Intra-abdominal Infections Flashcards


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1

Uncomplicated IAI

Confined to visceral structures and peritoneal cavity

2

Complicated IAI

Anatomical disruption, extends past single organ, or abscess is formed

3

Abscess:

Purulent collection of walled off fluids, separated from a surrounding tissue, filled with necrotic debris, bacteria, and inflammatory and immune cells

4

Abscesses typically occur adjacent to the site of primary diseases?

True

5

Another name for primary peritonitis:

Spontaneous bacterial peritonitis

6

SBP has an evident source in the abdomen?

False

7

SBP:

10-30% of patients with alcoholic cirrhosis, ascites

Typically a slower process to manifest symptoms

8

Secondary peritonitis:

Involves perforation of the GI tract, visceral perforation by a peptic ulcer, IBD, Appendicitis (CA-IAI)

9

Tertiary peritonitis:

Occurs in critically ill patients- persistent/recurrent peritonitis at least 48 hours after management of primary or secondary peritonitis

10

Organisms found in the stomach:

Streptococcus, lactobacillus

11

Organisms found in the small bowel

Streptococcus, enterococcus, E.coli, klebsiella, lactobacillus, diphtheroids

12

Organisms found in biliary tract

E. coli, klebsiella, or enterococci

13

Organisms found in distal ileum

E. coli, klebsiella, enterobacter, enterococci, B. fragilis, Clostridium, peptostreptococci

14

Organisms found in colon

E. coli, klebsiella, enterobacter, enterococci, B. fragilis, Clostridium, peptostreptococci, candida

15

Two cardinal symptoms of IAI?

Leukocytosis and fever

16

Diverticulitis

LLQ abdominal pain with constipation

17

Appendicitis

Sudden onset of epigastric pain, shifting to RLQ

18

Treatment goal of IAI:

SOURCE CONTROL

19

Approach to treatment for IAI:

1. Prompt surgical intervention and drainage of infected site

2. Hemodynamic resuscitation

3. Early administration of appropriate antimicrobial therapy

20

Antimicrobial therapy is curative for IAI?

False

21

What is the duration of therapy for IAI?

FOUR DAYS AFTER ADEQUATE SOURCE CONTROL

22

When should anti-microbial therapy be started?

As soon as IAI is suspected

23

What coverage do you need in IAI's?

Broadly cover aerobic and anaerobic organisms

24

Enterococcal coverage should be given in mild to moderate CA-IAI?

False- should only be given in sever CA-IAI or HA-infections

25

Which TWO candida species have to be treated with echinocandins?

Krusei and auris

26

What is the diagnostic criteria for SBP?

PMNs >250 cells/mm3

27

SBP treatment:

CTX ALONE

- Need to cover e.coli and streptococcus

28

What is the duration of therapy for SBP?

5 days