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cvs 4 Flashcards

1
Q

zero order kinetics

A 
WATTP
Warfarin
Aspirin
Theophyline
Tolbutamied
Phenytoin
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2
Q

constant amount of drug is metabolized

A

zero

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3
Q

fraction metabolized

A

first order

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4
Q

how many half lives to steady state

A

4 5

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5
Q

which bugs stain with zheil nelson

A

Myocobacterium
Nocardia
Cryptosporidium oocyst

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6
Q

M tb

A

gram +
acid fast
mycolic acid

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7
Q

acid fast stain

A

smear is first treated with aniline dye ( carbolfuchism)
the red dye penetrates throught the bacterial cell wall where it binds to MYCOLIC acids..

  1. then slide is treated with alcohol and hydrochloric acid — this dissolves the outer membrane and non tb bacteriabut the presence of MYOCOLIC acid prevents decolorization of bacteria.
  2. counter stain methylyne blue is added … non tb will stain blue
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8
Q

serpentine snake like virulence factor

A

cord factor

myocolic acid forms long BCFA / cord factor

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9
Q

what prevents phagolysosome formation

A

sulfatides

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10
Q

no rigid wall bugs

A 
CREAM 
Chlamydia
Rickettsia
Ehrlichia
Anaplasma
Mycoplasma/ ureaplasma
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11
Q

MTB replication takes place IN

A

alveoli

macrophages cannot destroy it initially

cell mediated immunity required — TH1—> IFNgamma—>macrophages—-> TNFalpha

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12
Q

what can destroy MTB

A

acidification

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13
Q

V/Q is low at

A

base

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14
Q

Primary TB infection

A

inhalation
LOWER lobe
unchecked virulence factors

areas of infection — ghon focus in lower lobe

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15
Q

what makes a ghon complex

A

ghon focus + I/L hilar lymph node

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16
Q

what happens to ghon complex in few weeks

A

the granuloma gets fibrosed and calcified

this fibrosed and calcified ghon complex is known as RANKE COMPLEX

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17
Q

reactivation of TB in which lobe

A

upper

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18
Q

what is milary TB

A

progressive primary tb
failed immune resp
adrenal gland/liver

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19
Q

M. scrofulaceum

A

scrofula cervical lymphadenitis

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20
Q

M. marinarum

A

aquarium handlers

hand

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21
Q

M. avium intracellulare

A

CD4 <100 HIV AIDS

txt —– azithromycin (macrolide)

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22
Q

name a cachectin

A

TNF alpha

cough / hemoptysis weight loss

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23
Q

PPD postive means

A

previous exposure / active infection

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24
Q

PPD negatiev

A
  • infection
    HIV CD4 count low
    in nocardia infection — weak acid fast
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25
Q

sarcoidosis CD4 CD8 ratio

A

INCREASED

CD4 —- consumes NCG

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26
Q

gold standard tb test

A

IGRA
quantiferon test

langhwan giant cells —– cd 14

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27
Q

catalase positive rod shape weakly acid fast

A

nocardia

branching filaments

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28
Q

SNAP mnemonic

A

Sulfonamide for nocardia

Penicillin for actinomyces

29
Q

Nocardia

A

AEROBE
weak acid fast
like TB but NEGATIVE PPD

brain disseminate

30
Q

Actinomyces

A

ANAEROBE
negative acid fast

yellow sulfur granulation
JAW infection
dental
PID

31
Q

aerobic bacilli

A

listeria

corynebacterium

32
Q

anaerobic bacilli

A

clostridium
cutibacterium
propionibacterium acne

33
Q

branching filaments anaerobe

A

actinomyces

34
Q

novobiacin + -

A

sensitive —- S. epidermis

resistant—– saprophyticus

35
Q

grows in 6.5 nacl bile and PYR +

A

enterococcus

subacute endocarditis after GU GI procedures

36
Q

bacitracin sensitive PYR +

A

GAS pyoegnes

37
Q

yellow sulfur granules

A

actinomyes

38
Q

red

39
Q

golden

40
Q

green

A

psueudomonas

41
Q

orange sand in diapers

A

lesch nyhan

42
Q

glove and stocking presentation

A

leprosy

armadillo reservoir

43
Q

TH1 leprosy

A

early
TUBERCULOID leprosy

positive lepronin test —- type 4 hsn
hypopigmented plawues and hairless skin

44
Q

TH2 leprosy

A

late
Lepramatous Leprosy

negative test
disseminated

45
Q

investigation of choice for leprosy

A

PCR and biopsy

46
Q

treatment for leprosy

A

dapsone

rifampin

47
Q

txt for lepromatous leprisy

A

dapsone
rifampin

clofozamine

48
Q

Listeria can cause ….. in infants

A

infantiseptica

low CMI or def CMI 
facultative intracellar
dairy products
deli meat
unpasteurized milk
COLD GROWTH

from birth canal during delivery

49
Q

actin polymerization

A

rocket tail

cell to cell migration listeria

50
Q

meningitis in infants

A

GEL
Group b
E coli
Listeria

51
Q

other conditions cuased by listeria

A

amnionitis
spontaneous abortions
fetal death
preamature birth

52
Q

Bartonella henslae < 100

A

stellate star shaped granuloma

bacillary angiomatosis

53
Q

kaposci sarcoma CD4 count

A

<500 HHV 8
lymphocitic infiltration
SPINDLE CELLS

purple lesions skin and GIT

54
Q

oral thrush CD4 count

A

<500
nystatin
scrape +ve

55
Q

EBV hairy leukoplakia

A

CANNOT SCRAPE

56
Q

HPV SCC strains

A

< 500

16 18 31 33

57
Q

CD4 < 200

A

PCP
JC—— oligodendrocyts CNS
HIV dementia
Histoplasma capsulatum —- wtloss/ftgue/cgh

58
Q

candida esophagitis CD4 count

A

<100

FLUCONAZOLE

59
Q

only azole to cross BBB

A

fluzonazole

60
Q

linear ulcers in esophagus

A

CMV <100

owl inclusions

61
Q

CMV retinitis txt

A

cotton wool spots

GANICYCLOVIR if fails then — FOSCARNET

62
Q

CD<100

A 
candida esophagitis
EBV prmary cell lymphoma
cryptococcus
CMV retinitis, esophagitis, colitis, encephalitis
cryptosporidium
toxoplasmosis --- multiple ring enhancing lesions withEDEMA
MAC
aspergillus --- prexisting cavities
63
Q

ixodes tick

A

BAB
Borrelia
Anaplasma
Babesia

64
Q

lyme diseas 1 2 3

A
  1. skin— erythema migrans
  2. muscle, heart, nerves—- 3rd deg block, bells palsy
  3. bone—- arthritis, encephalopathy
65
Q

teratment for lyme

A

doxycycline

66
Q

txt lyme in pregnant / children

A

amoxicillin

ceftriaxone (CNS)—- 3rd gen

67
Q

leptospirosis signs symptoms

A

myalgias
erythematous conjunctiva
photophobia

HAWAIII

68
Q

Weil disease

A

ictero hemorrhagic

69
Q

conjunctival injection also a give away for which intoxication

dr taher classes HK (24 decks)

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