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17 Cards in this Set
- Front
- Back
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what is the function of B lymphocytes
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humoral immunity - this is why patients may have chicken pox a 2nd time or be succeptible for encapsulated bacteria such as H. influenza
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what are the T cells
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Tc - cytotoxic
Th - activate B cells and Tc Ts - suppress intensity of immune response |
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what is the definition of neutropenia
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neutrophil count <500
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what temperature ranges would immediately classify a patient as having neutropenic fever
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temp >38.3 C (104F)
temp >= 38 C (100.4) for at least an hour 3 readings of a temp >= 38 C (100.4) in a 24 hr time period |
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what is the equation for ANC
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ANC = total WBC count * (%neutrophils)
% neutrophils = PMNs + Bands |
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what are the gram positive organisms commonly seen
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S. aureus
S. viridans Enterococcus (E faecalis, E facecium) |
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what are the gram negative organisms commonly seen
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P aureginosa
S maltophilia Enterobacter Serratia Citrobacter E. Coli Klebsiella |
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what are low risk patients
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neutropenia expected to resolve in 7-10 days
no comorbidites no infection |
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what is the treatment regimen for low risk patients
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ciprofloxacin + amox/clav
ciprofloxacin + clindamycin if allergic to PCN |
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what are High risk patients
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profound neutropenia (neutrophils <100)
neutropenia expected to last > 7 days comorbid conditions (hypotension etc) |
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what drugs can be used for single drug therapy (all have coverage over gram - and p. aureginosa)
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meropenem
imipenem cefepime pipercillin/tazobactam aztreonam ceftazadime (no gram+ coverage) |
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what drugs are used in combo therapy with aminoglycosides
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aminoglycoside (amikacin, tobramycin, gentamicin) + meropenem, cefepime, ceftazidime, imipenem, pipercillin/tazobactam, aztreonam
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what drugs are used in therapy with floroquinolone
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FQ: ciprofloxacin, levofloxacin + cefepime, ceftazidime, pipercillin/tazobactam, meropenem, imipenem
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what drugs are used in VRE treatment
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linezolid
daptomycin tigecyclin dalfopristin/quinopristin |
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if a pt presents with a fever > 38.3 + neutropenia (<500 neutrophils) and is a low risk pt what PO treatment do they receive
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ciprofloxacin + amox/clav
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if a pt presents with a fever > 38.3 + neutropenia (<500 neutrophils) is a high risk pt and vanc is not needed, what are the one drug and two drug regimens they could receive
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one drug:
cefepime ceftazideme pipercillin/tazobactam carbopenem two drug cefepime ceftazideme pipercillin/tazobactam carbopenem + aminoglycoside (amikacin, tobramycin, gentamicin) |
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if a pt presents with a fever > 38.3 + neutropenia (<500 neutrophils) is a high risk pt and vanc is needed
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vancomycin
+ cefepime ceftazidime pipercillin/tazobactam carbopenem + aminoglycoside (amikacin, tobramycin, gentamicin) |
