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FM2 > Anaerobes > Flashcards

Anaerobes Flashcards

1
Q

Describe synergy between aerobes and anaerobes

A

Aerobes colonize and utilize oxygen, producing anaerobic conditions for aerobes to colonize

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2
Q

List some clinical findings that suggest that anaerobes are present

A
  1. syndrome recognition
  2. failure to respond to antibiotics that don’t cover anaerobes
  3. sterile pus- positive gram stain but negative culture
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3
Q

Describe principles of treatment of anaerobic infections

A
  1. source control, debridement
  2. antibiotics
  3. active or passive immunity for toxin mediated disease
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4
Q

List antibiotics that are generally rated “A+” for anaerobes

A 
metronidazole
carbapenems
beta lactamase inhibitor combinations
tigercycline
moxifloxacin
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5
Q

Describe the use of clindamycin in anaerobic infections

A

A+ above the diaphragm

C below the diaphragm

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6
Q

Describe the use of vancomycin and penicillin in anaerobic infections

A

good for gram positive only

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7
Q

Describe the use of cefoxitin in anaerobic infections

A

moderate activity

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8
Q

Describe mechanisms by which anaerobes cause disease

A
  • mucosal barrier disruption
  • devitalized tissue

predisposing infections: malignancy, occlusion, vascular disease, diabetes, trauma, immune compromise, foreign bodies, antibiotics that select out anaerobes

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9
Q

Differentiate Bacteriodes fragilis from other Bacteroides

A

Bacteroides fragilis: most commonly isolated anaerobe, found in abscess, increasing drug resistance through beta lactamases

Other Bacteroides: mouth and GU tract

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10
Q

Describe the appearance, location, and pathogenicity of Fusobacterium

A

Fusobacterium necrophorum- long thin rods, mouth and gingival flora, active endotoxin

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11
Q

Describe the appearance, location, and pathogenicity of Peptostreptococcus

A

Secondary to B fragilis in frequency of recovery from clinical isolates, found in mouth, GI, GU tracts, nearly always found with mixed flora

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12
Q

List aerobes and anaerobes that are oral cavity flora

A

aerobes: streptococci, lactobacilli, staphylococci, cornyebacteria
anaerobes: bacteroides, fusobacterium, prevotella, peptostreptococcus, porphyromonas

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13
Q

Poor ____ is a risk factor for increased concentrations of anaerobes in the oral cavity

A

dentition

gingival crevices, tonsillar and tongue crypts, dental plaques

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14
Q

List foci of spread of dental ifnection

A

vestibular abscess–> buccal space, palatal abscess, sublingual space, submandibular space, maxillary sinus

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15
Q

___________ is a mixed infection of the submandibular space

A

Ludwig’s angina

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16
Q

_________ is an infection with Fusobacterium necrophorum that leads to jugular vein thrombosis and septic emboli

A

Lemierre’s syndrome

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17
Q

List lab findings that indicate presence of anaerobic infection (ex to distinguish from malignancy)

A

Many PMNs
no squamous epithelial cells in sputum sample (marker of good sample)
Many GPC, GNR, GPR

18
Q

List factors that lead to anaerobic lung infections

A

Oral anaerobes mixed with aerobes (Prevotella, Fusobacterium, Peptostreptococci, Bacteroides)
Poor dentition, gingival disease
Commonly misdiagnosed as malignancy or TB

19
Q

List signs of anaerobic lung disease

A

constitutional symptoms- weight loss, anorexia, night sweats

fetid sputum

20
Q

List treatment for anaerobic lung infections

A

Weeks-months of antibiotics

21
Q

Define and describe empyema

A

Infection of pleural space
Pleural fluid will have low pH, low glucose, high LDH, and positive gram stain or culture
Treat with drainage, antibiotics, decortication if necessary

22
Q

In the _____, anaerobes outnumber aerobes 1000:1

A

colon

23
Q

List two major types of intra-abdominal anaerobic infections

A

Peritonitis (perforated viscus)

Abscess (intraperitoneal or visceral)

24
Q

List steps for management of intra-abdominal abscess

A

Drainage- percutaneous catheter, surgical

Antibiotics

25
Q

The terminal spore of ____________ is extremely hardy and found in soil or animal intestinal tracts

A

Clostridium tetani

26
Q

How does the tetanus syndrome develop

A
  • spores enter via wound
  • incubation average 8 days
  • proliferate under low O2 conditions
  • produces toxin which disseminates through blood and lymphatics
27
Q

_____ toxin enters the nervous system at presynaptic terminals of lower motor neurons, and is carried in a ______ direction to the CNS. It prevents neurotransmitter release from _____ cells.

A

Tetanus
Retrograde
Inhibitory

28
Q

Generalized tetanus proceeds in a ___ pattern, causing trismus, neck stiffness, problems swallowing, abdominal muscle rigidity, and spasms

A

Descending

29
Q

List complications of tetanus

A 
Laryngospasms
Fractures
Autonomic hyperactivity
Pulmonary embolism
Aspiration pneumonia
30
Q

Describe components of treatment for tetanus

A

Muscle relaxants, HTIG, antibiotics, wound debridement

31
Q

List some features of “tetanus prone” wounds

A

Older, stellate configuration, deeper, crush/ burn/ frostbite, contaminated, devitalized tissue present

32
Q

The ___ toxin prevents release of acetylcholine and causes weakness in the motor system and dysfunction in the autonomic systme

A

Clostridia botulinum

33
Q

The ____ spore is a subterminal spore that is heat stable and found in soil and marine environments

A

Closdridium botulinum

34
Q

List mechanisms of infection for the different types of botulism

A
  • foodborne: ingest preformed toxins from canned foods, fish, fruits
  • infant: ingest spores in honey or soil
  • wound: spores germinate in wound
  • inhalational: toxin (bioterrorism)
35
Q

Describe clinical features of botulism

A
  • acute bilateral cranial nerve dysfunction
  • descending motor weakness
  • patient is alert and afebrile
36
Q

Describe treatment for botulism

A

Trivalent antitoxin available from CDC
Wound debridement
Antibiotics

37
Q

List soft tissue infections caused by clostridia species

A

Gas gangrene, clostridium perfringens

Treat with early and aggressive surgical debridement, penicillin, clindamycin

38
Q

Clostridium ____ produces spores that can germinate under favorable environmental conditions and produce exotoxins A and B to cause mucosal damage and diarrheal illness

A

difficile

–> pseudomembranous colitis

39
Q

_______ is the most common cause of unexplained leukocytosis in hospitalized patients

A

C diff

40
Q

Clostridium _____ causes food poisoning by producing a toxin in vivo (NOT pre-formed); vomiting is rare

A

Perfringens

FM2 (11 decks)

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