Immature neutrophils (bands) normal range

A

0 - 5%

45
Q

Eosinophils normal range

A

0 - 5%

46
Q

Basophils normal range

A

0 - 2%

47
Q

Lymphocytes normal range

A

15 - 40%

48
Q

Monocytes normal range

A

2 - 8%

49
Q

Leukocytosis (increased neutrophils ± bands) – associated with

A

bacterial infection

50
Q

Presence of immature forms (left shift) is an indication of

A

an increased

bone marrow response to the infection

51
Q

elevated neutrophils +/- bands potentially due to

A

non-infectious diseases (e.g., leukemia, stress)

or

drug therapy (e.g., steroids, lithium)

52
Q

elevated neutrophils +/- bands may be absent due to

A

neutropenic hosts; blunted in elderly

53
Q

Leukopenia (abnormally low WBC count) may be sign of

A

an overwhelming infection; poor prognostic sign

54
Q

B-lymphocytes ® proliferate into _________, which produce antibodies
involved in ________ immunity; some develop into memory cells

A

plasma cells

humoral

55
Q

T-lymphocytes – involved in ____________ immunity

A

cell-mediated

56
Q

T helper/inducer cells (CD4) –> regulation of the immune system; help
with ________ _________ and secrete ____________ that help protect
against bacterial/viral infections and tumors; the major marker of
immunocompetence in patients with ___________ (this cell line is
depleted with HIV infection)

A

antibody production

lymphokines

HIV infection

57
Q 
T suppressor (CD8) ® bind to and directly kill \_\_\_\_ \_\_\_\_\_; help with
regulation of \_\_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_ immunity
A

tumor cells

humoral

cell-mediated

58
Q

Define monocytosis

A

important phagocytic cells responsible for antigen processing
and presentation; associated with tuberculosis or lymphoma

59
Q

Define eosinophilia

A

associated with allergic reactions or protozoal/parasitic

infections

60
Q

Localized signs and symptoms of infection

A

a. Pain and inflammation – swelling, erythema, tenderness, purulent or abnormal
drainage
• Easily detected in superficial infections or infection of the bone or joint

b. Inflammation in deep-seated infections (e.g., pneumonia, meningitis, urinary
tract infection) – must examine tissues/fluids (sputum, CSF, urine)

c. May be absent in neutropenic hosts

61
Q

ESR and CRP and infection

A

Elevated in the presence of an inflammatory process but does not confirm the
presence of infection

62
Q

Normal ESR values

A

0 to 15 mm/hr in males

0 to 20 mm/hr in females

63
Q

Normal CRP values

A

0 to 0.5 mg/dL

64
Q

ESR and CRP elevated in presence of which infections

A

otitis media,
osteomyelitis, prosthetic joint infections, endocarditis, pelvic inflammatory
disease, and infections in transplant patients

65
Q

Serial measurement of ESR and CRP may be useful in assessing response to…

A

treatment of deep-seated infections, such as endocarditis or osteomyelitis

66
Q

PCT and infections

A

A precursor of calcitonin, a calcium regulatory hormone, which is a more
specific marker for bacterial infections than ESR or CRP

Some data suggest that PCT levels may be useful for assessing the efficacy of
empiric antibiotic therapy as well as for determining when antibiotic therapy
can be discontinued during the treatment of an infection

67
Q

Normal PCT value

A

Normal value = < 0.05 μg/L

68
Q

Meaning of PCT ≥ 10 μg/L ®

A

sepsis/systemic bacterial infection

69
Q

Meaning of PCT between 2 and 10 μg/L

A

suggestive of sepsis

70
Q

Meaning of PCT between 0.25 and 2 μg/mL

A

other condition or localized infection

71
Q

CONTINE ON PAGE 7

A

START AT D. RADIOGRAPHIC TESTS

Therapeutics V (17 decks)

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