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USMLE > DIT VII: Micro > Flashcards

DIT VII: Micro Flashcards

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USMLE® Step 1 flashcards
0
Q

Infections associated with birds (5)

A

Histoplasma capsulatum, Crytococcus neoformans, Chlamydophila psittaci, H5N1 influenza, West Nile virus

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1
Q

Dermatophytes (4)

A

Trichophytin, Microsporum, Epidermophytin, Malassezia furfur

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2
Q

Opportunistic fungal infections (4)

A

Candida albicans, Aspergillus, Cryptococcus neoformans, Mucor and Rhizopus spp

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3
Q

What is ringworm

A

Tinea corporis and capitis, caused by dermatophytes

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4
Q

What is tinea unguium

A

Onychomycosis, dermatophyte infection of fingernails

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5
Q

found in SW U.S. incl west Texas and California

A

Coccidioides immitis

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6
Q

Found in Mississippi and Ohio river basins

A

Histoplama capsulatum

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7
Q

Causes San Joaquin Valley fever

A

Coccidioides immitis

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8
Q

Found in rural Latin America

A

Paracoccidioides brasiliensis

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9
Q

Assoc w plant thorns and cutaneous injury

A

Sporothrix schenckii

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10
Q

Found in states E of Mississippi River

A

Blastomyces dermatitides

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11
Q

Found in bat and bird droppings

A

Histoplasma cpasulatum

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12
Q

Mold form contains barrel-shaped arthroconidia

A

Coccidioides immitis

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13
Q

Assoc w dust storms

A

Coccidioides immitis

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14
Q

Broad-based budding of yeast

A

Blastomyces dermatitides (BBB = broad-based buds)

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15
Q

Multiple-budding of yeast form

A

Paracoccidioides brasiliensis

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16
Q

Causes diaper rash

A

Candida albicans

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17
Q

Opportunistic mold with septate hyphae that branch at 45 degr. angle

A

Aspergillus fumigatus (Acute Angles = Aspergillus)

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18
Q

Opportunistic mold with irreg nonseptate hyphae that branch at wide angles (>90 degr)

A

Mucor & Rhizopus spp.

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19
Q

Causes thrush in immunocompromised pts. and vulvovaginitis in women

A

Candida albicans

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20
Q

Known for causing pneumonia in AIDS pts

A

Pneumocystis jirovecii

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21
Q

When to start Bactrim prophylaxis in AIDS pts?

A

When CD4 count <200 (against Pneumocystis jirovecii pneumonia)

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22
Q

Yeast known for causing meningitis in AIDS patients

A

Cryptococcus neoformans

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23
Q

Most common opportunistic infection in HIV pts

A

Pneumocystis jirovecii

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24
Q

Prophylaxis for Cryptococcus in AIDS pts

A

Fluconazole

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25
Q

Prophylaxis for PCP in AIDS pts

A

TMP-SMX (trimethoprim sulfa)

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26
Q

Treatment for Sporothrix schenckii

A

Oral potassium iodide / itraconazole

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27
Q

Treatment for oral candidiasis

A

Nystatin / fluconazole

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28
Q

Treatment for systemic candidiasis

A

Amphotericin B

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29
Q

Dx test for systemic candidiasis

A

Germ tubes in standard blood cultures

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30
Q

Dx test for Cryptococcus neoformans

A

India ink to stain capsule. Can also use tests for Crypto antigen or latex agglutination test

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31
Q

Dx test for Pneumocystis jirovecii

A

Silver stain

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32
Q

PCP pneumonia: type and CXR appearance

A

Diffuse interstitial pneumonia (atypical), ground glass appearance

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33
Q

What is associated with fungus ball in the lungs

A

Aspergilloma (Aspergillus fumigatus)

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34
Q

Features of infection with Mucor and Rhizopus spp.

A

Large necrotic lesions (black eschar), cranial nerve involvement

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35
Q

Organism associated with tinea versicolor

A

Malassezia furfur

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36
Q

Clinical features of tinea versicolor

A

Hyper/hypopigmented areas on prox limbs and trunk, large macules may coalesce, not usually pruritic

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37
Q

Tx for tinea versicolor

A

topical azole / selenium sulfide (Selsun blue)

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38
Q

Dx test for tinea versicolor

A

KOH prep of skin scraping –> spaghetti and meatball appearance

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39
Q

Granulomas: systemic mycoses vs TB

A

System mycoses = non-caseating granulomas

TB = caseating granulomas

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40
Q

Dx test for systemic mycoses

A

Sabouraud agar

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41
Q

Histoplasma capsulatum: size, where it resides

A

smaller than RBCs, Histo Hides in macrophages

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42
Q

Paracoccidioides brasiliensis: size, histological appearance

A

Much larger than RBC, captain’s wheel formation

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43
Q

Clinical features of Sporothrix schenckii infection

A

Introduced via trauma to skin, pustule / ulcer at infection site, nodules along lymphatics

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44
Q

MOA of penicillin (3)

A
  1. bind to penicillin-binding proteins
  2. inhibit formation of cross-linkages between peptidoglycans
  3. upregulate autolysins
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45
Q

Is penicillin bactericidal or bacteriostatic?

A

bactericidal

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46
Q

Forms of penicillin

A

Penicillin G = IV

Penicillin V = oral

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47
Q

Uses of penicillin

A

Gram + (eg strep pneumo, strep pyogenes, Actinomyces, GBS), spirochetes (eg syphilis), Gram + rods (Clostridium, Listeria, bacillus), Gram - cocci (Neisseria)

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48
Q

ADRs of penicillin

A

H.S. rxns, hemolytic anemia, thrombocytopenia

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49
Q

Penicillinase: what does it do, where is it produced

A

hydrolyses beta-lactam ring of penicillins, a lot of Gram - organisms produce in periplasm (coded by plasmids)

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50
Q

2 mechanisms of resistance against penicillins

A
  1. penicillinase (beta-lactamase)

2. alteration of beta-lactam targets (PBPs)

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51
Q

Penicillinase-resistant penicillins (4)

A

methicillin, nafcillin, oxacillin, dicloxacillin

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52
Q

Aminopenicillins (2)

A

ampicillin, amoxicillin

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53
Q

ADRs of aminopenicillins

A

H.S. rxns, generalized rash when given for mononucleosis

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54
Q

Carboxypenicillins (3)

A

ticarcillin, carbenicillin, piperacillin

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55
Q

Uses for carboxypenicillins

A

Pseudomonas, Gram - rods

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56
Q

Beta-lactamase inhibitors (3)

A

clavulanic acid, sulbactam, tazobactam

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57
Q

Name the group: methicillin, nafcillin, oxacillin, dicloxacillin

A

penicillinase-resistant penicillins

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58
Q

Name the group: ampicillin, amoxicillin

A

aminopenicillins

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59
Q

Name the group: ticarcillin, carbenicillin, piperacillin

A

carboxypenicillins

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60
Q

Clinical uses for ampicillin and amoxicillin

A

Gram + bacteria

Gram - rods (“HEELPSS”): H. influenzae, E. coli, Listeria, Proteus mirabilis, Salmonella, Shigella

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61
Q

“HEELPSS” organisms: what are they, what can be used against them?

A

Gram - rods: H. influenzae, E. coli, Listeria, Proteus mirabilis, Salmonella, Shigella
Use amoxicillin or ampicillin

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62
Q

What has greater bioavailability, ampicillin or amoxicillin?

A

amoxicillin

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63
Q

Penicillin used for syphilis

A

Penicillin G

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64
Q

Penicillin used for UTI

A

amoxicillin

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65
Q

Penicillin used for Pseudomonas

A

ticarcillin, carbenicillin, piperacillin (carboxypenicillins)

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67
Q

Penicillin used for neonatal infections

A

ampicillin (+ gentamicin)

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68
Q

HACEK organisms: what are they, and what are they known for?

A

Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella
- cause culture-negative endocarditis

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69
Q

Bacterial structure: gelatinous, polysaccharide coating, aids in attachment to foreign material

A

Glycocalyx

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70
Q

Quellung reaction: what does it test for, when will it be positive?

A

Anti-capsular serum, encapsulated organisms will appear swollen under microscope

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71
Q

Stain for Cryptococcus neoformans

A

India ink

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72
Q

Prokaryotic ribosomal subunits

A

50S + 30S = 70S

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73
Q

Eukaryotic ribosomal subunits

A

60S + 40S = 80S

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74
Q

What is bacterial transduction?

A

Phage attaches to bacterium, injects DNA

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75
Q

Name the species: cell wall contains mycolic acid, rich in lipids

A

Mycobacteria

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76
Q

Name the structure: forms attachment between 2 bacteria during conjugation

A

Pilus

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77
Q

Which organisms do not take Gram stain?

A

Gram - organisms, Mycobacteria, Mycoplasma, Treponema, Legionella pneumophila

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78
Q

How is Treponema visualized?

A

Dark field microscopy

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79
Q

Uses for Giemsa stain

A

Borrelia, Rickettsiae, Chlamydia, Plasmodium, Trypanosomes, Histoplasma

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80
Q

What is Periodic Scid-Schiff stain used to visualize, and what is it used to diagnose?

A

Stains glycogen and mucoploysaccharides, + in Whipple’s disease (Tropherymena whippelii)

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81
Q

What does Ziehl-Neesen stain used for?

A

Acid-fast organisms (eg Mycobacterium tuberculosis)

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82
Q

What does India ink stain for?

A

Cryptococcus neoformans

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83
Q

What does silver stain indicate?

A

Fungi (Pneumocystis jirovecii), Legionella

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84
Q

Where is endotoxin produced?

A

In outer membrane of Gram - organisms

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85
Q

What is a superantigen? Name 2 organisms producing superantigens

A

Exotoxin able to bind MHC II abd TCR simulataneously. Eg S. aureus and Strep pyogenes (Group A)

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86
Q

Hemolytic anemia + thrombocytopenia + acute renal failure

A

Hemolytic-uremic syndrome (HUS)

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87
Q

What toxin is produced by Corynebacterium diphtheria, and what is its MOA?

A

Diphtheria toxin: inactivates elongation factor EF-2, inhibiting protein synthesis

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88
Q

Pharyngitis with gray pseudomembranes, cardiac & nerve cell damage

A

Corynebacterium diphtheriae

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89
Q

What toxin is produced by Pseudomonas aeruginosa, and what is its MOA?

A

Exotoxin A: targets EF-2

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90
Q

What toxin is produced by Shigella, and what is its MOA?

A

Shiga toxin: cleaves host RNA at adenine base in 60S ribosomal subunit

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91
Q

What toxin is produced by enterohemorrhagic E. coli (EHEC), what is its serotype, and its effect?

A

E. coli 0157:H7 produces verocytotoxin (Shiga-like toxin): bloody diarrhea, damage to renal & endothelial cells (HUS)

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92
Q

What toxins are produced by enterotoxigenic E. coli (ETEC), their MOA, and their effect?

A

Heat labile toxin (increases cAMP) and heat stable toxin (increases cGMP): cause watery diarrhea

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93
Q

What is the #1 cause of traveller’s diarrhea?

A

Enterotoxigenic E. coli (ETEC)

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94
Q

What toxin is produced by Yersinia entercolitica, its MOA, and its effect?

A

Heat stable toxin, increases cGMP, causes abdo pain (like appendicitis)

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95
Q

What toxin is produced by Bordetella pertussis, and what is its MOA?

A

Pertussis toxin: binds and inhibits inhibitory proteins –> increases cAMP

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96
Q

What toxin is produced by Clostridium tetani, its MOA, and its effect?

A

Tetanospasmin: blocks release of GABA & glycine –> persistent musc contraction, lockjaw, spastic paralysis

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97
Q

What toxin is produced by Clostridium botulinum, its MOA, and its effect?

A

Exotoxins A-G: inhibit release of ACh, cause flaccid paralysis

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98
Q

What toxins are produced by Clostridium perfringens, and what is their effect?

A

Alpha toxin (phospholipase): gas gangrene & myonecrosis. Enterotoxin: food poisoning if cooked food left out too long (spores germinate).

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99
Q

What toxin is produced by Bacillus anthracis (including components)?

A

Anthrax toxin: edema factor (increases cAMP), lethal factor, protective antigen

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100
Q

What toxin is produced by Vibrio cholerae, and what is its MOA?

A

Choleragen (cholera toxin): stimulate adenylyl cyclase, increases cAMP, Cl- and water go into lumen

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101
Q

Effects of S. aureus alpha-toxin & beta toxin

A

Alpha: hemolysis. Beta: sphingomyelinase.

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102
Q

Effects of S. aureus proteins A, B, and C of gamma-toxin

A

A=B = hemolysin. B+C = leukocidin.

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103
Q

Effects of S. aureus hemolysin

A

Hemolysis

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104
Q

Effects of S. aureus Leukocidin

A

Destroys leukocytes

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105
Q

Effects of S. aureus enterotoxins A-E

A

Food poisoning, vomiting, diarrhea

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106
Q

Toxic shock syndrome: organism and toxin responsible, S&S

A

S. aureus TSST-1: high fever, hypotension, diffuse rash

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107
Q

Scalded skin syndrome: organism and toxin responsble

A

S. aureus epidermolytic / exfoliative toxins

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108
Q

Toxins secreted by Strep pyogenes (Group A Strep) and their effect

A

Streptolysin O: hemolysis (Oxygen labile). Streptolysin S: hemolysis (oxygen Stable). Erythrogenic / pyogenic toxins: scarlet fever.

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109
Q

What is the cause of scarlet fever?

A

Erythrogenic / pyogenic toxins of Strep pyogenes (Group A Strep)

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110
Q

1 blood culture contaminant

A

S. epidermidis

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111
Q

What does hemolysis test assess, and what are the possible results?

A

Ability to hemolyse blood agar. Beta hemolysis: complete ability, ring around colony. Alpha hemolysis: partial, green ring around colony. Gamma hemolysis: none.

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112
Q

Name the infection and clinical manifestation: contaminated deli meat, unpasteurized milk & cheese

A

Listeria, meningitis in very young and very old

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113
Q

Name the bacteria: large golden colonies

A

S. aureus

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114
Q

Name the bacteria: yellow granules (“sulfur granules”)

A

Actinomyces israelii

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115
Q

Name the bacteria: blue-green pigment

A

Pseudomonas aeruginosa

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116
Q

Name the bacteria: red pigment

A

Serratia marcescens

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117
Q

What kind of infection does Staph saprophyticus cause?

A

Common cause of UTIs (10-20% of females)

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118
Q

Name the bacteria: indwelling foreign device infections

A

S. epidermidis

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119
Q

Name the organism: pneumonia with rust coloured sputum

A

Strep pneumoniae

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120
Q

Name the organism: most prominent organism found in dental plaque, can erode and cause dental caries

A

Strep mutans (type of viridans Strep)

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121
Q

Name the organism and prophylaxis: enters circulation during dental procedures and causes subacute endocarditis

A

Strep sanguinis, amoxicillin

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122
Q

Cause of acute pharyngitis

A

Group A Strep (Strep pyogenes)

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123
Q

Name the organism: acute pharyngitis, cellulitis, bacteremia, pneumonia, necrotizing fasciitis

A

Group A Strep (Strep pyogenes)

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124
Q

Name the organism: acute post-streptococcal glomerulonephritis, rheumatic fever

A

Group A Strep (Strep pyogenes)

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125
Q

Name the organism: streptococcal toxic-shock syndrome, necrotizing fasciitis

A

Group A Strep (Strep pyogenes)

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126
Q

Jones criteria for rheumatic fever

A

Joints, Pancarditis, subcutaneous Nodules (Aschoff nodules), Erythema marginatum, Sydenham chorea

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127
Q

Aschoff nodules

A

Rheumatic fever

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128
Q

Minor criteria for rheumatic fever

A

Arthralgia, fever, raised ESR/CRP, prolonged PR interval

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129
Q

What diseases do Group B strep cause in infants, and what is the prophylaxis?

A

Pneumonia, sepsis, meningitis. Prophylactic penicillin during labour.

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130
Q

What diseases do Group B strep cause in pregnant women?

A

Asymptomatic bacteruria, UTI, post-partum endometritis, bacteremia

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131
Q

What diseases do Group B strep cause in nonpregnant adults?

A

Bacteremia, skin & soft tissue infections

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132
Q

Causes of neonatal sepsis (3)

A

GBS, E. coli, Listeria monocytogenes

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133
Q

What infections do enterococci cause?

A

Endocarditis & UTIs (esp in hospital)

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134
Q

Enterobacter vs Enterococcus

A

Enterobacter = Gram - rod. Enterococcus = Gram + coccus.

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135
Q

What organism causing endocarditis is also associated with colon cancer?

A

Strep bovis

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136
Q

Causes Q fever

A

Coxiella burnetii

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137
Q

Spores with “drumstick-like appearance”

A

Bacillus spp. & Clostridium spp.

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138
Q

Rx for Corynebacterium diphtheriae

A

Erythromycin/penicillin, vaccine, antitoxin

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139
Q

Large painless ulcer with centra necrosis (depressed black eschar), surrounded by edema

A

Cutaneous anthrax (Bacillus anthracis)

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140
Q

“Wool sorters’ disease”, mediastinal widening on CXR

A

Inhalational (pulmonary) anthrax (Bacillus anthracis)

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141
Q

What type of bacteria is Listeria monocytogenes?

A

Gram + rod, facultative intracellular

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142
Q

General Rx for anaerobes

A

Metronidazole, clindamycin

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143
Q

What infections can Actinomyces cause?

A

Cervicofacial disease (usually around mandible): inflammatory changes on skin, develop sinus tracts that drain pus and “sulfur granules”

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144
Q

Most common cause of of osteomyelitis

A

S. aureus

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145
Q

Pharyngitis resulting in glomerulonephritis

A

Strep pyogenes

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146
Q

Diarrhea after using antibiotics

A

C. difficile

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147
Q

Branching, filamentous Gram (+) rods with sulfur granules

A

Actinomyces israelii

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148
Q

Name the organism: pneumonia (esp in CF), otitis externa, UTIs, osteomyelitis (esp in DM), sepsis, contaminated medical equipment & catheters, burns, hot tub folliculitis

A

Pseudomonas aeruginosa

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149
Q

Rx for Pseudomonas aeruginosa

A

Piperacillin & ticarcillin, cefepime, ceftrazidime, imipenem, meropenem, fluoroquinolones

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150
Q

Name the organism: increased risk gastric adenocarcinoma & lymphoma, urease +

A

Helicobacter pylori

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151
Q

Dx for H. pylori

A

Urea breath test, stool antigens, serology studies

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152
Q

Rx for H. pylori (triple and quad therapy)

A

Triple: PPI + clarithromycin + amoxicillin/metronidazole.
Quad: bismuth + PPI + metronidazole + tetracycline

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153
Q

Urethritis, PID, STI, septic arthritis, conjunctivitis in newborns

A

N. gonorrhoeae

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154
Q

Rx for N. gonorrhoeae (1st and 2nd line)

A

1st line: ceftriaxone. 2nd line: azithromycin / doxycycline

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155
Q

Name the organism: meningitis, Waterhouse-Friderichsen syndrome, sepsis, DIC

A

N. meningitidis

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156
Q

Rx for for N. meningitidis (prophylaxis & Tx)

A

Prophylaxis: rifampin, ciprofloxacin, or ceftriaxone. Tx: ceftriaxone or penicillin G

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157
Q

Epiglottitis, otitis media, sinusitis, pneumonia

A

H. influenzae

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158
Q

Name the disease and organism: airway compromise, difficulty breathing & swallowing, drooling, “sniffing dog position”, “thumb sign”, esp ages 2-7 years

A

Epiglottitis, H. influenzae (worst form is Hib)

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159
Q

“Thumb sign” on X-ray

A

Edema due to epiglottitis

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160
Q

Dx of H. influenzae type B (Hib)

A

Produces IgA protease, culture on chocolate agar, need factors V & X for growth

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161
Q

Cultured on chocolate agar, needs factors V & X for growth

A

Hib

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162
Q

Tx and prophylaxis for Hib

A

Ceftriaxone (Tx), rifampin (prophylaxis)

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163
Q

Cause of chancroid

A

Haemophilus ducreyi

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164
Q

Cause and symptoms of Pontiac fever

A

Legionella pneumophila, flu-like symptoms

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165
Q

How to visualize, culture, and Dx Legionella pneumophila

A

Silver stain, charcoal yeast extract culture, needs iron and cysteine. Dx: antigen in urine

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166
Q

Rx for Legionella pneumophila

A

Erythromycin, other macrolides

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167
Q

Organism: Life-threatening meningitis + purpura

A

N. meningitidis

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168
Q

Organism: burn wound infection

A

Pseudomonas aeruginosa

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169
Q

Organism: septic arthritis in young, sexually active patients

A

N. gonorrhoeae

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170
Q

Dx of Shigella

A

Stool culture

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171
Q

Tx of Shigella

A

Supportive, fluoroquinolones (1st line), TMP-SMX or azithromycin (2nd line)

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172
Q

Organism: infected poultry and eggs, turtles, osteomyelitis in sickle cell, reactive arthritis. When does diarrhea begin?

A

Salmonella, diarrhea begins 1-3 days after

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173
Q

Tx for Salmonella food poisoning

A

Supportive for healthy adults, fluoroquinolones (1st line)

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174
Q

Disease and organism: “Rose spots” on abdomen

A

Typhoid fever (Salmonella typhi)

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175
Q

Bloody diarrhea after poultry/meat/unpasteurized milk, 1-2 weeks, assoc with Guillain-Barre syndrome

A

Campylobacter jejuni

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176
Q

Tx for Campylobacter jejuni

A

Fluoroquinolones, azithromycin

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177
Q

Organism and MOA: “Rice water” diarrhea

A

V. cholerae: heat labile toxin increases cAMP

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178
Q

Tx for V. cholerae

A

Oral rehydration

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179
Q

Organism & Tx: bloody diarrhea, undercooked pork & milk, household pets, mesenteric adenitis, outbreaks in daycares

A

Yersinia enterocolitica, supportive Tx

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180
Q

Lobar pneumonia in weakened immune systems, red current jelly sputum, major cause of UTIs

A

Klebsiella pneumoniae

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181
Q

Toxins produced by C. diff and MOA

A

Toxin A (enterotoxin): binds to brush border, causing fluid secretion and inflamm. Toxin B (cytotoxin): kills enterocytes.

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182
Q

Organism, risk factors, and histo appearance: pseudomembranous colitis

A

C. difficile, associated with antibiotic uses (clindamycin, ampicillin). Necrosis with exudates, fibrin, leukocytes, looks like membrane.

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183
Q

Dx of C. diff

A

C. diff toxin in stool

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184
Q

Tx of C. diff

A

Metronidazole, vancomycin (oral)

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185
Q

Cause of food poisoning and onset of diarrhea: meats, mayo, custard

A

S. aureus, 1-2 hours

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186
Q

Cause of food poisoning: reheated rice

A

Bacillus cereus

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187
Q

Cause of food poisoning: shellfish

A

Vibrio parahemolyticus & vulnificus

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188
Q

Cause of food poisoning: improperly canned foods

A

C. botulinum

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189
Q

Cause of food poisoning: reheated meat

A

C. perfringens

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190
Q

Cause of food poisoning: undercooked hamburger meat

A

E. coli 0157:H7

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191
Q

MOA and Tx for ETEC diarrhea

A

Heat-labile (incr cAMP) and heat stable (incr cGMP), no blood. Rx: supportive, cipro/levofloxacin, azithromycin (paeds)

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192
Q

Manifestations and Tx of EHEC diarrhea

A

Shiga-like toxin, bloddy diarrhea, can lead to HUS. Tx supportive

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193
Q

MOA of enteopathogenic E. coli (EPEC)

A

Adheres to apical surfaces, flattening villi and decr absorption –> watery diarrhea

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194
Q

MOA and Tx of enteroinvasive E. coli (EIEC)

A

Invades intestinal wall, leads to necrosis, inflamm, bloody diarrhea, and fever. Tx: fluoroquinolones, TMP-SMX, azithromycin.

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195
Q

Diarrhea transmitted from household pets

A

Yersinia enterocolitica

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196
Q

Most common cause of traveller’s diarrhea

A

Enterotoxigenic E. coli (ETEC)

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197
Q

Causes of food poisoning due to exotoxin (2)

A

S. aureus, B. cereus

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198
Q

What is the leukocyte esterase test used for?

A

Tests for esterase in urine from WBCs, indicates inflamm in urinary tract, also elevated in gonorrhea

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199
Q

What is the nitrite test used for?

A

Tests urine for presence of Enterobacteria (common cause of UTIs)

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200
Q

What infection do the following organisms have in common? E. coli, S. saprophyticus, Klebsiella pneumoniae, Proteus, Serratia marcescens, Enterobacter cloacae, Pseudomonas

A

Cause UTIs

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201
Q

Carry urease, cause stag horn calculi (which are made of what?)

A

Proteus mirabilis & vulgaris; ammonium + Mg + phosphates stones

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202
Q

UTI Tx for Gram - organisms

A

Sulfonamides + TMP, aminopenicillin, fluoroquinolones, nitrofurantoin

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203
Q

Name the drug by ADRs: hypersensitivity rxns, hemolysis, nephrotoxicity, kernicterus, displaces other drugs from albumin, Stevens-Johnson syndrome, photosensitivity

A

Sulfonamides

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204
Q

Drugs with photosensitivity reactions (3)

A

“SAT”: Sulfonamides, Amiodarone, Tetracyclines

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205
Q

What other drugs should eb avoided in patients with sulfa allergy? (7)

A

“Sulfa Pills Frequently Cause Terribly Acute Symptoms”: Sulfasalazine, Probenecid, Furosemide (loops), Celecoxic, Thiazides/TMP-SMX, Acetazolamide, Sulfonylureas

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206
Q

MOA of sulfonamides

A

Folic acid inhibitors, by competitively inhibiting dihydropterate synthetase

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207
Q

MOA of trimethoprim

A

Inhibits dihydrofolate reductase (in folic acid synth)

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208
Q

What drugs can cause Stevens-Johnson syndrome (SJS)?

A

Seizure drugs (ethosuxamide, lamotrigine, carbamazepine, phenobarbital, phenytoin), sulfa drugs, penicillins, allopurinol

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209
Q

MOA of fluoroquinolones, general family suffix

A

-floxacin; inhibits DNA gyrase (topoisomerase II)

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210
Q

ADRS: GI upset, damage to cartilage, tendonitis

A

Fluoroquinolones

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211
Q

MOA of metronidazole

A

Forms toxic free radicals, leading to DNA damage

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212
Q

Uses for metronidazole

A

“GET GAP on the metro!”: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Clostridium, Bacterioides), H. Pylori

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213
Q

Function of enzyme urease, in which organism is it found?

A

Splits urea into NH3 and CO2, found in Proteus

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214
Q

Most common bacteria in a patient with struvite kidney stones

A

Proteus (then Staph)

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215
Q

Cause and transmission of Lyme disease

A

Borrelia burgdorferi, transmitted by Ixodes tick

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216
Q

Name the disease: fever, headache, fatigue, depression, erythema migrans

A

Stage 1 Lyme disease (days to 1 month)

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217
Q

Name the disease: bilateral Bell’s palsy, meningitis, peripheral neuropathies, AV nodal block, myopericarditis

A

Stage 2 Lyme disease (weeks to months)

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218
Q

Name the disease: chonic monoarthritis (esp knee), migratory polyarthritis, subacute encephalitis

A

Stage 3 Lyme disease (months to years)

219
Q

Rx for Lyme disease

A

Doxycycline (early, 10-14 days), amoxicillin (kids), IV ceftriaxone (late)

220
Q

Cause of Weil’s disease

A

Icterohemorrhagic Leptospirosis (Leptospira interrogans)

221
Q

Where is Leptospira interrogans found, and what does it cause?

A

In water contaminated with animal urine. Leptospirosis: fever, chills, myalgia, headache, asymptomatic phase, meningitis, liver damage, jaundice, renal failure.

222
Q

Name the disease: single painless chancre

A

Primary syphilis

223
Q

Name the disease: fever, chills, malaise, maculopapular rash (trunk, extremities, palms, soles), condyloma lata, alopecia areata

A

Secondary syphilis

224
Q

What are condyloma lata?

A

Wart-like lesions on moist areas (mouth, perineum), indicates secondary syphilis

225
Q

Name the disease: gummas, aortitis, meningitis, hearing loss

A

Tertiary syphilis

226
Q

Name the disease: tabes dorsalis

A

Tertiary syphilis

227
Q

Name the disease: “tree barking” of aorta

A

Tertiary syphilis; due to destruction of vasa vasorum (supplies tissue of aorta)

228
Q

Describe and name the disease: Argyll-Robertson pupil

A

Tertiary syphilis; constricts with accommodation but not reactive to light in that pupil

229
Q

Describe and name the disease(s): Charcot’s joints

A

Tertiary syphilis, diabetic peripheral neuropathy; damage because of loss of proprioception/sensory info

230
Q

Name 4 diseases causing rash on palms and soles

A

Kawasaki disease, Coxsackie A virus, Rocky Mountain Spotted Fever, secondary syphilis

231
Q

Name the disease: saber shins, saddle nose, Hutchinson teeth, frontal bossing

A

Late congenital syphilis

232
Q

Name the disease: snuffles

A

Early congenital syphilis

233
Q

Dx of syphilis

A

VDRL, RPR, FTA-Abs, dark microscopy

234
Q

Cause of syphilis

A

Treponema pallidum

235
Q

Tx for syphilis

A

IV penicillin G, or doxycycline

236
Q

Name 4 things that can cause a false positive VDRL

A

“VDRL”: Viruses (mono, EBV), Drugs, Rheumatic fever, Lupus & Leprosy

237
Q

6 diseases that can cause Bell’s palsy

A

Lyme disease, Herpes zoster, AIDS, Sarcoidosis, Tumours, Diabetes

238
Q

Disease and organism: regional LAD, basilary angiomatosis, cats

A

Cat scratch disease, from Bartonella

239
Q

Organism: recurrent fever from variable surface antigens, from ticks and lice

A

Borrelia recurrentis

240
Q

Disease and organism: undulent fever, from unpasteurized milk and dairy

A

Brucellosis, from Brucella spp.

241
Q

Disease and organism: bloody diarrhea, fecal-oral from livestock, sexual

A

Campylobacter jejuni

242
Q

Disease and organism: severe pneumonia, parrots & other birds

A

Psittacosis, from Chlamydophila psittaci

243
Q

Disease and organism: flu-like, abrupt fever, incr perspiration, 1-2 weeks, from spores from tick feces and cattle placenta

A

Q fever, from Coxiella burnetii

244
Q

Disease and organism: headache, muscle ache, fatigue, blunting of immune system, from lone star tick

A

Ehrlichiosis, from Ehrlichia chaffeensis

245
Q

Disease and organism: from tick bites, rabbits, deer, can be used as biological warfare

A

Tularemia, from Francisella tularensis

246
Q

Disease and organism: from animal urine in water, zoonotic bacteria

A

Leptospirosis, from Leptospira spp.

247
Q

Disease and organism: can come from armadillos

A

Leprosy, from Mycobacterium leprae

248
Q

Organism: cellulitis, osteomyelitis, bite from cat or dog

A

Pasteurella multocida

249
Q

Cause of epidemic typhus and transmission

A

Rickettsia prowazekii, transmitted by louse

250
Q

Cause of Rocky Mountain Spotted fever and transmission

A

Rickettsia rickettsii, from Dermacentor tick bite

251
Q

Cause of endemic typhus and transmission

A

Rickettsia typhi, from fleas

252
Q

Cause of bubonic plague and transmission

A

Yersinia pestis, from flea bites and prairie dogs

253
Q

What is Pott’s disease?

A

TB in vertebral bodies

254
Q

Ghon focus vs Ghon complex

A

Ghon focus: primary TB lesion in mid-lower zones of lung, can be seen on CXR when calcified. Ghon complex: Ghon focus + hilar LAD

255
Q

Dx of TB

A

Lowenstein-Jensen agar (takes 2-4 weeks to culture), Gram +, acid fast stain of sputum (3 days in a row)

256
Q

What does Mycobacterium kansasii cause, and in which patients?

A

Pulmonary TB-like symptoms, esp in pts with chronic bronchitis and emphysema

257
Q

What is the prophylaxis for Mycobacterium avium intracellulare / MAC in AIDS, and when to start?

A

Azithromycin when CD4

258
Q

What environments is Mycobacterium marinum associated with?

A

Aquatic-associated: shipyards, boat, aquarium

259
Q

Tx for latent TB

A

6-9 months of isoniazid (INH)

260
Q

Drug cocktail used in Tx of TB

A

“RIPE”: Rifampin + Isoniazid (INH) + Pyrazinamde + Ethambutol

261
Q

What is Lowenstein-Jensen agar used for?

A

Dx of TB (takes 2-4 wks to culture)

262
Q

What is Hansen’s disease also known as?

A

Leprosy

263
Q

What is the causative organism in leprosy?

A

Mycobacterium leprae

264
Q

Name the two types of leprosy and their clinical manifestations

A

Leprosy: infection of superficial nerves, loss of sensation in digits and feet. Lepromatous type: diffuse, failed CMI, nodules, contagious, thick plaques on dorsum of fingers and wrists. Tuberculoid type: more limited disease, hypoaesthetic nodules.

265
Q

How is leprosy transmitted?

A

Person-to-person, armadillos

266
Q

Tx for 2 types of leprosy

A

Lepromatous type: dapsone, rifampin, clofazimine (24 months). Tuberculoid type: dapsone + rifampin (12 months)

267
Q

MOA of isonazid, ADRs, and prevention of ADRs

A

MOA: inhibits synth of mycolic acids. ADRs: neurotox (prevent with pyridoxine – vit B6), hepatotox, drug-induced SLE

268
Q

Name the TB drug: RNA pol inhibitor, Revs up microsomal P450, Red-orange body fluids, Rapid Resistance if used alone

A

Rifampin

269
Q

MOA of pyrazinamide and ADRs

A

MOA: inhibits mycolic acid synth by blocking mycobacterial pyrazinamidase, effective in acidic phagolysosomes. ADRs: hyperuricemia, hepatotox.

270
Q

MOA of ethambutol and ADRs

A

MOA: blocks arabinosyl transferase, decreasing carbohydrate polymerization of mycobacterium cell wall. ADRs: optic neuropathy (red-green colour blindness, reversible)

271
Q

Which TB drug causes reversible red-green colour blindness?

A

Ethambutol

272
Q

Calcified granuloma in the lung, plus hilar LAD

A

Ghon complex

273
Q

Back pain, fever, night sweats, and weight loss

A

Pott’s disease (TB in vertebral body)

274
Q

Name the disease: Gardnerella vaginalis, Mobiluncus, Bacterioides, Mycoplasma

A

Bacterial vaginosis

275
Q

Name the finding and disease: vaginal squamous cells covered in bacteria

A

Clue cells, bacterial vaginosis

276
Q

Rx for bacterial vaginosis

A

Metronidazole (cream or oral)

277
Q

What is the Rickettsial triad, and what is the general Tx?

A

Fever + headache + rash; doxycycline

278
Q

On which coast of the US is Rocky Mountain Spotted fever found?

A

East

279
Q

Name the types of Rickettsiae (2): rash starts centrally and spreads outward, doesn’t involve palms and soles

A

Rickettsia typhi (endemic typhus), Rickettsia prowazekii (epidemic typhus)

280
Q

Name the disease: transmitted by tick, no rash, granulocytes with berry cluster organisms (morula)

A

Ehrlichiosis

281
Q

Name the disease and causative organism: fever, interstitial pneumonia, spread via tick feces and cow placenta

A

Q fever, due to Coxiella burnetii

282
Q

What does the Weil-Felix reaction test for? When will it be +/-?

A

Tests for Abs against Rickettsiae. + in all Rickettsial infections, - in Coxiella.

283
Q

Name 3 causes of atypical pneumonia and a general Tx (if you don’t know which one it is)

A

Legionella penumophila, Chlamydophila pneumoniae, Mycoplasma pneumoniae; azithromycin

284
Q

Rx for Chlamydophila pneumoniae

A

Doxycycline

285
Q

Name the type of Chlamydia trachomatis: chronic infections, esp trachoma (granular conjunctivitis)

A

Types A, B, and C

286
Q

Name the type of Chlamydia trachomatis: urethritis, PID, ectopic pregnancy, infertility, neonatal penumonia and conjunctivitis

A

Types D – K

287
Q

Name the type of Chlamydia trachomatis: lymphogranuloma venereum (acute lymphadenitis), primary ulcer, rectal disease

A

Types L1, L2, L3

288
Q

Dx of Chlamydiae species

A

Giemsa stain

289
Q

Rx for Chlamydia trachomatis: general and newborns

A

Azithromycin, erythromycin eye drops in all newborns as prophylaxis

290
Q

Which cause of pneumonia causes a high titer of cold agglutinins?

A

Mycoplasma pneumoniae (IgM Abs, agglutinate or lyse RBCs only in cold env’ts)

291
Q

MOA of penicillins

A

Bind to penicillin-binding proteins, inhibit formation of cross-linkages between peptidoglycan chains

292
Q

What organisms produce penicillinases, and where?

A

Many Gram – organisms, in periplasm

293
Q

Which penicillins are resistant to penicillinase?

A

Methicillin, nafcillin, oxacillin

294
Q

Which are the aminopenicillins, and what are their clinical uses?

A

Ampicillin & amoxicillin. Gram + bacteria, Gram – rods (“HEELPSS”: H. Influenzae, E. Coli, Enterococci, Listeria, Proteus, Salmonella, Shigella). Eg UTIs, colon, neonatal infections

295
Q

Which antibiotics can cause a generalized rash if given for mononucleosis?

A

Aminopenicillins (ampicillin, amoxicillin)

296
Q

Which are the carboxypenicillins and what are their clinical uses?

A

Ticarcillin, carbenicillin, piperacillin. Pseudomonas, Gram – rods.

297
Q

Name the class: clavulanic acid, sulbactam, tazobactam

A

Beta-lactamase inhibitors

298
Q

Which aminopenicillin has the greater oral bioavailability?

A

Amoxicillin > ampicillin

299
Q

Penicillin used to treat syphilis

A

Penicillin G

300
Q

Penicillin used to treat UTI

A

Amoxicillin

301
Q

Penicillins used to treat Pseudomonas

A

Ticarcillin, carbenicillin, piperacillin (carboxypenicillins)

302
Q

Penicillin used to treat neonatal infections

A

Ampicillin (+ gentamicin)

303
Q

Which generation of cephalosporins have increasing Gram – coverage?

A

In general: incr generations have more Gram – coverage, less Gram + coverage

304
Q

Which are the 1st generation cephalosporins and what are their clinical uses?

A

Cefalozin, cephalexin. Gram + cocci, some Gram - (“PEcK”: Proteus mirabilis, E. Coli, Klebsiella)

305
Q

Which are the 2nd generation cephalosporins and what are their clinical uses?

A

Cefoxitin, cefaclor, cefuroxime, cefprozil. Gram + cocci, Gram - (“HENS PecK”: H. Flu, Enterobacter, Neisseria, Serratia marcescens + PEcK)

306
Q

Which are the 3rd generation cephalosporins and what are their clinical uses?

A

Ceftriaxone, cefotaxime, ceftazidime, cefdinir. Serious Gram – infections (HENS PecK + Citrobacter), Gram – meningitis, less Gram + (Strep pneumo)

307
Q

Which 3rd generation cephalosporin is excreted in bile, so is good for patients with renal failure?

A

Ceftriaxone

308
Q

Which 3rd generation cephalosporin can also cover Pseuomonas?

A

Ceftazidime

309
Q

Which 3rd generation cephalosporin is used to treat resistant otitis media?

A

Cefdinir

310
Q

What is the 4th generation cephalosporin and what does it cover?

A

Cefepime. Broad spectrum (Gram + and –), Pseudomonas.

311
Q

ADRs of cpehalosporins

A

H.S. Rxns (can have cross-reactivity with penicillins), nephrotox if used with aminoglycosides, disulfiram-like rxn

312
Q

MOA of aztreonam

A

Monocyclic beta lactam, inhibits cell wall synth, binds to PBP-3, synergistic with aminoglycosides

313
Q

Clinical uses for aztreonam

A

Gram – bacteria: PecK + Serratia, good for penicillin-allergic patients and those with renal insufficiency

314
Q

Why is imipenem always used in combination with cilastatin?

A

Cilastatin inhibits renal dehydropeptidase 1 –> decr deactivation of imipenem in renal tubules (incr action)

315
Q

Clinical uses for carbapenems

A

Gram + cocci, Gram – rods, anaerobes, Pseudomonas, empiric Tx of life-threatening infections

316
Q

ADRs of carbapenems

A

GI distress, skin rash, some neurotoxicity

317
Q

MOA of vancomycin

A

Inhibits cell wall glycopeptide poolymerization by binding to D-ala D-ala moieties of cell wall glycopeptide precursors. Not absorbed in the GI tract.

318
Q

Clinical uses for vancomycin

A

Gram +, MRSA, Enterococci, C. Diff (oral vancomycin), Coag – Staph endocarditis, S. Epidermidis

319
Q

ADRs of vancomycin

A

“NOT”: Nephrotox, Ototox, Thrombophlebitis, + Red Man Syndrome

320
Q

What is the cause of Red Man Syndrome and how is it treated?

A

Vancomycin triggering non-specific mast cell degranulation. Pretreat with antihistamines, slow down infusion.

321
Q

What causes vancomycin resistance?

A

AA change: D-ala D-ala –> D-ala D-lac

322
Q

Tx for C. Diff colitis

A

Oral vancomycin

323
Q

Inpatient Tx for MRSA

A

Vanocmycin

324
Q

Broad spectrum coverage for appendicitis

A

Imipenem/cilastatin or meropenem

325
Q

What are the 30S and 50S inhibitors?

A

“buy AT 30, CCELL at 50”. 30S: Aminoglycosides, Tetracyclines. 50S: Chloramphenicol, Clindamycin, Erythromycin (macrolides), Linomycin, Linezolid

326
Q

MOA of tetracyclines

A

Binds 30S, prevents attachment of aminoacyl-tRNA

327
Q

Which tetracycline is fecally eliminated?

A

Doxycycline

328
Q

What inhibits absorption of tetracyclines in gut?

A

Milk or antacids, Fe, Ca2+, Mg2+, divalent cations

329
Q

Name drug by ADRs: GI distress, discolouration of teeth in children, inhibits bone growth in children, photosensitivity, contraindicated in pregnancy

A

Tetracyclines

330
Q

Which antibiotic can cause blue pigmentation of skin with prolonged use? (Hint: it’s a tetracycline)

A

Minocycline

331
Q

MOA of linezolid and clinical uses

A

Binds 23S portion of 50S. Uses: MRSA (can be oral, as outpatient), VRE

332
Q

Clinical uses for tetracyclines

A

“VACCUUM TH e BedRoom”: V cholerae, Acne, Chlamydia, Ureaplasma urealyticum, Mycoplasma pneumoniae, Tularemia, H pylori, Borrelia burgdorferi, Rickettsia

333
Q

Clinical uses for macrolides

A

“PUS”: Pneumonia (esp atypical), URI (Strep pneumo and pyogenes), STD (Chlamydia, Gonorrhea)

334
Q

Name the class, and how they are produced: quinupristin, dalfopristin (Synercid)

A

Streptogramins, synthesized by Streptomyces virginiae

335
Q

MOA of streptogramins and clinical uses

A

Bind to 23S portion of 50S. MRSA, VRE, Staph and Strep skin infections (SERIOUS STUFF!)

336
Q

Name the class by ADRs: hepatotox, pseudomembranous colitis, arthralgias, myalgias, inhibits P450

A

Streptogramins

337
Q

Name the class: gentamicin, neomycin, amikacin, tobramycin, streptomycin

A

Aminoglycosides

338
Q

Name the class: bactericidal, requires O2 for uptake, ineffective against anaerobes

A

Aminoglycosides (AminO2glycosides)

339
Q

Clinical uses for aminoglycosides

A

Severe Gram – rod, work synergistically with beta lactams, bowel Sx and infections (neomycin)

340
Q

Name the class by ADRs: Nephrotox (esp with cephalosporins), Ototox (esp with loop diuretics), Teratogenic

A

Aminoglycosides

341
Q

Name the macrolides and their MOA

A

Erythromycin, azithromycin, clarithromycin. Bbind to 23S rRNA of 50S subunit

342
Q

Name the class by ADRs: prolonged QT, GI discomfort, acute cholestatic hepatitis, eosinophilia

A

Macrolides

343
Q

Drug interactions with macrolides

A

Incr serum conc of theophylline, incr action of oral anticoagulants (eg warfarin)

344
Q

Tx for MRSA skin abscess

A

Oral clindamycin

345
Q

MOA and clinical uses of chloramphenicol

A

Inhibits 50S peptidyltransferase. Meningitis (H flu, N meningitidis, Strep pneumo)

346
Q

Name the class by ADRs: anemia (dose dependent), aplastic anemia (dose independent), grey baby syndrome

A

Chloramphenicol

347
Q

What is the cause and Tx of grey baby syndrome?

A

Due to buildup of toxic metabolites of chloramphenicol (babies don’t have much UDP-gluconyltransferase): vomiting, ashen skin, poor musc tone, CVS collapse. Tx: stop drug, exchange transfusion, phenobarbital (induces UDP glucuronyltransferase)

348
Q

MOA and clinical uses of clindamycin

A

Blocks peptide bond formation with 50S ribosomal subunit. Anaerobic infections, MRSA, protozoa, topically for acne, Bacterioides fragilis, C perfringens, orally for MRSA skin abscesses

349
Q

ADRs of clindamycin

A

Pseudomembranous colitis

350
Q

MOA and clinical uses of polymixins

A

Cationic detergents, disrupt cell memb and inactivate endotoxins. IV last resort for resistant Gram – infections, topical for many OTC antibiotic ointments (eg neosporin)

351
Q

ADRs of polymixins

A

IV is neurotoxic and nephrotoxic (renal ATN)

352
Q

What is the prophylaxis for Pneumocystis jirovecii in HIV patients, and when should it be started?

A

TMP-SMX, when CD4

353
Q

Common causes of pneumonia in neonates and Tx

A

GBS, E. Coli. Ampicillin + gentamicin

354
Q

Common causes of pneumonia in 4wks – 18 yrs and Tx

A

RSV, Mycoplasma, C. Trachomatis, C. Pneumoniae, Strep pneumo. Macrolides (azithro), ceftriaxone (for Strep pneumo)

355
Q

Common causes of pneumonia in adults 18-40yrs and Tx

A

Strep pneumo, Mycoplasma, C pneumoniae. Azithromycin + ceftriaxone

356
Q

Common causes of pneumonia in elderly and Tx

A

Strep pneumo, influenza, anaerobes, H flu, aspiration, Gram – rods. Multi drugs or broad spec (cefepime, carbapenems)

357
Q

Common causes of hospital-acquired pneumonia and Tx

A

MRSA, Gram – rods. Vancomycin + gentamicin

358
Q

Common causes of aspiration pneumonia and Tx

A

Anaerobes; clindamycin

359
Q

Common causes of pneumonia in alcoholics/IV drug users

A

Strep pneumo, Klebsiella, Staph, anaerobes

360
Q

Common causes of pneumonia in CF

A

Pseudomonas, S aureus, Strep pneumo

361
Q

Common causes of meningitis in newborns to 6 mos

A

GBS, E coli, Listeria

362
Q

Common causes of meningitis in 6 mos to 6 years

A

Enteroviruses (Echo, Coxsackie), Strep pneumo, N meningitidis (with purpura), Hib

363
Q

Common causes of meningitis in 6 yrs to 60 yrs

A

Strep pneumo, N meningitidis, enteroviruses, HSV

364
Q

Common causes of meningitis in >60 yrs

A

Strep pneumo, Gram – rods, Listeria

365
Q

Common causes of meningitis in HIV

A

Cryptococcus

366
Q

Tx of meningitis

A

Culture CSF, treat empirically (ceftriaxone, vancomycin), dexamethasone

367
Q

CSF findings in bacterial meningitis

A

Incr pressure, incr WBCs (neutrophils), incr protein, decr glucose

368
Q

CSF findings in fungal & TB meningitis

A

Incr pressure, incr WBCs (lymphocytes), incr protein, decr glucose

369
Q

CSF findings in viral meningitis

A

Normal to incr P, incr WBCs (lymphocytes), normal to slightly incr protein, normal glu

370
Q

Cause of osteomyelitis in diabetics and drug users

A

S aureus, Pseudomonas

371
Q

Cause of osteomyelitis in prosthetic replacements

A

S aureus, S epidermidis

372
Q

What are condyloma acuminata, what do you see on histology, and what is the causative organism?

A

Genital warts, koilocytes (squamous cells with perinuclear cytoplasmic clearing), HPV-6 & 11

373
Q

What strains of HPV are associated with cervical cancer?

A

HPV-16 & 18

374
Q

What is the chandelier sign and what does it indicate?

A

Cervical motion tenderness. PID, usually caused by Chlamydia trachomatis or Neisseria gonorrhoeae

375
Q

What is Fitz-Hugh-Curtis syndome?

A

Rare complication of PID, severe infection of liver capsule

376
Q

Nocosomial infections in a newborn nursery

A

CMV, RSV

377
Q

Nocosomial infections: urinary catheterization

A

E. coli, Proteus, Pseudomonas, MRSA

378
Q

Nocosomial infections: respiratory therapy equipment

A

Pseudomonas

379
Q

Nocosomial infections: dialysis, needle sticks

A

HBV

380
Q

Nocosomial infections: hyperalimentation (parenteral feeding)

A

Candida albicans

381
Q

What is the most common TORCH infection?

A

CMV

382
Q

Name the TORCH infection: unilateral hearing loss, seizures, chorioretinitis, hydrocephalus, intracranial calcifications

A

CMV

383
Q

Name the TORCH infection: chorioretinitis, hydrocephalus, intracranial calcifications, cats

A

Toxoplasma

384
Q

Name the TORCH infection: PDA, cataracts, deafness, blueberry muffin rash

A

Rubella

385
Q

Name the TORCH infection: temporal lobe encephalitis, vesicular lesions

A

HSV

386
Q

Name the TORCH infection: hydrops fetalis

A

Parvovirus B19

387
Q

Two causes of low pH vaginal discharge

A

Physiologic discharge, Candidiasis

388
Q

Two causes of high pH vaginal discharge

A

Trichomonas, bacterial vaginosis

389
Q

Most common reportable STD

A

Chlamydia

390
Q

Painful, indurated, ulcerated genital lesion with exudate

A

Chancroid

391
Q

Common Tx for Trichomonas

A

Metronidazole

392
Q

Common Tx for gonorrhea

A

Ceftriaxone

393
Q

Common Tx for chlamydia

A

Doxycycline or azithromycin

394
Q

Name the viral class: calicivirus, picornavirus, reovirus, hepevirus

A

Non-enveloped RNA viruses

395
Q

Name the viral class: parvovirus, adenovirus, papillomavirus, polyomavirus

A

Non-enveloped DNA viruses

396
Q

Where do DNA viruses replicate, and what are the exceptions?

A

Nucleus, except pox family (smallpox, molluscum contagiosum)

397
Q

Where do RNA viruses replicate, and what are the exceptions?

A

Cytoplasm, except influenza and retrovirus

398
Q

Which is the ssDNA virus?

A

Parvovirus

399
Q

Which are the circular DNA viruses?

A

Papillomavirus, polyomavirus, hepadnavirus (partially)

400
Q

Which virus has 2 copies of ssRNA (diploid)?

A

Retrovirus

401
Q

Which are the dsRNA viruses?

A

Reovirus, rotavirus

402
Q

Name the (+) stranded ssRNA

A

Retrovirus, togavirus, flavivirus, coronavirus, hepevirus, calicivirus, picornavirus

403
Q

Which dsDNA viruses are not infectious when naked?

A

Poxvirus, hepatitis B (need protein components)

404
Q

What shape are DNA virus capsids?

A

Icosahedral (except poxvirus)

405
Q

Name the live attenuated viral vaccines (8)

A

Smallpox, Yellow Fever, chicken pox (varicella), MMR, Sabin polio vaccine (oral), herpes zoster, intranasal influenza, rotavirus

406
Q

When are varicella and MMR vaccines contraindicated in AIDS patients?

A

When CD4

407
Q

Name 4 killed virus vaccines

A

Injectable influenza, rabies, Hep A, Salk polio (injectable)

408
Q

Name 2 subunit vaccines

A

Hep B, HPV

409
Q

Name 3 egg-related vaccines

A

Influenza, yellow fever, MMR

410
Q

Name the causative agent: cold sores, gingivostomatitis, keratoconjunctivitis, temporal lobe encephalitis, cold cores

A

HSV-1 (HHV-1)

411
Q

What is the Tzanck smear and what does it look for?

A

Scrape base of open vesicle and mount on slide, look for nultinucleated giant cells. Suggests HSV-1, HSV-2, VZV

412
Q

What can VZV (HHV-3) cause in adults?

A

Pneumonia, encephalitis

413
Q

How are HSV-1, HSV-2, and VZV diagnosed?

A

Tzanck smear, PCR of vesicular fluid (HSV), intranuclear eosinophilic inclusions (Type A Cowdry bodies/Type 1 Cowdry inclusions)

414
Q

What are Type A Cowdry bodies / Type 1 Cowdry inclusions, and what do they sggest?

A

Intranuclear eosinophilic inclusions; HSV & VZV

415
Q

Name the disease and causative agent: 15-24 age group, infects B cells, Downey cells, fever, sore throat, posterior cervical LAD, exudative pharyngitis

A

Infectious mononucleosis; EBV (HHV-4)

416
Q

Name the finding and disease: atypical T cells with foamy-appearing basophilic cytoplasm

A

Downey cells, infectious mononucleosis

417
Q

What cells are infected in infectious mononucleosis?

A

B cells, triggering a T cell response and atypical lymphocytosis

418
Q

What is a major complication of infectious mononucleosis?

A

Splenomegaly

419
Q

What is the Monospot test, and what is it used for?

A

Dx of mono, detects heterophile Abs (antigens foudn in horse, sheep, and beef RBCs)

420
Q

Causes of heterophile (-) mononucleosis (5)

A

CMV, acute HIV, toxoplasmosis, viral hepatitis, strep throat

421
Q

EBV-associated malignancies (6)

A

Hodgkin & Burkitt lymphoma, nasopharyngeal carcinoma, diffuse large cell lymphoma, oral hairy leukoplakia, lymphoproliferative disorders

422
Q

Name the causative agent: heterophile-negative mini, life threatening pneumonia in marrow transplant pts, retinitis/GI ulcerations/esophagitis in AIDS

A

CMV (HHV-5)

423
Q

“Owl’s eye” nuclear inclusions in mononuclear and polymorphonuclear cells

A

CMV

424
Q

Name the disease and causative agent: children, 3-5 days high fever, diffuse maculopapular rash, can cause febrile seizures

A

Roseola / sixth disease / exanthem subitum; HHV-6

425
Q

Name the causative agent: causes highly vascular tumours, infects spindle cells from vascular and lymphatic endothelial tissue, prevalence higher in men who have sex with men

A

HHV-8 (Kaposi Sarcoma-associated Herpesvirus, KSHV)

426
Q

What does HHV-7 cause?

A

May cause roseola-like infection

427
Q

Tx for Kaposi sarcoma tumours

A

HAART, alitretinoin (topical), vinblastine (intralesional), dauno/doxorubicin

428
Q

Types of Kaposi sarcoma (3)

A

Classic (slow growing, mets rare), epidemic (HIV/AIDS), immunocompromised (transplant patients)

429
Q

MOA of acyclovir, and clinical uses

A

Guanosine analog, phosphorylated by viral thymidine kinase, inhibits DNA polymerase. HSV-1 & 2, VZV, EBV.

430
Q

MOA and clinical uses of famciclovir

A

Prodrug of an acyclic guanosine nucleoside analog, relies on viral thymidine kinase. HSV-1 & 2, VZV.

431
Q

MOA, clinical uses, and ADRs of ganciclovir

A

Activated by CMV viral kinase, inhibits viral DNA pol. Used for CMV. ADRs: bone marrow suppression, renal toxicity

432
Q

MOA and clinical uses of foscarnet

A

Inhibits DNA pol, doesn’t require activation by thymidine kinase. Uses: resistant HSV, CMV retinitis.

433
Q

What does parvovirus B19 cause in adults?

A

Inflammatory arthritis (looks like RA)

434
Q

What is the causative agent of common warts?

A

HPV Types 1 & 2

435
Q

What is the causative agent of 90% of genital warts?

A

HPV Types 6 & 11

436
Q

What virus is associated with invasive cervical, vulvovaginal, anal, penile, and H&N cancers?

A

HPV Types 16 & 18

437
Q

Name the dsDNA virus: URI followed by conjunctivitis, febrile pharyngitis, acute hemorrhagic cystitis, pneumonia, diarrhea

A

Adenovirus

438
Q

Name the causative agent: infected cow udder, “milkmaid’s blisters”, provides immunity to smallpox

A

Vaccinia poxvirus (cowpox), DNA virus

439
Q

Name the causative agent: umbilicated, flesh-coloured dome shaped lesions, relatively benign, usually resolves within 1 yr

A

Molluscum contagiosum (DNA virus)

440
Q

Name the causative agent: progressive multifocal leukoencephalopathy in HIV patients

A

JC virus (type of Polyomavirus)

441
Q

Aplastic anemia in a sickle cell patient

A

Parvovirus B19

442
Q

Child with a fever and “slapped cheek” rash on the face that spreads to the body, lacy

A

Parvovirus B19 (Fifth disease)

443
Q

What is the structure of reoviridae? Name two types.

A

Non-enveloped, icosahedral, dsRNA; rotavirus & coltivirus

444
Q

Name the causative agent and structure: #1 cause of fatal diarrhea in children worldwide, outbreaks in winter months, often in daycares and playgroups

A

Rotavirus (nonenveloped dsRNA)

445
Q

Name the disease, causative agent, and structure: mountainous regions of W. U.S. And Canada, spread by woodtick, acute and self-limited flu-like illness

A

Colitvirus (nonenveloped dsRNA)

446
Q

Name 3 enteroviruses, the general structure, and family

A

Poliovirus, Coxsackivirus, Echovirus; (+)ssRNA; Picornaviridae

447
Q

Name the causative agent and structure: aseptic meningitis, myocarditis, herpangina, febrile pharyngitis, hand foot mouth, myocarditis and pericarditis

A

Coxsackievirus; (+)ssRNA, Enterovirus, Picornaviridae

448
Q

Name the causative agent and structure: infects grey matter of anterior horn of spinal cord & motor neurons of pons and medulla, paralysis

A

Poliovirus, (+)ssRNA (Enterovirus, Picornaviridae)

449
Q

What are the two polio vaccines?

A

Sabin: oral, live. SalK: injected, Killed.

450
Q

Name the causative agent and structure: aseptic meningitis, myocarditis, URIs, summer outbreaks, detected with PCR of CSF

A

Echovirus: (+)ssRNA (Enterovirus, Picornaviridae)

451
Q

Name 2 causes of common cold

A

Rhinovirus (Picornaviridae), Coronavirus

452
Q

Name the causative agent and structure: viral gastroenteritis, outbreaks on cruise ships and in nursing homes, spread via fecal-oral or vomit

A

Norwalk virus; (+)ssRNA (Caliciviridae)

453
Q

Name the causative agent and structure: transmitted by Aedes mosquito, Sub-Saharan Africa and S. America, high fever, hemorrhagic disease, jaundice, coffee ground hematemesis, epistaxis, gum bleeding, petechiae/purpura, liver damage

A

Yellow Fever virus; (+)ssRNA (Flavivirus)

454
Q

Name the causative agent and structure: 4 serotypes, most prevalent mosquito-borne viral disease worldwide, muscle/joint pain, headache, retro-orbital pain,

A

Dengue Fever, from Dengue virus; (+)ssRNA (Flavivirus)

455
Q

What is the tourniquet test, and what is it used for?

A

Field test for Dengue hemorrhagic fever. BP cuff inflated to between SBP and DBP, leave for 5 min. Excess petechiae = incr capillary wall fragility + thrombocytopenia.

456
Q

Name the causative agent and structure: fever, LAD, arthralgias, maculopapular rash, congenital defects (PDA, pulm stenosis, cataracts, deafness)

A

Rubella virus; (+)ssRNA (Togavirus)

457
Q

From which family is the virus causing SARS?

A

Coronavirus

458
Q

Name 4 causes of rash on palms and soles

A

Hand foot & mouth disease (Coxsackievirus), Meningococcus, Rocky Mountain Spotted Fever, Syphilis

459
Q

Name 4 arboviruses that cause encephalitis

A

St. Louis encephalitis virus, Eastern equine encephalitis virus, Western equine encephalitis virus, California encephalitis virus

460
Q

From which family is the Human T Cell Leukemia Virus (HTLV)?

A

Retrovirus (enveloped +ssRNA)

461
Q

Name the causative agent and structure: bird reservoir, mosquito vector, headache, malaise, back pain, myalgia, anorexia. Severe symptoms: meningitis, encephalities, flaccid paralysis (anterior horn), AMS, death

A

West Nile Virus; (+)ssRNA (Flaviviridae)

462
Q

Dx and Tx for West Nile Virus

A

Dx: serology for IgM anti-WNV Abs. Tx: supportive

463
Q

What are the functions of hemagglutinin and neuraminidase?

A

Hemagglutinin promotes attachment of influenza virus to host cell, neuraminidase helps release progeny virus

464
Q

Which are the neuraminidase inhibitors and what is their MOA?

A

Oseltamivir, zanamivir. Block release of viral progeny

465
Q

Name the causative agent and structure: coryza, cough, conjunctivitis, Koplik’s spots, widespread maculopapular rash (starting at head and moving downward)

A

Rubeola virus (Measles); enveloped (-)ssRNA (Paramyxovirus)

466
Q

Name the finding and causative agent: blue-grey spots on buccal mucosa, surrounded by red

A

Koplik’s spots, rubeola virus (measles)

467
Q

Name the disease by complications: fetal loss, premature delivery, encephalitis (eg subacute sclerosing panencephalitis), giant cell pneumonia

A

Measles (rubeola virus)

468
Q

Name the causative agent and structure: parotitis, orchitis, meningitis

A

Mumps virus; enveloped (-)ssRNA (Paramyxovirus)

469
Q

Name the causative agent and structure: travels up peripheral nerves to CNS, Negri bodies, bullet-shaped capsids, fever, malaise, N/V, agitation, hallucinations, hydrophobia

A

Rabies virus; enveloped (-)ssRNA (Rhabdovirus)

470
Q

Name the finding and causative agent: eosinophilic cytoplasmic inclusions, contain viral nuclear capsids (bullet-shaped)

A

Negri bodies; Rabies virus

471
Q

3 RNA viruses spread by rodent urine

A

Hantavirus, Lassa fever, LCM virus

472
Q

Name the causative agent: hemorrhagic fever, pulmonary syndrome (progressive pulm edema, resp failure), spread by aerosolized mouse urine

A

Hantavirus (RNA virus)

473
Q

2 RNA viruses causing hemorrhagic fever, DIC, shock

A

Ebola virus, Marburg hemorrhagic fever

474
Q

Name the causative agent and treatment: URI, diarrhea, fever, pancytopenia, elevated aminotransferases, bird to human spread

A

Avian influenza (H5N1); oseltamivir

475
Q

Name the causative agent and treatment: typical flu + GI symptoms, derived from 4 strains from 3 species

A

Swine flu (H1N1); oseltamivir or zanamivir

476
Q

Name the disease and Tx: barking seal cough, resp distress, inspiratory stridor, steeple sign on CXR, ages 6 mos to 3 years

A

Parainfluenza / Croup (laryngo-tracheo-bronchitis); cool mist humidifier (no proven benefit), racemic epinephrine, one dose dexamethasone, supportive, oxygen as needed

477
Q

What is the steeple sign on CXR and what is it a sign of?

A

Due to subglottic narrowing, may indicate croup

478
Q

Name the causative agent: bronchiolitis +/- pneumonia, brassy cough, wheezing, winter, fusion (F) protein allowing infected cells to bind to nearby uninfected cells

A

Respiratory Syncytial Virus (RSV) bronchiolitis

479
Q

Tx for RSV bronchiolitis

A

Supplemental O2, albuterol / racemic epinephrine (not routine), ribavirin (in adults, esp if after bone marrow transplant)

480
Q

MOA, uses, and ADRs of ribavirin

A

Guanosine analog, inhibits synth of guanine nucleotides. Uses: RSV, Hep C. ADRs: teratogen, hemolytic anemia.

481
Q

Name the class and MOA: ritonavir, indinavir, nelfinavir, atazanavir

A

Protease inhibitors; prevents HIV-1 protease from chopping viral polypeptides into individual functional proteins

482
Q

Name the HIV drug by ADRs: GI intolerance, inhibit P450, hyperlipidemia / hypertriglyceridemia, lipodystrophy, pancreatitis, nephrolithiasis, incr bilirubin

A

Protease inhibitors

483
Q

Name the class and MOA: zidovudine, didanosine, lamivudine, abacivir, emtricitabine

A

Nucleoside reverse transcriptase inhibitors (NRTI); competitively inhibit HIV reverse transcriptase, must be activated by thymidine kinase

484
Q

Name the class and MOA: tenofovir

A

Nucleotide reverse transcriptase inhibitors (NtRTI); competitively inhibit HIV reverse transcriptase, must be activated by thymidine kinase

485
Q

Name the HIV drug class by ADRs: bone marrow suppression, pancreatitis, peripheral neuropathy, hepatic steatosis, hypersensitivity reaction

A

Nucleoside reverse transcriptase inhibitors (NRTI)

486
Q

Name the class and MOA: nevirapine, delavirdine, efavirenz, etravirine, rilpivirine

A

Non-nucleoside reverse transciptase inhibitors (NNRTI); non-competitively inhibit reverse transcriptase, don’t need to be phosphorylated to be active

487
Q

Name the HIV drug by ADRS: rash, neuropsychiatric symptoms, false-positive drug test to cannabinoids, teratogenic

A

NNTRIs (esp efavirenz)

488
Q

MOA of enfuvirtide

A

HIV drug; fusion inhibitor, binds to gp41

489
Q

MOA of raltegravir

A

HIV drug; integrase inhibitor

490
Q

MOA of maraviroc

A

HIV drug; CCR5 antagonist (ie on macrophages), inhibits gp120 conf change so virus can’t bind host cell effectively

491
Q

MOA and clinical uses of Amphotericin B

A

Polyene antifungal: binds ergosterol, forms pores in memb. Used for systemic fungal infections.

492
Q

Name the antifungal by ADRs: fever & chills, hypotension, hypokalemia, anemia, phlebitis, arrhythmias, nephrotoxicity

A

Amphotericin B (“Amphoteribble”)

493
Q

Name the antifungal: can be used infused intrathecally

A

Amphotericin B

494
Q

MOA and clinical uses of nystatin

A

Polyene antifungal: binds ergosterol, forms pores in memb. Used for cutaneous candidiasis, oropharyngeal candidiasis. Topical only (too toxic for systemic)

495
Q

MOA of azole antifungals

A

Inhibits P450 enzyme that converts lanosterol to ergosterol

496
Q

Name the antifungal by ADRs: decr production of cortisol and testosterone (gynecomastia and impotence), drug-drug interactions (blocks P450), incr hepatic enzymes, hepatotoxicity

A

Azoles

497
Q

MOA and clinical uses of flucytosine

A

Converted into 5-FU, disrupts DNA & RNA synth. Used in combo with amphotericin B for systemic candidal and crypococcal infections

498
Q

MOA and clinical uses of caspofungin

A

Echinocandin antifungal: inhibits synth of beta-1,3D glucan, inhibiting cell wall synth. Used for ASPergillosis, candida

499
Q

MOA and clinical uses of terbinafine

A

Inhibits fungal squalene epoxidase, inhibiting ergosterol synth. Topical for tinea pedis & cruris, oral for onychomycosis and tinea capitis. Deposited in hair, nails, and fat.

500
Q

MOA and clinical uses of griseofulvin

A

Targets microtubule function, inhibits mitosis, deposits in keratin-containing tissue. Used for tinea corporis and capitis, onychomycosis

501
Q

Name the antifungal by ADRs: may be teratogenic, headache, GI symptoms, confusion, P450 inducer

A

Griseofulvin

502
Q

Name the causative agent and Dx test: mild and self-limiting diarrhea in normal individuals, chronic watery diarrhea in AIDS patients

A

Cryptosporidium; Dx by oocysts on acid fast stain of stool

503
Q

Name the causative organism and Dx test: fatty, foul-smelling diarrhea, flatulence, abdo bloating, belching, hikers and campers

A

Giardia lamblia; Dx by pear-shaped trophozoites (double nuclei, owl’s eye appearance) or cysts in stool

504
Q

Name the causative organism and Tx: pear-shaped trophozoites (double nuclei, owl’s eye appearance) or cysts in stool

A

Giardia lamblia; metronidazole, tinidazole

505
Q

Name the causative organism and Dx: bloody diarrhea, flask-shaped ulcer, invasion of colon, liver abscess

A

Entamoeba histolytica; Dx via trophoziotes/cysts in stool with multiple nuclei, Abs against entamoeba, stool antigen test

506
Q

Tx for Entamoeba histolytica

A

Metronidazole or tinidazole (for trophozoites), + iodoquinol or paromomycin (for cysts)

507
Q

Most common protozoal infection in the U.S.

A

Trichomonas vaginalis

508
Q

Dx and Tx for Trichomonas vaginalis

A

Wet mount of vaginal discharge shows trophozoites (pear-shaped, very motile). Metronidazole

509
Q

Name the causative organism and Dx: ring enhancing lesions on MRI in HIV, congenital abnormalities (chorioretinitis + hydrocephalus + intracranial calcifications)

A

Toxoplasma gondii; serology (Abs) or biopsy of lesion

510
Q

Tx for Toxoplasma gondii

A

Sulfadiazine + pyrimethamine + folinic acid

511
Q

Name the causative organism and Tx: rapidly fatal meningoencephalitis, transmission from swimming in freshwater lakes, enters brain through cribiform plate

A

Naegleria fowleri; amphotericin B

512
Q

Name the causative organism and Dx: tsetse fly, fever, LAD, somnolence, encephalitis, coma, death

A

Trypanosoma brucei (Africa sleeping sickness); long wispy-looking organisms on blood smear

513
Q

Causative organism and Tx for African Sleeping Sickness

A

Trypanosoma brucei; suramin (early blood borne disease), melarsoprol (CNS involvement)

514
Q

Name the causative organism and Dx: S. America, reduviid bug, dilated cardiomyopathy, megaesophagus, megacolon

A

Trypanosoma cruzi (Chagas disease); blood smear

515
Q

Causative organism and Tx for Chagas disease

A

Trypanosoma cruzi; benznidazole, nifurtimox

516
Q

Name the causative organism, Dx, and Tx: sand fly, spiking fevers, hepatosplenomegaly, pancytopenia

A

Visceral leischmaniasis (Leischmania donovani); amastigotes inside macrophages; use liposomal amphotericin B

517
Q

Name the causative organism and Tx: sand fly, ulcerating papules slow to heal

A

Cutaneous leischmaniasis (Leischmania donovani); sodium stibogluconate

518
Q

Malaria: what is the mode of transmission? Which strains have 48h and 72h cycle?

A

Transmitted by Anopheles mosquito. 48 h: P. Ovale and vivax. 72 h : P. Malariae

519
Q

Which strains of malaria can cause dormant infection in the liver, and what is the Tx?

A

P. vivax and ovale; primaquine

520
Q

Name the causative organism: banana-shaped gametocytes on blood smear, “diamond ring”

A

Plasmodium falciparum (malaria)

521
Q

Tx for malaria

A

Chloroquine, + primquine (for P. Vivax or ovale). If chloroquine resistant: quinine + doxycycline, atovaquone-proguanil, artemesan-lumefantrine, mefloquine

522
Q

Name the causative organism and Tx: Ixodes tick, ring form on blood smear, tetrad shape (Maltese cross) inside RBCs, fever, hemolytic anemia, northeastern U.S.

A

Babesia microti (Babesiosis); quinine + doxycycline

523
Q

Most common protozoal diarrhea

A

Giardia lamblia

524
Q

Name the causative organism, Dx, and Tx: most common helminth infection in U.S., anal pruritis

A

Enterobius vermicularis (pinworm); Scotch tape test; albendazole, mebendazole, or pyrantel pamoate

525
Q

Name the causative organism and Tx: 2nd most common helminthic infection in U.S., bowel-lung-bowel cycle, can cause Loeffler eosinophilic pneumonitis

A

Ascaris lumbricoides (giant roundworm); mebendazole, albendazole, pyrantel pamoate

526
Q

Name the causative organism, Dx, and Tx: undercooked meat (pork, wild game), migration from GI to muscle, myositis, fever, eosinophilia, periorbital edema

A

Trichinella spiralis; muscle biopsy (see larvae); use benzimidazoles

527
Q

Name the causative organism and Tx: larvae live in soil and penetrate skin, travel to lungs and then GI (autoinfection), dermatitis

A

Strongyloides stercoralis; ivermectin, mebendazole

528
Q

Name the causative organism and Tx: penetrate skin of feet, autoinfection, suck blood from wall of small intestine, abdo discomfort, anemia

A

Ancylostoma and Necator (hookworms); albendazole, mebendazole, pyrantel pamoate

529
Q

Name 3 nematodes that enter humans orally

A

“EAT”: Enterobius, Ascaris, Trichinella

530
Q

Name the causative organism and Tx: undercooked pork, adult infects GI, larvae infect tissues (cysticercosis), myositis, brain cysts, seizures, AMS, psych symptoms

A

Taenium solium; praziquantel, albendazole + dexamethasone (neurocysticercosis)

531
Q

Name the causative organism and Tx: raw fish, B12 deficiency, megaloblastic anemia

A

Diphyllobothrium latum (fish tapeworm); praziquantel

532
Q

Name the causative organism and Tx: dog feces, mature larval cysts in host parenchyma (liver and eyes), anaphylaxis

A

Echinococcus granulosis (dog tapeworm); Sx removal/aspiration of cysts, injection of scolicidal agent (EtOH, hypertonic saline), albendazole

533
Q

Name the causative agent and Tx: mosquitoes, inflammation and obstruction of lymphatics, elephantiasis, hydrocele, lymphatic filariasis

A

Wuchereria bancrofti; diethylcarbamazine

534
Q

Which three roundworms are transmitted through the soil?

A

“SANd”: Strongyloides, Ancylostoma, Necator

535
Q

Name the causative organism and Tx: freshwater snail as intermediate host, swimmer’s itch, migrates to lung/liver, portal HTN and splenomegaly

A

Schistosoma mansoni & haematobium (blood flukes); praziquantel

536
Q

Which trematode is associated with squamous cell cancer of the bladder?

A

Schistosoma haematobium (blood fluke)

537
Q

Name the causative organism and Tx: chronic bronchitis, hemoptysis, undercooked crab meat

A

Paragonius westermani (lung fluke); praziquantel

538
Q

Name the causative organism and Tx: undercooked fish, inflammation of biliary tract, pigmented gallstones, cholangiocarcinoma

A

Clonorchis sinensis (liver fluke); praziquantel, albendazole

539
Q

Tx for Pediculosis capitis (head lice)

A

Permethrin, pyrethrin, malathion, ivermectin, spinosad, benzyl alcohol

540
Q

Tx for Pediculosis pubis (pubic lice, crabs)

A

Permethrin, pyrethrin

541
Q

Name the causative organism and Tx: severe pruritis, small papules at site of entry, webbing between fingers, linear burrows

A

Scabies; permethrin 5% cream, ivermectin

542
Q

Name the causative organism: highly contagious, widespread keratotic crusted lesions in immunocompromised patients

A

Norwegian scabies

543
Q

Name the helminth: adult patient from Mexico with new onset seizures and brain calcifications

A

Taenium solium

544
Q

Why is lindane not the preferred agent in the treatment of lice?

A

Neurotoxicity

USMLE (23 decks)

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