Emerging Infectious Diseases Kays Flashcards by Rehman Hameed

most frequent cause of CRE (carbapenemase-resistant enterobacterales) infections in the United States

KPC (Klebsiella pneumoniae carapenemase)

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mean incubation period for SARS-CoV-2

5-6 days (range 2-12 days)

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FDA-approved humanized monoclonal antibody against the human IL-6 receptor

tocilizumab

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remdesivir MOA for COVID

interferes with viral RNA-dependent RNA polymerase; delayed chain termination of viral RNA transcription

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remdesivir should be initiated within ___ days of symptom onset for COVID

7 days

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nirmatrelvir/ritonavir (Paxlovid) is suggested to be initiated within ___ days of symptom onset

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true or false: Paxlovid is dosed based on renal function

true

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what year was Monkeypox discovered?

1958 (first human case in 1970)

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what drug is recommended in ambulatory pts (at least 18 years of age) with mild-to-moderate COVID-19 at high risk of progression to severe disease who have no other treatment options?

molnupiravir (Lagevrio)

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most common symptom of Monkeypox

rash

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true or false: Monkeypox is more common in females

false (0% female, > 99% male, < 1% trans/nonbinary)

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Monkeypox treatment drug

Tecovirimat

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recommended regimen for chlamydial infection among adolescents and adults

doxycycline 100 mg orally BID for 7 days

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alternative drugs for treatment of STIs (2 of them; not doxycycline)

azithromycin or levofloxacin

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what drug is the recommended regimen for uncomplicated gonococcal infection of the cervix, urethra, or rectum among adults and adolescents?

ceftriaxone 500 mg in single dose for persons < 150 kg

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drug for primary and secondary syphilis among adults (2 of them)

benzathiene penicillin; doxycycline

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drug for neurosyphilis, ocular syphilis, or otosyphilis among adults

aqueous crystalline penicillin G

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example of acquired resistance (slide 52 of 82)

fluoroquinolones vs P. aeruginosa

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what is intrinsic resistance vs acquired resistance? (from the internet)

Intrinsic is a natural resistance, the organism is always resistant. Acquired is is when an organism is initially susceptible, but mutations occur that make it resistant (“acquired”)

three specific mechanisms of intrinsic resistance (slide 55 of 82)

-enzymatic inactivation
-alteration of target site
-altered permeability of bacterial cell

3 mechanisms of genetic exchange for resistance (slide 53 of 82)

-conjugation
-transduction
-transformation

common cause of CRE in Europe

OXA-48

which gene encodes for resistance to colistin?

MCR-1

3 stages of COVID-19 disease progression

-stage 1 -> early infection
-stage 2 -> pulmonary phase
-stage 3 -> hyperinflammation phase

when is the viral response phase for COVID-19? (slide 11)

from start of stage I to end of stage II

when is the host inflammatory response phase for COVID-19? (slide 11)

from stage II to end of stage III

3 STI's we talked about in lecture

chlamydia gonorrhea syphilis

what was Alexander Fleming's warning in 1945?

basically about how the misuse of penicillin would lead to resistance

which is not an example of intrinsic resistance? (slide 52) a. beta-lactams vs mycoplasma b. fluoroquinolones vs P. aeruginosa c. vancomycin vs gram-negatives d. cephalosporins vs enterococci e. aminoglycosides vs anaerobes

b. fluoroquinolones vs P. aeruginosa

which is most common mechanism of resistance? a. conjugation b. transduction c. transformation

a. conjugation

which mechanism of genetic exchange involves transfer of genes between bacteria by bacteriophage (viruses)? a. conjugation b. transduction c. transformation

b. transduction

Ambler classification is for what class of enzymes?

beta-lactamases (goes from A to D)

two urgent antibiotic resistance threats in the US, 2019 (bolded on slide 60)

-Carbapenem-resistant Acinetobacter -Carbapenem-resistant Enterobacterales

KPC is a. class A b. class B c. class C d. class D

a. class A

NDM (New Delhi metallo-beta-lactamase) is readily transmissible among gram-neg bacilli and is a. class A b. class B c. class C d. class D

b. class B

OXA-type (Oxacillinase) is the predominant cause of carbapenam-resistant Acenetobacter baumannii (CRAB) and is a. class A b. class B c. class C d. class D

d. class D

which is a potent, reversible inhibitor of class A, class C, and some class D (OXA-48) β-lactamases? a. ceftazidime b. avibactam

b. avibactam

which is a 3rd generation cephalosporin with activity against P. aeruginosa? a. ceftazidime b. avibactam

a. ceftazidime

ceftazidime-avibactam (Avycaz) 3 FDA-approved indications (slide 67)

-complicated intra-abdominal infections, in combo with metronidazole -complicated urinary tract infections, including pyelonephritis -hospital-acquired bacterial pneumonia (HABP)/ventilator-associated bacterial pneumonia (VABP)

which is a broad-spectrum carbapenem? a. meropenem b. vaborbactam

a. meropenem

which is a novel boronic acid-based beta-lactamase inhibitor? a. meropenem b. vaborbactam

b. vaborbactam

Vaborbactam inhibits which two classes of lactamases?

A and C

meropenem-vaborbactam (Vabomere) FDA approved indication

complicated urinary tract infections, including pyelonephritis

Recarbrio is a combo of imipenem, cilastatin, and relebactem. What drug class are imipenem and relebactam?

imipenem -> carbapenem relebactam -> beta-lactamase inhibitor against class A and C

FDA approved indications of imipenem-cilastatin-relebactam (Recarbrio) (2 of them)

-complicated UTI including pyelonephritis -complicated intra-abdominal infections

what drug is a "Trojan horse" siderophone cephalosporin?

cefiderocol (Fetroja)