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Clinical Therapeutics > To Kill a Bug > Flashcards

To Kill a Bug Flashcards

1
Q

A pt presents w/an erythematous fluctuant area on her right bicep. She is dx with an abscess w/surrounding cellulitis. An I&D is done an wound cultured. What is next?

A

Prescribe an antibiotic and discharge home, check cultures in 48 hours

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2
Q

A preliminary report is reported the next day (pt with abscess). Gram + cocci in clusters. What is most likely organism?

A

Staphylococcus species

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3
Q

25 YO female present with dysuria, frequency and urgency. What is the best tx plan for her?

A

Initiate antibiotics based on the most likely offending organism

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4
Q

What are some common gram + cocci organisms?

A

Streptococcus, Staphylococcus, Enterococcus, Peptostreptococcus

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5
Q

What are some common gram + bacilli organisms?

A

Bacillus anthracis, Clostridium sp, Corynebacterium sp, Listeria sp

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6
Q

What are some common gram - cocci organisms?

A

N. gonorrhea, N. meningitides, Moraxella catarrhalis

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7
Q

What are some common gram - Lactose-fermentors?

A

Serratia sp, Enterobacter sp, E.coli, Klebsiella sp, Citrobacter sp

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8
Q

What are some common gram - Non-Lactose Fermentors?

A

Psuedomonas, Proteus, Shigella, Salmonella, Stenotrophomon, Campylobacter, Legionalla, Bacteroides, Yersinia, Acinetobacter

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9
Q

Which organism normally colonizes the skin, nares, and respiratory tract?

A

Staph aureus

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10
Q

Staph aureus can cause what?

A

Cellulitis, abscess, bone, joint, endocarditis

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11
Q

What else is a common bacteria on the skin?

A

Staph epidermidis

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12
Q

What organism is associated with prosthetic and device infections?

A

Staph epidermidis

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13
Q

Staph epidermidis can contaminate what?

A

Blood cultures

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14
Q

What are the two organisms that are alpha hemolytic?

A

Strep. pneumoniae, strep viridans

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15
Q

What are the two organisms that are beta hemolytic?

A

Group A hemolytic strep (pyogenes), Group B hemolytic strep

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16
Q

What are the two organisms that are gamma hemolytic?

A

Enterococcus, Peptostreptococcus

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17
Q

What is an example of an opportunistic pathogen?

A

Enterococcus. Effects immunocompromised, prolonged hospitalizations, etc.

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18
Q

Enterococcus commonly causes what type of infection?

A

Urinary tract

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19
Q

Enterococcus normally colonizes which part of the body?

A

Intestine

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20
Q

Which two Enterococcus species have increasing resistance (VRE)?

A

Faecalis and Faecium (Gram + chains)

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21
Q

What are the enteric gram negatives?

A

Enterobacteriaciae family

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22
Q

Which organisms are in the Enterobacteriaciae family?

A

E.coli, Proteus, Serratia, Acinetobacter, Citrobacter, Enterbacter, Salmonella, Klebsiella

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23
Q

Enteric gram negatives can cause what types of infections?

A

Community: UTI, abdominal infections
Hospital: Late Hospital Acquired or Ventilator assisted pneumonia, complicated UTI

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24
Q

What are the H-N-M organisms?

A

Gram - cocci, Haemophilus, Neisseria, Moraxella

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25
Q

Common infections of Haemophilus and Moraxella include what?

A

Upper and lower respiratory tract infections

26
Q

Common infections of Neisseria are what?

A

Meningitis and STIs

27
Q

What is a gram - non-lactose fermenting organism?

A

Pseudomonas Aeruginosa

28
Q

Common infections with P. Aeruginosa

A

Wounds, osteomyelitis, corneal ulcer (contact lens), hot tub folliculitis, Late hospital acquired of healthcare associated pneumonia

29
Q

What are some common gram + anaerobes?

A

Clostridium sp, Actinomyces, Lactobacillus, Propionibacterium, Peptostreptococcus

30
Q

What are some common gram - anaerobes?

A

Bacteroides fragillis, Fusobcaterium, Porphyromonas, Veillonella

31
Q

Anaerobes usually cause what types of infections?

A

Co-infections

32
Q

Erysipelas is caused by which pathogen?

A

Beta-hemolytic strep (S.pyogenes)

33
Q

Uncomplicated cellulitis is caused by which pathogens?

A

Beta-hemolytic streptococci and s. aureus

34
Q

Furuncles, carbuncles, or abscess are caused by which pathogen?

A

S. Aureus including MRSA

35
Q

Which 4 pathogens cause conjunctivits?

A
  1. S. aureus
  2. S. pneumoniae
  3. H. influenza
  4. M. catarrhalis
36
Q

Throat infections are caused by which pathogens?

A

Group A beta-hemolytic streptococcus (S. pyogenes)

37
Q

Mouth/tooth infections caused by which pathogens?

A

Streptococcal species, Peptosctreptococcus and other gram + anaerobes

38
Q

Community acquired pneumonia is caused by which 4 pathogens?

A

SMCH (smooch)

  1. Streptococcus pneumonia
  2. Mycoplasma pneumonia
  3. Chlamydia pneumonia
  4. Haemophilus influenza
39
Q

Empiric therapy

A

Antibiotics chosen prior to knowing identification and sensitivity of pathogen

40
Q

Broad spectrum

A

Effective against a broad range of bacteria

41
Q

De-escalation

A

Narrowing therapy from broad agents

42
Q

Anti-microbial stewardship

A

Preserving broad-spectrum antibiotics, limit development of resistance

43
Q

Opportunistic infection

A

An infection caused by an agent (bacteria, virus, fungi, protozoa) that is capable of causing disease only when the host’s resistance is lowered by a disease or drug

44
Q

Nosocomial infection

A

An infection acquired in a hospital setting or health care facility

45
Q

What is colonization?

A

Identification of an organism that normally grows in the organ system, NOT considered pathogenic in the context of the pts clinical picture

46
Q

What is an example of colonization?

A

Lactobacillus found in a vaginal culture

47
Q

What is contamination?

A

An unintended introduction of a bacterial organism that isn’t infectious

48
Q

What is an example of a contamination?

A

Coagulase - staph species in a single set of blood cultures

49
Q

What is an infection?

A

Invasion of a host by disease causing agents. Identification of a likely pathogen in a pt with symptoms consistent w/expected signs and symptoms of the disease

50
Q

What is an example of an infection?

A

+ strep pyogenes throat culture in setting of exudates, odynophagia and erythema

51
Q

6 examples of sterile sites

A

CSF, blood, peritoneum, synovial fluid, pleural fluid, urine

52
Q

A female present with urinary symptoms, she has a culture which reports E.coli. Which does the organism most likely reflect?

A

Infection

53
Q

20 YO female has a throat swab. It is + for strep pyognes. She is afebrile, w/out any symptoms. What is the most likely significance of this organism?

A

Colonization

54
Q

All of the following are opportunistic pathogens except?

A

Enterobacteriaciae

Enterococcus, Pseudomonas, Clostridium Dificile

55
Q

What are the SPACE organisms?

A 
Serratia
Pseudomonas
Acinetobacter
Citrobacter
Enterobacter
Klebsiella
56
Q

Which drugs cause highest seizure risk?

A

Cefepime, Fluoroquinolones, Carbapenems

57
Q

Which drugs are hepatotoxic?

A

Nafcillin, Oxacillin, Fluoroquinolones

58
Q

What is and ADR with aminoglycosides?

A

Nephrotoxicity and ototoxicity

59
Q

Which drugs frequently cause CDIFF

A

Clindamycin, ampicillin, amoxicillin, fluoroquinolones, cephalosporins

60
Q

How to treat CDIFF

A

Metronidazole IV or PO; Vanco PO

Clinical Therapeutics (8 decks)

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