Infectious Diseases Flashcards

1
Q

Antifungals: polyenes

A

MOA: perforates fungal cell membrane
Broad spectrum
E.g. amphotericin, nystatin
SE: nephrotoxic

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2
Q

Antifungals: echinocandins

A

MOA: inhibits cell wall synthesis, especially Beta 1,3 D glucan synthesis
Well tolerated, does not penetrate CSF or urine
E.g. caspofungin, micafungin

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3
Q

Antifungals: azoles

A

MOA: interferes with cell membrane synthesis (ergosterol)
Triazoles: fluconazole (C. albicans), voriconazole (Aspergillus fumigatus)
Imidazoles: clotrimazole, miconazole
SE: induces CYP450 –> hepatotoxicity

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4
Q

In an immunosuppressed patient, prolonged fever and neutropenia - antifungal choice

A
  1. Amphotericin
  2. Fluconazole (low risk)
  3. Caspofungin
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5
Q

Candidaemia or invasive candida infection - antifungal choice

A
  1. Fluconazole
  2. Amphotericin B
  3. Caspofungin
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6
Q

Invasive aspergillus infection - antifungal choice

A
  1. Voriconazole
  2. Amphotericin B
  3. Caspofungin
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7
Q

Ganciclovir resistance genes

A

UL97 and UL54

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8
Q

Clinical features of CMV infection in HSCT patient

A

Most at risk 1-4mo post-HSCT
Most fatal: pneumonitis
Fever, retinitis, pneumonitis, oesophagitis, gastritis, hepatitis, colitis
Pancytopenia, leukopenia, thrombocytopenia

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9
Q

Side effects of antiviral agents to treat CMV

A
First line: ganciclovir 
- Neutropenia, suppresses T cell function
- Other main issue with ganciclovir = resistance
Second line: foscarnet
- Significant nephrotoxicity 
- GCV-resistant CMV
Third line: cidofovir
- Significant nephrotoxicity
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