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Flashcards in Infectious Disease Deck (37):
1

What is immune senescence?

Immune response decline with age

2

What is the cause of immune senescence? (2)

Depressed T cell responses and depressed T cell/macrophage interactions

B cells produce lower affinity antibodies

3

True or false: age has a greater influence on immune senescence than the impact of comorbidities and host resistance

false--other way around

4

True or false: fever may be absent in 30-50% of frail older adults with serious infections?

True

5

What are the three different ways a fever can be redefined in old age?

Temp >2 F above baseline
Oral temp >99 F
Rectal temp >99.5

6

True or false: renal function declines with aging, regardless of any renal pathology

True

7

What is the most common causative agent of UTIs?

E.coli

8

What are the minimum criteria to diagnose a UTI without a catheter?

Fever AND some other common signs of UTIs

9

What are the minimum criteria to diagnose a UTI with a catheter?

Fever OR some other common signs of UTIs /psych symptoms

10

What are the minimum criteria to diagnose skin and soft tissue infections in the elderly?

Fever OR redness, TTP, warmth etc

11

What is the earliest sign of geriatric pneumonia?

Tachypnea

12

What are the minimum criteria to diagnose a respiratory tract infection in the elderly?

Fever w/ productive cough
Fever, AND tachycardia

13

How do the minimum criteria to diagnose respiratory infections changes with a pt what has COPD?

No fever needed--just increased purulent cough

14

What are the tracts that are more common sites of sepsis infections for older adults than younger?

GI and GU

15

What is the strongest independent predictor of mortality in elderly pts with pneumonia?

Comorbidities

16

True or false: mortality from pneumonia in older adults is 3x to 5x that of younger adults

true

17

What is the most common causative agent of pneumonia? The other two

1. Strep pneumoniae
2. Gram negatives
3. Staph aureus

18

What is the first line therapy for pneumonia in elderly adults?

Beta-lactam + beta lactamase inhibitor

19

What is the treatment for MRSA?

Vancomycin

20

What are the four ways to reduce the risk of pneumonia?

1. Immunization
2. Stop smoking
3. Treat comorbidities
4. Control sources of infx

21

What is asymptomatic bacteriuria?

Chronic colonization of the urinary tract in some women--no need to treat. In fact, don't

22

What is the cause of cystitis in men?

Prostatic disease or tract disease

23

What is the treatment for all pts with TB?

Isoniazid x9 months

24

What are the two indications for treatment of TB?

1. Never have been treated in the past
2. Active disease is excluded

25

New heart murmur + fever = ?

Infective endocarditis

26

What is the most likely pathogen for septic arthritis?

Staph Aureus

27

What is the most likely pathogen for osteomyelitis?

Staph Aureus

28

What are the common causes of osteomyelitis?

DM foot ulcers
Decubitus ulcers

29

True or false: the response of older adults to HAART (highly aggressive antiretroviral therapy) is not as good as those in young adults

False-actually similar response to the meds

30

What is the MOST treatable cause of dementia?

HIV

31

What infections are associated with Bell's palsy?

Herpes zoster--lyme's disease

32

ABdominal pain in old age demands what?

Good PE
Surgical consult

33

True or false: you treat infectious diarrhea in elderly pts as you would for adults?

true

34

What should you order if you suspect an intra-abdominal infection?

CT or labled WBC study

35

What should you order if you suspect a cholecystitis, appy, or abscess?

US

36

What should you order if you suspect ischemic bowel?

Angiography or sigmoidoscopy

37

What are the two abx for c.diff infections?

Metronidazole
Vanco