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Midterm2 Flashcards

0
Q

Honey mooner

A

Staphylococcus Saprophyticus

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1
Q

Most common UTI pathogen

A

E.Coli

PEK

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2
Q

Most frequent risk factor for UTI

A

Sex

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3
Q

Inflammatory response to UTI

A

Pyuria (WBC in urine) local

Fever, leukocytosis

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4
Q

UTI presentation

A

Pain, urgency, supra public pain or heaviness

Hematuria (blood in urine)
Change mental status in elderly

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5
Q

Pyuria w/asymptomatic bacteriuria do not indicate for _____, and not indicate for__________ treatment._________ must be present. Exception:______

A

UTI
ANTIBIOTIC
SYMPTOMS

pregnant with bacteriuria,
Traumatic genitourinary procedures anticipating mucosal bleeding

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6
Q

Acute cystitis

A

Infection of bladder

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7
Q

Pyelonephritis

A

Infection of kidney

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8
Q

Asymptomatic bacteriuria

A

Bacterial growth >= 10^5cfu/ml or >=10^2 in catheterized urine culture
With no symptom

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9
Q

WBC casts

A

Cylindrical structure formed in the renal tubule

Upper tract or tubules (possible pyelonephritis)

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10
Q

Pyuria

A

More than 10 WBC/mm3

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11
Q

Leukocyte esterase

A

Enzyme release by WBC

Positive test indicate for inflammation

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12
Q

Nitrite

A

Produced by enterobacteriaceae only

Positive test indicate bacteriuria

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13
Q

Uncomplicated acute cystitis 1st line

A

Nitrofurantoin 100mg PO BID x5
Bactrim PO BID x3
Fosfumycin 3G x1

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14
Q

Uncomplicated acute cystitis 2nd and 3rd line

A

FQs- minimize resistance x3days
Cipro/levo 250-500 PO

PO BL for 7days not as efficacious

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15
Q

Uncomplicated pyelonephritis

A

FQs
Cipro 500mg PO bid x7
Levo 750 PO daily x7
Bactrim PO bid x7 preferred over FQ if know susceptibility

PO BL x14

Initial IV rocephin or AG is recommended to all

Nitrofurantoin and fosfomycin should be avoid in pyelonephritis due to inadequate drug level in renal tissue

16
Q

Complicated Cytitis IV

A

Cipro 400mg bid
Levo 500 daily
Ceftriaxone 1g daily
Tobra/ gentamicin

17
Q

Complicated Cytitis PO

A

Cipro 500 bid
Levo 750 daily
Fosfomycin 3mg on day one and three

Ampicillin/amoxicillin for enterococcus coverage

18
Q

Complicated UTI duration of therapy

19
Q

Complicated pyelonephritis

A

Rocephin 1g IV daily
Cipro 400 IV bid
Levo 750 IV daily
Tobra/gentamicin

20
Q

CAUTI treatment

A

Removal CAUTI

Rocephin 1g IV daily
Cipro 500 PO / 400 IV bid
Levo 250-500 PO/IV daily

21
Q

Prevention of recurrent in young ladies

A

Post coital Bactrim 40/200mg PO x1
Nitrofurantoin 50mg PO x1
Inadditional to post coital voiding

22
Q

Phenazopyridine (pyridium)

A

OTC
TID X2
False positive on nitrites test
Red discoloration of urine

23
Q

Endocarditis

A

Infection on heart valve or chamber

24
Endocarditis presentation
FROM JANE | fever, Roth spots, Osler node, murmur, janeway lesion, anemia, nail hemorrhage, emboli
25
TEE transesophageal echo gram
Highly sensitivity to vegetation detect smaller than 3 mm Readily detect paravalvular/ periannular abscesses Preferred for prosthetic valves Invasive
26
Endocarditis risk
High: prosthetic, previous endocarditis, Drug abuser CHF, CHD, ICD, DM, Chronic IV, dental, Mitral valve prolapse, Health related exposure, Rheumatic heart disease
27
Endocarditis causes
Strepto: Viridans, bovis Staphylo: aureus, Enterococcus: faecalis
28
Steps in endocarditis
Damage, NBTE, HEMATOGENOUS spread of bacteria, Vegetation form by bacteria and platelets, fibrin, BIO-FILM, SEPTIC EMBOLI= vegetation breaks away Abscesses= paravalvular/periannular
29
Most common sign and symptom of endocarditis
Fever and murmur
30
Lab and image of endocarditis
Elevated ESR and CRP Leukocytosis is common X-Ray: cannonball- like infiltrate ( good for IVDA and RS heart murmur)
31
Diagnosis of endocarditis
Echo and blood culture
32
Blood culture in endocarditis
Multiple culture 15 min apart Subacute: 3 separate culture over 24 hr Acute: 2-3 over 45 mins.
33
Duke criteria major
2+ blood culture 12 hr apart | + echo
34
Duke criteria minor
Predisposing heart condition Fever over 38 One + blood Vascular phenomena
35
Endocarditis strepto treatment
PenG 4MU IV q4hr or 24MU daily Rocephin 2g IV daily +/- gentamicin 3mg/kg IV 24 hr . X2weeks Native valve = 4weeks; prosthetic valve 6weeks If resistant to Pen follow enterococcus treatment
36
Endocarditis Staphy treatment
Nafcillin/oxacillin 2g IV q4hr Cefazolin 2g IV q8hr Gentamicin 1mg/kg IV q8hr MRSA: vanco/daptomycin 8mg/kg IV q24hr + genta with daptomycin Native valve: 6weeks Prosthetic: 6-8weeks + rifampin 300mg IV/PO q8hr
37
Endocarditis enterococcus treatment
Ampicillin 2g IV q 4hr /PenG 4MU IV q4hr or 24MU IV q24hr + Gentamicin 1mg/kg q8hr/ Rocephin 2g IV q12hr Native 6week; prosthetic 6-8weeks Daptomycin + genta if resistant Dapto x 8week+ if resistant to gentamincin

pharmacy (15 decks)

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