MEDICATIONS AND TREATMENT

Heat (70 °C)

What physical method is used to kill Staphylococcus aureus?

Normal disinfectant chemicals (e.g., 3% hexachlorophene, medical grade disinfectants)

What substances are used, with proper cleaning, to kill Staphylococcus aureus?

Biosafety standards

What practices are important in hospital settings, especially with MRSA, to prevent the spread of Staphylococcus aureus?

Antimicrobials

What general class of substances are Staphylococcus species susceptible to, though resistance can develop?

Nasal antibiotics

What type of antibiotic is given to nasal carriers of S. aureus (including MRSA) to control spread?

Daily chlorhexidine wipes

What hygiene practice is recommended for patients who are nasal carriers of S. aureus to control its spread?

Drainage (incision and drainage of abscesses)

What is the primary treatment for abscesses caused by Staphylococcus, often requiring multiple incisions to be effective?

Antimicrobial therapy

What general therapy is used for Staphylococcus infections?

Supportive care

What general care is provided for Staphylococcus food poisoning and other non-invasive illnesses caused by toxin release?

Cleanliness, hygiene, and aseptic management

What practices are important in hospital and clinical settings to control the ubiquitous Staphylococcus species?

Penicillin

What is the drug of choice for rheumatic fever and other Streptococcus infections, as the bacteria has not yet developed antimicrobial resistance to it?

Elimination of carriers

What control measure is prioritized for Streptococcus infections to prevent reinfection and continuous spread?

Chemoprophylaxis guidelines

What guidelines are used for cases of recurring strep throat?

Anti-streptokinase (as IV bolus)

What antigenic substance can be given as an IV bolus to treat pulmonary embolism and coronary artery thrombosis by lysing clots?

Enzymatic cleaning of pus/abscess (using Deoxyribonuclease/Streptodornase)

What use does the enzyme Deoxyribonuclease have, by thinning pus viscosity?

Vaccines (capsular polysaccharide-based)

What prophylactic measure is used for S. pneumoniae to induce antibody production against specific serotypes?

Optochin test

What antimicrobial susceptibility test differentiates Streptococcus pneumoniae (sensitive) from Streptococcus viridans (resistant)?

Bacitracin test

What antimicrobial susceptibility test differentiates Group A Streptococcus pyogenes (sensitive) from Group B Streptococcus agalactiae (resistant)?

Multi-drug approach

What treatment strategy is often needed for Enterococcus spp. infections due to their wide antimicrobial resistance?

Penicillin, Ampicillin

What are the recommended treatments for Streptococcus gallolyticus?

Antimicrobials

What is the general treatment for Bacillus anthracis infections?

Vaccine (unencapsulated bacteria with Protective Antigen)

What active immunization measure contains unencapsulated bacteria with PA and is used against Bacillus anthracis?

Human recombinant antibody

What experimental treatment for Bacillus anthracis is not FDA approved but can be acquired from the CDC, noted under "agents of bioterrorism"?

Antitoxin

What specific medication is used for Clostridium botulinum intoxication, although it is not widely available?

Supportive care (Mechanical ventilation, 100% hyperbaric oxygen)

What are key supportive measures for Clostridium botulinum intoxication, especially for respiratory paralysis?

Monitoring home canning

What prevention measure is recommended for Clostridium botulinum contamination?

Thorough cooking (100°C for 20 minutes)

What heat treatment for food can kill Clostridium botulinum toxins?

Discontinue antibiotics

What is the first step in treating antibiotic-associated diarrhea or pseudomembranous colitis caused by Clostridium difficile?

Vancomycin (oral)

What specific oral antibiotic is administered to kill Clostridium difficile?

Metronidazole

What specific antibiotic is administered to kill Clostridium difficile?

Fecal transplantation

What innovative procedure involves transplanting feces into the colon via endoscopy to restore normal flora, used for Clostridium difficile infection?

Antimicrobials

What is the general treatment for Listeria monocytogenes infections?

Giving lymphocytes

What type of immune cells can be given to patients with Listeria infection, as antibodies are ineffective due to the intracellular nature of the infection?

Tetanus toxoid

What inactivated tetanus toxin is used for active immunization against tetanus?

Tetanus immunoglobulin (IG)

What preformed antibodies are given for instant but temporary passive protection against tetanus?

Diuretic

What drug, used in hypertension treatment, lowers the stroke volume (SV)?

Beta Blocker

What drug, used in hypertension treatment, lowers the heart rate (HR)?

ACE Inhibitors and Angiotensin Receptor Blockers (ARB)

What drugs, used in hypertension treatment, lower systemic vascular resistance (SVR)?

IV lines and fluids or blood

What are interventions used to increase preload in shock patients?

Inotropes and vasopressors

What drugs are given to patients with failing hearts (e.g., from MI) to improve contractility?

Oxygen administration (Ventilate)

What is the "V" in the VIP mnemonic for resuscitation?

Fluid resuscitation (Infuse)

What is the "I" in the VIP mnemonic for resuscitation?

Vasoactive agents (Pump)

What is the "P" in the VIP mnemonic for resuscitation?

Life-saving measures (Salvage phase)

What are performed in the initial phase of shock treatment to obtain a minimal acceptable blood pressure?

Organ support (Stabilization phase)

What is provided in the stabilization phase of shock treatment to minimize complications?

Weaning from vasoactive agents and achieving negative fluid balance (De-escalation phase)

What are the goals in the de-escalation phase of shock treatment?

Escalation-de-escalation strategy

What modern approach to shock treatment involves giving multiple treatments simultaneously at the start and then weaning them off as the patient gets better?

Hemorrhage control

What is the primary management for blood loss in hypovolemic shock?

Blood replacement

What is necessary to restore volume lost in hypovolemic shock, with the amount estimated by shock classification?

Emergency angioplasty

What intervention is performed for cardiogenic shock to open blocked coronary arteries and restore perfusion, often rushing the patient to the cardiac catheterization laboratory?

Pericardiocentesis

What procedure is undergone to relieve cardiac tamponade, involving ultrasound-guided removal of pericardial fluid?

Draining the pneumothorax

What is the treatment for tension pneumothorax, involving procedures like using a butterfly and cup of water or a chest tube?

Puncturing the rib below the chosen intercostal space then sliding the needle above the rib

What technique is used to safely puncture the lung for draining, avoiding the Vein-Artery-Nerve (VAN)?

Hour-1 Bundle

What is the most important treatment for septic shock?

Measurement of Lactate Levels (baseline and remeasure after 6 hours)

What is Step 1 of the Hour-1 Bundle to assess resuscitation adequacy?

Obtainment of Blood Culture (before antibiotics)

What is Step 2 of the Hour-1 Bundle to increase diagnostic yield?

Administration of Broad-Spectrum Antibiotics

What is Step 3 of the Hour-1 Bundle for unknown organisms, covering Gram-positive and Gram-negative bacteria?

Rapid Administration of Fluids (30 mL/kg crystalloid)

What is Step 4 of the Hour-1 Bundle to relieve hypotension for lactate ≥ 4 mmol/L?

Application of Vasopressor (if hypotension persists, target MAP ≥ 65 mmHg)

What is Step 5 of the Hour-1 Bundle for septic shock?

Norepinephrine

What is the drug of choice for septic shock to maintain mean arterial pressure?

Hydrocortisone

What corticosteroid plays a role in maintaining perfusion in septic shock?

Vasopressin

What hormone, along with norepinephrine and hydrocortisone, helps maintain perfusion in septic shock?

Control the source (of infection)

What is a key management strategy for septic shock?

Antimicrobials

What are administered early in septic shock to improve survival rates?

High-quality CPR (Chest compressions and rescue breaths)

What is the cornerstone of care to optimize outcome in cardiac arrest, delivered at a 30:2 ratio for adults?

Defibrillation (with AED)

What intervention is delivered to treat ventricular fibrillation and improve survival rates in cardiac arrest?

Advanced Life Support (ALS)

What advanced care must be given within 8 minutes of cardiac arrest to avoid brain death?

Surveying the scene

What is the initial step in BLS to ensure safety?

Calling emergency services

What is done after observing absent or abnormal breathing in BLS?

Head tilt, chin lift

What maneuver is used to open the airway in BLS, unless spinal injury is suspected?

Jaw thrust

What maneuver is used to open the airway when spinal injury is suspected, requiring spine stabilization?

Look, listen, and feel (LLF)

What method is used to check for breathing in BLS, though deemphasized for lay people due to potential delays?

Rescue breaths (2 breaths, 1 second/breath)

What are given after 30 chest compressions in adult CPR?

Hands-only CPR

What type of CPR is performed if untrained, unable to give rescue breaths, or in suspected COVID-19 cases?

Automated External Defibrillator (AED)

What device is used to analyze heart rhythm and deliver an electrical shock if advised for ventricular fibrillation?

Powering on AED

What is Step 1 in using an AED, activating voice prompts for guidance?

Attaching electrode pads (upper-right chest, left of nipple/armpit)

What is Step 2 in using an AED, placed on the bare chest?

Clearing the victim and analyzing rhythm

What is Step 3 in using an AED, where no one should touch the victim for 5-15 seconds?

Delivering shock (if advised)

What is Step 4 in using an AED, ensuring safety before pushing the button?

Immediately resuming CPR (30:2)

What is done after the AED delivers a shock, starting with chest compressions?

Continuing CPR (if no shock advised)

What is done after AED analysis if no shock is advised, until advised otherwise?

Not interrupting resuscitation

What is the rule for CPR until a health professional tells you to stop, the victim is definitely waking up/moving/breathing normally, or you become exhausted?

Recovery Position

What position is an unresponsive but normally breathing victim placed in?

Doffing of PPE

What crucial process is observed after resuscitation in COVID-19 cases to avoid contamination, being more dangerous than donning?

Putting a mask on the patient and rescuer, wearing full PPE (N95, goggles, face shield, gown, double gloves, hair cap, booties)

What are self-protection measures for CPR in suspected or confirmed COVID-19 cases?

Continuous chest compressions while on mechanical ventilator (SIMV or AC mode, FIO2 1.0, BUR 10-12)

What is performed if a COVID-19 patient is on a mechanical ventilator during CPR?

Early intubation

What is considered if a COVID-19 patient is not on a mechanical ventilator during CPR, followed by hooking to MV?

Burr hole

What surgical procedure is done to relieve intracerebral pressure caused by a brain hematoma?

Tissue plasminogen activator (t-PA)

What counterregulatory mechanism limits the hemostatic plug by lysing fibrin, and is also used therapeutically in MI and ischemic stroke?

Thrombomodulin

What endothelial molecule binds thrombin, converting it into an anticoagulant that activates Protein C, thus blocking the coagulation cascade?

Heparin-like molecules

What cofactors on endothelial surfaces interact with antithrombin III to inactivate thrombin and other coagulation factors?

Protein C

What protein, when activated by the thrombin-thrombomodulin complex, inhibits clotting by proteolytic cleavage of factors Va and VIIIa?

Adenosine diphosphatase

What enzyme degrades ADP, thereby inhibiting platelet aggregation?

Unfractionated heparin

What anticoagulant therapy can be used to prevent coronary artery clot propagation in MI?

Low molecular weight heparin

What anticoagulant therapy can be used to prevent coronary artery clot propagation in MI?

Direct thrombin inhibitors

What anticoagulant therapy can be used to prevent coronary artery clot propagation in MI?

Factor X inhibitors

What anticoagulant therapy can be used to prevent coronary artery clot propagation in MI?

Prothrombin Time (PT) test

What lab test assesses the extrinsic pathway by adding tissue factor and phospholipid to citrated plasma?

Sodium citrate

What chemical chelates calcium and prevents spontaneous clotting in PT and PTT tests?

Partial Thromboplastin Time (PTT) test

What lab test screens the intrinsic pathway by adding negatively charged particles, phospholipids, and calcium to citrated plasma?