Bugs & Drugs Flashcards

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1
Q

hemolytic anemia associated with G6PD deficiency can present with _______

A

fatigue and scleral icterus (yellow in eyes) with elevated lactate dehydrogenase and total bilirubin

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2
Q

patients with G6PD deficiency are susceptible to developing ____ when they are exposed to ____ drugs

A

hemolysis when they are exposed to oxidizing agents such as sulfonamides like sulfamethoxazole

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3
Q

trimethoprim and pyrimethamine mechanism

A

inhibits dihydrofolate reductase (folate synthesis need for DNA)

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4
Q

sulfonamides and dapsone mechanism

A

inhibits dihydropteroate synthase (folate synthesis needed for DNA)

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5
Q

aminoglycosides are commonly associated with what side effects?

A

ototoxicity (high frequency hearing loss) and nephrotoxicity

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6
Q

tetracyclines toxicity includes:

A

tooth discoloration, photosensitivity reactions and inhibition of bone growth in children

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7
Q

flouroquinolone toxicity includes:

A

achilles tendonitis

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8
Q

macrolides toxicity includes:

A

acute cholestatic hepatitis, eosinophilia and skin rashes

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9
Q

what are the aminoglycosides?

A

30s ribosomal subunit against gram negative rod infections. Cannot treat anaerobes bc requires O2 for uptake
“GNATS”
gentamicin, neomycin, amikacin, tobramycin, streptomycin

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10
Q

when combined with alcohol, ____ causes a disulfiram-like “hangover” reaction

A

metronidazole
buildup of acetylaldehyde

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10
Q

what are the fluoroquinolones?

A

end in “floxacin”
inhibit topo 2 (DNA gyrase)
bactericidal
against gram negative rods of urinary and GI tracts (including pseudomonas)

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10
Q

symptoms and treatment of trichomonas vaginitis

A

frothy, yellow-green foul smelling discharge. pear shaped trichomonads
metronidazole

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10
Q

symptoms and treatment of candida vulvovaginitis

A

thick, white, “cottage cheese” discharge.
pseudohyphae
treat with azoles

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11
Q

how does metronidazole work?

A

forms toxic free radical metabolites in the bacterial cell that damage DNA
bactericidal and antiprotozoal

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12
Q

what is the mechanism of resistance to aminoglycosides?

A

inactivation via enzymatic modification like acetylation, phosphorylation, adenylation etc.

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13
Q

what is the mechanism of resistance for vancomycin?

A

amino acid modification of D-Ala-D-Ala to D-Ala-D-Lac

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14
Q

what is the mechanism of resistance for penicillins?

A

structural change in transpeptidases (PBPs = penicillin binding proteins)

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15
Q

what is the mechanism of resistance against macrolides?

A

methylation of 23S rRNA-binding site to prevent the drug from binding

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16
Q

what are the penicillinase-resistant penicillins?

A

dicloxacillin, nafcillin, oxacillin

use “Naf” for staph! (except MRSA)

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17
Q

what is the mechanism for penicillinase-resistant penicillins?

A

similar to penicillin but has a narrow spectrum. Penicillinase resistant because bulky R groups block access of beta-lactamase to beta-lactam ring

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18
Q

aspergillus fumigatus

A

branching of septate hyphae, catalase positive
immunocompromised patients can get aspergillomas after TB infection
treat with voriconazole or echinocandins (2nd line)

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19
Q

cryptococcus neoformans

A

narrow budding, heavily encapsulated yeast. can see clear halo with india ink
found in soil and pigeon droppings

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20
Q

sores on penis can indicate ____

A

syphillis, confirm diagnosis with flourescent treponemal antibody test. treat with penicillin G

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21
Q

how do macrolides work?

A

inhibits protein synthesis by blocking translocation

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22
Q

how do cephalosporins work?

A

beta lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases

23
Q

what type of infection does ciprofloxacin treat?

A

aerobic gram-negative rod infections

24
Q

what drug can cause “red man syndrome” and is also often used to treat MRSA?

A

vancomycin

25
Q

what categories of bacteria does clindamycin treat?

A

anaerobes and gram positive organisms, good for treating pulmonary abscess

26
Q

what is the first line treatment of UTIs in pregnant women?

A

nitrofurantoin, it damages bacterial DNA and ribosomal proteins after intracellular reduction into reactive molecules

27
Q

what is the mechanism of resistance for macrolides?

A

methylation of rRNA at a ribosome-binding site

28
Q

what type of bacteria is C. Diff?

A

gram positive, anaerobic, spore former

29
Q

what is the treatment for clostridium profringes?

A

clindamycin

30
Q

what is bacitracin active against?

A

gram positive staph and strep

31
Q

chlamydia has what type of discharge?

A

watery

32
Q

gonorrhoeae has what type of discharge

A

thick, can be green-yellowish or white

33
Q

what is the treatment for chlamydia?

A

azithromycin (macrolide) or doxycycline (tetracycline)

34
Q

what is the treatment for gonorrhoeae?

A

cephtriaxone (cephalosporin)

35
Q

what penicillins are beta lactamase resistance?

A

nafcillin and oxacillin have a bulky R side chain that blocks beta lactamases from beta lactam ring

36
Q

what drug works synergistically with beta lactams?

A

aminoglycosides (concentration dependent)

37
Q

what is the drug of choice for staph aureus? (not MRSA)

A

nafcillin

38
Q

what are the anti pseudomonal penicillins?

A

piperacillin and ticarcillin

39
Q

what fungal disease presents as annular plaques?

A

tinea corporis “ringworm”

40
Q

what is used to treat systemic ringworm?

A

itraconazole, blocks the formation of fungal membrane sterols by inhibiting fungal cytochrome P-450

41
Q

what antifungal is used for chronic suppression of cryptococcal meningitis in people with HIV?

A

fluconazole

42
Q

how does MRSA resist beta lactams?

A

by altering its penicillin binding protein

42
Q

treatment for leishmania donovani

A

atovaquone and azythromycin

43
Q

what parasite presents with bloody stool?

A

entamoeba hystolytica

44
Q

what parasite presents with swollen eye?

A

trypanososma cruzi (chagas disease caused by kissing bug)

45
Q

what is the treatment for complicated malaria?

A

quinine

46
Q

what is the treatment for uncomplicated malaria?

A

chloroquine, second choice primaquine but can cause cardiac arrhythmia

47
Q

what are the prophylactics for malaria?

A

atovaquone (inhibits ETC)
proguanil (inhibits DHFR)

48
Q

what parasite presents with maltese cross in blood smear?

A

babesa (tick bite in northeast)

49
Q

what kind of virus is HIV?

A

retrovirus (+ ssRNA)

50
Q

what enzyme do retroviruses (+ssRNA) use?

A

reverse transcriptase

51
Q

all DNA viruses except poxvirus replicate in the ____

A

host cell nucleus

52
Q

all RNA viruses except influenza replicate in the ____

A

cytoplasm

53
Q

DNA viruses use what machinery to replicate?

A

enters the nucleus and uses host cell nucleic acid synthesis machinery

54
Q

RNA viruses use what machinery to replicate?

A

since they replicate in the cytoplasn, they use their own machinery in combo with host cell ribosomes

+ssRNA can be directly translated by host ribosomes
-ssRNA brings RNA-dependent RNA polymerase to switch to +ssRNA

55
Q

what are some DNA viruses?

A

herpesvirus & pox virus (enveloped),
papillomavirus (naked)

56
Q

what does the diptheria exotoxin do

A

ribosylates EF-2, inhibiting protein synthesis

57
Q

what does the cholera exotoxin do

A

ribosylates GTP binding protein, increasing cAMP = fluid loss as seen in rice water stools