First Aid Flashcards
Triad of Rocky Mountain spotted fever
Headache
Fever
Rash (wrists, ankles then trunk, palms, soles) (vasculitis)
3 diseases with palms and soles rash
Coxsackievirus A
Rocky Mountain spotted fever
Secondary syphilis
Penicillin G (IV/IM) and Penicillin V (oral) used against
Gram +
Gram - cocci (N. meningitidis)
Spirochetes
Penicillinase-sensitive penicillins
Penicillin G, penicillin V
Ampicillin
Amoxicillin (greater oral bioavailability)
Ampicillin and amoxicillin used against
Many G- rods (HHEELPSS)
Penicillinase-resistant penicillins
Oxacillin
Nafcillin
Dicloxacillin
Penicillinase-resistant penicillins used against
S. aureus except MRSA
Antipseudomonal penicillins
Piperacillin
Ticarcillin
Antipseudomonal penicillins used against
Pseudomonas spp.
Gram - rods
Beta-lactamase inhibitors
Clavulanic acid
Sulbactam
Tazobactam
4 organisms not covered by 1-4th gen of Cephalosporins
Listeria
Atypicals (chlamydia, mycoplasma)
MRSA
Enterococci
1st gen Cephalosporins (cefazolin, cephalexin)
Gram + cocci
Proteus mirabilis
E. Coli
Klebsiella pneumoniae
2nd gen Cephalosporins (cefaclor, cefoxitin, cefuroxime)
Gram + cocci H. Influenzae Enterobacter aerogenes Neisseria spp. Serratia marcescens Proteus mirabilis E. Coli Klebsiella pneumoniae
3rd gen cephalosporins (ceftriaxone, cefotaxime, ceftazidime)
Ceftriaxone: meningitidis, gonorrhea, disseminated Lyme ds
Ceftazidime: pseudomonas
4th gen cephalosporins (cefepime)
Gram -
Pseudomonas
Gram +
5th gen cephalosporins (ceftaroline)
Gram +
Gram -
MRSA
(NOT pseudo)
Carbapenems
Imipenem
Meropenem
Ertapenem
Doripenem
Carbapenems used against
Gram + cocci
Gram - rods
Anaerobes
Monobactams (Aztreonam) used against
Gram - rods ONLY
If penicillin allergy or renal insuff who cannot tolerate aminoglycosides
Vancomycin (glycopeptide)
Gram + ONLY
Including MRSA, sensitive enterococcus, C. difficile
Protein synthesis inhibitors
50S: chloramphenicol, clindamycin, linezolid, macrolides, streptogramins
30S: aminoglycosides, tetracyclines
Aminoglycosides
Gentamincin Neomycin Amikacin Tobramycin Streptomycin
Aminoglycosides used against
Severe Gram - rod infections
Tetracyclines
Tetracycline
Doxycycline
Minocycline
Tetracyclines used against
Borrelia burgdorferi
Mycoplasma pneumoniae
Rickettsia
Chlamydia
Chloramphenicol used against
Meningitis (H. Influenzae, Neisseria meningitidis, Strepto pneumoniae)
Rocky mountain spotted fever (Rickettsia rickettsii)
Clindamycin used against
Anaerobic infections (Bacteroides spp., Clostridium perfringens) Invasive group A strepto infection
Clindamycin vs Metronidazole
Clindamycin: anaerobic infections above the diaphragm
Metronidazole: anaerobic infections below the diaphragm
Oxazolidinones (Linezolid) used against
Gram + (including MRSA and VRE)
Macrolides
Azithromycin
Clarithromycin
Erythromycin
Macrolides used against
Atypical pneumonias (Mycoplasma, Chlamydia, Legionella)
STIs (Chlamydia)
Gram + cocci (Strepto infections if allergy to penicillin)
Bordetella pertussis
Acid folic synthesis and reduction inhibitors
Sulfonamides (sulfamethoxazole, sulfisoxazole, sulfadiazine)
Trimethoprim
Sulfonamides used against
Gram + Gram - Nocardia Chlamydia Sulfamethoxazole for simple UTIs
Dapsone (similar to sulfonamides)
Leprosy
Pneumocystis jirovecii prophylaxis
Trimethoprim used against
Combined with SMX for: UTIs Shigella Salmonella Pneumocystis jirovecii Pneumonia ttt and prophylaxis Toxoplasmosis prophylaxis
Gyrase inhibitors
Fluoroquinolones (ciprofloxacin, norflo, levoflo, oflo, moxiflo, gemiflo, enoxacin)
Quinolone (Nalidixic acid)
Fluoroquinolones used against
Gram - rods of urinary and GI tracts (+ pseudomonas)
Neisseria
Some Gram +
Daptomycin used against
Staph aureus skin infections (+ MRSA)
Bacteremia
Endocarditis
VRE
Metronidazole used against
Giardia Entamoeba Trichomonas Gardnerella vaginalis Anaerobes (bacteroides, C. diff) H. Pylori (with Clarithromycin + PPI)
Prophylaxis against Mycobacterium
M. Tuberculosis: Isoniazid
M. Avium and M. Intracellulare: azithromycin, rifabutin
M. Leprae: -
Mycobacterium treatments
M. Tuberculosis: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
M. Avium - M. Intracellulare: Azithromycin or Clarithromycin + Ethambutol. Can add Rifabutin or Ciprofloxacin
M. Leprae: for tuberculoid, long-term Dapsone + Rifampin. For lepromatous, add Clofazimine
Rifamycins (mRNA synthesis inhibitors): Rifampin - Rifabutin
Used against
M. Tuberculosis
M. Leprae
Meningococcal prophylaxis
Chemoprophylaxis in contacts of children with H. Influenzae B
Isoniazid (mycolic acid synthesis inhibitor) used against
M. Tuberculosis (monotherapy for latent TB, monotherapy for prophylaxis, combined for treatment)
Treatments of MRSA, VRE, multidrug-resistant P. aeruginosa and multidrug-resistant Acinetobacter baumannii
MRSA: vancomycin, daptomycin, linezolid, tigecycline, ceftaroline
VRE: linezolid and streptogramins (quinupristin, dalfopristin)
MDR P. aeruginosa and MDR A. baumannii: polymyxins B and E (colistin)
Amphotericin B (acts on cell membrane integrity) used against
Serious, systemic mycoses Cryptococcus Blastomyces Coccidioides Histoplasma Candida Mucor
Nystatin (acts on cell membrane integrity)
Topical use only for diaper rash, vaginal candidiasis
For oral candidiasis
Flucytosine (nucleic acid synthesis inhibitor) used against
Systemic fungal infections with Amphotericin B (especially meningitis by Cryptococcus)
Azoles (ergosterol synthesis inhibitors)
Clotrimoxazole Fluconazole Itraconazole Ketoconazole Miconazole Voriconazole
Azoles used against
Local and less serious systemic mycoses
Fluconazole: chronic suppression of cryptococcal meningitis in AIDS patients + candidal infections
Itraconazole: Blastomyces, coccidioides, histoplasma
Clotrimoxazole and Miconazole: topical infections
Terbinafine (lanosterol synthesis inhibitor) used against
Dermatophytoses (especially onychomycosis)
Echinocandins (cell wall synthesis inhibitors)
Anidulafungin
Caspofungin
Micafungin
Echinocandins used against
Invasive aspergillosis
Candida
Griseofulvin used against
Oral treatment of superficial infections
Inhibits growth of dermatophytes
Antiprotozoan therapy
Pyrimethamine (toxoplasmosis)
Suramin and melarsoprol (trypanosoma brucei)
Nifurtimox (T cruzi)
Sodium stibogluconate (leishmaniasis)
Anti-mite/louse therapy: for scabies (Sarcoptes scabei) and lice (Pediculus and Phthirus)
Permethrin
Malathion
Lindane
Chloroquine used against
Plasmodial species (other than P. falciparum)
P. falciparum: artemether/lumefantrine or atovaquone/proguanil
Life-threatening malaria: quinidine (quinine) or artesunate
Antihelminthic therapy
Mebendazole (microtubule inhibitor) Pyrantel pamoate Ivermectin Diethylcarbamazine Praziquantel
Neuraminidase inhibitors (inhibition of progeny virus release)
Oseltamivir
Zanamivir
Oseltamivir and zanamivir used against
Treatment and prevention of Influenza A and B
Nucleic acid synthesis inhibitors (antiviral): 3 mechanisms
Guanosine analogs (Acyclovir, Famciclovir, Valacyclovir and Ganciclovir) Viral DNA polymerase inhibitors (Cidofovir, Foscarnet) Guanine nucleotide synthesis (Ribavirin)
Acyclovir, Famciclovir, Valacyclovir used against
HSV VZV Weak activity against EBV No effect on latent forms of HSV ans VZV For herpes zoster: Famciclovir
Ganciclovir (Valganciclovir) used against
CMV
Foscarnet used against
CMV retinitis in immunocompromised patients when ganciclovir fails
Acyclovir-resistant HSV
Cidofovir used against
CMV retinitis in immunocompromised patients
Acyclovir-resistant HSV
Protein synthesis inhibitors (antiviral)
Interferon-alpha: against chronic HBV and HCV, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma
Interferon-beta: against multiple sclerosis
Interferon-gamma: chronic granulomatous disease
Uncoating inhibitors (antiviral)
Amantadine
Rimantadine
No longer used for Influenza (high resistance)
HIV therapy drugs
NRTIs NNRTIs Protease inhibitors Integrase inhibitors Fusion inhibitors (on attachment or penetration)
7 NRTIs
Abacavir (CI if HLA-B*5701 mutation)
Didanosine
Emtricitabine
Lamivudine
Stavudine
Tenofovir (nucleotide/ others nucleosides)
Zidovudine (for general prophylaxis and during pregnancy)
3 NNRTIs
Delavirdine (CI in pregnancy)
Efavirenz (!!! Vivid dreams and CNS symptoms) (CI in pregnancy)
Nevirapine
7 Protease inhibitors
Atazanavir Darunavir Fosamprenavir Indinavir (!!! Nephropathy, hematuria) Lopinavir Ritonavir Saquinavir
3 Integrase inhibitors
Raltegravir
Elvitegravir
Dolutegravir
2 Fusion inhibitors
Enfuvirtide (binds gp41, inhibits penetration) (! Skin reaction)
Maraviroc (binds CCR-5 on host cell, inhibits attachment)
Hepatitis C therapy: 3 drugs
Ribavirin: against chronic HCV, RSV (Palivizumab in children)
Sofosbuvir: against chronic HCV with Ribavirin +/- peginterferon alfa
Simeprevir: against chronic HCV with Ledipasvir
Giemsa stain (5 organisms)
Chlamydia Borrelia Rickettsia Trypanosomes Plasmodium
PAS stain (glycogen) (1 organism)
Trophyrema whipplei (Whipple ds)
Silver stain (3 organisms)
Fungi (Coccidioides, Pneumocystis jirovecii)
Legionella
Helicobacter pylori
Thayer-Martin agar (selective media)
Neisseria
Vancomycin (against G+)
Trimethoprim and Colistin (against G-)
Nystatin (fungi)
Mac-Conkey agar
Lactose-fermenting enterics (acid, pink)
Anaerobes
Nocardia
Pseudomonas aeruginosa
Mycobacterium tuberculosis
Anaerobes (lack catalase and/or superoxide dismutase)
Clostridium
Bacteroides
Fusobacterium
Actinomyces
3 obligate Intracellular bugs
Rickettsia
Chlamydia
Coxiella
8 facultative intracellular bugs
Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia pestis
7 encapsulated bacteria
Pseudomonas aeruginosa Streptococcus pneumoniae Haemophilus influenzae type B Neisseria meningitidis E. Coli Salmonella Group B Strep
2 pneumococcal vaccines
Pneumococcal conjugate vaccine (Prevnar)
Pneumococcal polysaccharide vaccine with no conjugated protein (Pneumovax)
8 urease-positive organisms (struvite stones)
Proteus Cryptococcus H. Pylori Ureaplasma Nocardia Klebsiella Staph epidermidis Staph saprophyticus
10 catalase-positive organisms
Nocardia Pseudomonas Listeria Aspergillus Candida E. Coli Staphylococci Serratia B. Cepacia H. Pylori
Chronic granulomatous disease (NADPH oxidase deficiency) recurrent infections with
Catalase-positive organisms
In vivo biofilm-producing bacteria
1- Catheter + prosthetic devices
2- Dental plaques + infective endocarditis
3- Respiratory tree colonization in Cystic fibrosis + Contact lens
4- Otitis media
1- Staph epidermidis
2- Strepto viridans (mutans, sanguinis)
3- Pseudomonas aeruginosa
4- Nontypeable (unencapsulated) H. Influenza