Principles of Infectious disease Flashcards

1
Q

What is the systematic approach for selecting antimicrobial agents

A

Confirm presence of infection
identify pathogen
select presumptive therapy
therapeutic steps

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2
Q

What does a left shift indicate

A

Bands (premature neutrophils) in blood > 10%

Bacterial infection

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3
Q

How to confirm presence of infection

A
H&P exam
predisposing factors
signs and symptoms
- fever
- wbc count
- esr
- crp
- procalcitonin
- pain and inflammation
- disease specific signs and symptoms
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4
Q

what is the range for CRP

A

.5 - 1 normal
1 - 1.5 moderate inflammation
>10 infection

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5
Q

What is bacteria classified as

A

Susceptible
intermediate
resistent

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6
Q

What should peak dosage be

A

2 - 4 x MIC

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7
Q

What factors increase antibiotic resistance

A
Overuse
low dose
prolonged exposure
inappropriate antibiotics
day care
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8
Q

What are requirements for antimicrobial activity

A

penetrate cell
reach target
kill organism

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9
Q

What are mechanisms of resistance

A

decreased permeability - porin channels close
drug efflux - pump abx out
drug inactivation - enzymes attack abx
altered target - change ribosomes with CH3 so no binding

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10
Q

what are gram + cocci

A

Staph
Strep
Enterococcus

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11
Q

What are gram - cocci & cocco-bacilli

A

H. flu
Neisseria
Moraxella catarrhalis

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12
Q

What are Enterobacteriacea

A
EKP
- e. coli
- klebsiella
- proteus
ESP
- enterobacter
- serratia
- providencia
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13
Q

What are anaerobes

A

bacteroides fragilis

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14
Q

What is PA

A

pseudomonas aeruginosa

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15
Q

How to identify pathogen

A

Stains
Serologies
Culture and sensitivity

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16
Q

What are the stains

A
Gram Stain
- G+ purple (peptidoglycan)
- G- pink
Acid-fast
- mycobacteria
- nocardia
India Ink
- cryptococcus
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17
Q

What are gram stains routinely performed on

A

CSF for meningitis
Urethral smears for STI
abscesses or effusions

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18
Q

What is the gold standard for identifying bacteria

A

Cultures

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19
Q

What are the types of antibody and antigen detection

A

Immunoflorescence
Latex agglutination
Enzyme-linked Immunoassay

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20
Q

What is identified through immunoflorescence

A
CMV
RSV
Varicella
Treponema pallidum
Borrelia burgdorferi
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21
Q

What is identified through Latex agglutination

A

Meningococcus in CSF

Legionella pneumophelia

22
Q

What is identified through Enzyme-linked immunoassay

A
HIV
Herpes
RSV
Preumococcus
N. gonorrhea
Haemophilus pylori
23
Q

What is identified through PCR

A

Anthrax

24
Q

What are host factors to consider when selecting therapy

A
drug allergies
age
pregnancy
renal and hepatic function
site of infection
underlying disease states
concomitant drug therapy
25
Q

What are drug factors to consider when selecting therapy

A
antimicrobial activity
spectrum of activity
pharmacokinetics
pharmacodynamics
tissue penetration
adverse effects
cost
convenience
26
Q

What does bactericidal mean

A

kills organisms

27
Q

What does bacteriostatic mean

A

inhibit growth of bacteria but does not kill. Lets body immune system kill bacteria

28
Q

How prevent bacterial growth

A

destroy cell wall

inhibit protein synthesis

29
Q

What is MIC

A

Minimum inhibitory concentration

lowest antimicrobial concentration that prevents visible growth

30
Q

What are the susceptibility testing methods

A
macrodilution
microdilution
kirby-Bauer disk diffusion
E-test
Automated
31
Q

What are the automated susceptibility testing methods

A

Vitek

Microscan

32
Q

What are concentration and time-dependent effects

A

MIC
concentration-dependent killing rate
postantibiotic effect

33
Q

Which 2 bacteria should have 2 abx used on them at same time

A

Enterococcus

Pseudomonas aeruginosa

34
Q

What are typical pathogens for Acute Otitis Media

A

S. pneumoniae
H. flu
M. catarrhalis

35
Q

What are typical pathogens for Sinusitis

A

S. pneumoniae
H. flu
M. catarrhalis

36
Q

What are typical pathogens for Meningitis

A

S. pneumoniae
H. flu
N. meningitidis

37
Q

What are typical pathogens for Chronic Bronchitis

A
C. pneumoniae
M. Pneumoniae
S. pneumoniae
H. flu
M. catarrhalis
38
Q

What are typical pathogens for Pneumonia

A
M. Pneumoniae
S. pneumoniae
H. flu
Pseudomonas
Staph aureus
39
Q

What are typical pathogens for Bowel perf-appendicitis

A
E. coli
Klebsiella
Enterococcus
Pseudomonas
Bacteriodes Fragilis
40
Q

What are typical pathogens for Urinary Tract Infections

A

E. Coli
Klebsiella
Proteus
Enterococcus

41
Q

What are typical pathogens for Osteomyelitis

A

Staph

42
Q

What do staph affect

A

skin

soft tissue

43
Q

What do Strep effect

A

Respiratory tract infections

44
Q

What do enterococcus effect

A

GI

wounds

45
Q

What do Neisseria effect

A

meningitis

46
Q

What do H flu and moraxella catarrhalis effect

A

sinusitis
bronchitis
acute otis media

47
Q

What do EKP effect

A

many
UTI
GI

48
Q

What do ESP effect

A

GI

49
Q

What do pseudomonas aeruginosa effect

A

pneumonia

various

50
Q

What do anaerobes effect

A

GI

aspiration pneumonia