Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

inf & imm > Week 1 UTI, Pneumonia, Skin & Soft Tissue > Flashcards

Week 1 UTI, Pneumonia, Skin & Soft Tissue Flashcards

1
Q

What are the types of UTI?

A
  • Cystitis
  • Pyelonephritis
  • Catheter-associated UTI
  • Prostatitis
  • Perinephric / intrarenal abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is cystitis and where does it affect?

A
  • Infection and inflammation of the bladder
  • Lower UTI, uncomplicated UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is pyelonephritis and where does it affect?

A
  • Infection of the kidney
  • More serious infection
  • Upper UTI
  • Complicated UTI requiring a longer treatment as it usually has systemic effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Differences in signs/symptoms of Upper and Lower UTI?

A

Upper:
- Fever
- Flank pain (upper abdomen and sides)
- N&V
- Fatigue
- Similar urinary symptoms as Lower UTI

Lower:
- Increased frequency of urination
- Urgency to urinate
- Burning sensation during urination (dysuria)
- Hematuria (blood in urine)
- Foul-smelling urine
- Pelvic discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is prostatitis and what is the difference between acute and chronic?

A
  • Inflammation of the prostate gland

Acute:
- Bacterial infection as tight bladder muscle leads to poor bladder emptying
- Px benefits from a course of antibiotics

Chronic:
- Recurrent, intermittent flare-up of pain due to chemical inflammation from urine
- Not due to bacteria
- Not relieved by antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is perinephric or intrarenal abscess?

A

Rare but serious conditions

Perinephric abscess:
- Pus that occurs due to a bacterial infection in the perinephric fat and fascia surrounding the kidney

Intrarenal abscess:
- Infective fluid in the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What samples do you send to diagnose cystitis? (IMPT)

A
  • Midstream urine culture in adults
  • Bag urine or suprapubic urine in children
  • Catheter sample (although a positive culture could just indicate colonisation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What samples do you send to diagnose pyelonephritis? (IMPT)

A
  • Same as cystitis (MSU, bag urine, suprapubic urine, catheter sample)
  • Blood culture (as patient is usually febrile or septic at this stage)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What samples do you send for catheter-associated UTI? (IMPT)

A

Catheter sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to UFEME results for CAUTI?

A
  • In long-term use (> few weeks), results become unreliable
  • Will show ++ signs in many areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What samples are needed for the diagnosis of prostatitis?

A
  • Urine culture
  • Prostate tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What samples are needed for the diagnosis of perinephric / intrarenal abscess?

A

Urine or pus sent from theatre or radiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What Gram negative bacilli are associated with UTI? (IMPT)

A
  • E. coli (most common)
  • P. aeruginosa (due to previous antibiotic exposure or urinary catheter)
  • Proteus (associated with kidney stones/staghorn calculus)
  • Klebsiella pneumoniae
  • Enterobacter, Citrobacter, Morganellea, Serratia
  • Salmonella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What Gram positive cocci are associated with UTI?

A
  • Enterococcus (usually in patients on a lot of antibiotics)
  • Group B Streptococcus
  • Staphylococcus saprophyticus (honeymoon UTI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What fungi can cause UTI?

A

Candida (although very rare and usually if the patient was recently exposed to antibiotics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management of cystitis and CAUTI? (IMPT)

A

If px is stable and well:
- Oral antibiotics
- Short course of 3-7 days
- Men require a longer course than women
- If catheter is present, min. 5 days of antibiotics needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the management of pyelonephritis and/or urosepsis? (IMPT)

A
  • IV antibiotics
  • Can transition to oral antibiotics after 48 hours if condition improves
  • Longer course of 7-14 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

FYI: What are the management strategies for prostitis?

A
  • Select few antibiotics
  • Long course of weeks to months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

FYI: What are the management strategies for perinephric / intrarenal abscess?

A
  • IV antibiotics
  • Drainage of pus by surgeon or radiologist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is asymptomatic bacteruria?

A
  • Presence of >10^5 CFU/ml (100,000 CFU/ml) bacteria in urine culture but px is asymptomatic
  • Condition common in elderly >65 y/o, in women
  • Condition whereby antibiotics should not be given (will drive abx resistance instead)
    ~ Only give if px is:
    * Pregnant (UTI can become upper UTI)
    * Undergoing urological procedure or surgery (tools may further damage urethra and complicate UTI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the concentration of bacteria in urine culture needed to diagnose UTI?

A

> 10^5 CFU/ml (100,000 CFU/ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is long-term antibiotic prophylaxis recommended and why?

A
  • Not recommended unless:
    ~ Children with recurrent UTI and vesicoureteral reflux with risk of renal scarring
    ~ Severe UTI that compromised patients’ QOL
23
Q

What antibiotic is Klebsiella pneumoniae naturally resistant to?

A

Ampicillin

24
Q

What Gram-negative bacteria is naturally resistant to many antibiotics?

A

Pseudomonas aeruginosa

25
Q

What does ““susceptible, increased exposure”” mean in urine culture reports?

A

There is a need to give increased dosage for antibiotics to work

26
Q

What Gram-positive bacteria is naturally resistant to many antibiotics and what are they?

A

Enterococcus faecalis
- Cephalosporins, clindamycin and co-trimoxazole
- However, susceptible to ampicillin/amoxicillin and nitrofurantoin for uncomplicated UTI

27
Q

When choosing antibiotics for a patient with polymicrobial infection:

A
  • Consider target organisms (concentration of bacteria and type that is more related to UTI instead of more commensal bacteria)
  • If there is intent to target all the organisms, may need to use broad-spectrum antibiotics
28
Q

What is the downside of using broad-spectrum antibiotics?

A

GI-associated diarrhoea caused by Clostridium difficile (not as common in SG, but still dangerous)

29
Q

What are the 3 most prominent pulmonary infections? (IMPT)

A
  • Community acquired pneumonia (CAP)
  • Hospital acquired pneumonia (HAP)
  • Ventilator associated pneumonia (VAP)
30
Q

What is the difference between HAP and VAP? (IMPT)

A

HAP:
- Pneumonia which occurs >48 hours after hospital admission

VAP:
- Pneumonia which occurs 48-72 hours after endotracheal intubation

31
Q

What other types of pulmonary infections are there? (4)

A
  • Aspiration pneumonia
  • Empyema (infection of pleural space often due to pneumonia)
  • Lung abscess (pus within lung)
  • Mycobacterial infection (due to Mycobacterium tuberculosis or non-tuberculosis mycobacterium)
32
Q

What are the expected pathogens causing CAP? (IMPT)

A

Typical bacteria
- Streptococcus pneumonia
- Haemophilus influenza (now rare due to presence of vaccine)

Atypical bacteria (harder to distinguish due to shape and takes longer to grow, and patient often seems fine though her condition is very serious)
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- Legionella pneumoniphila

Others
- Influenza virus
- Staph aureus (post influenza)
- Klebsiella pneumonia

33
Q

What are the expected pathogens causing HAP/VAP? (IMPT)

A

Coliforms
- Usually MRSA
- Gram-negative bacteria
- Acinetobacter
- Enterobacter
- Klebsiella
- Proteus

Pseudomonas aeruginosa

34
Q

What are the expected pathogens that causes aspiration pneumonia?

A
  • Px bacterial flora in their mouth
  • HAP/VAP pathogens if px is in hospital or has previous antibiotic exposure
35
Q

What are some pathogens that cause infection in immunocompromised patients? (IMPT)

A
  • Candida
  • Aspergillus species (found in bone marrow)
  • Pneumocystis jirovecii (HIV)
36
Q

What test is done on blood culture and when is it sent? (IMPT)

A
  • Culture and sensitivity
  • Done when the px becomes febrile or septic
37
Q

What tests can be done on sputum, endotracheal aspirate (ETA) and bronchio-alveolar lavage (BAL)?

A

1) Gram stain (miscroscopy)
- Usually done when suspecting bacterial or viral origins
- If there is a high epithelial cell count, it indicates a poorly taken and unreliable sample

2) Culture and sensitivity
- Done when suspecting bacterial origins

3) PCR
- For viral detection and viral culture is not performed
- Also to detect atypical bacteria causing CAP

38
Q

Bronchio-alveolar lavage?

A
  • Most invasive way to get a sample
  • Quality of sample is still better than sputum as sputum may still contain microbes from Upper RT
39
Q

What are some common skin & soft tissue infections? (11)

A
  • Cellulitis
  • Impetigo
  • Intertrigo
  • Lymphangitis
  • Erysipelas
  • Gas gangrene
  • Necrotising fasciitis
  • Diabetic foot ulcers/ chronic wounds
  • Septic arthritis
  • Osteomyelitis
  • Discitis
40
Q

Cellulitis

A

Signs:
- Red
- Hot
- Tender
- More diffuse margin than erysipelas (as it affects subcutaneous tissues)

  • Usually infected by
    ~ Staph aureus (esp MRSA)
    ~ Beta-haemolytic Strep (especially Group A Strep)

https://i0.wp.com/cdn-prod.medicalnewstoday.com/content/images/articles/152/152663/cellulitis-on-the-leg-image-credit-john-campbell-2018.jpg?w=1155&h=1734

41
Q

Impetigo

A

Signs:
- Honey-coloured/yellow crusted lesions (erupted from vesicles) or
- Red sores
- Around peri-oral region, hands or feet
- Mostly in infants and young children

  • Usually infected by
    ~ Staph aureus (esp MRSA)
    ~ Beta-haemolytic Strep (especially Group A Strep)

https://medlineplus.gov/images/Impetigonew_share.jpg

42
Q

Intertrigo

A
  • Inflammation that can lead to secondary infx by bacteria
  • Usually in skin folds (more moisture and heat)
  • DM is a risk factor
  • Infection by
    ~ Staph aureus
    ~ Candida
    ~ Coliforms

https://res.cloudinary.com/zava-www-uk/image/upload/c_fill/q_70/a_exif,f_auto,e_sharpen:100,c_thumb,w_720,h_405,fl_lossy/v1602835473/de/krankheiten-und-symptome/intertrigo/jfhmgqqhyzpzrpg9mhf8.png

43
Q

Lymphangitis

A
  • Inflammation of the lymphatic system by infection
  • Red, dark streaks seen
  • Usually infected by
    ~ Group A Strep
    ~ Staph aureus
    ~ Pasteurella mulocida (in cat scratches)

https://www.10faq.com/assets/img/what-is-lymphangitis-01.jpg

44
Q

Erysipelas

A
  • Large red patches on the skin, usually on face and legs
  • Patches are more well-defined than cellulitis (as it affects outer layer of epidermis)
  • Px usually has pre-existing oedema or lymphatic obstruction
  • by Group A Strep

https://www.dermatologyadvisor.com/wp-content/uploads/sites/20/2019/01/erysipelas_face4_146106.jpg

45
Q

Gas gangrene / myonecrosis (IMPT)

A
  • Death of body tissue
  • Affects deep tissue/muscle first due to penetrating injury
  • Due to Clostridium perfringens (mostly)
  • Spontaneous type caused by Group A Strep
  • Immunocompromised infx from other Clostridia, Staph aureus or Vibrio from raw seafood
  • Medical emergency
  • May have blisters with gas bubbles around the infected area

https://image.slidesharecdn.com/gangrene-170814020703/95/gangrene-16-638.jpg?cb=1502676697

46
Q

Necrotising fasciitis / flesh-eating disease
- what
- signs
- types

A
  • Death of soft body tissue
  • Due to various bacteria
  • Affects superficial /fascia and subcutaneous tissue first
  • Medical emergency

Signs:
- (Early) Tenderness to palpation even beyond apparent area of skin involvement
- (Intermediate) Blisters and/or bullae (serous fluid) formation
- (Late) Crepitus, necrosis which may progress to gangrene

Type 1/Fournier’s gangrene (more common)
- Affects perineal, genital and perianal region
- By polymicrobial aerobes (Strep, Gram-negatives)

Type 2
- More aggressive
- Infection by Group A or Staph aureus

47
Q

Diabetic foot ulcers / chronic wounds

A
  • New infections usually due to Staph aureus or Streptococci
  • Chronic wound infections usually due to Gram neg organisms or Gram neg+Gram pos
  • Requires a deep tissue culture to guide antibiotic therapy
48
Q

Septic arthritis

A
  • Infection of a joint (usually knee or hip)
  • Staph aureus (usually)
  • Treatment weeks or months long
49
Q

Osteomyelitis

A
  • Bone infection
  • Often from bloodstream infection
  • Staph aureus (usually)
  • Treatment weeks or months long
50
Q

Discitis

A
  • Infection of spine
  • Staph aureus (usually)
  • Treatment weeks or months long
51
Q

What conditions do infection with Staph aureus usually cause?

UTI, Pneumonia & Skin and Soft Tissue

A
  • Cellulitis
  • Impetigo
  • Lymphangitis
  • Intertrigo
52
Q

What conditions do infections with Group A Strep usually cause?

A
  • Cellulitis
  • Impetigo
  • Erysipelas
  • Lymphangitis
  • Necrotising faciitis
  • Gas gangrene / myonecrosis
53
Q

What can be done to test for soft tissue infections?

A
  • Wound swab (avoid dry swabs)
  • Pus swab
  • Pus aspirate
  • Skin scrapping (Scabies, skin fungal infx)
  • Deep tissue culture / biopsy (diabetic foot ulcers)
    ~ Superficial debridement first before obtaining a deep sample
  • Blood culture

inf & imm (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions