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Spring 2022: Therapeutics IV > Principles of Antibiotic Selection (Kays) > Flashcards

Principles of Antibiotic Selection (Kays) Flashcards

1
Q

Gram positive bacteria stain _____

A

(positive) purple

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2
Q

Gram negative bacteria stain _______

A

red

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3
Q

What is the difference between bacilli and cocci?

A

bacili: rod shape
cocci: little circles

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4
Q

Which bacteria are lactose-fermenting?

A
  • Citrobacter
  • Enterobacter
  • E. coli
  • Klebsiella
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5
Q

What can mask a fever?

A
  • Antipyretics
  • Corticosteroids
  • Antimicrobial therapy
  • Overwhelming infection
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6
Q

Systemic signs of an infection:
Fever (temperature > _____)

A

38C/ 100.4F

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7
Q 
Systemic signs of an infection: 
Increased WBCs (\> \_\_\_\_\_\_\_\_ /mm<sup>3</sup>)
A

> 10,500

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8
Q

Normal WBC count?

A

4,500 - 10,500/mm3

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9
Q

Systemic signs of an infection:
Fast or slow breathing and HR?

A

Fast (tachycardia and tachypnea)
HR > 90 beats/min
RR > 20 breaths/min

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10
Q

Systemic signs of an infection:
Hypo- or hypertension?

A

HYPOtension

(SBP < 90 mmHg or an MAP < 70)

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11
Q

Normal WBC differential:
Mature neutrophils: _____%

A

50-70%

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12
Q

Normal WBC differential:
Immature neutrophils: ____%

A

0-5%

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13
Q

Normal WBC differential:
Eosinophils: ____ %

A

0-5%

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14
Q

Normal WBC differential:
Basophils: ____%

A

0-2%

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15
Q

Normal WBC differential:
Lymphocytes: _____%

A

15-40%

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16
Q

Normal WBC differential:
Monocytes: _____%

A

2-8%

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17
Q

Which WBCs are agranulocytes?

A

lymphocytes and monocytes

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18
Q

Which WBCs are granulocytes?

A

the “phils” (neutrophils, eosinophils, basophils)

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19
Q

Other names for mature neutrophils?

A

PMNs, polys, segs

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20
Q

Other names for immature neutrophils?

A

bands

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21
Q

What is leukocytosis?

A

increased neutrophils (+/- bands)

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22
Q

The presence of immature forms of neutrophils means what?

A

left shift (indication of bone marrow response to the infection)

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23
Q

Leukocytosis generally indicates that there is a ______ infection

A

bacterial

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24
Q

Lymphocytosis generally indicates that there is a _________ infection

A

viral/fungal/TB

25
Q

What disease states is monocytosis usually associated with?

A

tuberculosis or lymphoma

26
Q

What disease states is eosinophillia usually associated with?

A

ALLERGIC REACTIONS! or protozoal/parasitic infections

27
Q

Which is depleted in HIV infection: CD4 or CD8?

A

CD4

28
Q

Which binds to and directly kills tumor cells: CD4 or CD8?

A

CD8

29
Q

Which helps with antibody production and secretion of lymphokines: CD4 or CD8?

A

CD4

30
Q

What lab tests are elevated in the presence of the inflammatory process, but NOT confirmatory of infection?

A

ESR and CRP

31
Q

Normal ESR value?

A

0 - 15 mm/hr (males)
0 - 20 mm/hr (females)

32
Q

Normal CRP value?

A

0 - 0.5 mg/dL

33
Q

What is PCT?

A

procalcitonin (precursor of calcitonin)

34
Q

Normal PCT value?

A

< 0.05 ug/L

35
Q

Is PCT more or less specific than ESR or CRP for bacterial infections?

A

MORE! PCT is good for finding out if a bacterial infection is present.

36
Q

What PCT range is suggestive of sepsis?

A

2 - 10

37
Q

What PCT range is indicative of sepsis/systemic bacterial infection?

A

10+

38
Q

What PCT value indicates another condition/localized infection?

A

0.25 - 2

39
Q

Define “sensitivity”.

A

positive result in presence of disease/infection

40
Q

Define “specificity”.

A

negative result in the absence of disease/infection

41
Q

Is false negative rate associated with sensitivity or specificity?

A

sensitivity

42
Q

What is the difference between empiric and directed therapy?

A

Empiric: BROAD SPECTRUM before a pathogen is identified

Directed: after a pathogen is identified or susceptibility results are known

43
Q

We want to move patients from IV to PO therapy when they are clinically stable with a functioning GI tract and there are available agents with good PO bioavailability…but what are cases where you should NOT transition to PO?

A
  • CNS infection
  • Endocarditis
  • Staph aureus bacteremia
44
Q

What are the 3 primary reasons for combination antimicrobial therapy?

A
  1. Broaden spectrum of coverage
  2. Achieve synergistic bactericidal activity
  3. Prevents emergence of resistance (ex: HIV drug therapy)
45
Q

What are the disadvantages of combo microbial therapy?

A
  • Increased cost
  • Greater toxicity risk
  • Superinfection with resistant bacteria
  • Antagonism
46
Q

Which organisms are spirochetes?

A
  • Treponema pallidum (syphilis)
  • Borrelia burgdoferi (Lyme disease)
  • Leptospira interrogans
47
Q

Give a species example of aerobic gram-positive cocci in clusters.

A

Staphylococcus

48
Q

Give an example of aerobic gram-positive cocci in pairs.

A

Streptococcus pneumoniae

49
Q

Give an example of aerobic gram-positive cocci in chains.

A
  • viridans streptococci (α-hemolytic)
  • group streptococci (β-hemolytic)
50
Q

Give a species example of aerobic gram-positive cocci in pairs & chains.

A

Enterococcus

51
Q

Give a species example of aerobic gram-positive coccobacilli.

A

Haemophilus

52
Q

Give some examples of atypical bacteria.

A
  • Chlamydophila pneumoniae
  • Chlamydia trachomatis
  • Legionella pneumophila
  • Mycoplasma pneumoniae
53
Q

Give a species example of anaerobic gram-negative bacilli.

A
  • Bacteroides
  • Fusobacterium
54
Q

What are the non-infectious causes of fever?

A
  • malignancy
  • collagen vascular disease (autoimmune)
  • drug fever (beta-lactams, anticonvulsants, allopurinol, hydralazine, nitrofurantoin, sulfonamides, phenothiazines, methyldopa)
  • blood transfusion
55
Q

Stains are a means of _______ examination.

A

direct

56
Q

How many sets of blood cultures should be taken from a patient for diagnostic purposes?

A

2 sets (aerobic and anaerobic) from different sites, 1 hour apart if possible

57
Q

True or false: isolation of an organism from a clinical specimen does NOT always represent the presence of infection (and vice versa).

A

true

58
Q

How long should we wait for a patient to clinically respond to antimicrobial therapy before considering it a failure?

A

2-3 days after initiation

Spring 2022: Therapeutics IV (12 decks)

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