Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Principals 2 > HAI & Abx > Flashcards

HAI & Abx Flashcards

(71 cards)

Start Studying
1
Q

What is the most common cause of HAI?

A

Surgical site infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does a SUPERFICIAL INCISIONAL SSI (surgical site infection) occur?

A

Just in the area of incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 most common types of bacteria associated with SSI?

A

Staphylococcus
Streptococcus
Pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where does a DEEP INCISIONAL SSI occur?

A

Beneath the incision area in muscle and area surrounding muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does an ORGAN/SPACE SSI occur?

A

Any area other than skin or muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SSI Wound Types: Clean

A

No evidence of infection
Does not involve organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

SSI Wound Types: Clean-contaminated

A

No evidence of infection
DOES involve internal organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SSI Wound Types: Contaminated

A

Involves organ with spillage of contents from organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

SSI Wound Types: Dirty

A

Known infection at time of surgery
Ex: Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What length of surgery is associated with increased chance of SSI?

A

> 2 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Grading Categories of Evidence: 1A

A

Strong Recommendation
Mod-High quality evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What comorbidities are most associated with increased risk of SSI?

A

Immunocompromised
Obesity
DM
CA
Smoker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What 2 kinds of surgeries are most associated with SSI?

A

Abdominal
Emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Grading Categories of Evidence: 1B

A

Strong Recommendation
Low quality evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Grading Categories of Evidence: 1C

A

Strong Recommendation
Required by state/federal regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Recommendations & Evidence:
Parenteral Abx

A

Admin only when indicated (1B)
Timing so Abx in tissue upon incision (1B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Grading Categories of Evidence: 2

A

Weak Recommendation
(These still occur on person-by-person basis d/t preference)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Recommendations & Evidence:
Non-parenteral Abx

A

Do not apply Abx ointment to incision (1B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Recommendations & Evidence:
Glycemic Control

A

Perioperative Control (1A)
Glucose Target <200 mg/dL (1A)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Recommendations & Evidence:
Normothermia

A

Maintain perioperative normothermia (1A)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Recommendations & Evidence:
Oxygenation

A

No Recommendation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Recommendations & Evidence:
Antiseptic Prophylaxis

A

Bathe PM before (1B)
ETOH based skin prep intraop (1A)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Recommendations & Evidence:
Systemic Immunosuppressive Therapy

A

Risk vs Reward per surgeon
Avoid if pt has multiple SSI risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Recommendations & Evidence:
Blood Transfusion

A

DO NOT withhold necessary transfusion to prevent possible SSI (1B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
What is the most common reason for TKA revision?
Infection
22
When should Abx be initiated before surgery?
30-60 minutes Before torniquet use
23
What 2 kinds of Abx need to be initiated earlier than the standard time? How much earlier?
Vanco & Fluoroquinolones 2 hrs
24
What are the 3 common subclasses of Beta Lactams used perioperatively?
PCNs Cephalosporins Carbapenems
24
When should Abx be redosed?
2 half lives (while in OR) Excessive blood loss
25
What are the 5 common surgical Abx classes?
Beta Lactams Aminoglycosides Fluroquinolones Vanco Metronidazole
26
How do Beta Lactams work?
Inhibit cell wall synthesis
27
What bacterial enzyme inhibits Beta Lactam? Where on the bacteria is it located?
Beta-lactamase Outer surface of cytoplasmic membrane
28
What kind of infections are PCNs most commonly used for (3)?
Skin Catheter Upper Respiratory
28
What kind of coverage do PCNs have?
Mostly Gram +
28
What kind of bacteria are PCNs the DOC for (3)?
Streptococci Meningococci Pneumococci
29
Does Cefazolin (Ancef) cross the BBB?
No
29
What are the 2 most common adverse reactions to PCNs (2)?
GI Upset Vaginal Candidiasis
30
What is the DOC for surgical prophylaxis? What drug class is it?
Cefazolin (Ancef)
31
Is there cross-reactivity between PCNs and Cephalosporins?
No, unless true anaphylaxis
31
What coverage does Cefazolin (Ancef) have?
Gram +
32
What 2nd Gen Cephalosporin is sometimes used? What added coverage does it have in addition to Cefazolin (Ancef)
Cefoxitin (Mefoxin) Better Gram -- coverage
33
What cephalosporin is reserved for multi-resistant organisms? Does it penetrate the BBB?
Cefepime (Maxipime) Yes
34
What are 5 adverse reactions to cephalosporins?
Rash Nephritis Vit K deficit Fever Colitis (3rd gen)
34
If someone has a true anaphylactic reaction to cephalosporins and/or PCNs, what other Abx should be used (2)?
Vancomycin Clindamycin
35
What Beta-Lactam Abx has the broadest coverage of Gram+ and Gram--?
Carbapenems
36
What type of bacteria is Carbapenems MOST effective against?
Gram --
37
What makes carbapenems so effective?
They inhibit beta-lactamase enzyme in bacteria
38
Do carbapenems penetrate the BBB?
Yes
39
What Abx is representative of carbapenems?
Meropenem (Merrem)
40
What are 3 adverse reactions to carbapenems?
N/V/D Rash Injection site reactions
41
What medication is a contraindication to administering carbapenems? Why?
Valproic Acid (Depakote) Decreases levels up to 90%
42
How does Vancomycin act against bacteria?
Inhibits cell wall synthesis
43
What coverage does Vanco have? Why?
Only Gram + Too large to penetrate Gram- cell wall
44
What is unique about how Vancomycin works? What is the consequence of it?
Only works if bacteria is actively dividing Action against bacteria is very slow
45
What are adverse reactions to Vanco? Are they common?
Phlebitis at injection site Nephro/Oto toxicity Red Man syndrome Chills/Fever YES 10%
45
What 2 infections is Vanco best at treating? What is the usually the offending bacteria?
BSI (blood stream infection) Endocarditis MRSA
46
What is the MOA of aminoglycosides?
Inhibit ribosomes --> misreading mRNA
47
What Abx are aminoglycosides synergistic with? What infection is this synergy effective against?
Beta-Lactams Enterococcal Endocarditis
48
What is the class example of aminoglycosides?
Gentamycin
49
What are 3 adverse reactions to aminoglycosides?
Ototoxicity Nephrotoxicity Curare-like effect
50
What increases the risk (5) of nephrotoxicity from aminoglycosides?
Renal Insufficiency Concurrent loop diuretics High doses Dosing for >5 days Elderly
51
What is the MOA of Fluroquinolones?
Inhibition of gyrase --> inhibition of transcription and replication
52
What is the coverage of Fluroquinolones?
Gram-
53
What are 2 examples of Fluroquinolones?
Ciprofloxacin (Cipro) Levofloxacin (Levaquin)
54
What are 3 adverse reactions to fluroqinolones?
N/V/D Prolonged QT Cartilage damage/Tendon rupture
55
What increases the risk of cartilage damage/tendon rupture from fluroquinolones?
Renal insufficiency Concurrent steroid use Elderly
56
What is the MOA of Metronidazole (Flagyl)?
Toxic byproducts result in unstable DNA molecules
57
What are the targets of Metronidazole (Flagyl)?
Anerobic bacteria Protazoa
58
What is the indication for Metronidazole (Flagyl)?
Abdominal infection C-diff Vaginitis
59
What are adverse reactions to Metronidazole (Flagyl)?
Disulfiram Effect w/ ETOH Peripheral Neuropathy (Prolonged use) Nausea
60
What are the weight ranges and doses for Cefazolin (Ancef) administration?
<80kg = 1g 80-120kg = 2g >120kg = 3g

Principals 2 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions