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STEPH BPT 2021 > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

A weekly drug used as chemoprophylaxis for malaria

Contraindications

A

Mefloquine

Neuropsychiatric disorders, conduction abnormalities, epilepsy

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2
Q

Severe malaria characterisitics

A

Reduced GCS, jaundice, oliguria, hypoglycaemia*, APO

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3
Q

Cancer associated with chronic typhoid infection

A

Gallbladder carcinoma

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4
Q

Gene conferring colistin resistance

A

MCR-1

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5
Q

EBV Oncogenic gene

Associated Cancers

A

LMP-1

Post-transplant lymphoproliferative disorders (small intestine, lung highest)
NP cancer 
Hodgkin's lymphoma 
Gastric Carcinoma 
Oral hairy leukopaenia
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6
Q

Drug associated with hypersensitivity reaction associated with HLAB5701

A

Abacavir (NRTI)

Abacavir binds to the ‘‘self-peptides’’ of the MHC1 of HLA5701, altering its structure -> triggers a cytotoxic T cell response

HLA-B*57.01 have more effective cytotoxic responses against HIV than people with other HLA types

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7
Q

Virulence factor of staph auerus associated with skin and soft tissue and nectrotising pneumonia

A

Panton-Valentine Leucocidin toxin

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8
Q

TB meningitis altered regimen

A

Moxifloxacin is better than ethambutol for CSF penetration
9-12 months therapy
Dexamethasone early to reduce risk of IRIS

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9
Q

Enterococci species sensitive to amoxicillin

A

E. Faecalis

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10
Q

AmpC gene

A

ESCAPPM beta lactamase gene

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11
Q

CRE treatment

A

Colostin
Tigecycline
High dose carbepenam
Aztreonam

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12
Q

Ceftazadime avibactam

A

KPC resistant organisms

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13
Q

NDM resistance drug

A

Colostin

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14
Q

Treatment of aspergillosis

A

Voriconazole

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15
Q

Benching filamentous fungi with branching hyphae

A

Aspergillis

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16
Q

Antibiotics that acts by binding to DD-transpeptidase, inhibiting its cross-linking activity and preventing new cell wall formation

A

Penicillin

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17
Q

Malaria species with hypnozites

A

Plasmodium ovale and Plasmodium vivax

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18
Q

Medication that treats malarial hypnozites

A

Primaquine

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19
Q

Cephalosporins with activity against pseudomonas

A

Ceftazidime

Cefepime

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20
Q

5th generation cephalosporin that has activity against MRSA

A

Ceftaroline

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21
Q

pharmacokinetic/pharmacodynamic mechanism best determines the clinical efficacy of penicillin based antibiotics

A

Time above MIC

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22
Q

What is the mechanism by which carbapenemase-producing gram negative organisms confer resistance to meropenem?

A

Inactivation by hydrolysing beta-lactamases

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23
Q

Action of integrase inhibitor

A

Prevent binding of preintegration complex (PIC) to host cell DNA preventing rna production

Raltegravir
Dolutegravir

SE: well tolertared
Weight gain

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24
Q

Action of protease inhibitors

A

Stop cleavage of gag-pol poly proteins resulting in immature virions

Darunavir
Atalazanavir

Metabolic SEs
Hepatotoxic

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25
Q

Action NNRTIs

A

Prevent reverse transcriptase from adding néw nucleotides to the chain

Efavirenz
Etravirine
Nevirapine

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26
Q

NRTIs action

A

Inhibits viral replication by competitively binding reverse transcriptase (false nucleotide)

Abacavir
Tenofavir
Lamivudine
Emtricitabine
Zidovudine

SE: mitochondrial toxicity (peripheral neuropathy, pancreatitis, lipoatrophy, hepatic steatosis

abacavir- CV events

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27
Q

Parasitic cause of eisinophilic encephalitis

A

Angiostrongylus cantonensis

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28
Q

Culture negative infection with systemic features post cardiac surgery

A

Mycobacterium

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29
Q

New antibiotic treatment for C Diff

A

fidaxomicin

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30
Q

Screening test for syphilis

A

EIA

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31
Q

Confirmatory test for syphillis

A

TPHA/TPPA

VDRL/RPR test (can be used for monitorig disease activity)

32
Q

Empiric therapy of bacterial meningitis

A 
IV Dexamethason
IV ceftriaxone or cefotaxime 
Add IV benpen for listeria if 
- Over 50 
 - immunocompromised
- pregnant
IV vanc if pneumococcal risk 
- otitis/sinusitis, mastoiditis
33
Q

Treatment of Step Pneumo meningitis

A

IV ceftriaxone and vanc if MIC >1.5

IV dexamethasone

34
Q

Drugs that should not be used to treat brain abscesses

A

Aminoglycosides, erythromycin, tetracyclines, clindamycin, and first generation cephalosporins should not be used to treat brain abscess because these drugs do not cross the blood brain barrier at high concentrations

35
Q

Strep involved in dental disease

A

strep viridans

36
Q

Culutre negative endocarditis organisms

A

Coxiella burnetti
Bortenella
chlamydia
Legionella

Rx: ceftriaxone and gentamicin

37
Q

IE empiric treatment

A

Flucloxacillin + Ben Pen+ Gentamicin
or
Vancomycin + Gentamicin

38
Q

MAC treatment

A

clarithromycin or azithromycin PLUS rifampicin

rifabutin PLUS ethambutol.

39
Q

Heart abnormalities/conditions for which preventative antibiotics are recommended

A

– A prosthetic heart valve
– Valve repair with prosthetic material
- Rheumatic valve
– A prior history of infective endocarditis
– Many congenital (from birth) heart abnormalities

40
Q

Procedures for which high risk patients should have prophylactic antibiotics for

A

Dental procedures that involve manipulation of either gingival tissue or the periapical region of teeth or perforation of the oral mucosa; this includes routine dental cleaning.

Tonsillectomy/adenoidectomy

Surgery. atsite of an established infection

41
Q

Treatment of malaria

A

P.vivax, ovale, malariae: – chloroquine/hydroxychloroquine (3 day course)

P.vivax (chloroquine resistant)
– Arthemether–lumafantrine (Riamet) first line in indonesia, timor,PNG, solomon island, vanuatu. 3 days
– primaquine as anti relapse therapy for 14 days after chloroquine

P.falciparum
– Arthemether-lumafrantine (Riamet) for 3 days is first line – Atorvaquone-Proguanil (Malarone) is second line
– Quinine and doxycycline for 7 days is third line.
– IV artesunate for severe malaria(jaundice,reduced LOC,oliguria,anemia,pulmonary edema,hypoglycemia)
– use quinine and clindamycin if pregnant.

42
Q

Treatment of schistosomiasis

A

Praziquantel

43
Q

Treatment of amaebic liver abscess

A

metronidazole /tinidazole and paromomycin.

44
Q

High risk HPV

A

16, 18

45
Q

Live vaccines

A 
MMR
Oral polio 
VZV/Zoster
Yellow 
Oral typhoid
BCG
46
Q

Mechanism of MRSA resistance

A

mecA gene for penicillin-binding protein
PBP-2a - Reduced affinity for beta-lactam drug binding
Not enzymatic, can’t be overcome by beta-lactamase inhibitor

47
Q

Linezolid mechanism and side effects

A

Inhibits protein synthesis, binds to 50s ribosomal subunit
Bacterostatic
Good bioavailability and CNS/bone penetration

SE: Reversible bone marrow suppression, irreversible neurotoxicity, optic neuropathy (rare) , serotinin syndrome

48
Q

Daptomycin MOA and SE

A

Bacteriocidal antibiotic causes depolarisation of bacterial cell membrane

SE: Myopathy, peripheral neuropathy, eosinophilic pneumonia

49
Q

Tigecycline

A

Bacterostatic
Binds to 30s subunit of ribosome, protein synthesis inhibitor

high volume of distribution

50
Q

Ceftaroline MOA and utility

A

5th gen cephalosporin with high affinity for PBP-2a

51
Q

Mechanism of strep pneumoniae penicillin resistance

A

Alteration of PBP (transpeptidase enzyme)

Can be overcome by increasing dose (not in CNS infections)

52
Q

Mechanism of strep pneumoniea macrolide resistance

A

mefA gene - efflux pump

ermB gene - alteration of binding site

53
Q

Carbapenam resistant organisms

A 
KPC (Kleb pneumonia carbapenemase)
NDM-1 (New Delhi- metallo-beta-lactamase)
OXA (oxacillin-type BL - Tur key) 
VIM
IMP
54
Q

ECHAPPM organisms

A

Gram negatives!

Enterobacter
Serratia marcescens
Citrobacter freudii

Hafnia alvei
Acinetobacter and aeromonas
proteus vulgaris 
providencia 
morganella morganii
55
Q

Mechanisms of ESCAPPM resistance

A

AmpC gene on chromosomes or plasmids encodes for beta-lactamases

56
Q

Treatment of ESCAPPM

A

Carbapenems

Cefepime

57
Q

Mechanism of ESBLs

A

Group of enzymes that hydrolzyse all penicillins, cephalosporins (including cefepime) and aztreonam

Genes are carried on plasmids

TEM1, TEM2, SHV1

58
Q

Organisms that commonly carry ESBL

A

E.Coli

Klebsiella

59
Q

Treatment of ESBL

A

Carbapenams

60
Q

Treatment of CRE

A

Colistin
High dose tigeycline
Aminoglycasides
High dose carbapenamse

61
Q

Beta-lactamase inhibitors

A

Clauvulonic acid
Tazobactam
- Preferentially binds BL

Avibatam - - inactivetes

62
Q

Mechanism of Staph aureus resistance to vancomycin

A

VanA gene acquired from enterococci via conjugation - plasmid-mediated transfer

encodes D-ala-D-ala -> D-ala-D-lac;substitution of a;anine for lactate

63
Q

Treatment of Enterococcus faecium

A

Majority are resistant to penicillin/amoxi
All Enterococci resistant to cephalosporins
Treat with vancomycin or teicoplanin

64
Q

Common cause or aeseptic meningitis

A

Enterovirus

65
Q

When would dolutegravir + lamivudine not be used

A

VL >500,000, HBV coinfection, pregnant woman

66
Q

Treatment of candida

A

Caspofungin (Echinocandin)

67
Q

Treatment of Cryptococcus

A

Amphotericin (polyene) + Flucytosine

68
Q

Treatment of aspergillus (septate mould)

A

Voriconazole

69
Q

Treatment of mucor(non-septate)/fusarium

A

Amphotericin

70
Q

Highest risk of CMV in allogenic SCT patients

A

CMV D-/R+

71
Q

Highest risk patient group in solid organ transplant

A

CMV D+/R-

72
Q

Treatment of PJP

A

Trimethoprim-sulfamethoxazole (TMP-SMX)
Steroids if pO2 <70mmHg/ hypoxia

ART should commence 2 weeks post-therapy

73
Q

mechanism by which strep pyogenes causes valvular disease in rheumatic fever

A

Molecular mimicry

74
Q

PJP prophylaxis in HIV

A

cotrimoxazole

75
Q

Asthma and CF associated condition with raised IgE

A

Allergic Bronchopulmonary Aspergillosis

STEPH BPT 2021 (16 decks)

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