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7364 Critical Care Block 1 > Common Infections > Flashcards

Common Infections Flashcards

1
Q

4 main risk factors for invasive fungal infections?

A
  • broad spectrum antibiotics
  • abdominal surgery
  • ## parenteral nutrition
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2
Q

Positive nasal carriage is a risk factor for resistance for what?

A

hospital acquired MRSA

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3
Q

2 main risk factors for Pseudomonas resistance?

A
  • previous infection

- prior antibiotics within 90 days

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4
Q

2 main risk factors for ESBL/AMP-C/carbapenemase resistance?

A
  • previous infection

- prior antibiotics within 90 days

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5
Q

3 main risk factors for hospital acquired MRSA?

A
  • previous infection
  • prior antibiotics within 90 days
  • positive nasal carriage
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6
Q

ICU admission is a risk factor for multi-drug resistant organisms.

a. true
b. false

A

b. false

NOT a risk factor, but some risk factors occur more frequently in ICUs, such as central venous catheters

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7
Q

What beta lactamase inhibitor is +/- effective for ESBLs?

A

tazobactam

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8
Q

What antibiotic class is effective against ESBLs?

A

carbapenems

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9
Q

What antibiotic class is effective against Amp-C?

A

carbapenem,

+/- cefepime

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10
Q

2 clues for ESBL resistance?

A

3rd gen cephalosporin R

cephamycin S

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11
Q

2 clues for Amp-C resistance?

A

3rd gen cephalosporin S

cephamycin R

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12
Q

Antibiotic for low inoculum ESBL?

A

pip-taz

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13
Q

Antibiotic class for high inoculum ESBL?

A

carbapenem

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14
Q

Antibiotic for low inoculum AMP-C?

A

cefepime

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15
Q

Antibiotic for high inoculum AMP-C?

A

carbapenem

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16
Q

Sepsis:

QSOFA criteria?

A

2 of the following:

  • RR >= 22bpm
  • altered mentation
  • SBP < = 100mmHg
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17
Q

Sepsis:

SIRS criteri?

A

2 of the following:

  • temp > 38.3C or < 35C
  • HR > 90
  • RR > 20
  • WBC > 12 or < 4 or > 10% bands
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18
Q

How soon should antimicrobials be started with sepsis?

A

within 1 hour

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19
Q

3 common Catheter line associated blood stream infection (CLABSI) pathogens?

The suits at the SEC are BLOODsuckers

A

S - Staph aureus
E - coagulase negative Staph
C - Enterobacteriacea

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20
Q

What pathogen is a CLABSI contaminant if only 2/2?

A

coag negative Staph (CoNS)

21
Q

What is the duration of CLABSI Tx?

A

14 days from first negative culture

22
Q

Empiric candidemia Tx?

A

micafungin 100mg daily

echinochandin

23
Q

Definitive candidemia Tx?

A

fluconazole 12mg/kg load then 6mg/kg daily

pull the line!!

24
Q

Duration of candidemia Tx?

A

2 weeks from first negative culture

25
Q

Catheter associated UTI:

It is classified as CAUTI if >=10^3 cfu/mL even without Sx

a. true
b. false

A

b. false

Urinary catheter + s/SX + >=10^3cfu/mL

26
Q

3 common CAUTI pathogens?

Elvis the King Pees

A

E. coli
K. pneumoniae
P. mirabilis

27
Q

Antibiotics are always used for CAUTI

a. true
b. false

A

b. false

d/c or change catheter

if abx are needed probably user ceftriaxone

28
Q

2 C. diff drugs for initial episode/non-severe?

A

vancomycin 125mg

fidaxomycin 200mg

29
Q

How many minor criteria required to be CAP?

A

3 or more

30
Q

How many major criteria required to be classified as CAP?

A

1 or more

invasive mechanical ventilation
septic shock with need for vasopressors

31
Q

RR >= __ is minor criteria for CAP?

A

30

32
Q

PaO2/FiO2 ratio of <= __ is minor criteria for CAP

A

250

33
Q

BUN >= __ is minor criteria for CAP

A

20

34
Q

WBC count < __ cells/mm3 is minor criteria for CAP

A

4000

35
Q

Platelet count < __ cells/mm3 is minor criteria for CAP

A

100,000

36
Q

Core temp < _C is minor criteria for CAP

A

36

37
Q

Which influenza neuramidase inhibitor is IV only?

A

peramivir

38
Q

what drug class is first line Tx for influenza?

A

neuramidase inhibitors

oseltamivir (PO)
zanamavir (inhaled)
peramivir (IV)

39
Q

Suspect secondary community acquired MRSA after influenza when what are present?

A

cavitary lesions on Xray

40
Q

Age >= __ is a risk factor for serious Covid

A

60

41
Q

2 Tx options for Covid Tx in pts that are hospitalized and require oxygen?

A
  • dexamethasone

- dexamethasone plus remdesivir

42
Q

1 Tx option for Covid Tx in pts hospitalized and require mechanical ventilation?

A

dexamethasone

43
Q

HAP occurs __ hours or more after admission that was not incubating at the time of admission

A

48

44
Q

3 pt related risk factors for HAP MRSA?

A
  • abx within 90 days
  • ventilation
  • septic shock
45
Q

2 non pt related risk factors for HAP MRSA?

A
  • unknown MRSA prevalence

- local prevalence > 20%

46
Q

Early onset HAP is within the first __ days of hospitalization

A

4

late onset is 5 days or more

47
Q

VAP occurs within __ to _ hours after intubation

A

48, 72

48
Q

Common VAP pathogens?

A
  • Pseudomonas
  • Klebsiella pneumoniae ESBL
  • Acinetobacter sp.
  • MRSA
  • Legionella

“water bugs”

49
Q

How many days of therapy are needed for VAP?

A

7

7364 Critical Care Block 1 (11 decks)

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