immunocompromised, nosocomial FUO Flashcards Preview

Clin Med 1 Test 3 > immunocompromised, nosocomial FUO > Flashcards

Flashcards in immunocompromised, nosocomial FUO Deck (21):
1

what viruses are frequent pathogens of HIV assoc FUO (2)

CMV, HSV

2

what bacterial infections are common in HIV assoc FUO (2)

mycobacterial (MAI), pic line inf

3

in what time frame are nosocomial infections likely to occur

48-72 hrs after admission

4

how frequent are nosocomial inf among hospitalized pts

5-10% of those admitted will acquire nosocomial inf

5

"a frequent cause of FUO"

Clostridium difficile colitis (esp if diarrhea minimal or absent)

6

other non-infectious causes of FUO (3)

drug reaction, tissue injury or infarct, thromboembolic

7

"a frequent cause of nosocomial FUO"

C diff - especially when diarrhea is minimal or absent

8

3 noninfectious causes of nosocomial FUO

tissue injury/infarction, drug rxn, thromboembolic dz

9

what may happen to the breathing rate and BP of the infected hospital pt

tachypnea /resp alkalosis, hypotension

10

what may happen to the frequency of urination and WBC in the infected hospital pt

oliguria (scant urine), leukocytosis (increase)

11

what is theclassic pathology of a nosocomial pneumonia

microaspiration of pharyngeal org's (75% of seriously ill colonized by atypicals)

12

MCC of Noso pneumo

S aureus

13

4 organisms typical of Noso Pneumonia

PA, Enterobacter, K pneumoniae, E coli

14

Under what conditions is an indwelling catheter likely to cause infections (2)

greater than 72 hours, open drainage/interruption of closed drainage

15

MCC of nosocomial UTI

coagulase-neg Staph or S aureus (Candida in immunocompromised)

16

What is found to be ineffective in the case of nosocomial UTI's

prophylaxis by antibiotics, irrigation acidification

17

first line tx of Candida UTI

discontinue catheter and broad-spec abx

18

second line tx of Candida UTI (which hasn't proven overly effective)

oral fluconazole (Diflucan) or single dose IV amphotericin B

19

first line tx of nosocomial UTI

vancomycin 15 mg/kg IV BID

20

newer causative org's of noso UTI

ENTEROCOCCUS FAECIUM (resistant to vanc), [Citrobacter, Acinitobacter, Stentotrophomonas]

21

empiric tx of the seriously ill pt

vanco and carbapenem with or without Amikacin/Gentamicin