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IP3 > ID2 > Flashcards

ID2 Flashcards

1
Q

Hep C RNA or DNA

A

RNA

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2
Q

azole order of drug interactions

A

voriconazole
itraconazole
fluconazle
posaconazole

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3
Q

Hep D RNA DNA

A

incomplere RNA requires HBV for replication

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4
Q

TX of meningitis in >50 years

A

vanco plus ampicillin plus cefotaxime or ceftriaxone

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5
Q

vaccinated HBV serology

A

HBsAb

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6
Q

PCP contagious?

A

NO

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7
Q

Echinocandins MOA

A

Beta-1,3-glucan synthesis inhibitors

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8
Q

Hep C tx drug Class

A

NS34a protease inhibitors
Ns5B protease inhibitors
Ns5A

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9
Q

Acute IE

  • onset
  • mortality
  • symptoms
  • clinical finding
A

fulminant
< 6 weeks
high fever >101
elevated WBC

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10
Q

Kernig Sign sensitivity and specificity?

A

Low

High

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11
Q

major symptoms of interferons

A

flu like symptoms

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12
Q

When to initiate steroid in meningitis

A

first dose 10-20 mins before intial antibiotic

not recommended if pt has recieved antibiotics

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13
Q

is immunity to viruses lifelong?

A

yes

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14
Q

which drugs inhibit HBV and HIV RT

A

Emtricitabine
lamivudine
Tenofovir

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15
Q

how does RNA retrovirus attach to cell

A

gp 12o

gp41

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16
Q

E. coli & kelbsiella meningitis tx and duration

A

3rd gen ceph

21 days

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17
Q

voriconazole SE

A

blurred vision

photosensitivity

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18
Q

whatis immune reconstitiution inflammatory syndrome

A

successful restoration of immune system amy lead to exaggerated immune attack on other microorganisms

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19
Q

Possible IE DX

A

clinical criteria
1 major and 1 minor criteria
3 minor

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20
Q

Hep B RNA or DNA

A

DNA

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21
Q

Cryptococcosis treatment

A

AmB + flucytosine
-induction
fluconazole
-chronic

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22
Q

are posaconazole po and IV interchangable

A

NO

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23
Q

WBC in meningitis bacterial vs viral

A

1000-5000

100-500

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24
Q

Coccidiodomycosis treatment

A

AmB

mild: fluconazole
chronic: fluconazole

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25
Q

AmB MOA

A

bind to ergosterol, increase cell permeability causing leaking of cell contents and cell death

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26
Q

Which 3 s&S of meningitis indicate lumbar puncture

A

HA
fever
neck stiffness

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27
Q

as HIV replication increases CD4?

A

decreases

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28
Q

Cleared HBV serology

A

HBsAB

HBcAB

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29
Q

role of M2 protein

A

allows genome release within cells

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30
Q

HACEK stand for?

A 
Haemophilus
Aggregatibacter
Cardiobacterium
Eikenella
Kingella
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31
Q

Subacute IE

  • onset
  • mortality
  • symptoms
  • cause
A

slow, indolent
>6 weeks
low grade fever, night sweats, weight loss, myalgia, fatigue
prior valve disease

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32
Q

Types of opportunistic mycoses

A

Aspergillosis
Candida
Cryptococcosis
Mucormycosis

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33
Q

which is the only fungal infection with primary prophylaxis

A

PCP

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34
Q

Adjust for renal impairment in echinocandins

A

NO

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35
Q

signs of meningitis in elderly

2

A

symtoms absent

more sublte

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36
Q

HEV acute or chronic

A

Acute

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37
Q

Mac contagious?

A

unlikely

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38
Q

AmB SE

A

nephrotixicity
electrolyte wasting
infusion related toxicity

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39
Q

duration of secondary toxo prophylaxis

A

cd4 >200 x6 months

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40
Q

DNA virus CMV prefferred

A

Ganciclovir
Valganciclovir
Cidofovir
Letermovir

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41
Q

HIV NRTI ending

A
  • vir

- ine

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42
Q

MAC primary prophylaxis indication and DOC

A

cd4 <50

Azithromycin

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43
Q

s. agalactiae meningitis tx and duration

A

ampicillin or pen G

14-21 days

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44
Q

Infection process

6

A 
adsorption
penetration &amp; uncoating
replicate, trancription, translate
assembly
release new virus
secondary infection
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45
Q

HDV acute or chronic

A

acute then chrnoic

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46
Q

Velpatasvir/sofosbuvir/voxilaprevir indication

A

only patients who have failed newer DAAs

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47
Q

Mucormycosis treatment

A

correct underlying cause (DM) and AmB

posaconazole

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48
Q

what is viral hepatitis?

A

inflammation of the liver from hep A,b,c,d,e virus

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49
Q

Meningitis N. meningitis tx and duration

A

3rd gen ceph

7 days

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50
Q

Caspofungin Cyp450?

A

not and inducer or inhibitor

w/ strong inducer inc. dose

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51
Q

protease endings

A

-navir

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52
Q

Protein in CSF bacterial vs viral

A

> 150

50-100

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53
Q

TEE mean?

A

Transesophageal echocardiogram

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54
Q

Glecaprevir/Pibrentasvir genotype coverage

A

1-6

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55
Q

DX signs in IE

5

A 
heart murmur
clubbing in extremeties
roth's spot
osler's nodes
embolic phenomena
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56
Q

TTE better at seeing?

A

right-sided infection

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57
Q

2 Hep that have fecal-oral transmission

A

A, E

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58
Q

MOA Maraviroc

A

drupts HIV adsoprtion via CCR5

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59
Q

Gram + bacilli in meningitis

A

L. monocytogenes

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60
Q

Gram - cocci in meningitis

A

N. meningitidis

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61
Q

when to avoid IV posaconazole

A

eGFR 50

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62
Q

TTE poor visual in?

3

A

obese
pulmonary disease
chest wall deformity

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63
Q

Chemorophylaxis in meningitis for H. influenzae type B

A

Rifampin only

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64
Q

CSF appearance of Bacterial vs viral

A

cloudy

clear to cloudy

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65
Q

which systemic mycosis causes more fatalities

A

candida

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66
Q

azole major class SE

A

hepatoxicity

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67
Q

which NRTI has SE of sensory neuropathy and pancreatitis

A

stavudine

didanosine

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68
Q

primary prophylaxis for PCP

A

bactrim

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69
Q

Which Hepatitis needs HBV

A

D

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70
Q

what to avoid when combo NRTI

A

overlapping additonal toxicity
overlapping metabolic activation
same analog of a base

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71
Q

which immune system produces interferons

A

cellualr immune system

via Th1

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72
Q

which side of the heart in IE is most common for structural heart disease or valve replacement

A

left

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73
Q

Flucytosine mucormycosis?

A

no activity

used as adjuvant

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74
Q

Glucose in CSF:Blood bacterial vs viral

A

<40 2:3

<40

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75
Q

3 viruses most common cause of viral hepatitis

A

A,b,c

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76
Q

Toxoplasmosis most common cause

A

reactivation of latent tissue cysts

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77
Q

azoles d-d intx

A

fluconazole has the weakest interactions

78
Q

TX of meningitis in head trauma, CSF shunt, neurosurgery

A

vanco plus cefepime, ceftazidime, or meropenem

79
Q

options for an anaphylacoid PCN allergy for IE

A

allergy consult
–desentization
vancomycin
daptomycin

80
Q

S&S of meningitis

7

A 
HA
fever
Neck stiffness
altered mental status
photophobia
seizures
abnormal CNS findings
81
Q

What does HBsAg mean and its significance

A

hep B surface antigen

indicates infection

82
Q

Pathogens in subacute IE

3

A

Viridians group strep (mouth pathogens)
* S. mitis, S. mutans, S. sanguinis, S. salivarus
Strep bovis
Coagulase-negative staph

83
Q

primary prophylaxis for toxo and duration

A

Bactrim

cd4 >200x3 months

84
Q

influenza tx drug class

A

M2 blockers

Neurmainidase inhibition

85
Q

CD4 <50 OI

A

MAC

86
Q

Glecaprevir/Pibrentasvir drug avoidance

A

ethinyl estradiol

87
Q

Types of primary fungal infections

A

Blastomycosis
Histoplasmosis
Coccidiodomycosis

88
Q

Blastomycosis when spreads causes

A

skin and bone lesions

89
Q

fluconazole active against?

A

Candida
cryptococcal
coccidioidomycosis

90
Q

H. influenzae meningitis tx and duration

A

3rd gen ceph

7 days

91
Q

TTE mean?

A

transthoracic echocardiogram

92
Q

Ledipasvir/Sofosbuvir drug interaction

A

antacids: separate by 4 hours
H2 blocker: same time or 3 hours
PPI: same time or empty stomach

93
Q

Corticosteroid meningitis indication

A

adults w/ pneumococcal meningitis

infants >6 weeks and children w/ H. influenzae type b meningitis

94
Q

Sources of infection in meningitis

4

A

Contiguous spread
hematogenous
direct inoculation
reactivation of latent disease

95
Q

source of MAC

A

water
dust
soil
bird poop

96
Q

voriconazole counsel

A

fatty food inhibit absorption

take on empty stomach 1-2 hours before or after meal

97
Q

P. aeruginosa meningitis tx and duration

A

ceftazidime
cefepime
meropenem
21 days

98
Q

Echinocandins SE

A

well tolerated
inc. liver enzymes
flushing w/ infusion

99
Q

Which valve on the right side most common in IE

A

Tricuspid

100
Q

Hep A acute or chronic

A

acute

101
Q

Interferon spectrum

A

most RNA/DNA and tertrviruses

102
Q

Voriconazole steady state

A

reached in 1 hour if loading dose given

103
Q

HBcAb mean and significane

A

Hep B core antibody

appears at symptoms onset and persists for life

104
Q

most common cause of IE

A

s. auerus

105
Q

MOA of enfuvirtide

A

prevents intramolecular folding of gp41 that is required for virus fusion

106
Q

NNRTI indication

A

HIV 1

107
Q

What is the brudzinski sign

A

Flexion of the neck results in involuntary knee and hip flexion

108
Q

Hep E RNa or DNA

A

RNA

109
Q

MOA of interferon

A 
inhibit:
penetration/uncoating
transcription/translatioin
protein glycosylation
activate NK
110
Q

labs in IE

6

A 
leukocytosis
anemia
ESR
RF
SCr
positive blood cultures
111
Q

Which NRTI work on Hep B and HIV

A 
Tenofovir
Entecavir
Lamivudine
Adefovir
Telvivudine
112
Q

Signs of meningitis in children

2

A

irritability

poor feeding

113
Q

combo w/ flucytosine for blastomycoses

A

itraconazole

114
Q

Blastomycosis treatment

A

AmB for severe

itraconzaole once stable and if mild-mod

115
Q

Retroviruses

A

HIV 1,2

116
Q

RNA viruses

A

influenza
RSV
Hep C

117
Q

Enterococcus in IE?

A

E. facealis

E. faecium

118
Q

TX MAC general

duration

A

2+ agents for resistance
3 drug if cd4 <50 and no ART
indefinite
x12 months and cd4 >100 and asymptomatic

119
Q

NNRTIs in the middle

A

-vir-

120
Q

Definite IE Dx

A 
pathological criteria
clinical criteria
2 major criteria
1 major and 3 minor
5 minor
121
Q

histoplasmosis treatment

A

itraconazole with LD

122
Q

CD4 <200 OI

A

PCP

123
Q

NRTI indication

A

HIV 1 and 2

124
Q

function of LTR

A

used for integration into host genome by viralintegrase

125
Q

what 2 drugs do you use to kill biofilm on prosthetic valves

A

Rifampin

gentamicin

126
Q

Ledipasvir/Sofosbuvir genotype coverage

A

1,4,5,6

127
Q

What is the Kernig Sign

A
  • The hip is flexed to 90 degrees and teh clinician attempts to straighten the knee
  • pain limits extension of the knee
128
Q

who to give primary prophylaxis for toxo

A

+ antibody

cd4 <100

129
Q

IDU tend to include which valve for IE

A

tricuspid

130
Q

do NNRTI require phosphoylation

A

no

131
Q

Meningitis chemoprophylaxis indication

A

those in close contact with an infected patient

132
Q

HBeAg mean and its significance

A

Hep B early antigen

indicate active viral replication

133
Q

Pathogens in acute IE

4

A

staph. aureus
Strep pneumoniae
Strep pyogenes
Neisseria gonohoeae

134
Q

Gram - bacilli in meningitis

3

A

Enterbacteriacease
-community
P. aeruginosa and acinetobacter
-healthcare

135
Q

which drugs antagonize integrase to prevent splicing of HIV DNA into host DNA

A

raltegravir
dolutegravir
elvitegravir

136
Q

Risk Factors for IE

5

A 
structural heart disease
IV drug use
prosthetic/mechanical devices
poor dention
central venous catheter
137
Q

what WBC is most commonly found in bacterial meningitis

A

neutrophils

138
Q

itraconazole counsel

A

take with a full meal

NO PPIs

139
Q

L. monocytogenes meningitis tx and duration

A

ampicillin
pen G
>21 days

140
Q

HBV tx drug class

A

DNA polyermase inhibitor

RNA polyermase inhbitor

141
Q

Combo w/ flucytosine for meningitis

A

amphotericin

142
Q

Rejected IE DX

A

alternate DX

resolution of syndrome

143
Q

Velpatasvir/Sofosbuvir genotype coverage

A

1-6

144
Q

HCV acute or chronic

A

chronic

145
Q

TX of meningitis in 1 month-2 years

A

vanco plus cefotaxine or ceftriaxone

146
Q

Hep B acute or chornic

A

acute then chronic

147
Q

Should you empircally treat with PCN for IE?

A

NO not until MIC is known

148
Q

chemoprphylaxis in meningitis for N. meningitidis

A

Rifampin
Cipro
Ceftriaxone

149
Q

For staphylococci for non-IDU which therapy should you avoid

A

Nafcillin + gentamicin

-more nephrotoxicity

150
Q

DNA viruses

A

Hep B
CMV
VZV
HSV

151
Q

chronic viral hepatitis strains

A

B,C,D

152
Q

Brudzinkski sign sensitivity and specificity?

A

Low

High

153
Q

which valve on the left side most common in IE

A

mitral

154
Q

Which pathogen is associated with colon cancer

A

S. gallolyticus

formerly S. bovis

155
Q

Aspergillious treatment

A

voiconazole DOC

156
Q

HBC PCR significance

A

quantifies presence of HBV DNA

157
Q

integrase endings

A

-gravir

158
Q

TX of meningitis in 2 years-50 years

A

Vanco plus cefotaxime or ceftriaxone

159
Q

coccidioidomycosis other name

A

valley fever

160
Q

flucytosine major SE

A

bone marrow suppression

161
Q

NNRTI 1st gen vs 2nd gen

A

1st: butterfly like
2nd: horse shoe

162
Q

Anidulafungin d-d intx

A

minimal

163
Q

which azole has the broadest activity

A

posaconazole

164
Q

Gram - in IE?

A

Pseudomonas

165
Q

Acute HBV serology

A

HBsAg
HBcAb
HBcAb

166
Q

Palivizumab MOA and indication

A

passive immunization for RSV

167
Q

Acute hepatitis strains?

A

A,D, E

168
Q

what wBC is most commonly found in bacterial meningitis

A

lymphocytes

169
Q

CD4 50-100 OI

A

CMV
cryptosporidiosis
toxiplasmosis

170
Q

interferon MOA

A

activates cytotoxic t cells, NK cells, and macrophages

171
Q

Hep A RNA or DNA

A

RNA

172
Q

order from outer to inner name the meninges

A

Dura mater
arachnoid mater
pia mater

173
Q

posaconazole counsel

A

400% inc. absorption with fatty food

174
Q

posaconazole dosing

A

2-4 dosess/day

more frequent gives better serum levels

175
Q

TX of meningitis in <1 month

A

Ampicillin plus aminoglycoside or cefotaxime

176
Q

secondary prophylaxis for PCP how long to treat

A

unil cd4 >200x3 months

177
Q

HBsAb mean and its significane

A

Hep B surface antibody
immunity to HBV
-passive or active

178
Q

MOA of HIV protease

A

cleaves gag-pol polyprotein producing RT, HIV protease, integrase, structural proteins

179
Q

Fungi in IE?

A

candida

aspergillius

180
Q

Which side of the heart in IE is most common for IDU

A

right

181
Q

which drug class cause fat redistribution and hyperlipdiemia

A

HIV protease

182
Q

chronic HBV serology

A

HBsAg

HBcAb

183
Q

HIV entry inhibitors

A

enfuvirtide

maraviroc

184
Q

Gram + cocci in meningitis

3

A

S. pneumoniae
-community
S. aureus and CoNS
-Healthcare

185
Q

DNA virus HSV/VZV preffered

A

Acyclovir
valacyclovir
penciclovir
famciclovir

186
Q

Can TTE dianose

A

no not good enough image

187
Q

azole MOA

A

block ergosterol synthesis via 14-a-demethylase inhibitors

188
Q

HIV tx drug class

A

NRTI

NNRTI

189
Q

Micafungin cyp450

A

not inducer/inhibitor

not substrate

190
Q

S. pneumoniae meningitis tx and duration

A

vanco and 3rd gen ceph

10-14 days

191
Q

HBV treatment

A 
interferon-a
preferred: 
-entacavir
-Tenofovir
Non-preferred:
-Lamivudine
-Adefovir
-Telbivudine
192
Q

can different viruses produce the same disease symptoms

A

yes

IP3 (7 decks)

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