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44 Cards in this Set

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what is the most common cause of immune deficiency?
Malnutrition
which organism is most commonly responsible for gram-negative sepsis?
E. coli
which endotoxin is most commonly responsible for sepsis?
Lipid A
what is the role of the endotoxin Lipid A in sepsis?
lipid a causes release of TNF alpha from macrophages
endotoxin lipid a is part of which component of gram-negative bacterial membranes?
It is part of the lipopolysaccharide LPS of gram-negative bacterial membranes
what is the LPS receptor?
CD 14
what is the other noteworthy portion of lipopolysaccharide, LPS?
O antigen polysaccharide sidechain, which is the major surface antigen of gram-negative bacteria and therefore the major determinant of antigen specificity
why do we get hyperglycemia just before patient becomes clinically septic?
Due to impaired glucose utilization
what is the most common bacteria in central line related infections?
Staph aureus
which organisms are responsible for necrotizing infections seen just hours postoperatively?
Beta hemolytic streptococcus (group A) and Clostridium perfringens due to exotoxins
which exotoxin is responsible for gas gangrene associated with Clostridium perfringens?
Alpha toxin, a hemolytic lecithinase exotoxin
what CBC and electrolyte abnormalities are typically associated with soft tissue necrotizing infections?
White blood cell count greater than 20,000 and hyponatremia
which organism is responsible for Fournier's gangrene?
it is usually caused by mixed organisms
what is the effect of Clostridium difficile exotoxin?
Colitis
what is the effect of Clostridium botulinum exotoxin?
G.I. symptoms, diplopia, dysphasia, and paralysis
what is the treatment of Clostridium difficile infection?
Oral Flagyl or vancomycin, or IV Flagyl
what is the effect of Clostridium tetani exotoxin?
muscle rigidity and spasms
what bacterial count is needed to diagnose a wound infection?
>10 to the fifth bacteria
what is the most common gram-negative bacteria in surgical wound infections?
E. coli
what is the most common organism overall in wound infections?
Staph aureus
what is the most common anaerobic in wound infections?
Bacteroides
what is the most common nonsurgical hospital infection?
Urinary tract infection
what is the most common infectious cause of post operative death?
Pneumonia
what is the most common single organism in the ICU pneumonia?
Staph aureus
what is the most common class of organisms in ICU pneumonia?
Gram-negative organisms
what should be suspected if a patient on appropriate antibacterials does not improve?
Fungal infection
what is the treatment for a brown recluse spider bite?
Dapsone initially, may need local resection if large ulcer
what are the most common organisms involved in septic arthritis?
Neisseria gonorrhea, staph aureus, and Streptococcus
what are the most common organisms involved in peritoneal dialysis catheter infections?
Staff and Streptococcus
what is the treatment of peritoneal dialysis catheter infections?
intraperitoneal antibiotics. If there is peritonitis lasting more than five days need to remove the catheter
what is the most common cause of spontaneous bacterial peritonitis SBP?
Decreased host defenses not transmucosal migration
how is the diagnosis of SBP made?
PMN >500 cells per cc in the ascites fluid. cultures of the ascites fluid are not sensitive as they are often negative
a decrease in which component of the ascites fluid is associated with increased risk for SBP?
Low ascites protein content less than 1 g/dL is associated with an increased risk for SBP
what is the next step in SBP that does not improve despite antibiotic therapy?
Look for a source of infection such as an abscess or bowel perforation
what is the most common sequela of hepatitis C infection?
Chronic hepatitis in 60% of patients, followed by cirrhosis and 15% of patients, and lastly hepatocellular carcinoma in 1 to 5% of patients
when does seroconversion after HIV exposure occur?
1 to 3 months post exposure
which medications decrease the risk of seroconversion and when should they be given?
AZT and Lamivudine decrease the risk of seroconversion, but need to be given with in 1 to 2 hours post exposure
what is the most common cause for laparotomy in HIV patients?
Opportunistic infections, CMV the most common, followed by neoplastic disease, gastric lymphoma most common
what are the most common causes of upper G.I. bleed in HIV patients?
Gastric lymphoma and Kaposi's sarcoma
what are the most common causes of lower G.I. bleed in HIV patients?
CMV colitis and rectal lymphoma
when should PCP prophylaxis be started in HIV patients?
CD4 count less than 200 or in the presence of oral thrush
what medications are given for PCP prophylaxis?
Oral Bactrim or aerosolized pentamidine in patients with sulfa allergies
what is the most common organism in human bites?
Eikenella
what is the most common organism in cat and dog bites?
Pasteurella Multocida