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28 Cards in this Set
- Front
- Back
Separate strep species based on hemolysis
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Alpha (partial hemolysis): S. viridins and S. pneumoniae
Beta (complete hemolysis): Strep groups A-D, F, G (groups A (S. pyogenes), B, and G are virulent) Gamma (no hemolysis): enterococci |
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T/F: Streptococcal species are normal skin flora.
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FALSE (but can be acquired)
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Infections caused by S. pyogenes (Group A Strep)
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Puerperal fever/sepsis (post-partum), Scarlet fever, Pharyngitis, erysipelas, cellulitis, impetigo
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Drug of choice for Strep
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Penicillin (if anaphylactic to PCN, macrolides; if rash, 1st generation cephalosporins)
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Who is at highest risk for Group B Strep infections?
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Neonates and pregnant women (also adults with immunosuppression)
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Listeria in an immunocompetent patient vs. immunocompromised
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Immunocompetent: gastroenteritis, fever (generally clears on its own)
Immunocompromised/neonates: septicemia/meningitis |
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What type of bacteria is often isolated from immunocompromised patients with some sort of indwelling medical device (ex: CSF shunt, catheters)?
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Micrococcus
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What is the preferred agent for empiric micrococcus treatment?
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Vancomycin
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What type of infections are commonly caused by Enterobacter?
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NOSOCOMIAL bacteremia, pneumonia (esp. early post lung transplant), SSTIs, UTIs (w/ catheter)
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Preferred treatment for Enterobacter
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4th generation cephalosporin (Cefepime) and carbapenems; or cipro
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What are the 3 main complications of pneumococcal PNEUMONIA?
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Pericarditis, empyema, lung abscess
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Why is vancomycin important in the empiric treatment of meningitis?
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In the case of penicillin resistant S. pneumoniae (would be resistant to cephalosporins like Rocephin)
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Why does dexamethasone reduce morbidity and mortality in S. pneumococcal meningitis?
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Reduces the vigorous immune reaction to the bacteria that is thought to be the cause of the most morbidity and mortality
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What is unique about pneumonia caused by R. equi?
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Usually only pathogenic in immunocompromised hosts and causes pneumonia with cavitation and abscess formation in the lung (in 50% of cases)
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What infections are commonly caused by Serratia?
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UTI, LRTI (after mechanical ventilation), bacteremia, endocarditis/osteomyelitis
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What is the most common cause of drug fever?
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Hypersensitivity
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What drug is most commonly associated with neuroleptic malignant syndrome?
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Haloperidol
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What is the definition of FUO?
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1. Temp >38.3 C (101 F)
2. > 3 wks duration of illness 3. Failure to reach dx after 1 week of inpatient investigation |
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What is the most common cause of FUO?
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Infection
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What cancers most commonly present as FUOs?
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Lymphoma and leukemia
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What is the difference between a leukemoid reaction and leukemia?
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A leukemoid reaction is a temporary excessive WBC response associated with a cause outside the bone marrow, such as sepsis.
Leukemia is a permanent and progressive leukocytosis. |
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What are the common characteristics of neuroleptic malignant syndrome?
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Rigidity, AMS, autonomic changes and hyperthermia
Also, tachycardia, tachypnea, incontinence, coma, death |
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Treatment for neuroleptic malignant syndrome
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1. Stop neuroleptics
2. Control fever/fluid support 3. Dopamine agonists (bromocriptine, amantidine), beta blockers, benzos, dantrolene (for muscle rigidity) |
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Most common complications of MRSA bacteremia
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Abscesses of abdominal viscera, brain abscesses, meningitis, septic arthritis, osteomyelitis, endocarditis
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Infectious causes of pericarditis
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1. Viral (coxsackievirus, adenovirus) - effusion may develop, constriction rare
2. Pyogenic (pneumococcus, streptococcus, staph) - effusion, adhesions, and calcification/constriction may occur 3. TB (constriction in up to 50% of cases) 4. Fungal (histo, coccidio, candida, blasto) |
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What is the most frequent viral cause of pericarditis?
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Enterovirus (coxsackievirus)
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Cardiac tamponade is more likely to occur from infectious/noninfectious causes of pericarditis.
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Noninfectious
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Treatment of pericarditis
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Bed rest, anti-inflammatories (nonsteroidal or glucocorticoid)
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