NURO 670 Final - Infections
Exam Study Guide
what's in a UA? what does it mean? - Answer WBCs - >5 WBCs = infection
RBCs - infection, trauma, cancer
leukocyte esterase - byprod of WBC
nitrites - infection w/ gram negative rods (reducing nitrate to nitrite)
protein - renal impairment (htn, basement membrane dysfunction)
casts - prod by DCT, renal parenchymal disease
what do counts mean in a urine culture? - Answer >100,000 = infection
>10,000 in women = potentially acute cystitis
-always obtain W/ UA
colonization vs infection ? - Answer colonization - common/benign, does not always
need tx
infection - need tx
what do you do when CVC is colonized? - Answer take it out. need to find out if true
bacteremia vs. line infection.
when is the best time to get blood cultures? whats the best way to do it? - Answer -1 hr
before temperature spikes if you have a crystal ball.
-before abx administration.
-a-lines ok due to less stagnant.
-always draw from newest CVC.
-don't draw >3 cultures in 24hrs.
common bugs for CAP - Answer pneumococcus
haemophilus
mycoplasma
streptococcus
, (viruses - 20% of all cases)
common bugs for nosocomial PNA - Answer resistant organisms + ESBLs
presence on WBCs on BALs/sputum cultures mean what? - Answer important indicator
of immune response; should have WBCs with the infection
how to best get sputum cultures? intubated vs non-intubated - Answer nonintubated -
spit/rinse before cough. *epithelial cells = contaminated
intubated - get w/ BAL or discard first portion of aspirate. avoid saline.
how to get sputum culture for TB? - Answer first thing in AM - specimen x3days
AFB = results in 24hrs.
PCR = results in hours
liquid (BACTEC) = 10-14days
solid media = 6-12wks
common causes of diarrhea from community? - Answer ova/parasites
protozoa (giardia, entamoeba histolytica)
stool culture - salmonella, shigella, campylobacter, E coli
fecal leukocytes and occult blood - define - Answer fecal leukocytes - infection/immune
response within stool
occult blood - can be from irritation from infection
common causes of diarrhea in inpatients? how to dx? - Answer C diff!
-only one sample per day
-if antigen (-) = NO CDIFF
-if antigen (+) = need test for Cdiff toxin.
*if HIV = test for CMV, crytosporidium, mycobacterium avium
MIC vs MBC - define - Answer MIC - min inhibit conc.
= lowest conc of drug that will inhibit growth
MBC - min bactericidal conc
= lowest conc of drug that kills bacteria
classifications of sensitivity reporting - Answer sensitive
Exam Study Guide
what's in a UA? what does it mean? - Answer WBCs - >5 WBCs = infection
RBCs - infection, trauma, cancer
leukocyte esterase - byprod of WBC
nitrites - infection w/ gram negative rods (reducing nitrate to nitrite)
protein - renal impairment (htn, basement membrane dysfunction)
casts - prod by DCT, renal parenchymal disease
what do counts mean in a urine culture? - Answer >100,000 = infection
>10,000 in women = potentially acute cystitis
-always obtain W/ UA
colonization vs infection ? - Answer colonization - common/benign, does not always
need tx
infection - need tx
what do you do when CVC is colonized? - Answer take it out. need to find out if true
bacteremia vs. line infection.
when is the best time to get blood cultures? whats the best way to do it? - Answer -1 hr
before temperature spikes if you have a crystal ball.
-before abx administration.
-a-lines ok due to less stagnant.
-always draw from newest CVC.
-don't draw >3 cultures in 24hrs.
common bugs for CAP - Answer pneumococcus
haemophilus
mycoplasma
streptococcus
, (viruses - 20% of all cases)
common bugs for nosocomial PNA - Answer resistant organisms + ESBLs
presence on WBCs on BALs/sputum cultures mean what? - Answer important indicator
of immune response; should have WBCs with the infection
how to best get sputum cultures? intubated vs non-intubated - Answer nonintubated -
spit/rinse before cough. *epithelial cells = contaminated
intubated - get w/ BAL or discard first portion of aspirate. avoid saline.
how to get sputum culture for TB? - Answer first thing in AM - specimen x3days
AFB = results in 24hrs.
PCR = results in hours
liquid (BACTEC) = 10-14days
solid media = 6-12wks
common causes of diarrhea from community? - Answer ova/parasites
protozoa (giardia, entamoeba histolytica)
stool culture - salmonella, shigella, campylobacter, E coli
fecal leukocytes and occult blood - define - Answer fecal leukocytes - infection/immune
response within stool
occult blood - can be from irritation from infection
common causes of diarrhea in inpatients? how to dx? - Answer C diff!
-only one sample per day
-if antigen (-) = NO CDIFF
-if antigen (+) = need test for Cdiff toxin.
*if HIV = test for CMV, crytosporidium, mycobacterium avium
MIC vs MBC - define - Answer MIC - min inhibit conc.
= lowest conc of drug that will inhibit growth
MBC - min bactericidal conc
= lowest conc of drug that kills bacteria
classifications of sensitivity reporting - Answer sensitive
