Blood Stream/Skin & Soft tissue/Ear, Eye, Nose, Throat Infections

Question 1

Primary Bacteremia

Answer 1

Blood infection from an unknown source

Question 2

Secondary Bacteremia

Answer 2

Localized infection spread into the blood

Question 3

Sepsis

Answer 3

Bacteremia + symptoms
Body’s xtreme response to infection, blood poisoning by bacteria

Question 4

Transient bacteremia

Answer 4

Common, asymptomatic, usually only lasts minutes
Ex. dental, endocarditis

Question 5

Intermittent bacteremia

Answer 5

Extravascular source that leaks into the blood
Ex. UTI, perf bowel

Question 6

Continuous bacteremia

Answer 6

Intravascular source, consistent presence in blood
Ex. Catheter

Question 7

Blood culture for diagnoses

Answer 7

2/site (anaerobe, aerobe), 2 sites, 5 min apart, of 8-10 mL each
In kids: 2 bottles with 1-3 mL each

Question 8

Lines (ex: catheter)

Answer 8

Risk biofilm production - need to test for a line infection. Switch it out if infected, get peripheral blood cultures and blood from the line

Question 9

Diagnoses for S. aureus

Answer 9

Always treat S. aureus, gram negatives and group A Strep 1/4 or 2/4 from the same site = contaminant, not a bacteremia
Contaminant = substances in environment, or substance present in clinical sample not relevant to patient’s condition/diagnosis
Bacteremia = presence of bacteria in the bloodstream

Question 10

How is something classified?

Answer 10

By depth and bacterial/fungal/viral/parasitic. Caused by an opening in the skin.

Question 11

Wounds

Answer 11

Clean, clean contaminated (resp), contaminated (colon), infected

Question 12

Bites

Answer 12

Can cause cellulitis, abscess, and deep tissue infections. Animal bites or clenched fists.

Question 13

Epidemic Impetigo

Answer 13

Lesions of mouth and nose, contagious, antibiotics.
Group A strep, S. aureus

Question 14

Erysipelas

Answer 14

Rapid infection of deeper skin layers, raised borders, cause of sepsis Group A Strep

Question 15

Cellulitis

Answer 15

Acute spread in subQ (subcutaneous) after local trauma. Sepsis A strep, S. aureus, neg bacilli, pseudo
(Causes redness, swelling, and pain)

Question 16

Furuncle/Carbuncle

Answer 16

Infected sebaceous gland, treated with penicillins. (Reddish tender mumps)
S. aureus

Question 17

Decubitus Ulcer

Answer 17

Bed sore, skin breakdown. Multi colonized or none at all

Question 18

Fasciitis

Answer 18

Rapid cellulitis, necrosis, toxin producing, trauma. Group A strep
(Inflammation of fascia)

Question 19

Dermatophytes

Answer 19

hair, skin, nails
fungal, tropical treatment

Question 20

Scabies

Answer 20

Tiny mite that burrows and lays eggs, causing inflammation

Question 21

Lice/crabs

Answer 21

Doesn’t move sites, easily controlled

Question 22

Viral skin infection

Answer 22

Herpes 1, 2, and varicella zoster

Question 23

Conjunctivitis/pink eye

Answer 23

Bacterial, viral or allergies. Contagious, common in children. Adenovirus, strep pneumo, h influenza. Gonorrhea, chlamydia, HSV in infants from mom

Question 24

Otitis externa/swim ear

Answer 24

Treatment focused on drying. Pseudomonas, fungi (antibiotic overuse)

Question 25

Otitis media

Answer 25

Swelling of tube prevents fluid drainage. Strep pneumo, H influenza, RSV, flu

Question 26

Pharyngitis

Answer 26

Usually viral. HSV, HIV, Mono, cold/flu, A strep, chlamydia, gonorrhea, diphtheria

Question 27

Tracheobronchitis (upper resp) 1. Parainfluenza 2. Resp. syncytial virus 3. B Pertussis

Answer 27

Croup/laryngitis/bronchitis in adults. RSV, Flu, B Pertussis 1. croup/laryngitis in kids, bronchitis in adults. Clinical detection: PCR 2. Outbreak in winter, causes bronchitis and pneumonia. PCR testing 3. Gram neg, whooping cough. Highly contagious. DTAP vaccine

Question 28

Pneumonia (lower resp)

Answer 28

Infected and inflamed lungs. Serious in kids and elderly. PCR test. Bacterial or viral. Strep pneumo, legionella (A/C), mycoplasma (100 day cough), c. pneumo (birds), g neg bacilli Ventilator Pneumo: Severe. Pseudomonas, strep, staph, MRSA, Klebsiella. Biofilm formation

Question 29

TB (lower resp)

Answer 29

Mostly latent, 10% chronic. Immunocompromised at high risk. Airborne (pressure room). TB skin test, smear, PCR. Can take 1/2 yr to culture. Up to 9 months of antibiotics.