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Feola Block 4 lecture
957
30
Science
Professional
12/09/2011

Additional Science Flashcards

 


 

Cards

Term

what are the two questions you should ask when treating blood stream infections?

 

Definition

1. what is my source?

2. is is community or hospital?

Term

lung, CA

 

What pathogens are you thinking about?

 

What antibiotics should you use?

Definition

in a CA, lung case you should think Strep pneumo, h flu, legionella, chlamydia pneumoniae.

 

Use FQ or (cefipime + macrolide)

Term

Source: lung

HA

Definition

Think aerobic gram - bacteria

 

treate with (cefepime or piperacillin) + AG

Term

source: abdomen

CA

Definition

E. coli, b frag

 

pip/tazo or amp/sulbactam

or 

 

FQ + metronidazole

Term

source: abdomen

commensal/HA

Definition

aerobic gram -

anaerobes

candida sp.

 

carbapenem

or 

pip/tazo +/- AG 

 

(consider antifungal) 

Term

source:  SSTI

CA

Definition

Strep pyogenes

Staph aureus

polymicrobial

 

(Vanc or linezolid or daptomycin) +/- pip/tazo

Term

source:  SSTI

HA

Definition

MRSA

aerobic gram - bacilli

 

vanc + (cefepime or pip/tazo)

Term

source: Urinary tract

CA

Definition

pathogens:  e. coli

klebsiella sp.

enterobacter sp.

proteus sp. 

enterococci

 

FQ

 

if gram positive cocci:  amp + gentamicin

 

Term

Urinary tract

HA

Definition

aerobic gram - bacilli

enterococci

 

vanc + (cefepime or FQ)

Term

Source: meninges

CA

Definition

S. pneumo

Neisseria meningitidis

Listeria monocytogenes

H. influenzae

 

Vanc + (ceftriaxone or cefepime)

Term

source: meninges

HA

Definition

aerobic gram - bacilli

staphylococci

 

 

cefepime + vanc

 

be very aggressive with positive and negative! 

Term
Name three situations when you pull the line?
Definition
S. aureus, tunneling, candida
Term
What are most cases of severe sepsis caused by?
Definition

normal flora due to significan immune effect

 

(epithelial barrier disruption or immunosuppression)

Term
What are the top three sites of infection in bacteremia cases?
Definition

1. lung

2. abdomen

3. urinary tract 

 

However, there is not an identifiable source 30-50% of the time!

Term
What is the most common pathogen in gram negative sepsis?
Definition

E. coli

 

others are Klebsiella, serratia, enterobacter, proteus, p. aeruginosa, h flu

 

generally requries a compromised state:  (broad sprectrum ab or integrity of GI mucosa has been compromised) 

Term
Does gram - or gram + sepsis have a higher mortality rate?
Definition
negative
Term
What are the common gram + pathogens?
Definition

S. aureus, S. epi (coag negative staph), strep pneumo, enterococcus faecalis

 

 

Term
What is coag negative staph? and what is is related to?
Definition

Staph epidermidis

 

devices -- artificial heart valves, stents, catheters 

Term
What bacteria do the cephalosporins not cover well, this lack in coverage can lead to overgrowth and gram + sepsis?
Definition
enterococcus
Term
I am in IV drug user, what bacteria should you be thinking of?
Definition
S. aureus
Term
the patient has a peticial rash, you should think:
Definition
meningicoccus
Term
What bacteria might be to blame for endocarditis?
Definition
Viridans strep, strep bovis, enterococci, staph
Term
IV catheter related, think:
Definition

CNS

s. aureus

klebsiella

enterobacter

serratia 

 

if it is tunneling, add candida!  

TPN also increases candida risk 

Term
in a burn patient one should think of: 
Definition

s. epi

s. aureus

p. aeruginosa

enterobacteriaceae

cornebacterium

Term
I forgot to take my tampon out...ooops...now these bacteria are everywhere causing toxic shock syndrome..
Definition
group A streptococci, s. aureus, clostridium
Term

What normally causes fungal sepsis?

 

what drugs may you use to treat empirically?

Definition

candida 

 

amphotericin B, voriconazole, caspofungin 

pull catheter if line infection

d/c antimicrobials if possible 

Term
If you suspect p. aeruginosa, what two drugs does Dave suggest?
Definition
cefepime or pip/tazo
Term
if you suspect enterobacter, what two drugs does DAve recommend?
Definition
AGL or FQ
Term
What should you cover if the source is unknown?
Definition
pseudo and MRSA 
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