Intra-abdominal infection

Question 1

What is colonisation?

Answer 1

presence of a microbe in the human body without an inflammatory response

Question 2

What is bacteraemia?

Answer 2

presence of viable bacteria in the blood

Question 3

What is sepsis?

Answer 3

life-threatning organdysfunction caused by a dysregulated host response to infection

Question 4

What are the common causes of peritonitis?

Answer 4

perforated duodenal ulcer; appendix; diverticulum; tumour

Question 5

What are the components of qSOFA?

Answer 5

RR >22bpm; sBP <100; altered GCS

Question 6

What does >2 on qSOFA mean?

Answer 6

mortality >10%

Question 7

What are the criteria for SIRS?

Answer 7

> 2 of :temp >38 or <36; HR >90; RR >20; WBC >12,000/<4000 or >10% immature neutrophils

Question 8

Aside from infection, what else can cause SIRS?

Answer 8

trauma; burns; pancreatitis

Question 9

What is the difference between SIRS and sepsis?

Answer 9

sepsis is SIRS with a presumed or confirmed infectious process

Question 10

What is septic shock?

Answer 10

sepsis plus signs of at least one acute organ dysfunction- e.g hypotension

Question 11

What are coliforms?

Answer 11

E.coli and similar organims that inhabit the large bowel e.g klebsiella; proteus; enterbacter

Question 12

Give an example of a strict aerobe?

Answer 12

pseudomonas

Question 13

Give examples of strict anaerobes?

Answer 13

clostridium; baceteroides

Question 14

Where are strict anaerobes generally found?

Answer 14

large bowel

Question 15

What are the common commensals of the mouth?

Answer 15

strep. viridans; neisseria; anaerobes

Question 16

What is the empiric antibiotics for intra-abdominal infections?

Answer 16

amoxicillin; gentamicin; metronidazole

Question 17

what does amoxicillin cover for intra-abdo infections?

Answer 17

streptococci and enterococci

Question 18

What does gentamicin cover in intra-abdo infections?

Answer 18

aerobic coliforms

Question 19

what does metronidazole gover for intra-abdo infections?

Answer 19

anaerobes

Question 20

What is empiric treatmnet of intra-abdo sepsis for penicillin allergy?

Answer 20

vancomycin; gentamicin; metronidazole

Question 21

What is given prophylactically for GI/hepatobiliary surgery?

Answer 21

gentamicin and metronidazole

Question 22

What should be monitored daily with gentamicin therapy?

Answer 22

renal function

Question 23

What is the longest a patient can be on gentamicin before ID/micro approval?

Answer 23

72 hours

Question 24

What is the oral step down for intra-abdo sepsis for penicillin allergy?

Answer 24

co-trimoxazole; gentamicin and metronidazole

Question 25

Why can vancomycin only be given IV?

Answer 25

isnt' absorbed from the GI tract

Question 26

What is the MOA of gentamicin?

Answer 26

binds to the ribosome interrupting protein synthesis

Question 27

Why can azithromycin be given as a single dose orally?

Answer 27

very long half life (5 days)

Question 28

How long should you wait to have sex after treatment for chlamydia?

Answer 28

a week after both partners ahve been treated

Question 29

Which STI can be transmitted through fomites?

Answer 29

trichomonas

Question 30

Who requires a chlamydia test of cure?

Answer 30

pregnant people

Question 31

When should you do a test of cure with chlamydia?

Answer 31

5-6 weeks

Question 32

What bottles are done with blood cultures?

Answer 32

one aerobic and one anaerobic