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BPT annoying facts > Infectious disease 4 > Flashcards

Infectious disease 4 Flashcards

1
Q

Infectious aortitis cause?

A

Syphillis (past)

1st - Staphyloccocal and salmonella
2nd - M. bovis from BCG vaccine

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2
Q

If has MDR TB - what test will be positive?

A

Quantiferon gold - T cell releases IFN-y

T-SPOT - peripheral mononuclear cells releases IFN-y

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3
Q

Quantiferon gold
TB1 measures what?
TB2 measure what?

A

TB1 - CD4 T cell response

TB2 - CD4 and CD8 T cell response

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4
Q

TB meningitis treatment?

A

Moxifloxacin ( better CSF penetration)

Dexamethasone - reduces mortality - TB-IRIS

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5
Q

Latent TB treatment?

A

9 months of Isoniazid OR
4 months of rifampicin
isoniazid

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6
Q

Active TB treatment?

A

RIPE for 2 months then
RI for 4 months
*Isoniazid - early bactericidal activity

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7
Q

Among TB drugs - which is most potent to cause hepatitis?

A

Pyrazinamide > isoniazid> Rifampicin

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8
Q

Risk factor highest for latent TB to convert into active TB?

A 
HIV (highest)
Solid organ transplant
CKD
TNF-a
Diabetes ( lowest risk)
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9
Q

In which TB - early ART maybe harmful and causes TB-IRIS?

A

TB meningitis

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10
Q

Paradoxical worsening of TB after removal of biologics happened most with what drug?

A

Adalimumab > Infliximab

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11
Q

Steroids in TB useful in what situation and not useful in what situation?

A

Meningeal TB/pericardial TB = improve survival but not morbidity

Pleural TB - faster healing but no effect on morbidity/mortality

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12
Q

Immunity to influenza is due to antibodies against what component?

A

Hemagglutinin proteins ( it binds to sialic acid)

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13
Q

Neuraminidase function?

A

Cleave sialic acid and release the virus to neighboring epithelial cells

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14
Q

SIRS definition?

A 
T > 38/ < 36
WBC > 32/ < 4/ or > 10% bands
PaCO2< 32
RR > 20
HR > 90
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15
Q

What management in sepsis are questionable?

A

Albumin - risk of renal failure

Dopamine - increase mortality

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16
Q

Tri-azoles antifungal mechanism?

A

inhibits C-14a demethylase - for ergosterol synthesis

17
Q

Principles of anti-fungal - when use;

Neutropenic unstable patient

A

Neutropenic unstable - Echinocandins ( caspofungins)/ amphotericin

Resistant candidemia - Polyenes (amphotericin)

18
Q

VRE ;
VanA gene confers resistance towards?
VanB gene confers resistance towards?

A

VanA = Vancomycin and Teicoplanin

VanB = Vancomyin

19
Q

VanA gene - how it confers resistance?

A

Alter peptidoglycan terminus

20
Q

West nile virus clinical features?

What mosquito species spread it?

A

Mimics dengue + neuroinvasive = seizures/meningoencephalitis

Culex - Aedes

21
Q

Coagulase negative Staph - Treatment?

Species for coagulase negative staph?

A

Vancomycin

Staph epidermidis = axillae/anterior nares/toes
Staph hemolyticus/hominis = axillae
Staph capitis = scalp
Staph lugdunesis = groin/perineum

22
Q

B-lactam are analogues of?

A

D alanyl- D alanine

23
Q

teicoplanin highly effective against?

A

MRSA
VanB - VRE
VISA

24
Q

Macrolide mechanism of action?

A

Stop peptidyl transferase (50s inhibitor) + immunomodulatory = suppress neutrophils/inflammation

25
Q

Lincosamide mechanism of action?

A

Stop peptidyl transferase (50s inhibitor)

26
Q

Antibiotics that are nucleic acid inhibitors?

A 
Nitroimidazoles ( METronidazole)
Nitrofurantoin
Fluoroquinolones
Rifamycins
-MET call = NFR
27
Q

Specific MOA for
Metronidazole

Nitofurantoin

A

Metronidazole = disrupt DNA and inhibit transcription/translation

Nitrofurantoin = Bacterial flavoproteins metabolise nitrofurantoin = DNA damage

28
Q

Trimethoprim mechanism of action?

Side effect?

A

Anti-folate = Dihydrofolate reductase inhibitor

Side effect : Block ENa channel - High K/ High Cr

29
Q

Sulphonamides ( Sulfamethaxazole) mechanism of action?

Side effect?

A

Anti-folate = Dihydropteroate synthase inhibitor

Side effect : SJS/TEN/Agranulocytosis

30
Q

Rifampicin also used in what? ( apart from TB)

A

Invasive staphlococcal infection - OM/metal hardware infection

31
Q

Commonest congenital heart defect? - need antibiotic prophylaxis for IE?

A

Patent Foramen ovale - No

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