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absite infxn

QuestionAnswer
what pathogens are in stomach? How many? virtually sterile, some GPC and yeast
what pathogens are in sm bowel? How many? 10^5, mostly GPCs
what pathogens are in distal sm bowel? How many? 10^7, GPCs, GPR, GPCs
what pathogens are in colon? How many? 10^11, almost all anaerobes, some GNRs, GPCs
MC anaerobe GI Bacteroides fragilis
MC aerobe in GI e coli
MC GN sepsis E coli
name toxins in E coli sepsis Endotoxin lipopolysacc lipid A released, triggers TNF from macrophages->complement and coag cascade
what happens to blood glucose before/during sepsis incrsd, at first due to impaired utilization, then due to insulin resistance
when do abscesses appear 7-10 d s/p surgery
types of bac in abscesses all have anaerobe, 80% have aerobes
tx abscess drainage, but add Abx if DM, cellulitis, bioprosthetic implants, s/s sepsis, F, WBC
rate of wound infxn clean surgery, ex hernia, 2%
rate of wound infxn clean contaminated, ex elective colon resxn w prep, 5%
rate of wound infxn contaminated surgery, ex gun shot bowel, 5-10%
rate of wound infxn grossly contaminated surgery, ex abscess, 30%
MC organism in surgical wound S aureus
MC GNR in surgical wound infxn E Coli
MC non surgical infxn s/p surgery UTI
3 MC organism line infxn Staph Epi, #2 S aureus, #3 yeast
how many CFU mean line infxn 15
when can necrotizing fascitis appear within hrs s/p surgery
MC causes nec fascitis Grp A strep (Strep Pyo), C perfringens
what 3 grps at risk for nec fasc DM, immunocomp, poor blood supply
what lab work see in nec fascitis WBC>20, hypoNa
key findings physical exam nec fascitis thin gray drainage, edema, skin blistering/sloughing, crepitus/soft tissue gas,
tx nec fascitis debridement and PCN
what's fournier's gangrene, what pts get it, and what organisms perineal and scrotal area in DM and immunocompromised. Mixed organisms
is nocardia a fungus? Tx? no, bactrim
where is histo found? Cocci? Tx? histo in Mississippi and Ohio river valleys, tx both amph for severe infxn
tx candida flucanazole, amph for severe
where does cryptococc infect? Tx? neuro (meningitis), amph for severe [remember cryptospor is parasite causing diarrhea]
diagnosis for SBP 500PMN/cc (another place says 250); note cx often negative
if monobac what SBP 2 org MC? E Coli, Strep
tx SBP ceftriax
ppx SBP fluoroquin
if SBP not improving on Abx, then think intrabd source, ie perf diverticular abscess
what's 2ry SBP, organisms intrabd source (transmucosal migration, perf as opposed to decrsd host defense); polymicrob (B Fragilis, E Coli, Enterococc)
risk HIV transmission if + blood transfusion? + mother? Needle stick? 70%, 30%, 0.3%
what give for HIV exposure and when AZT, lamivudine 1-2 hrs
seroconversion in HIV 6-12wks
MC cause GI complaints HIV CMV colitis
where does lymphoma appear in HIV, MC type and tx stomach, B cell NHL, tx w chemo
is upper or lower GI bldg more common in HIV lower
MC 2 causes upper GI bleeding in HIV Kaposi, lymphoma
MC 3 causes lower GI bleeding hiV CMV, bac, HSV
how commonly does HepC become chronic 60%
how often does cirrhosis develop in hep C over how long; what can help prevent that 15% over 20yrs; IFN
how often HCC in HepC 1-5%
tx for brown recluse spider bite dapsone
3 MC organisms septic joint Gono, Staph, H Flu
empiric tx septic joint until cx Cephalo and vanc until cx
organisms in DM foot infxns mixed: staph, strep, GNR, anaerobe
tx DM foot infxn Unasyn, Zosyn
organism in cat/dog bite, tx Pasteurella multocida, augmentin
organism in human bite, tx Eikenella, augmentin
bug for impetigo, erysipelas, cellulitis, folliculits Staph, strep
bug in furuncle, tx Staph Epi or Staph Aureus, drain and Abx
2 MC bug in peritoneal dialysis cath infxn Staph Epi or Aureus, can also be fungal which is hard to tx
tx peritoneal dialysis cath infxn intraperitoneal vanc and gen
Created by: ehstephns on 2013-01-21



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