Common Infections

Question 1

4 main risk factors for invasive fungal infections?

Answer 1

• broad spectrum antibiotics
• abdominal surgery
• ## parenteral nutrition

Question 2

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

Answer 2

hospital acquired MRSA

Question 3

2 main risk factors for Pseudomonas resistance?

Answer 3

• previous infection

- prior antibiotics within 90 days

Question 4

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

Answer 4

• previous infection

- prior antibiotics within 90 days

Question 5

3 main risk factors for hospital acquired MRSA?

Answer 5

• previous infection
• prior antibiotics within 90 days
• positive nasal carriage

Question 6

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

a. true
b. false

Answer 6

b. false

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

Question 7

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

Answer 7

tazobactam

Question 8

What antibiotic class is effective against ESBLs?

Answer 8

carbapenems

Question 9

What antibiotic class is effective against Amp-C?

Answer 9

carbapenem,

+/- cefepime

Question 10

2 clues for ESBL resistance?

Answer 10

3rd gen cephalosporin R

cephamycin S

Question 11

2 clues for Amp-C resistance?

Answer 11

3rd gen cephalosporin S

cephamycin R

Question 12

Antibiotic for low inoculum ESBL?

Answer 12

pip-taz

Question 13

Antibiotic class for high inoculum ESBL?

Answer 13

carbapenem

Question 14

Antibiotic for low inoculum AMP-C?

Answer 14

cefepime

Question 15

Antibiotic for high inoculum AMP-C?

Answer 15

carbapenem

Question 16

Sepsis:

QSOFA criteria?

Answer 16

2 of the following:

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

Question 17

Sepsis:

SIRS criteri?

Answer 17

2 of the following:

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

Question 18

How soon should antimicrobials be started with sepsis?

Answer 18

within 1 hour

Question 19

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

The suits at the SEC are BLOODsuckers

Answer 19

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

Question 20

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

Answer 20

coag negative Staph (CoNS)

Question 21

What is the duration of CLABSI Tx?

Answer 21

14 days from first negative culture

Question 22

Empiric candidemia Tx?

Answer 22

micafungin 100mg daily

echinochandin

Question 23

Definitive candidemia Tx?

Answer 23

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

pull the line!!

Question 24

Duration of candidemia Tx?

Answer 24

2 weeks from first negative culture

Question 25

Catheter associated UTI: It is classified as CAUTI if >=10^3 cfu/mL even without Sx a. true b. false

Answer 25

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

Question 26

3 common CAUTI pathogens? Elvis the King Pees

Answer 26

E. coli K. pneumoniae P. mirabilis

Question 27

Antibiotics are always used for CAUTI a. true b. false

Answer 27

b. false d/c or change catheter if abx are needed probably user ceftriaxone

Question 28

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

Answer 28

vancomycin 125mg | fidaxomycin 200mg

Question 29

How many minor criteria required to be CAP?

Answer 29

3 or more

Question 30

How many major criteria required to be classified as CAP?

Answer 30

1 or more invasive mechanical ventilation septic shock with need for vasopressors

Question 31

RR >= __ is minor criteria for CAP?

Answer 31

30

Question 32

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

Answer 32

250

Question 33

BUN >= __ is minor criteria for CAP

Answer 33

20

Question 34

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

Answer 34

4000

Question 35

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

Answer 35

100,000

Question 36

Core temp < _C is minor criteria for CAP

Answer 36

36

Question 37

Which influenza neuramidase inhibitor is IV only?

Answer 37

peramivir

Question 38

what drug class is first line Tx for influenza?

Answer 38

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

Question 39

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

Answer 39

cavitary lesions on Xray

Question 40

Age >= __ is a risk factor for serious Covid

Answer 40

60

Question 41

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

Answer 41

- dexamethasone | - dexamethasone plus remdesivir

Question 42

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

Answer 42

dexamethasone

Question 43

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

Answer 43

48

Question 44

3 pt related risk factors for HAP MRSA?

Answer 44

- abx within 90 days - ventilation - septic shock

Question 45

2 non pt related risk factors for HAP MRSA?

Answer 45

- unknown MRSA prevalence | - local prevalence > 20%

Question 46

Early onset HAP is within the first __ days of hospitalization

Answer 46

4 late onset is 5 days or more

Question 47

VAP occurs within __ to _ hours after intubation

Answer 47

48, 72

Question 48

Common VAP pathogens?

Answer 48

- Pseudomonas - Klebsiella pneumoniae ESBL - Acinetobacter sp. - MRSA - Legionella "water bugs"

Question 49

How many days of therapy are needed for VAP?

Answer 49

7