Microbiology - GRS Flashcards
Most marked deficits in the elderly
Drying of skin and mucus membranes, low antibody production, low IL-2 and T cell
Greatest impact on innate and host resistance is
comorbidity - presence of chronic disease
Factors affecting immune function in elders
comorbidity, nutrition, medications, depression,
Atypical presentation of a sick elderly
Fever, Chills and sweating can be absent during bacteremia and sepsis
Fever definition in an elderly
Temp >2F over baseline
Oral Temp >99F
Rectal temp >99.5F
Septic management in elderly
Adjunct therapy with activated Vitamin C for >75yrs
Strongest predictor of mortality of pneumonia in elderly
Comorbidity
Most predominant organism cause of pneumonia in elderly
Streptococcus pneumoniae
H. influenza, Moraxella catarrhalis, Klesiella are more common in younger people or elderly
Elderly, especially those with COPD and in long term facilities
Common causes of community acquired pneumoniae in nursing home patients
S. aureus and respiratory viruses
First line therapy for elderly
beta-lactam/beta lactamases or cephalosporin
Most effective drug therapy for S. pneumoniae or very sick elderly
Fluoroquinolones
Elderly in MRSA region, the initial regimen of treatment should include
Vancomycin or linezolid
Ways to reduce risk of pneumonia in elderly
Immunization, smoking cessation, treat cormobidities, and good infection control
What age to vaccinate elderly with influenza
> 50yrs
Most effective treatment of H. influenza in elderly
M2 inhibitors or neuraminidase inhibitor within 24 hours of onset
Most common organism in UTI
G- just like younger adults
What organism difference in elderly with UTI than younger adult
Pseudomonas, Entoerococcus, S. agalactiae, coagulase negative Staphy
Mode of action for asymptomatic bacteruria
Nothing!!!!
Older woman with dysuria, urgency and frequency changes. Diagnosis and Treatment
Lower UTI and Fluoroquinolones
Older woman with fever, chills, nausea, flank pain. Diagnosis and treatment
Upper UTI and IV antibiotics
Primary or Secondary contraction of TB in elderly
Most active cases are reactivation
Difference in TB in younger and older person
Older more likely to have extrapulmonary disease
Treatment of TB in elderly
Like young adults…..9 months of prophylactic therapy
Organism causing septic arthritis and osteomyelitis in elderly
S. aureus
HIV mode of infection in elderly
intercourse
Difference in approach of HIV in elderly and youths
Just more awareness of CVD
Most treatable infectious cause of dementia
HIV
Drug of choice for bacterial meningitis
Ceftriaxone plus vancomycin
Drug of choice for Listeria
Ampicillin
Drug of choice for Pseudomonas
Ceftazidime
Treatment of Neurosyphilis
Penicillin G
Major risk factor for reactivated varicella zoster virus
Advancing age
Most disabling complication of reactivated varicella zoster virus
Herpetic neuralgia - shocking pain
Fever of unknown definition
Temp >38.3 for 3 weeks and undiagnosed after 1 week of medical evaluation
What causes more fever of unknown origin in elderly than young adults
Collagen vascular disease
