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MOHD Keystone Exam 3 > ID > Flashcards

ID Flashcards

1
Q

Use this in uncomplicated UTI

A

Nitrofurantoin

Trimethoprim Sulfa

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2
Q

These have surface proteins that allow attachment to host proteins

A

Staphylococcus
Streptococcus

(not Gram- rods)

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3
Q

Use this in complicated UTI

A

Fluroquinolone

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4
Q

Continuous bacteremia is

A

infection in the bloodstream

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5
Q

Use this antimicrobial to treat Chlamydia

A

Azythromycin (Macrolide)

Or Doxy?

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6
Q

Gram positive cocci
Catalase +
Coagulase +

A

Staph Aureus

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7
Q

Intermittent bacteremia may be due to

A

transient in the blood; local infection in the body OR after a procedure

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8
Q

Causes of urethritis

A 
GC
CT
HSV
Trichomonas Vaginalis
Mycoplasma gentalium
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9
Q

Most common organism in uncomplicated UTI

A

E.coli

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10
Q

This infection has a mucopurulent meatal discharge

A

GC Urethritis

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11
Q

This organism is usually lymphatic spread

A

Strep pyogenes

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12
Q

Use this antimicrobial to treat Gonorrhea

A

Ceftriaxone (3rd gen cephalosporin) IM or IV

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13
Q

This organism if usually hematogenous spread

A

Staph aureus

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14
Q

Most common cause of infective endocarditis

A

S. aureus

viridans strep
E. faecalis (GU)

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15
Q

How do you treat HSV encephalitis?

A

Acyclovir

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16
Q

Common cervicitis pathogens

A

NG
CT
HSV

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17
Q

Who is at increased risk for chlamydia or gonorrhea?

A

Sexually active women

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18
Q

Definition of SIRS

A 
TPR WBC
Temp 38
P >90
R >20
WBC 12k
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19
Q

Pneumocystis jiroveci would likely be seen in

A

HIV infected

Pneumonia

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20
Q 
CAP
Candidiasis
HSV
Shingles
Seborrheic dermatitis
Leukoplakia

Are likely to be seen at CD4 counts…

A

200-500

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21
Q

CD4 count tells you

A

What types of diseases people are most susceptible to

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22
Q

Organisms in the gut –>

A

Gram negative rods
Anerobes
Enterococci
Micro-aerophilic streptococci

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23
Q

Macrophages do this and ingest these

A

Activate T helper cells

Ingest intracellular organisms (Fungi, protozoa, bacteria, parasites)

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24
Q

What is the basis of combination anti-retroviral therapy?

A

Three drugs from at least 2 classes

–> Lifelong treatment because of need for adherence

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25
Q

CMV Infections are associated with

A

Transplant and immunosuppressive medications

Causes organ-specific infection: hepatitis, pancreatitis, pneumonitis, GI disease

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26
Q

Patients with antibody or complement defects are prone to infections with

A

encapsulated organisms:
S. pneumo
N. miningitidis
H. influenzae

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27
Q

Organisms on the skin –> leading to infection

A

Coagulase negative staphylococci
Staph aureus

Central line: Gram negative, Candida

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28
Q

What time frame after transplant is greatest risk?

A

4 weeks to 6 months: opportunistic, relapsed, residual

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29
Q

Infections associated with Steroids

Steroids block IL-2, cause lymphopenia, decrease Ab production, decrease chemotaxis

A

Infections that require macrophage mediated killing or require neurophilic killing

30
Q

Organisms in the oral mucosa –> leading to infection

A

Streptococcus
Anaerobes
H. influenza
N. meningitidis

31
Q

Anti-TNF-a inhibitors are associated with

A

mycobacterial and fungal (histoplasma in the midwest)

granulomatous and intracellular infections

32
Q

Cytotoxic T cells do this

A

Kill virus laden cells (CMV, HCV, EBV, HSV, VZV)

33
Q

Who is a high risk neutropenic patient?

A

> 7 days of neutropenia or ANC

34
Q

Definition of neutropenic fever

A

Single temp >38.3 or sustained >38 for 1hr

ANC

35
Q

What component of otitis media makes it more difficult to treat?

A

Biofilm formation

36
Q

What is the most common bacterial cause of pharyngitis?

A

Streptococcus pyogenes (GAS)

37
Q

Usual culprit in Acute Rhinosinusitis

A

VIRAL: rhino-, flu/paraflu
- most resolve spontaneously

bacterial: S. pneumo, H. info, M. catt, anaerobes (dental)
- more likely if 7+ days or worsening; severe symptoms (fever >38, pain); facial erythema/swelling/pain

38
Q

Pharyngeal ulcers are suggestive of

A

Viral pharyngitis

39
Q

What risk factors for otitis media can be changed?

A

daycare, smoke exposure, formula v breastfeeding, pacifier use

40
Q

Self-limited inflammation of the bronchi with cough lasting >5 days +/- sputum

A

Acute bronchitis –>

Usually VIRAL cause

41
Q

Highly enlarged tonsils are suggestive of

A

Infectious mononucleosis

42
Q

Antibiotics for Community Acquired pneumonia

A

Macrolides
Doxycycline
Cephalosporins

43
Q

Conjunctivitis in Otitis media is associated with this organism

A

H. influenzae

44
Q

Diagnosis of sinusitis is usually

A

CLINICAL
(Imaging or sinus aspirate if complicated)

Same is true for OM and pharyngitis –> Clinical diagnosis

45
Q

Common organisms in ventilated patients pneumonia

A

Enteric Gram(-)
P. aerunginosa
S. aureus + MRSA

46
Q

Otitis Media organisms

A

2/3 may be mixed bacterial/viral

Bacteria:
S. pneumo
H. influ
Moraxella caterrhalis

Viruses: RSV, flu, enterovirus, cold, metapneumo

Atypical: Mycoplasma, Chlamydia, TB

47
Q

Symptomatic inflammation of the nasal cavity/paranasal sincuses lasting

A

Acute Rhinosinusitis

48
Q

When might observation be appropriate for otitis media?

A

> 6 months or > 2 years, nonsevere and unilateral, not immunocompromised, no high fever

49
Q

Present with cough >5 days, purulent sputum, wheezing, atypically fever, CXR with normal or thickened bronchial walls

A

Acute bronchitis

50
Q

Possible complications of sinusitis

A

Cellulitis (periorbital, orbital)
Abscess (orbital, epidural, subdural, parenchymal)
Meningitis
Venous sinus thrombosis

51
Q

Common organisms for Community Acquired Pneumonia

A 
S. pneumo*#
Mycoplasma#/Chlamydia#
H. influenzae (smokers, COPD)
S. aureus (post-influenza)*
Legionella (severe, multi-lobe)*
Gram negative rods*
Viruses#

ICU*
Outpatient#

52
Q

–> Viral causes more common:
cold virus, RSV, influenza/para-influenza, metapneumovirus

–> Bacterial causes: Mycoplasma pneumoniae, Chlamydia pneumonia, Bordatella pertussis

A

Causes of acute bronchitis

53
Q

What is the most common treatment for strep throat?

A

Penicillin

54
Q

What is the most common treatment for otitis media?

A

Amoxicillin

55
Q

What is used to treat tickborne diseases like HME, HGA, Lyme, RMSF?

A

Doxycycline

56
Q

What is used to treat cervicitis?

A

Azithromycin (macrolide) for Chlamydia

57
Q

What can Ceftriaxone be used to treat?

A

Respiratory (meningitis, pneumonia)
Enteric (UTI)
Gonorrhea

58
Q

S. pneumoniae
H. influenzae
Moraxella catarrhalis

These are common to

A

Bacterial acute OM
Bacterial acute sinusitis
CAP

59
Q

Typically a viral infection rather than bacterial

A

Acute bronchitis

60
Q

Usually caused by GAS but may be G(-) anaerobe

A

Bacterial pharyngitis

61
Q

Most common SSI organism

A

Staph aureus!

Candida - most common fungus

62
Q

CLABSIs most important risk factor

A

Central line!

Age, malnutrition, immunosuppression, loss of skin integrity, severity of illness, ICU/hospital stay

63
Q

Alcohol based hand rubs do not kill

A

C. diff!

64
Q

RIsk factors for CDAD (C. difficile)

A 
Age
Antimicrobial use (ceph, clinda, fluroquinolones)
Use of PPI/H2 blockers
Infected roommate
Prolonged stay
Multiple, severe conditions
Immunosuppressive therapy
65
Q

What guides selection of therapeutic agents in the lab?

A

Most narrow spectrum + least expensive that will have 90%+ success rate (based on MIC)

66
Q

Encapsulated organisms that are affected by antibody defects

A

S. pneumo
N. meningitidis
H. influenzae

67
Q

Common pathogens in neutropenic fever

A 
Gram positives (like staph aureus)
Gram negatives (like Enterobacter)(greatest mortality)
Fungal
68
Q

How do you treat neutropenic fever?

A

For high risk: cifepime IV or vancomycin or antifungals

For low risk: ciprofloxacin or amoxicillin

69
Q

Common pathogens in TNFa suppression

A

Bacterial URIs
M. tuberculosis
Histoplasmosis (in Iowa) or other fungi

70
Q

Rituximab (B cell lymphoma treatment) is associated with

A

decreased vaccine response and HBV reactivation

71
Q

Common infections in steroid use

A

(macrophage mediated killing impaired) Fungi, Tb, pneumocystis

(neutrophilic mediated killing impaired) S. aureus, Aspergillus

MOHD Keystone Exam 3 (5 decks)

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