Infectious Diseases Flashcards by Laura Brown

Which of the following is false about oseltamavir?

A. Reduces duration of symptoms by 1-2 days
B. More effective for Flue B than Flu A
C. Needs dose adjustment in renal impairment and elderly
D. Good for prophylaxis in exposed hospitalized patients

B - opposite, more effective for Flu A than B

Oseltamavir - neuramidase inhibitor

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When should oseltamvir be prescribed?

Prophylaxis in exposed hospitalized patients
Symptoms <48hrs in influenza A or B

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Which ambler class of antibiotic resistance is new delhi metallo beta lactamases?
How do they transmit resistance?

Class B - metalloBeta lactamses
Plasmid mediated.

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Which drugs treat VRE?
Which is not effective against Van A?

Teicoplanin (useleless against Van A, which has a MIC >64)

Tigecycline
Daptomycin
Linezolid

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What is the mechanism of action of triazoles?

Inhibits ergosteriol synthesis

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Which antifungals are active against aspergillus?

Voriconazole
Caspofungin
Andulafungin

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What is the mechanism of action of echinocandins?
Which drugs are in this class?

Caspiofungin, anidulafungin

Inhibits fungal cell wall synthesis

Noncompetitive inhibition of the enzyme 1,3-β glucan synthase –> results in inhibition of B glucan synthesis in the fungal cell wall

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Risk factors for TB reactivation

HIV - greatest RF
DM
CKD
Steroids >15mg/1 month
Advanced age
TNF-a inhbitors
Malignant lymphoma
Smoking

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Which of the following is a cause of painful gential ulcers?
A. Syphylis
B. Chancroid
C. Granuloma inguinale
D. Lymphogranuloma venereum

B. Chancroid

All others painless

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Non-treponemal tests for syphyllis and treponemal tests.

Which is best for screening?

Non-treponemal:
- VRDL
- RPR
- Toluidine Red Unheated Serum Test (TRUST)

Treponemal:
- FT-Abs
- TP-EIA
- TPPA (TP particle agglutination assay)
- chemiluminescense immunoassay (CIA)
- microhemagllutination test for antibodies (MHA-TP)

EIA is best

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What are the co-receptors used by HIV for entry into CD4 cells?

CCR5; R5 viruses) or CXC chemokine coreceptor 4 (CXCR4; X4 viruses)

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Benefits of TAF over TDF?
Disadvantages?

Less renal toxicity and bone loss
More weight gain

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Antibiotic classes with poor CNS penetration?

Aminoglycosides, erythromycin, tetracyclines, clindamycin, and first generation cephalosporins (cephalexin)

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Which group of patients should recieve tetanus immunoglobulin when presenting with a traumatic wound?

Patient has received less than 3 doses of tetanus toxoid vaccine or vaccination history is unknown AND a dirty/major wound

All patients should have tetanus vaccine except if less than 5 years since last dose

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Antibiotics that inhibit 30s ribosomal subunit

Aminoglycosides
Tetracyclines

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Antibiotics that inhibit 50s ribosomal subunit

Macrolides
Linezolid
Lincosamides (lincomycin, clindamycin)
Chloramphenical

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Daptomycin mechanism of action

Inhibits bacterial membrane function

Inserts into the membrane of gram positive bacteria–> disrupts membrane –> kills cell

3 major causes of eosinophilic meningitis

3 major parasites:
- Angiostrongylus cantonensis
- Baylisascaris procyonis
- Gnathostoma spinigerum.

Major side effects of abacavir
What class of drug?

Nucleoside reverse transcriptase inhbitoir

Major side effects - highest risk of MI, hypersensitivity reactions in patients with HLAB5701

Which class of HIV drugs cause lactic acidosis?

NRTIs

Which class of HIV drugs cause hyperlipidemia?

Protease inhibitors, -navirs (i.e. lopinavir)

Which drugs can be used to treat aciclovir-resistant HSV?
Which cannot?

Foscarnet or cidofovir

Gancivlovir and valganciclovir also cannot be used as TK mutation inactivates them

What drugs can be used to treat ESCAPM organisms? What ambler class are these organisms?

Carbapenems
Colistin
Amikacin
Fosfomycin for UTIs

Ambler C for cephalosporinases!

Which populations need endocarditis prophylaxis and for which procedures?

Prosthetic cardiac valves (NOT defibs/ppms)
Previous IE
High risk RHD
Cyanotic heart disease with unrepaired shunts/conduits or partially repaired

Procedures involving
- teeth/gums
- infected skin/muscle
- ENT infections (i.e. tonsillectomy, abscess drainage)

GU/GI only if established infection

List the live vaccines Who are they contraindicated in?

MMR BOYZ japanese diarrhea MMR, BCG, Oral polio, Yellow fever, VZV, japanese encephalitis, diarrhea - typhoid, rotavirus Immunocompromise (high dose pred, HIV CD4 <200, transplant, DMARDs) Pregnancy Immunodeficiency Aplastic anemia

Drugs used for MDR TB

bedaquiline, pretomanid, and linezolid

Which of the following is considered a positive mantoux test: A. Tuberculin skin reaction 8mm from an endemic country B. 9mm reaction in a prisoner C. 6mm with abnormal CXR D. 11mm in a healthy adult

C - correct, ≥5mm and CXR changes/close contact/HIV/immunosupressed = posigtive A and B - incorrect, needs to be ≥10mm in people at risk of reactivation (i.e. IVDU, malignacy, diabetes, ckd), <4yo, forein country, high risk setting (prisoner, healthcare worker) D - incorrect, needs to be ≥15mm in healthy individuals >4yo

Which patient groups are at highest risk of developing invasive fungal infections?

Allogenic hematopoetic stem cell transplant Acute myeloid leukemia Solid organ transplant (excluding kidney)

Diagnosis of acute Q fever

Isolation of C. Burnetti Detection of C. Burnetti by NAAT Seroconversion/4 fold increase in C. Burnetti antibody titre to phase II antigen by complement fixation assay OR indirect immunoflerscence IgG antibody assay (IFA)

Prophylaxis for HIV

CD4 <50 - azithro weekly for MAC + TMP/SMX 3/wk CD4 <200 - TMP/SMX 3/wk CD4 <100 + T.Gondii IgG - TMP/SMX daily (full dose)

During a contact trace, it is determined that Mr Jones was exposed to SARS-CoV-2 on Sept 18th (Day 0.) He interacted with Mr Smith on Day 5 before becoming symptomatic on Day 7 and receiving a positive result on Day 9. Mr Smith became symptomatic on Day 8 then was tested and received a positive result on Day 12. When assessing the transmission between Mr Jones and Mr Smith, what is the serial interval? What is the incubation period for each man?

Serial interval = 1 day Incubation period = 7 days (MJ), 3 days (Smith) Serial interval= time between symptom onset of primary case and symptom onset of secondary case (MJ symptomatic D7, Smith D8) Incubation period is time from infection to symptom onset (D0-->7 MJ, D5-->8 Smith)

A 59 year old male is admitted with febrile neutropaenia. E. Coli was isolated in blood and urine cultures: Resistant ampicillin/ceftriaxone Sensitive ADF/pip-taz/mero/cefepime/gent/TMP-SMX The best antibiotic treatment is: A. Meropenem B. Piperacillin/Tazobactam C. Piperacillin/Tazobactam plus Gentamicin D. Amoxicilin/Clavulonic acid plus Vancomycin

A - meropenem Patient has an ESBL (resistant to ceftriaxone) MERINO showed mero>pip-taz for ESBL bactermia

When isolated from the blood stream which bacteria has the highest chance of concurrent IE? a. staph aureus b. staph mitis c. staph. gallolyticus d. e. faecalis

D. S. gallolyticus (bovis) - among patients with bacteremia due to S. bovis biotype I (S. gallolyticus subsp gallolyticus), IE has been observed in 43 to 100%of cases s. aures = ~25%

Kaposi sarcoma - CD4 count - treatment - cause

HHV8 (herpes virus) typically <200 or 150 HAART alone in most

Treatment of strongyloides? Risk factors?

RF = malignancy, HTLV1, AIDs, immunosupression, alcohol, malignancy Treat with ivermectin

Bacteria associated with rhomboencephalitis

Lysteria - inflammation of the brainstem with ataxia, nystagmus and CN palsies

Bacteria that produce a lactamase penicillinase

Mechanism of staphs (mSSA), escapms (enterobacteracia) and ESBLs Klbeseall

Bacteria with altered D-ala-D-ala in cell wall

Mechanism of VRE (Van genes)

Bacteria that Altered penicillin-binding protein (PBP2) in cell wall

MRSA, PBP→ PBP2, recnoded by an acquired medA gene on staph cassette mobile

Bacteria that produce efflux pumps

Pseudomonas Tetracycline resistance in E.Coli Macrolide resistance in strep pneumonia

Microbe causing pseudoappendicitis syndrome

Yersinia enterolyticus

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Infectious Diseases Flashcards

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