Extra Flashcards
Name the live attenuated vaccines
Herpes zoster Varicella Influenza (also inactivated) Measles, mumps, rubella Oral typhoid Rotavirus Yellow fever Oral cholera
Name the inactivated vaccines
Diphtheria, tetanus, pertussis H. Influenzae Hep. A and B Human papilloma Influenza (also live attenuated) Meningococcal Pneumococcal Rabies Typhoid Inactivated polio
Candida albicans
Yeast
Part of normal flora (skin, vagina, mouth, bowels)
Opportunistic pathogen (thrush, vaginitis, diaper rash)
Can produce pseudohypha and true hypha (via germ tube)
To treat, use azoles, echinocandins, and polyenes
Aspergillus
Mold
Septate hyphae
Opportunistic pathogen
Rhizopus/mucor/rhizomucor
Zygomycete (nonseptate)
Causes rhinocerebral zygomycosis (mucormycosis)
Opportunistic pathogen
Thrives in high glucose and acidic environments
mycobacterium tuberculosis/bovis
Bacilli, obligate aerobe, AFB (mycolic acids, waxy coat, technically gram +), slow growing, infectious via respiratory route. Noninfectious in latent phase. Granuloma - immune system walling off infection, caesous necrosis. Ghon complex - lymph node +calcified granuloma. Early stage results in cough, bloody sputum, tissue necrosis. Cant tell between MTB and NTM through microscopy.
Pseudomonas aeruginosa
Gram negative, bacilli, obligate aerobe, oxidase positive, produces pyocyanin, does not ferment lactose or glucose, smells like corn chips, grows at 47 C.
Streptococcus species
Gram positive, microaerophilic, major cause of endocarditis (especially S. Mutans)
S. Pyogenes causes strep throat. Beta hemolytic (other strep.species are alpha or gamma). Inhibited by low concentration of bacitracin.
Staphylococcus aureus
Gram positive
Normal part of oropharyngeal flora (1/3rd of population)
May cause food poising, endocarditis, toxic shock syndrome, cellulitis, abscesses
Influenza A
Enters via viropexis
May cause the flu (fever, chills, aches) or viral pneumonia
Live attenuated or inactivated vaccine
Spread through respiratory route
Incubation = 1-2 asymptomatic
Virus is shed 5-10 days after symptoms appear
Bordatella pertussis
Causes whooping cough
Gram -, obligate aerobe, coccobacillus
Can cause pharyngitis
Inactivated vaccine available
Legionella pneumophilia
Gram -, obligate aerobe, pleomorphic, forms biofilm in water systems, grows on BYCE only (contains L cysteine, takes 3-7 days to grow). Can cause environmentally aquired atypical pneumonia.. can be necrotizing resulting in bloody mucousy sputum. Requires non B lactam antibiotics
Cryptococcus neoformans
Opportunistic fungi Yeast Obligate aerobe Capsule Causes lung diseases Found in bird poop
Haemophilis influenzae
Pleomorphic, gram -, facultative anaerobe
May cause pneumonia, otitis, *epiglottitis.
Only grows on chocolate agar** (requires hemin and NAD)
Only competent to transformation with same genus
Killed by aminopenicillins
Klebsiella pneumoniae
Enteric gram -, bacilli, capsule, facultative anaerobe, can cause acute atypical pneumonia, oxidase negative, lactose fermenter, glucose fermenter
Clostridium difficile
Gram positive, obligate anaerobe, forms spores and biofilms, may cause pseudomembranous colitis with antibiotics, fecal transplants may overcome these infections
Streptococcus pneumoniae
Gram positive, microaerophilic, capsule, catalase negative, sensitive to optochin, bile soluble (sodium desoxycholate), most common cause of acute typical pneumonia
SBA
Demonstrates hemolysis…
A - greenish halo
B - colorless halo
Gamma - no halo
Chocolate agar
Lysed SBA
Grows fastidious organisms
X and V factors
Grows haemophilis influenzae
CNA
Growth of G + while inhibiting growth of G -
It is SBA with acids added to it
Macconkey’s agar
Growth of G - while inhibiting G +, yeast, and G - cocci.
Pink = lactose fermenter
Yellowish = non lactose fermenter
TSB
Allows rapid growth of bacteria
Modified thayer martin agar
Contains vancomycin
Modified chocolate agar
Allows isolation of N gonorrhea
Natural penicillins
Mechanism
Inhibits transpeptidase
Activates autolytic enzymes
Bactericidal
Penicillinase sensitive
Natural penicillins
Clinical use
Commmon streptococci, pneumococci, enterococci, meningococci, treponema pallidum
Natural penicillins
Toxicity
Hypersentivity reactions
Hemolytic anemia
Aminopenicillins
Mechanism
Similar to natural penicillins except have an extended spectrum for gram negative species such as haemophilus
Often combined with clavulanic acid (Amoxicillin + clavulanic acid = augmentin)
Aminopenicillins
Clinical use
G +, G - rods
Listeria monocytogenes
Enterococci
*prophylaxis for endocarditis
Aminopenicillins
Toxicity
Ampicillin rash
Pseudomembranous colitis
Which has better oral bioavailability, amoxicillin or ampicillin?
Amoxicillin
Penicillinase-resistant penicillins
Mechanism.
Same as penicillin
Narrow spectrum
Penicillinase resistant
Penicillinase resistant penicillins
Clinical use
Anti-staphylococcal penicillins
NOT MRSA!
Penicillinase resistant penicillins
Toxicity
Headache
Metallic taste
What drug should you use to treat non MRSA staph infections?
Nafcillin
Anti-pseudomonas penicillins
Mechanism
Same as penicillins
Extended spectrum, (still penicillinase sensitive)
Anti-pseudomonas penicillins
Clinical use
Pseudomonas and gram - rods
Synergy with aminoglycosides
Anti-pseudonomal penicillins
Drugs
Ticarcillin
Carbenicillin
Piperacillin
Cephalosporins
Mechanism
Bactericidal
Penicillinase resistant
First generation cephalosporin clinical use
Proteus mirabilis
E. Coli
Klebsiella pneumonia
Second generation cephalosporins clinical use
Haemophilus influenza Enterobacter aerogenes Neisseria Proteus mirabilis E. Coli Klebsiella pneumonia Serratia marcescens
Third generation cephalosporin clinical use
Gram positive and gram negative cocci and gram negative bacilli
Meningitis, anaerobes, and gonococci, and pseudomonas
Fourth generation cephalosporin clinical use
Pseudomonas
Fifth generation cephalosporin clinical use
Covers MRSA
Carbapenems clinical use
Gram positive bacteria cocci
Gram - rods
Aneroebes
Drug of choice for enterobacteria
What is the drug of choice for enterobacteria?
Carbapenems
Toxicity of carbapenems
CNS toxicity***
Gi distress
Skin rash
Skeletal muscle toxicity
Aztreonam is a ____ but binds to ____
Monobactam
PBP3
(Penicillinase resistant)
Aztreonam clinical use
Works synergistically with aminoglycosides
Gram - aerobic rods
Serratia, pseudomonas, klebsiella
Aztreonam clinical use
Pseudomonas colitis
Fever
Diarrhea
Cellulitis
Vancomycin clinical use
Treats multi drug resistant gram + staphylococcus aureus (MRSA) and to treat clostridium dificile
Vancomycin toxicity
Neprhotoxicity
Ototoxicity
Thrombophlebitis
Red man syndrome
Daptomycin clinical use
Bactericidal
Treats MRSA
Zosyn is a combination of ___ with ___
Tazobactam and piperacillin
Unasyn is a combo of ___ with ___
Ampicillin and sulbactam
True or false… second generation cephalosporins are active against pseudomonas
False
