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ID - Unit 3 Flashcards

1
Q

how is coccidioides transmitted?

A

inhalation of spores

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2
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

leishmaniasis amastigotes in macrophages in spleen

Middle East

sand fly

black fever, pancytopenia, HSM

stibogluconate, Ampho B

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3
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

trypanosoma cruzii (trypanosome in blood)

S/Central America

Reduviid bug / kissing bug

Romana’s sign (early sign, periorbital edema, usually unilateral), later signs = megacolon, megaesophagus, dilated cardiomyopathy

BENZnidazole, niFURtimax (cruisin’ in my BENZ in my FUR coat)

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4
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

entamoeba histolytica (cysts with up to 4 nuclei, ingested RBCs)

developing countries, men who have sex with men

fecal-oral (ingest eggs in contaminated water)

often asymptomatic, may have colonic ulcerations, flask-shaped lesions in colon, bloody diarrhea, liver cysts (usually R lobe, anchovy paste)

metronidazole, paramycin, iodoquinol (luminal agent)

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5
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

trichomonas vaginalis (motile trophozoite on wet mount)

STI (NO CYST FORM!!)

vaginitis/cervicitis STRAWBERRY CERVIX, yellow/green discharge

metronidazole (must treat partner as well)

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6
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

Giardia lambia

North America, camping

fecal-oral ingestion of eggs in contaminated water

steatorrhea, flatulence

metronidazole

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7
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

cryptosporidium (acid-fast stain)

Immunocompromised

fecal-oral, contaminated water

small intestine watery diarrhea, self-limiting except in I/C is severe

nitazoxamide, spiromycin

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8
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

toxoplamsa gondii (crescent-shaped trophozoites, no kinetoplast or flagella)

cat feces, uncooked meat

congenital: deafness, intracranial calcifications, chorioretinitis

HIV: encephalopathy (ring-enhancing lesions), nd brain biopsy to differentiate from primary CNS lymphoma)

sulfadiazine + pyramethazine

prophylaxis if CD4 <100 with TMP-SMX

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9
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

cyclospora (acid-fast oocysts like cryptosporidium but 2X BIGGER)

Central America, Peru

fecal-oral, contaminated produce

in patients with achlorhydria, “flu-like” symptoms (lethargy, muscle aches), severe GI –> chronic loss of appetite, nausea, loose stools

TMP-SMX

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10
Q

Bug

A

p. vivax (only young RBCs infected)

stippling (Schuffner’s dots)

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11
Q

Bug

A

p. falciparum (no merozoites in RBCs = schizonts seen in circulation, clogged in capillaries in periph)

multiple ring forms / RBC = greater infectivity

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12
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

schistosoma japonicum (egg with small spine)

Japan

snails

ascites, anemia, abd pain, HSM, eggs in stool

praziquantel

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13
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

schistosoma haemotobium (terminal spine)

Egypt

snails

hematuria, may cause bladder cancer, eggs in urine

praziquantel

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14
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

wuchereria bancrofti (microfilaria in peripheral blood)

culex mosquito

elephantiasis

diethylcarbamazine

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15
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

trichinella (cyst w/ worm on muscle biopsy)

larvae ingested from raw pork / bear meat

BILATERAL periorbital swelling (contrast w/ unilateral for Chagas/trypanosoma cruzii), muscle pain

benzimidazoles

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16
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

enterobius vermicularis (albuminous egg) / pinworm

US very common

eggs ingested

perianal itching

mebendazole, pyrantel pamoate

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17
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

ascaris lumbricoides (cysts in stool)

eggs ingested, fecal-oral, LUNG PHASE (also strongyloides, hookworm)

GI, obstruction

benzimidazoles, ivermectin

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18
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

strongyloides

larvae entry skin (through feet), LUNG PHASE (also ascaris, hookworm)

GI (severe in I/C, COPD, corticosteroids), purulent sputum, AUTOINFECTION

ivermectin

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19
Q

Bug

Geography

Transmission

Symptoms

Treatment

A

taenia solium (eggs with thick shells w/ radial striations, can’t diff from saginata based on eggs, look at scolex, solium has hooks saginata no hooks)

central america

uncooked pork, ingestion of EGGS

SEIZURES

albendazole

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20
Q

does histoplasma “hide” in macrophages?

A

YUP

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21
Q

what fungus might be likely to infect cavities in the lungs (like, say, ones created from previous TB infection)?

A

aspergillus

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22
Q

soap bubble lesions

A

cryptococcus neoformans

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23
Q

what fungal infection is associated with DKA?

A

mucormycosis

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24
Q

why can’t ampho B be used for pneumocystic pneumonia?

A

BECAUSE PNEUMOCYSTIS HAS NO ERGOSTEROL WOAH!

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25
Q

what’s that random treatment unique to sporothrix?

A

KI

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26
Q

why is trypanosoma brucei such a bitch?

A

antigenic variation

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27
Q

why do you have to check for G6PD deficiency before giving someone anti-malarial drugs?

A

because they cause acute hemolysis you asshole

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28
Q

which trypanosoma brucei is worse?

A

rhodesiense (E) is worse than gambiense (W) because it has an animal reservoir and therefore can get more fucked up or something

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29
Q

does trichomonas have a cyst form?

A

NOPE

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30
Q

which nematodes have a lung phase?

A

ascaris, strongyloides, hookworms (necatur, ancylostoma)

31
Q

what tapeworm causes B12 deficiency?

A

the fish one (diphyllobothrium)

32
Q

which kinds of hepatitis can cause chronic infection?

33
Q

what is the treatment for chronic HCV infection?

A

sofosbuvir (NS5B/polymerase inhibitor) + velpatasvir (NS5A/protein needed for replication inhibitor)

34
Q

what is the treatment for chronic HBV infection?

35
Q

which hepatitis viruses are common in the US?

36
Q

what type of vaccine for Hep A?

A

killed whole virus (give active + passive for acute infection)

37
Q

what type of vaccine for HBV?

A

surface Ag subunit vaccine

38
Q

What type of vaccine for HCV?

A

THERE ISN’T ONE

39
Q

What type of vaccine for hep d?

A

The hep B one protects against Hep D (surface Ag subunit vacc)

40
Q

what type of vaccine for Hep E?

A

it’s not FDA approved so who the fuck cares

41
Q

what is the window period for HBV infection, and what do you look for on serology?

A

when HBsAg = anti-HBsAg and therefore neither shows up on serology, need to look for anti-HBcAg IgM

42
Q

what is the significance of anti-HbeAg?

A

can tell the patient that they are on the road to recovery because it shows up before anti-HbsAg

43
Q

do you treat acute HBV or HCV infection?

44
Q

does strongyloides show eggs in the stool on O&P

A

NO! Only larvae

45
Q

Is rhinovirus acid-stable?

46
Q

contaminated shellfish

47
Q

devil’s grip?

A

coxsackie B

48
Q

what drug treats aspergillus?

A

voriconazole

49
Q

what is the mechanism of action of ampho B

A

binds ergosterol and creates pores in the cell membrane

50
Q

what is the mechanism of action of flucytosine?

A

inhibits DNA and RNA synthesis

51
Q

what is the mechanism of action of imidazoles and triazoles?

A

inhibit 14a-demethylase, enzyme that converts lanosterol to ergosterol

52
Q

what is the mechanism of action of echinocandins?

A

inhibit B-D-glucan synthesis AT THE CELL WALL (only drug that acts at cell wall NOT cell membrane)

53
Q

what is the mechanism of action of terbinafine?

A

inhibits squalene epoxidase

54
Q

what is the mechanism of action of grisofulvin?

A

inhibits MTs, blocks metaphase (accumulates in keratin)

55
Q

what are the adverse drug reactions for ampho B?

A

“shake & bake” fever

renal tubular acidosis

low Mg and K

anemia

56
Q

what are the adverse drug reactions for flucytosine?

A

bone marrow suppresion

57
Q

what are the adverse drug reactions for imidazoles?

A

block steroid synthesis

liver function

long QT

GI

58
Q

what are the adverse drug reactions for triazoles?

A

teratogenic (fluconazole)

59
Q

what are the adverse drug reactions for echinocandins?

A

minor GI

histamine release

facial flushing

60
Q

what are the adverse drug reactions for terbinafine?

A

taste disturbance

GI

headache

hepatotoxic

61
Q

what are the adverse drug reactions for grisofulvin?

A

teratogenic

antibuse reaction

62
Q

which antifungals inhibit P450?

A

imidazoles (a lot)

triazoles (a little)

63
Q

which antifungals induce P450?

A

grisofulvin

64
Q

what is the treatment for cryptococcal meningitis?

A

Ampho B + flucytosine

followed by fluconazole

65
Q

what is the treatment for tinea (capitus, corporalis, pedis, cruris)

A

clotrimazole, ketoconazole, miconazole

66
Q

what is the treatment for candida infection in pregnancy?

A

clotrimazole, miconazole

67
Q

what is the treatment for candida (not pregnant)

A

fluconazole or voriconazole

(nystatin for vaginitis or thrush)

68
Q

what is the treatment for dimorphic fungi?

A

itraconazole

69
Q

what is an IV treatment for systemic candida or aspergillus

A

echinocandins

70
Q

what is the treatment for tinea capitus in kids?

A

terbinafine + grisofulvin

71
Q

what is the treatment for onchynomycosis?

A

grisofulvin or terbinafine

72
Q

what is a PO treatment for tinea?

A

grisofulvin

73
Q

what treatments can be used for disseminated candidiasis?

A

fluconazole, voriconazole, echinocandins (capsofungin), ampho B

74
Q

what is the only licensed treatment for mucormycosis

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