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32 Cards in this Set
- Front
- Back
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What are the top 4 noscomial infection sites?
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1) Urinary Tract
2) Surgical Site 3) Lung 4) Blood stream |
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What are the main organisms that cause surgical site noscomial infections?
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Gram + skin colonizers
1) S. aureus 2) CNS 3) enterococcus |
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What organisms cause noscomial pneumonia?
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S. Aureus (outlier)
GRAM NEGATIVES (pseudomonas, actinobacter, enterobacter, klebsiella |
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How can noscomial pneumonia be prevented?
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raise head of bed, avoid antacids, sedation vacation, reduce use of ventilators
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What are the risk factors for noscomial bloodstream infection?
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CVC USE!!
young or old age, malnutrition, IS therapy, loss of skin (burn), long stay at hospital |
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What organism causes lyme disease?
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borrelia burgdorferi
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what organism causes babesiosis?
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babesia microti
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what organism causes granulocytic anaplasmosis
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anaplasma pagocytophilum
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what organism causes RMSF?
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rickettsia rickettsii
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What is the distribution of Lyme Disease? What are its vectors associated with the area?
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Western Seaboard: blacklegged tick
East Coast, Great Lakes: deer tick *nymph is resp. for most disease |
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How long must a tick attach to spread Lyme dx? why?
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at least 24 hours: to upregulate specific virulence genes to allow transmission from the tick into blood
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What are the primary stage sx of lyme dx?
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constitutional symptoms, erythema migrans occuring days to weeks after the bite
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What is the secondary stage sx of lyme dx?
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weeks post bite reflecting dissemination
dermatologic: EM at diff site Cardiac: AV block Neurologic: bell's palsy, meningitis |
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What are the tertitary sx of lyme dx?
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months post bite:
Migratory Arthritis Neuroborreliosis (memory, confusion, peripheral neuropathy etc) |
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What are the steps in diagnosing Lyme Dx?
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1) Rash-is a clinical Dx!!
2) Elisa (if positive, confirm) 3) Immunoblot *works similar to HIV testing |
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When do you need to use IV cetftriaxone (instead of doxycycline) to treat Lyme Disease?
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Meningitis, cardiac manifestation, recurrent arthritis
(3-4 week duration with these sx) |
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What is the distribution of babesiosis
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Same as Lyme disease: western seaboard and east coast, this makes coinfection very common!. *ALSO BY TRANSFUSION
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What is the lab dx of babesiosis?
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low Hg and platelets, evidence of hemolysis, blood smear shows intraerythrocytic ring fomrs, resembling malaria parasites
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What is the treatment of babesiosis?
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Atovaquone and azithromycin or quionine plus clindamycin. NOT similar to lyme disease, so consider testing for both
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Where do anaplasmosis and ehrlichiosis infect?
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WBC
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What are the distributions of HGA and HME?
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HGA: same as lyme: western seaboard and eastern USA
HME: South east corner of USA |
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What are the clinical manifestations of HME/HGA (they are the same)
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fever, HEADACHE, myalgias, dry cough, rash
labs: leukopenia, elevated LFT, morulae |
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Where are RMSF cases found
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have been reported in almost al states, most cases are in midwest and southeastern states
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What are the sx of RMSF
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fever, N/V, headache, myalgia,
rash (macular or petichial) late sx: abdominal pain, joint pain, diarrhea |
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Most tick-associated infections are treated with...?
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doxycycline (exception is babesiosis)
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(tick borne diseases)
Failure to treat early with doxycycline is associated with high mortality rate in patients with... |
RMSF
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If a patient has an EM what test do you need to do next?
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NONE
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Ixodes scapularis (deer tick) can transmit what organisms
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borrelia burgdorferi
anaplasma phagocytophilum (HGA) babesia microti *same distrubution *consider co-infections |
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What are the signs of LV enlargement?
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PA: apex down and out
Lateral: LV projects out greater than 2 cms behind the IVC |
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What are the signs of LA enlargement?
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double density sign as the left atrium elevates the left mainstem bronchus
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What are signs of RV enlargement?
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Boot shaped heart
lateral: right ventricle will fill in the retrosternal clear space |
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What are signs of RA enlargement?
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Prominent right border
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