Infectious Disease 7 Flashcards
Schistosomiasis features
Schistosomiasis comes from?
treatment?
features - blood eosinophilia, bladder cancer or hematuria
Aetiology - Snails = Flat tapeworm
Tx - Praziquantel
Leishmaniasis features
treatment?
Chronic skin ulceration in nose/mouth
+ Hepatoslenomegaly
Tx - Amphotericin
Amoebiasis transmission mechanism?
Water/food - cyst
Fecal oral - trophozoites
Amoebiasis treatment?
Asymp. carriage = Paromomycin
Colitis, diarrhea = Metronidazole
Abscess ( trophozoites) = Drain it + Metronidazole + Ampicillin + Gentamicin
Strongyloidiasis aetiology?
Infection pattern?
Worms goes into lungs?
Treatment
Roundworm
Auto-infection + Hyperinfection in intestine
Lungs = Loffler syndrome - pulmonary eosinophilia of upper lobes
Ivermectin/Albendazole
Filariasis aetiology?
Treatment?
Roundworm
Tx - Ivermectin/Albendazole
Neurocysticerosis aetiology?
Taenia tapeworm
Tx
GI taenia = Praziquantel
Neuro taenia = Albendazole + Steroids
Hydatid disease aetiology?
Clinical presentation?
Tx?
Echinococcocis tapeworm
Clinical - large liver/alveolar cysts
Treatment
Albendazole + PAIR (Puncture,Aspirate,inject and reaspiration)
-if spilled in surgery
=Praziquantel
Angiostrongylus cantonesis aetiology?
Tx?
Snails - roundworm
=Eosinophilic meningitis!
Tx Albendazole + Steroids
Glutamate dehydrogenase sensitive in what infection?
C. difficile
C. difficile most virulent strain?
PCR 027
Staph aureus produces what?
MRSA produces what?
Protein A coagulase
PVL - panton-Valentine leucidin protein
What is jarish-herxheimer reaction and treatment?
Release of toxins from treponemal destruction = give with prednisolone + Benzylpenicillin
(syphillis)
Enterococcus usually treat with what abx?
Amoxicillin + Gentamicin
Bartonella infection - treat with?
Cat scratch disease
systemic + persistent lymphadenopathy = Azithromycin (macrolide)
Endocarditis = Doxycycline + Gentamicin/Rifampicin
Q fever treat with?
in pregnancy?
Doxycycline
Pregnancy = Bactrim + FOLIC ACID until 32 weeks no matter what!
Brucellosis from pigs - treat with?
Doxycycline + Rifampicin ( reduce rate of failure/relapse)
Which organism causes nitrates negative but leucocytes positive for UTI? ( don’t produce nitrate reductase)
Pseudomonas Enterococcus fecalis Acinebacter Staphylococcus Streptococcus
Alemtuzumab famously cause what type of infection?
Listeria
Primary prophylaxis in HIV - what organism and what’s the treatment?
Pneumocytic carinii
MAC
Toxoplasmosis
Bactrim - covers Toxoplasmosis and PJP
Azithromycin - covers MAC
PJP but allergy to Bactrim or sulphur - what’s the alternative?
Clindamycin + Primaquine
Toxoplasma but allergy to Bactrim - what’s the alternative?
Dapsone ( Need to include folic acid - calcium folinate) + Pyrimethamine
Whipple disease pathogenesis and treatment?
Gram +ve Trop Whippelli
manifest as malabsorption syndrome
Tx - IV Ceftriaxone, then Bactrim as maintenance
Trimethoprim mechanism of action?
Bacterial Dihydrofolate reductase inhibitor
Rifampicin inhibits bacterial RNA polymerase
The analogue in mammals/humans is cytarabine - how it works?
Inhibit a-DNA polymerase
sulfonamides - sulfamethazole mechanism of action?
Inhibit folate synthesis
Tetracycline usually inhibit 30s Ribosomal unit - but it can also attack 50s - how?
Competitive binding site of A site for tRNA - inhibit protein synthesis
4 main ways mechanism of antimicrobial resistance?
Modify anti-microbial molecule - destroy/chemical alteration
Prevents molecule reaching target - efflux/permeability alteration
Modify target site
Resistance ( global adaptive effect)
Prevents molecule from reaching target - efflux/permeability -porin - affects what antibiotics?
- Efflux pumps
- Tetracyclines
- Fluoroquinolones
- Chloramphenicol - Permeability - porins ( Pseudomonas/ Enterobacter)
- Tetracyclines
- fluoroquinolones
- b-lactams
Modify target site - affects what drug?
Target site mutation - Rifampicin/ Fluoroquinolones - main way of resistance
Methylation of 50s - lincosamides/macrolides
Replace antibiotics’ target with smtg else, cell wall continue to strengthens (MRSA/VRE)
Modify antibiotic molecules - what drugs affected?
B-lactam
aminoglycosides
NRTI/NtRI - mechanism of action?
Zidovudine - what analogues?
Lamivudine/Emtricitabine - what analogues?
Abacavir/entecavir - what analogues?
Tenofovir/tAdefovir - what analogues?
Incorporate into Viral DNA growing chain but incomplete - so halting replication
Zidovudine - Thymidine analogue
Lami/Emtri = Cytosine analogue
Aba/Ente = Guanosine NRTI ( nucleoside)
Teno/Ade = Guanosine NtRTI ( nucleotide)
Non-nucleotide RTI - mechanism and eg drugs?
Bind to reverse transcriptase enzyme, near catalytic side and deactivates enzyme
Efavirenz
Nevirapine
Antivirals for herpes group - aciclovir/famiclovir -mechanism of action?
Inhibit DNA polymerase
phosphorylated by Triphosphate form to be active
HIV lymphoma, Hodgkin lymphoma - what’s the virus causing it?
EBV!!!
Aciclovir and Herpes zoster opthalmicus?
Reduces pain and complications but NOT POST-HERPETIC NEURALGIA
TB most resistant to which drugs worldwide?
Isoniazid
Aflatoxins from Aspergillus fungi a/w?
P53 mutations = HCC
Staphylococcal Toxic Shock syndrome divided into 2 categories?
Pathogenesis?
Menstrual - tampon colonised by S. Aureus
Non-menstrual - burns/surgery/ post-influenza pneumonia
Superantigens bind to MHC II - interact with T cells - large amount of IL2, IL1, cytokines (TNF-a, IFy) release
