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BPT Written > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Erythromycin/ Clindamycin site of action?

A

50s subunit of ribosome, protein synthesis inhibitors

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2
Q

Linezolid side effects

A

Myelosuppression, peripheral neuropathy, seretonin syndromes

Rare: optic neuropathy

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3
Q

Aminoglycoside / tetracycline site of action

A

30s subunit of ribosome, protein synthesis inhibitors

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4
Q

Linezolid site of action

A

Both 50s and 30s subunit of ribosome, protein synthesis inhibitors

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5
Q

Method of action of beta lactams, vancomycin

A

Cell wall synthesis

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6
Q

Daptomycin method of action

A

Loss of cell wall selective permeability

Note: binds to surfactant & cannot be used in lung infections

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7
Q

Quinolone method of action (ciprofloxacin etc)

A

Inhibits gyrase, unwinding enzyme in DNA replication

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8
Q

Rifampicin method of action

A

Inhibit RNA polymerase in DNA transcription

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9
Q

Method of action of sulfamethoxazole, trimethoprim

A

Inhibits folate synthesis

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10
Q

Which antibiotic’s efficacy is determined by peak concentration?

A

Fluroquinolones, aminoglycosides (ciprofloxacin, gentamicin etc)

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11
Q

Which antibiotic’s efficacy determined by time above MIC?

A

Beta-lactams

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12
Q

Method of MRSA resistance?

A

Alteration of penicillin binding protein
MecA Gene encodes for PBP2a
Resistance to all penicillins / cephalosporins / carbapenems

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13
Q

What gene predominated in community acquired MRSA?

A

Panton-valentine leucocidin (PVL)

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14
Q

Daptomycin side effects

A

Rhabdomyolysid, eosinophilic pneumonia

Remember: double lung bad!

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15
Q

What gene confers vancomycin resistance?

A

Amino acid substitution: D-ala D-ala to D-ala D-lac
Prevents vancomycin binding to cross links
Van A gene - vancomycin and teicoplanin resistance
Van B/C gene - vancomycin only

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16
Q

What is the mechanism of S. pneumonia resistance to macrolides?

A

MefA gene - effluent pump (low resistance)

EmB gene - alteration of binding site (high resistance)

17
Q

List ESCHAPPM organisms

A 
Enterobacter 
Serratia 
Citrobacter freundii
Hafnia
Aeromonas
Proteus
Providencia 
Morganella

—> rapidly inducible production of beta-lactamase

18
Q

Mechanism of beta-lactam antibiotics?

A

Bind & acylate active site of penicillin binding protein (PBP) the enzyme essential for the biosynthesis of bacteria cell wall

19
Q

Mechanism of beta-lactamase?

A

Is an enzyme that can hydrolyze beta-lactam ring, thus deactivating beta-lactam antibiotics (i.e. resistance mechanism)

20
Q

Entry of HIV into host cell occurs via which protein?

A

gp120

21
Q

R5 strain of HIV

A

Most frequently transmitted
Less aggressive
Infects macrophages and T cells
Use CXR5 for CD4 cell entry

22
Q

HIV-2

A 
Less virulent
Lower viral load
Lower rates of vertical transmission 
Slower progression 
Less virulent 
Seen mainly in Western Africa and western India
23
Q

Strongest single predictive marker of disease progression at all stages of HIV?

A

CD38 expression by CD8 cells

24
Q

HAART: entry inhibitors

A

Prevent HIV-1 from entering and infecting immune cells
Not widely used
e.g. Maraviroc - CCR5 inhibitor

25
Q

HAART: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)

A

Active phosphorylation NRTI metabolites inhibit viral reverse transcriptase and viral DNA synthesis, preventing HIV replication

Nucleoside Analogues
Zidovudine (AE: lipodystrophy, anaemia, myopathy, black nails)
Didanosine (AE: pancreatitis, peripheral neuropathy)
Lamivudine (AE: pancreatitis)
Abacavir (AE: increased CVD, hypersensitivity reaction - rash, fever, GI symptoms; HLA-B*5701 allel)

Nucleotide Analogues
Tenofovir (AE: renal impairment, osteoporosis)

26
Q

HAART: Protease Inhibitors

A

Inhibit HIV proteases, preventing viral mutation and replication

Examples: Indinavir, Atazanavir, Saquinavir
AE: diabetes, hyperlipidaemia, buffalo hump, central obesity, P450 enzyme inhibition, lipodystrophy

Indinavir and Atazanavir: renal stones, hyperbilirubinaemia

All PIs need to be combined with Ritonavir for its pharmacological boosting effect

27
Q

HAART: absolute contraindications to Protease Inhibitors

A

Cisapride - torsades
Lovastatin - rhabdo (use pravastatin instead)
Midazolam - prolonged sedation

28
Q

HAART: Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

A

Reversibly inhibit HIV reverse transcriptase, reducing viral DNA synthesis

Nevirapine (AE: rash, hepatitis)
Efavirenz (AE: psychiatric adverse effects; contraindicated in first trimester of pregnancy)

29
Q

Effect of being heterozygous for CCR5 Delta 32 allel in the development of HIV and AIDS?

A

Slower disease progression to AIDS

30
Q

HAART: integrase strand transfer inhibitors

A

Inhibits HIV integrase, which prevents viral replication by stopping insertion of viral DNA into the host DNA

Raltegravir
Dolutegravir

31
Q

HIV and HBV Co-infection

A

Leads to

  • milder necroinflammatory activity
  • higher rate of chronic infection
  • lower rate of HBeAg seroconversion
  • more commonly HBeAg positive
  • higher DNA levels
  • faster progression to cirrhosis
32
Q

First line treatment of toxoplasma encephalitis in a patient with HIV?

A

Pyrimethamine-sulphadiazine

33
Q

At what CD4 count is CMV disease usually seen?

A

CD4 < 50

34
Q

Needle stick injury - risk of transmission

A

Hep B - 30%
Hep C - 3%
HIV - 0.3%

35
Q

Moxifloxacin covers which organisms

A

Streptococcus pneumonia
Staphylococcus aureus
Mycoplasma pneumonia’s
Serratia aeruginosa

36
Q

Only oral agent for pseudomonas cover?

A

Ciprofloxacin

BPT Written (16 decks)

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