Syndromic Approach To Infecitons

Question 1

What are the skin findings in dx necrotizing fascitis?

Answer 1

Erythema
Tense edema
Gray.discolored wound drainage
Vesicles or bullae
Skin necrosis
Ulcers
Crepitus

Question 2

What are the systemic features of necrotizing soft tissue infections?

Answer 2

Severe pain out of proportion to PE
Pain that extends pasts margin of apparent skin infection
Fever
Tachycardia, tachypnea
Diaphoresis
Delirium

Question 3

What layers of the skin is involved in Erysipelas?

Answer 3

Upper dermis
With clear demarcation of the border

Question 4

What part of the skin is involved in cellulitis?

Answer 4

Deeper dermis and SQ fat
No clear demarcation w/ more swelling

Question 5

What are the 2 processes of intra-abdominal infections?

Answer 5

Peritonitis
Abscesse

Question 6

How do u diagnose primary bacterial peritonitis?

Answer 6

Peritoneal fluid = >250PMNs/uL

Signle organism isolated

Empiric coverage for anaerboes not necessary

Question 7

What are teh risk factors for MDR PBP infection?

Answer 7

Nosocomial origin
Prolonged norfloxacin prophylaxis
Recent infection with Multidrug resistant organism
Recent use of beta lactam antibiotics

Question 8

What are the diff clinical syndromes assoc with UTI?

Answer 8

Asymptomatic bacteriuria
Cystitis
Peylonephritis
Complicated UTI
Acute bacterial prostatitis

Question 9

Whatare the characterstics of Cystitis?

Answer 9

Dysuria
Urinary frequency and urgency
Nocturia
Urine hesitancy
Suprapubic discomfort
Gross hematuria

• these can indicate prostate problems or neurogenic bladder

Question 10

How do u categorize as mild & severe pyelonephritis?

Answer 10

Mild = low-grade fever with or without lower back/costovertebral angle pain

Severe = nausea, vomiting, FLANK PAIN, & or LOIN PAIN, cystitis symptoms may be present, high-grade fever, rigots

Question 11

What is the main feature that distinguishes pyelonephritis from cystitis?

Answer 11

Fever

Question 12

What can infer that the problem in infective endocarditis is in the mitral valve?

Answer 12

Diastolic murmur

Question 13

What is a subacute infective endocarditis?

Answer 13

Structural cardiac damage
Rarely metastasize
Gradually progressive

Question 14

What can cause nonbacterial thrombotic endocarditis?

Answer 14

Local ecological factors
Bacteriosis
IgA protease
Bacterial adherence

Question 15

What are cutaneous manifestations of infecctive endocarditis?

Answer 15

Janeway lesions = small, erythematou or hemorrhagic, macular, nontender lesions on the palms and soles

Roth spots = oval retinal hemorrhages with pale centers

Osler’s nodes = small, tender, subcutaneous nodules developing in the pulp of digits or more proximal in fingers

Question 16

What is the commonly used criteria in diagnosign infective endocarditis?

Answer 16

Duke criteria

Question 17

What are the major criteria of Duke Criteria in IE?

Answer 17

Positive blood culture (S aureus, HACEK, community-acquired enterococci)

Evidence of endocardial involvement: positive echorcardiogram, new valvular regurgitation

Question 18

What cardiac imaging is used to detect vegetations in IE?

Answer 18

Transthoracic echocardigraphy (TEE)