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ID Exam 3
intra-abdominal infections
56
Anthropology
Graduate
11/06/2012

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Cards

Term
definition of intra abdominal infections
Definition
infection in peritoneal cavity or retroperitoneal space
Term
what organs make up the peritoneal cavity
Definition
stomache, small and large bowel, liver, spleen, gallbladder
Term
what organs make up the retroperitoneal space?
Definition
dueodenum, kidneys, pancrease, appendix
Term
common microflora of the stomach
Definition
strep, lactobacili
Term
common microflora of the biliary tract?
Definition
non- sterile
Term
what are common risk factros of having bacteria in the biliary tract?
Definition
>70 yrs, cholecystis, jaundice, stones
Term
what bacteria if have risk factors for bacteria are present in bilary
Definition
e coli, klebsiella, enterococci
Term
bacterria common in small bowel
Definition
strep, lactobacilli, e. coli, kelbsiella, diptheroids
Term
bacteria of the distal ileum
Definition
B. fragilis, anaerobes, enterobacter, e coli, kelbsiella, peptostrept, enterococci
Term
bacteria of the colon
Definition
bacteroides, e. coli, kelbsiella, clostridium, enterobacter, enteroocci, peptostrept
Term
what defines as complicated
Definition
when infection moved from original organ to peritoneal cavity
Term
what defines as primary?
Definition
did not disturb the integrity of the GI, monomicrobial
Term
what is the leading complication of primary
Definition
CAPD
Term
what is the primary infection due to cirrhosis
Definition
SBP
Term
what defines secondary
Definition
perforation of a hollow viscus
normally polymicrobial
Term
what defines tertiary
Definition
secondary infection not cured by ABXs
Term
is the peritoneal cavity sterile?
Definition
yes
Term
how does bacteria enter CAPD?
Definition
up catheter
Term
how does bacteria enter SBP
Definition
hematogenous
Term
what intestine diseases cna cause secodnary ?
Definition
ulcer colitis, diverticulitis, Crohn's disease_
Term
what organ diseases can cause secondary?
Definition
appendicitis, cholecystis, pancreatitis
Term
which type has a bigger immune response?
Definition
secondary
Term
what deos the immune repsonse cause a shift of?
leads to
Definition
proteins and fluid-> shock
Term
inflamm changes cause slow/fast GI motility
Definition
slow
Term
microscopic sequestration can leas to 2 things
Definition
clearence
abscess
Term
abscess formaiton is due to?
Definition
chronic inflammation
Term
where can abscesses occur?
Definition
peritoneal space
organ tissue
Term
neutrophils trapped in abscess last _ days?
Definition
3-5
Term
what oganisms habitite the most in abscesses?
Definition
anaerobes
Term
most common org for CAPD?
others?
Definition
s. aureus
strep, psuedomonas
Term
most common org for SBP?
others?
Definition
e coli
klebsiella, s. pneumonia
Term
common pathogens of community acquired secondary infections
Definition
E coli, bacteroides
Term
nosocomial infections and severe secondary infections involve?
Definition
MRSA, candida, other MDR
Term
sites w/o anaerobes
Definition
liver, spleen, gastoendual, biliary
Term
sites w/ anaerobes
Definition
appendix, intestine, abscess
Term
signs of primary infection
Definition
abdominal pain, nausea, vomiting, decreased bowel sounds
Term
sign of CAPD
Definition
cloudy effluent
Term
sign of SBP
Definition
altered mental status
Term
WBC, differential shows what for diagnosis of
CAPD:
SBP:
Definition
>50% PMNs
>250 PMNS
Term
what symptom is more common in severe?
Definition
fever
Term
if you have shock what are you classifiede as?
Definition
secondary
Term
non ABX treatment
Definition
fluids
address shock if needed
Term
what infection do you sue source control for
Definition
secondary
Term
def of source control
Definition
draingin of abscess or surgical repair of organ
Term
what is the point to remember for secondary ABX
Definition
start immediatley after diagnosis
Term
are single as good as combos?
Definition
yes
Term
what meds cna be mixed into dialysis bags
Definition
vancocin, AGs, Cephs
Term
avoid co administration of what ABXs?
Definition
AGs and penicillins
Term
what med do you avoid in intrabdominal bc of e. coli?
Definition
amp/sulb
Term
what meds do you not use bc of b. fragilis?
Definition
cefotetan
clindamycin
Term
what do you avoid using bc of toxicity
Definition
AGs
Term
For abscess:
bacteria shift to stationary- what meds are bad now?
Definition
active bacterial wall agents
Term
for Abscess:
decrease in bloodflow
-what meds are bad now?
Definition
conc dependent
Term
if abscess changes pH to acidic what med is not good now?
Definition
AG
Term
what is often need for abscess
Definition
draingage
Term
for abscess therapy what do you need to watch for?
Definition
appropiate BAX
Appropoate source control
resistance
superinfection
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