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BCGP > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

What Is the negative predictive value of urinalysis?

A

94%

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2
Q

How long post kidney transplant should patients be screened and possibly treated for asymptomatic bacteriuria?

A

30-60 days

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3
Q

Which Urinary pathogen is intrinsically resistant to nitrofurantoin?

A

Proteus mirabilis

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4
Q

What are the criteria for CDI to be rated as non-severe?

A

WBC < 15,000 cells/microL AND SCr < 1.5 mg/dL

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5
Q

Microbiological pathogenesis of pneumonia: what does HAP-SP stand for?

A

Haemophilus influenzae, Atypicals (Legionella, mycoplasma, chlamydophila), Streptococcus pneumoniae, staph aureus, Pseudomonas aeruginosa

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6
Q

Which antibiotic cannot be used to treat pneumonia because it is deactivated by pulmonary surfactant?

A

Daptomycin

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7
Q

Which anti-MRSA agents can be used to treat pneumonia?

A

Vancomycin or linezolid

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8
Q

What is the clinical criteria for stability for systolic BP in pneumonia?

A

> 90 mm Hg

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9
Q

What is the heart rate for criteria for Clinical stability in pneumonia?

A

< 100 bpm

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10
Q

What is the body temperature threshold for clinical stability in pneumonia?

A

< 100.4 F

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11
Q

What level of MRSA prevalence does anti- MRSA coverage not need to be included for HAP treatment?

A

=< 20%

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12
Q

What is the threshold to consider white blood count to be elevated?

A

11,200 or 11,800, Depending on the lab

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13
Q

What percent bands would be considered elevated?

A

7-8%, depending on the lab

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14
Q

What body temperature in Fahrenheit is considered a fever?

A

100.4 F or greater

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15
Q

How do you calculate mortality risk from lactic acid?

A

Multiply by ten

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16
Q

What is CRE?

A

Carbapenem resistant enterobacterales

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17
Q

Which criteria/ tools are best for determining whether to initiate antibiotics?

A

Loeb criteria

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18
Q

Which tool/criteria are best for prospective surveillance?

A

NHSN criteria

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19
Q

What percent sensitivity of isolates should you have an agent for empiric therapy?

A

80% or more

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20
Q

What is the most common pathogen in older adults in UTI?

A

E. Coli

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21
Q

Which antibiotics penetrate prostate fluid?

A

Carbapenems and fluoroquinolones

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22
Q

How long after removal of a catheter is a UTI still considered a catheter associated UTI (CAUTI)?

A

Up to 48 hours

23
Q

Which components of urinalysis could indicate a possible UTI?

A

1) Leukocyte esterases - medium or large
2) urinary nitrites- positive
3) pyuria - greater than 10

24
Q

What is the only specific sign or symptom we have/objective measure for pyelonephritis diagnosis?

A

Costovertebral angle tenderness (CVA) (aggressive palpation of the border of the kidney)

25
Q

31-60 days how do you decide whether to treat UTI Post kidney transplant ?

A

If you have two consecutive two consecutive urine samples, yielding more than 100,000 CFU of the same pathogen- may consider treatment for 5 days

26
Q

What level of susceptibility to a fluoroquinolone do you need to have to be able to use it for pyelonephritis?

A

90% or more

27
Q

When is the seven day treatment for pyelonephritis appropriate?

A

Resolution of symptoms occurs within the first 72 hours of antibiotics

28
Q

For CAUTI, When would be a catheter needs to be changed if a catheter is still needed?

A

If it has been in place for more than 2 weeks 

29
Q

What threat level does CDC consider Clostridioides difficile to be?

A

Urgent

30
Q

Which antibiotic cannot be used to treat C. difficile in someone with severe macrolide allergy?

A

Fidaxomicin

31
Q

What is the most Common pathogen for community acquired pneumonia ?

A

Viruses

32
Q

what is the most common bacterial pathogen of community acquired pneumonia?

A

Streptococcus pneumoniae

33
Q

When is Anaerobic coverage needed for pneumonia treatment?

A

Radiographic evidence of consolidation/empyema

34
Q

When are blood cultures and sputum culture recommended for pneumonia?

A

Severe disease, or when suspecting MRSA or Pseudomonas

35
Q

pneumonia is Severe when three minor criteria are present. What are the criteria Re:, respiratory rate, body, temperature, and blood pressure?

A

1) RR 30 breaths, per minute or more
2) core Temperature < 36 C (96.8 F)
3) hypotension requiring fluid resuscitation

36
Q

Pneumonia is severe when 3 minor criteria are present. What lab results are minor criteria?

A

1) uremia (BUN >= 20 mg/dL)
2) leukopenia (WBC < 4,000 cells/microL)
3) thrombocytopenia (PLT < 100,000/microL)

37
Q

Pneumonia is severe when 3 minor criteria are present. What are the minor criteria (miscellaneous)?

A

Confusion, multilobar infiltrates, Pa O2/Fi O2 =< 250

38
Q

Which tool is the best mortality / prognosis predictor in pneumonia?

A

PSI/PORT (Pneumonia Severity Index/ Patient Outcomes Research Team)

39
Q

PSI/PORT (Pneumonia Severity Index/ Patient Outcomes Research Team)= 130 points, What is the mortality rate?

A

9.3%

40
Q

PSI/PORT (Pneumonia Severity Index/ Patient Outcomes Research Team)= 131 points, What is the mortality rate?

A

27%

41
Q

Which Two groups of antimicrobial should be used to treat pneumonia without MRSA or Pseudomonas risk factors? (Except for outpatient without comorbidities)

A

Beta-lactam + macrolide

42
Q

Which agent can be used to treat pneumonia in an outpatient without comorbidities? (2 choices)

A

Amoxicillin, doxycycline

43
Q

What is the treatment duration required for pneumonia in a stable patient without MRSA or Pseudomonas?

A

5 days minimum

44
Q

What are the 7 criteria for clinical stability ?

A

Temp < 100.4 F
HR < 100 bpm
RR < 24/min
SBP > 90 mmHg
Normal mental status
Ability to maintain oral intake
SpO2 > 90%

45
Q

How many clinical instability criteria must be present before extending treatment for pneumonia to seven days?

A

2

46
Q

Hospital acquired pneumonia: patient who is not high risk of mortality and has had no IV antibiotics in the previous 90 days with an MRSA prevalence under 20%. Which organism Must be covered?

A

Pseudomonas

47
Q

HAP- pseudomonas regimens (4)

A

Pip-tax 4.5 gm q6h
Cefipime 2 g q8h (neurotoxicity risk)
Levofloxacin 750 mg q24h
Meropenem 1g q8h

48
Q

HAP - MRSA coverage regimens (2)

A

Vancomycin 15 mg/kg q8-12h (AUC 400, or trough 15-20 mcg/mL)
Linezolid 600 mg q12h

49
Q

HAP -When is double anti- Pseudomonal coverage needed? (3)

A

1) Septic shock w vent d/t pneumonia
2) Structural lung disease
3) No agent w susceptibility 90% or more

50
Q

Which meningitis vaccine is contraindicated in a patient w prior severe allergy to tetanus toxoid?

A

MenQuadfi (MenACWY-TT)

51
Q

Which Pneumonia vaccines are contraindicated in patients with severe reaction to diphtheria/Tdap?

A

PCV15, PCV20

52
Q

Allergy to egg- other than hives (eg anaphylaxis) - can the patient receive flu vaccination?

A

Administer in any inpatient or outpatient setting by HCP who can recognize and manage severe allergic reaction

53
Q

Patient XY received two shingrix doses four weeks apart. Does he need any more doses?

A

Yes -2

54
Q

Which pneumococcal serotypes have highest risk of morbidity and mortality? (2)

A

22F, 33F

BCGP (10 decks)

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