BPT Infectious Diseases Flashcards
Side effects and examples of NRTIs?
Mitochondrial toxicity: Neuropathy, myopathy, lactic acidosis, lipoatrophy, pancreatitis, hepatitis, hypersensitivity (abacavir + HLA-B5701)
E.g. lamivudine, emtricitabine, abacavir, tenofovir (LATE)
Empiric therapy for bacterial meningitis
- Benzylpenicillin (Listeria) + vancomycin (Pneumococcus) + ceftriaxone (Neisseria)
Side effects and examples of non-nucleoside reverse transcriptase inhibitors
Hypersensitivity reactions: rash, fever, hepatotoxicity, CNS disorders
E.g: efavirenz, etravirine, nevirapine, rilpivirine
Empiric therapy for infective endocarditis
- Benzylpenicillin (Strep). Flucloxacillin (Staph), Gentamicin (synergistic effect)
Side effects and examples of integrase inhibitors
Headache, fatigue, nasopharyngitis, hepatotoxicity, myalgia
E.g. Raltegravir, elvitegravir, dolutegravir
Side effects and examples of protease inhibitors
Metabolic side effects: dyslipidaemia, insulin resistance, diabetes, central fat accumulation, buffalo hump, increased MI risk. Crystal nephropathy
E.g. atazanavir, darunavir, ritonavir, lopinavir
Class and side effects of tenofovir
NucleoTide reverse transcriptase inhibitor
- Fanconi syndrome (proximal RTA - HCO / PO / Glucose loss) , osteoporosis
Class and side effects of abacavir
NRTI. SE: increased MI risk, hypersensitivity syndrome (HLA-B5701 +) risk of DRESS / DIHS; Fever, cough, dyspnoea, rash
Class and side effects of lamivudine, emtricitabine
NRTI
GI upset, rash. Dose reduction required in renal impairment
Class and side effects of dolutegravir; elvitagravir
Integrase inhibitor
Dolutegravir: insomnia, headache, hypersensitivity, elevated creatinine
Elvitagravir: diarrhoea, nausea, suicidal ideation *
Class and side effects of atazanavir, darunavir
Protease inhibitors
Both: hyperlipidaemia, buffalo hump, diarrhoea
Ata: unconj hyperbilirubinaemia, cholelithiasis/nephrolithiasis
Dar: fever, raised AST/ALT
Class and side-effects of ritonavir
Protease inhibitor
Multiple drug interactions - TCAs, CCBs, simvastatin, inhaled steroids
Inhibits: CYP3A4, 2D6, p-glycoprotein
Induces: CYP1A2, 2C8, 2C19
Staph aureus - toxin types and effects
- Panton-Valentine leukocidin: severe pyogenic skin and necrotising lung infections
- Pyogenic toxin super-antigen (TSS-1): toxic shock syndrome - rapid cytokine release
- Epidermolytic toxin A and B: scalded skin syndrome
- Enterotoxins: food poisoning
What are the ESCAPPM organisms?
Gram negative bacteria with intrinsic beta-lactamase and cephalosporinase activity - require gentamicin / meropenem. Enterobacter, Serratia, Citrobacter, Aeromonas, Proteus, Providencia, Morganella
Indications for prophylactic antibiotics before dental procedures
- Prosthetic valve or material used for valve repair
- previous infective endocarditis
- congenital heart disease (unrepaired cyanotic defects or repaired defects with prosthetic material or devices)
- Rheumatic heart disease in high-risk patients (e.g. low SES)
Which are the live attenuated vaccines?
BCG, MMR, oral polio, rotavirus, varicella / zoster, Japanese encephalitis, Yellow fever, typhoid
What is the main diagnostic test for Dengue used in QLD currently?
Dengue NS1 antigen
Sensitivity 98.5%, specificity 100%
Causes of fever in the returned traveller,
Dengue*, Influenza* Enteric fever (typhoid), yellow fever, chikungunya, rickettsial
Causes of fever in the returned traveller, 10-21 days
Malaria (falciparum), JE, Leptospirosis, Scrub typhus, Typhoid, Viral hemorrhagic fever, Trypanosomiasis, Brucellosis, Rickettsial, Q fever
Causes of fever in the returned traveller, > 21 days
Malaria (vivax, ovale), HAV / HBV / HEV, Rabies, Leishmaniasis, Amoebiasis, Tuberculosis, Schistosomiasis, HIV
Definition of MDR TB and treatment
Resistant to rifampicin and isoniazid.
Treat with aminoglycoside + moxiflox + PYR + ETH depending on sensitivities
Definition of XDR TB
Resistant to flouroquinolones, aminoglycosides, second line injectable drugs
What host genetic factors confer resistance to HIV infection?
CCR5 D32 homozygosity - resistant to infection. Heterozygosity - slower progression to AIDS.
How is treatment success measured in HIV?
Goal: virologic suppression - HIV RNA 200 copies/mL after 24 weeks or rebound to >200 after suppression.
Immunologic failure: CD4 increase 3mo on ART.
VRE: what are the differences between vanA and vanB?
vanA: typically higher MIC (higher resistance), teicoplanin resistant, more likely to transfer to other species (e.g. producing VRSA) compared with vanB
