Week 65 Sepsis

Question 1

qSOFA

Answer 1

Altered mental status
Fast RR >22
Low BP <100

Question 2

Gm Stain and Empiric tx

Gm + cocci in chains

Answer 2

Strep or Enterococcus
Strep = Ceftriaxone
Enterococcus = Amp or Linezolid

Question 3

Gm Stain and Empiric tx

Gm + cocci in clusters

Answer 3

Staph

Vancomycin

Question 4

Gm Stain and Empiric tx

Gm + bacilli

Answer 4

Anaerobic inf - Clostridium = Metronidazole or PipTazo
Listeria = Amp
Contaminant

Question 5

Gm Stain and Empiric tx

Gm - cocci

Answer 5

Neisseria

Ceftriaxone

Question 6

Gm Stain and Empiric tx

Gm - coccobacilli

Answer 6

Haemophilus

Ceftriaxone

Question 7

Gm Stain and Empiric tx

Gm - bacilli

Answer 7

Antibiogram
EBs = Ceft, PT, Mero
Pseudomonas = PT, Mero
Anaerobic (Bacteroides) = Met or PT

Question 8

Gm Stain and Empiric tx

Yeast

Answer 8

Candida = Fluconazole, micafungin
Cryptococcus = Ask for help

Question 9

Abx resistance

Gm + (3)

Answer 9

MRSA - Mutated PBP
B-lactam - destroy ring, porin channels
Vancomycin - altered cell wall target

Question 10

Abx resistance

Gm - (3)

Answer 10

ESBLs
AmpC
carbapenemases

Question 11

Purulent infection

Bug and drug

Answer 11

Staph aureus
incision and drainage
TMP/SMX or doxycycline
Sick = vancomycin IV

Question 12

Cellulitis

Bug and drug

Answer 12

Mostly Group A Strep
Cephalexin or Penicillin V
Sick = Cefazolin IV
Septic = PT and vanco

Question 13

Bites empiric tx

Answer 13

Amoxicillin-clavulanate

Question 14

Staph aureus toxic shock tx

Answer 14

vanco + clindamycin

Question 15

GAStrep toxic shock tx

Answer 15

vanco + PT + clindamycin