Diagnostic Imaging EBM

Question 1

What are the SIRS criteria?

Answer 1

1. temp> 38C (100.4F) or less than 36C
2. HR> 90
3. RR>20 or PaCO2 less than 32
4. WBC 12,000 or 10% bands

Question 2

What is the Patzakis classification?

Answer 2

Zone 1- forefoot (met necks distally)
Zone 2- midfoot(distal end of calc to met necks)
Zone 3- rearfoot (overlies calcaneus)

Question 3

Which region in the foot is most common and has greatest risk for osteomyelitis according to Patzakis?

Answer 3

Zone 1- forefoot (metatarsal necks distally)

*rearfoot is next most common and then midfoot

Question 4

What is the generic name for Primaxin?

Answer 4

Imipenem/Cilstatin

Question 5

Why is Cilstatin combined with imipenem?

Answer 5

bc Cilstatin, is a renal dihydropeptidase inhibitor that prevents hydrolysis and inactivation of imipenem in the kidney

Question 6

What is the dosage of Primaxin?

Answer 6

500mg q6-8hr IV

Question 7

what are the 3 FDA-approved abx for treatment of complicated SSTI including diabetic foot infections?

Answer 7

Ertapenem (Invanz)
Piperacillin/tazobactam (Zosyn)
Zyvox (Linezolid)

Question 8

what is the advantage of Ertapenem over Primaxin?

Answer 8

the once daily dosing

1g q24 hr IV/IM

Question 9

What are the common organisms found in human and animal bite wounds?

Answer 9

Pasteruella

Eichenella

Question 10

What is the DOC for human/animal bite wounds?

Answer 10

Augmentin

Question 11

What abx cover VRE (vancomycin-resistant enterococcus)?

Answer 11

Cubicin
Daptomycin
Linezolid

Question 12

What is the dosage for Nafcillin?

Answer 12

1-2g IV q4-6hr

Question 13

what are some unique pharmacologic properties of nafcillin?

Answer 13

it is metabolized by the liver!

DOC for MSSA

Question 14

what is the dosage for Dicloxacillin?

Answer 14

200-500mg PO BID- QID

Question 15

What is the dosage for Zosyn?

Answer 15

3.375 g IV q6hr

Question 16

What is the advantage of Zosyn over Unasyn/

Answer 16

Zosyn has pseudomonas coverage while Unasyn does not

Question 17

What is the dosage for Unasyn?

Answer 17

1.5-3.0g IV q6hr

Question 18

What are the criteria for AKI?

Answer 18

(changes occur within 48 hrs)

• Creatinine rises >0.3mg/dL or >50% from baseline
• urine output of 6h

Question 19

What is the normal reference range for BUN/Cr?

Answer 19

BUN 10-20mg/dL

Cr- 0.7-1.3 mg/dL

Question 20

what are normal reference ranges for ESR and CRP?

Answer 20

ESR: 1-20mm/hr
CRP: normal

Question 21

what are the indications for acute hemodialysis?

Answer 21

*mnemonic- AEIOU
A-acidosis: metabolic, unresponsive to other therapy
E-electrolytes: K+ most commonly, phosphorous, Na+
I- ingestion: alcohol (methanol, ethylene glycol), meds (ASA, digoxin)
O-overload of fluids not responsive to diuretics
U- uremia: serositis (pericarditis, pleuritis), encephalopathy, bleeding

Question 22

What is Bactrim used for?

Answer 22

pen-allergic pts

documented CA-MRSA

Question 23

What is the dosage for Bactrim?

Answer 23

5:1 ratio of SMP to TMP

800mg SMX; 160mg TMP

Question 24

What are the 2 golden rules for surgical prophylaxis?

Answer 24

1. abx should have achieved its max. concentration at the time of incision/insult
2. abx should cover the most likely organism that would be found if infection were to ensue

Question 25

what are the indications for surgical prophylaxis?

Answer 25

wound care surgery dental patients infective endocarditis

Question 26

Name the macrolides.

Answer 26

Azithromycin Clarithromycin Erythromycin

Question 27

What is the dosage for Vancomycin?

Answer 27

1g IV q12hrs (for severe infections) | 125mg PO q6 hrs (for C. diff colitis)

Question 28

What is the treatment and dosages for C. diff colitis?

Answer 28

Metronidazole- 500mg PO TID | Vancomycin- 125mg PO QID