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PHRM 865 > 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
What disease states is monocytosis usually associated with?
tuberculosis or lymphoma
26
What disease states is eosinophillia usually associated with?
ALLERGIC REACTIONS! or protozoal/parasitic infections
27
Which is depleted in HIV infection: CD4 or CD8?
CD4
28
Which binds to and directly kills tumor cells: CD4 or CD8?
CD8
29
Which helps with antibody production and secretion of lymphokines: CD4 or CD8?
CD4
30
What lab tests are elevated in the presence of the inflammatory process, but NOT confirmatory of infection?
ESR and CRP
31
Normal ESR value?
0 - 15 mm/hr (males) 0 - 20 mm/hr (females)
32
Normal CRP value?
0 - 0.5 mg/dL
33
What is PCT?
procalcitonin (precursor of calcitonin)
34
Normal PCT value?
\< 0.05 ug/L
35
Is PCT more or less specific than ESR or CRP for bacterial infections?
MORE! PCT is good for finding out if a bacterial infection is present.
36
What PCT range is suggestive of sepsis?
2 - 10
37
What PCT range is indicative of sepsis/systemic bacterial infection?
10+
38
What PCT value indicates another condition/localized infection?
0.25 - 2
39
Define “sensitivity”.
positive result in presence of disease/infection
40
Define “specificity”.
negative result in the absence of disease/infection
41
Is false negative rate associated with sensitivity or specificity?
sensitivity
42
What is the difference between empiric and directed therapy?
Empiric: BROAD SPECTRUM _before_ a pathogen is identified Directed: _after_ a pathogen is identified or susceptibility results are known
43
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?
* CNS infection * Endocarditis * *Staph aureus* bacteremia
44
What are the 3 primary reasons for combination antimicrobial therapy?
1. Broaden spectrum of coverage 2. Achieve synergistic bactericidal activity 3. Prevents emergence of resistance (ex: HIV drug therapy)
45
What are the disadvantages of combo microbial therapy?
* Increased cost * Greater toxicity risk * Superinfection with resistant bacteria * Antagonism
46
Which organisms are spirochetes?
* *Treponema pallidum* (syphilis) * *Borrelia burgdoferi* (Lyme disease) * *Leptospira interrogans*
47
Give a species example of aerobic gram-positive cocci in clusters.
*Staphylococcus*
48
Give an example of aerobic gram-positive cocci in pairs.
*Streptococcus pneumoniae*
49
Give an example of aerobic gram-positive cocci in chains.
* viridans streptococci (α-hemolytic) * group streptococci (β-hemolytic)
50
Give a species example of aerobic gram-positive cocci in pairs & chains.
*Enterococcus*
51
Give a species example of aerobic gram-positive coccobacilli.
*Haemophilus*
52
Give some examples of atypical bacteria.
* *Chlamydophila pneumoniae* * *Chlamydia trachomatis* * *Legionella pneumophila* * *Mycoplasma pneumoniae*
53
Give a species example of anaerobic gram-negative bacilli.
* *Bacteroides* * *Fusobacterium*
54
What are the non-infectious causes of fever?
* malignancy * collagen vascular disease (autoimmune) * drug fever (beta-lactams, anticonvulsants, allopurinol, hydralazine, nitrofurantoin, sulfonamides, phenothiazines, methyldopa) * blood transfusion
55
Stains are a means of _______ examination.
direct
56
How many sets of blood cultures should be taken from a patient for diagnostic purposes?
2 sets (aerobic and anaerobic) from different sites, 1 hour apart if possible
57
True or false: isolation of an organism from a clinical specimen does NOT always represent the presence of infection (and vice versa).
true
58
How long should we wait for a patient to clinically respond to antimicrobial therapy before considering it a failure?
2-3 days after initiation

PHRM 865 (59 decks)

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