Principles of Infectious disease

Question 1

What is the systematic approach for selecting antimicrobial agents

Answer 1

Confirm presence of infection
identify pathogen
select presumptive therapy
therapeutic steps

Question 2

What does a left shift indicate

Answer 2

Bands (premature neutrophils) in blood > 10%

Bacterial infection

Question 3

How to confirm presence of infection

Answer 3

H&P exam
predisposing factors
signs and symptoms
- fever
- wbc count
- esr
- crp
- procalcitonin
- pain and inflammation
- disease specific signs and symptoms

Question 4

what is the range for CRP

Answer 4

.5 - 1 normal
1 - 1.5 moderate inflammation
>10 infection

Question 5

What is bacteria classified as

Answer 5

Susceptible
intermediate
resistent

Question 6

What should peak dosage be

Answer 6

2 - 4 x MIC

Question 7

What factors increase antibiotic resistance

Answer 7

Overuse
low dose
prolonged exposure
inappropriate antibiotics
day care

Question 8

What are requirements for antimicrobial activity

Answer 8

penetrate cell
reach target
kill organism

Question 9

What are mechanisms of resistance

Answer 9

decreased permeability - porin channels close
drug efflux - pump abx out
drug inactivation - enzymes attack abx
altered target - change ribosomes with CH3 so no binding

Question 10

what are gram + cocci

Answer 10

Staph
Strep
Enterococcus

Question 11

What are gram - cocci & cocco-bacilli

Answer 11

H. flu
Neisseria
Moraxella catarrhalis

Question 12

What are Enterobacteriacea

Answer 12

EKP
- e. coli
- klebsiella
- proteus
ESP
- enterobacter
- serratia
- providencia

Question 13

What are anaerobes

Answer 13

bacteroides fragilis

Question 14

What is PA

Answer 14

pseudomonas aeruginosa

Question 15

How to identify pathogen

Answer 15

Stains
Serologies
Culture and sensitivity

Question 16

What are the stains

Answer 16

Gram Stain
- G+ purple (peptidoglycan)
- G- pink
Acid-fast
- mycobacteria
- nocardia
India Ink
- cryptococcus

Question 17

What are gram stains routinely performed on

Answer 17

CSF for meningitis
Urethral smears for STI
abscesses or effusions

Question 18

What is the gold standard for identifying bacteria

Answer 18

Cultures

Question 19

What are the types of antibody and antigen detection

Answer 19

Immunoflorescence
Latex agglutination
Enzyme-linked Immunoassay

Question 20

What is identified through immunoflorescence

Answer 20

CMV
RSV
Varicella
Treponema pallidum
Borrelia burgdorferi

Question 21

What is identified through Latex agglutination

Answer 21

Meningococcus in CSF

Legionella pneumophelia

Question 22

What is identified through Enzyme-linked immunoassay

Answer 22

HIV
Herpes
RSV
Preumococcus
N. gonorrhea
Haemophilus pylori

Question 23

What is identified through PCR

Answer 23

Anthrax

Question 24

What are host factors to consider when selecting therapy

Answer 24

drug allergies
age
pregnancy
renal and hepatic function
site of infection
underlying disease states
concomitant drug therapy

Question 25

What are drug factors to consider when selecting therapy

Answer 25

``` antimicrobial activity spectrum of activity pharmacokinetics pharmacodynamics tissue penetration adverse effects cost convenience ```

Question 26

What does bactericidal mean

Answer 26

kills organisms

Question 27

What does bacteriostatic mean

Answer 27

inhibit growth of bacteria but does not kill. Lets body immune system kill bacteria

Question 28

How prevent bacterial growth

Answer 28

destroy cell wall | inhibit protein synthesis

Question 29

What is MIC

Answer 29

Minimum inhibitory concentration | lowest antimicrobial concentration that prevents visible growth

Question 30

What are the susceptibility testing methods

Answer 30

``` macrodilution microdilution kirby-Bauer disk diffusion E-test Automated ```

Question 31

What are the automated susceptibility testing methods

Answer 31

Vitek | Microscan

Question 32

What are concentration and time-dependent effects

Answer 32

MIC concentration-dependent killing rate postantibiotic effect

Question 33

Which 2 bacteria should have 2 abx used on them at same time

Answer 33

Enterococcus | Pseudomonas aeruginosa

Question 34

What are typical pathogens for Acute Otitis Media

Answer 34

S. pneumoniae H. flu M. catarrhalis

Question 35

What are typical pathogens for Sinusitis

Answer 35

S. pneumoniae H. flu M. catarrhalis

Question 36

What are typical pathogens for Meningitis

Answer 36

S. pneumoniae H. flu N. meningitidis

Question 37

What are typical pathogens for Chronic Bronchitis

Answer 37

``` C. pneumoniae M. Pneumoniae S. pneumoniae H. flu M. catarrhalis ```

Question 38

What are typical pathogens for Pneumonia

Answer 38

``` M. Pneumoniae S. pneumoniae H. flu Pseudomonas Staph aureus ```

Question 39

What are typical pathogens for Bowel perf-appendicitis

Answer 39

``` E. coli Klebsiella Enterococcus Pseudomonas Bacteriodes Fragilis ```

Question 40

What are typical pathogens for Urinary Tract Infections

Answer 40

E. Coli Klebsiella Proteus Enterococcus

Question 41

What are typical pathogens for Osteomyelitis

Answer 41

Staph

Question 42

What do staph affect

Answer 42

skin | soft tissue

Question 43

What do Strep effect

Answer 43

Respiratory tract infections

Question 44

What do enterococcus effect

Answer 44

GI | wounds

Question 45

What do Neisseria effect

Answer 45

meningitis

Question 46

What do H flu and moraxella catarrhalis effect

Answer 46

sinusitis bronchitis acute otis media

Question 47

What do EKP effect

Answer 47

many UTI GI

Question 48

What do ESP effect

Answer 48

GI

Question 49

What do pseudomonas aeruginosa effect

Answer 49

pneumonia | various

Question 50

What do anaerobes effect

Answer 50

GI | aspiration pneumonia