Term
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Definition
# National Nosocomial InfectionSurveillance risk index: 1. ASA > 2; 2. Class III or IV wounds; 3. duration of operation greater than the 75 percentile for that particular procedure
# Body temp
# Blood sugar |
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Term
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Definition
# Class I (Clean): hernia repair or breast bx
# Class II (Clean/Contaminated): elective GI surgery
# Class III (Contaminated): bowel injury from trauma or inadvertent enterotomy
# Class IV (Dirty): perforated viscus or necrotizing soft-tissue infx (NSTIs) |
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Term
| Use of abx in clean cases |
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Definition
# anytime you are inserting a prosthetic device;
# should be done an hour prior to incision to ensure optimal tissue levels |
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Term
| Types of cases in which prophylactic abx are indicated |
|
Definition
| Any non-"Clean" case; when prosthetic is inserted. |
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Term
| Fever, diarrhea, vomiting, diffuse redness of the skin and hypotension less than 48 hrs after an operation followed by desquamation a day or two later |
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Definition
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Term
Toxic shock syndrome:
# offending agent
# sx
# physical exam
# treatment |
|
Definition
# S.aureus that express toxic shock syndrome toxin-1, enterotoxin B or enterotoxin C
# Fever, diarrhea, vomiting, diffuse erythema, hypotension less than 48 hrs from surgery
# exam of surgical site is unremarkable
# I&D and Abx (*** Clindamycin has anti-toxin effects/inhibits production) |
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Term
| Malignancies a/w Clostridium Septicum |
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Definition
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Term
# Bipolar safety pein-shaped, gram neg organism
# post-exposure ppx |
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Definition
# Yersinia pestis (AKA plague)
# doxy |
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Term
|
Definition
| Bronchopulmonary infection |
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Term
| Abx that exhibit synergism with gentamicin against enterococci |
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Definition
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Term
| Special toxicities of gentamicin |
|
Definition
| 8th CN and nephrotoxicity |
|
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Term
| Morphology and examples of bacteria susceptible to gentamicin |
|
Definition
| GNR, enterococcus and serratia |
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|
Term
| Special toxicity of prolonged use of Flagyl |
|
Definition
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Term
|
Definition
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Term
|
Definition
| Generalized rigidity and convulsive spasms of skeletal muscles, esp jaw and neck; intense facial spasms, AKA risus sardonicus |
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|
Term
Tetanus:
# Causative organism
# Causative agent and MOA
# Method of dx
# Treatment |
|
Definition
# Gram pos, anaerobic rod- Clostridium tetani
# Exotoxin- tetanospasmin, interferes with neurotransmitter release at peripheral motor endplates, spinal cord, brain and Sympathetic NS blocking inhibitory impulses leading to unopposed muscle spasm
# diagnosed clinically
# Supportive: human tetanus Ig, airwayprotection (trach), IV Mg and benzos for muscle spasms, high calorie nutrition |
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Term
| Bacteremia a/w colon cancer |
|
Definition
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|
Term
| Abx useful in treating MRSA |
|
Definition
| Linezolid, Synercid, vancomycin, rifampin |
|
|
Term
| Exotoxin produced by S. pyogenes |
|
Definition
| streptokinase (fibrinolytic) |
|
|
Term
| Exotoxin produced by S. aureus |
|
Definition
| hemolysin and leukocidin which damage plasma membranes and exfoliatin |
|
|
Term
| Exotoxin produced by C.perfringens |
|
Definition
| heat-labile enterotoxin that causes watery diarrhea |
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|
Term
Chloramphenicol:
# MOA
# special toxicity |
|
Definition
# inhibits protein synthesis
# aplastic anemia |
|
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Term
| Leading cause of death from liver dz in US |
|
Definition
|
|
Term
| Rates of chronic carrier states and chronic liver dz in pts with Hep C |
|
Definition
| 75-80% and 75% of those, respectively |
|
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Term
|
Definition
| Peginterferon alfa-2b plus ribavirin |
|
|
Term
| Rates of chronic carrier state in Hep B |
|
Definition
|
|
Term
| Post-exposure PPX and tx of anthrax |
|
Definition
| Cipro and Cipro/rifampin (penetrates CNS and intracellular locations)/clinda (blocks toxin production) |
|
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Term
| Natural hx of antrax infection |
|
Definition
| malaise, myalgia and fever after 1-6 day incubation period leading to chest pain, diaphoresis and respiratory distress |
|
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Term
|
Definition
| bullae, skin necrosis, gas on xray, crepitus |
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Term
|
Definition
| Aggressive hydration, broad spectrum abx, and surgical debridement and a second look debridement 12-24 hrs later +/- HBO |
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