Infectious Diseases Flashcards Preview

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Flashcards in Infectious Diseases Deck (65):
1

 2 new classes of antibiotics have been developed in the past 40 years.  True or false?

true

2

What are the surgical infection prevention guidelines? (7)

give antibiotics within 1 hour of incision

stop prophylactic antibiotics at 24 hours (48 for cardiac)

increase dose for larger pts

administer antibiotics appropriate for local resistance patterns

follow American Heart Association guidelines for pts at risk of infective endocarditis

adhere to procedure-specific recommendations

3

What antibiotic has a broad antimicrobial spectrum, low toxicity, incidence of allergic reaction, and has rare cross-sensitivity to PCN?

cephalosporins (Ancef)

4

What do you need to infuse slowly to avoid "Red Man Syndrome"?

Vancomycin

5

What causes the "Red Man Syndrome" from giving vancomycin too rapidly?

histamine release resulting in HYPOtension

Note: True allergy can cause CV collapse.

6

For what surgery does increased FiO2 intraop reduce the incidence of surgical site infections?

colorectal surgery

7

Hyperthermia increases the incidence of SSI. True or false?

false

Hypothermia

8

Increased anesthesia for the treatment of pain decreases the incidence of SSI. True or false?

true

9

Hypocapnea causes vasoconstriction which can impair perfusion to vital organs.  True or false?

true

and vice-versa

10

Low glucose inhibits leukocyte function thereby increasing risk of SSI.  True or false?

False.

High glucose

11

How many cases per year are due to CVC blood stream infections?

80k

12

What are the signs of a BS infection? (3)

  • non-specific signs of infection with no obvious source
  • indwelling catheter is present
  • change in mental status, hemodynamic instability, altered tolerance for nutrition, and malaise

13

What is the definition of a sepsis?

infection plus systemic inflammatory response

14

What characteristics describe a severe sepsis?

  • sepsis, plus
  • organ dysfunction
  • lactic acidosis
  • oliguria
  • confusion
  • hepatic dysfunction

15

What characteristics describe septic shock?

  • Severe sepsis plus
  • HYPOtension (systolic BP 90mmHg) despite adequate fluid resuscitation

16

What is the estimated mortality for septic shock?

50-80%

17

Patients that have sepsis may also have hyperglycemia.  True or false?

true

18

How do you manage treatment regarding surgery for a patient with sepsis? (5)

postpone surgery if possible

MAP > 65mmHg

CVP 8-12 mmHg

adequate urine output, normal pH

O2 sat > 70%

19

Indications of pulmonary sepsis organ failure:

____ minute ventilation

______ compliance

______ airway resistance

_____ skeletal muscle efficiency

_____pnea

 

> MV

< compliance

> resistance

< muscle efficiency

tachypnea

20

Indications of cardiovascular organ failure due to sepsis:

SBP < _____

______ cardiac filling pressures

______ cardiac output

_______ SVR

SBP < 90

lower cardiac filling pressures

lower cardiac output

greater SVR

21

What are gastrointestinal signs of sepsis organ failure? (2)

“Shock liver” (like heart attack of the liver)
Ileus (bowel obstruction)
 

22

What are causes of coagulation issues with sepsis related organ failure? (4)

Vit K deficiency
Effects of Factors II, VII, IX, & X
Thrombocytopenia (due to increased destruction)
DIC

23

What is an anaerobic, gram positive spore forming organism causing antibiotic diarrhea and pseudomembranous colitis?

Clostridium difficile infection

24

What are risk factors of Clostridium difficile? (9)

advanced age

severe underlying disease

GI surgery

presence of NG tube

antiulcer meds

ICU long hospital stay

antibiotics

depressed immune system

25

What are signs of Clostridium difficile infection?

diarrhea & abdominal pain

26

How do we diagnose clostridium difficile infection?

enzyme linked immunoassay for C.diff toxin

27

What is the treatment for Clostridium difficile infection? (3)

fluid & electrolyte replacement

discontinue offending agent

c diff antibiotic therapy (Flagyl & Vanco)

28

What infection is this image of?

Q image thumb

Clostridium difficile Colitis

29

What is caused by mycobacterium and survives in tissues with high oxygen concentration?

tuberculosis 

30

What infection is most likely to occur in racial & ethnic minorities (Asia), IV drug abusers, AIDS?

Tuberculosis

31

90% of patients infected never become symptomatic with tuberculosis.  True or false? 

true

32

What are clinical signs of TB?  (4)

Nonproductive cough
Anorexia/weight loss
Chest pain/hemoptysis
Night sweats

33

Tuberculin test (PPD)
Read in ____- _____hours
Positive result > ____mm induration (> ___ mm AIDS)

48-72 

10 

5

34

What will appear in CXRs for people with TB?

Apical infiltrates or upper lobe infiltrates with cavitation

35

Sputum smears are able to detect active TB in 90% of patients.  True or false? 

false

50-80% 

36

Patients with positive PPD should be treated with _____.

isoniazid

37

Considered non-infectious if patient has received treatment, is improving clinically, and has ___ negative sputum smears.

 3

38

If TB patient, HEPA filter placed on circuit (between Y connector & mask/LMA/ETT).  True or false?

true

39

What is an acute febrile illness associated with myalgias, malaise, and headache?

Influenza

40

What herpes viruses route of transmission is oral?

HSV-1

41

What virus does this describe?

  • Disseminated disease in immunocompromised hosts
  • Transmitted by infected secretions or leukocyte containing blood products
  • Parturient to fetal transmission-->CNS damage

Cytomegalovirus

42

What virus is an infectious mononucleosis associated with fever, LAD (lymphadenopathy), splenomegaly?

Epstein-Barr

43

Zidovudine (AZT) greatly reduces risk of transmission of what disease?

AIDS

44

Having what 2 forms of hepatitis at the same time can be  very dangerous?

Hep B and D

45

What types of hepatitis can often cause the most liver damage?

B, C, D

46

What  types of hepatitis are transmitted via the fecal-oral route? (2)

Hep A and E

47

What are the symptoms of hepatitis?

Dark urine, fatigue, anorexia, nausea, low grade fever, abdominal discomfort, myalgias, arthralgias, jaundice, hepatomegaly, and splenomegaly. 

48

What is the treatment for hepatitis?

IVF
Abstinence from alcohol
HCV: interferon & ribaviron
Liver Transplantation

49

What is a microbial infection that implants on heart valves?

Infective Endocarditis

50

Streptococcal organisms account for 50% of cases for those infected with endocarditis.  True or false?

true

51

What are predisposing factors for those with infective endocarditis? (4)

  • Operative procedures associated with transient bacteremia (dental, upper airway, gall bladder, lower GI tract, & GU tract)
  • IV drug abusers
  • *Patients with prosthetic heart valves*
  • Patients with congenital heart defects/valvular disease

52

What are the signs of infective endocarditis? (2)

  • indicated by heart murmur, anemia, fever with a history of cardiac disease and recent surgical procedure
  • evidence of cerebrovascular occlusion & hematuria

53

Name 3 CNS infections.

Meningitis

Brain Abscess

Epidural Abscess

54

What is meningitis characterized by?

Fever, headache, vomiting, nuchal rigidity, obtundation
CSF findings: > neutrophils, glucose concentration < 50% of blood glucose conc., > protein conc.

55

What is a brain abscess a result of?

Result of direct extension of contiguous infections (sinusitis, otitis media, lung abscess)

56

What diagnosing test do we perform to find a brain abscess?

MRI

57

An epidural abscess is usually present ___-___ hours after performance of epidural with severe backache, local tenderness, paraspinal muscle spasm, fever, and leukocytosis.

24-48

58

What infection is caused by inhalation of oropharyngeal secretions containing pneumococci and streptococci?

pneumonia

59

For those with pneumonia, OP secretions inhaled during sleep is less common in healthy patients and more common in alcoholics, drug addicted, and patients with neurologic disorders. True or false?

true

60

What infection does this describe?

  • Complication of bacterial pneumonia
  • Common in alcoholics & poor dental hygiene 

lung abscess

61

What infection does this describe?

  • Suspected in patients who have undergone abdominal surgery who have unexplained fever
  • Diagnosis: wide separation between gastric bubble and diaphragm on CXR.
  • Treatment: surgical drainage and antibiotics

subphrenic abscess

62

Most common of all bacterial infections affecting humans
> in females < 50 yrs of age is the contraction of _____.

Urinary Tract Infection

63

What is the most common organism causing UTI?

E. coli

64

What infection does this describe?

  • Progressive inflammatory destruction of bone
  • Staphylococcus aureus adheres to bone and expresses receptors for bone matrix
  • Surgical sample, CT & MRI

osteomyelitis

65

After contact with C. diff patient, immediately use hand foam.  True or false?

false, FOAM will not work