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Pharmacology > Intro to Infectious Disease, Bacteriology and Vaccines > Flashcards

Intro to Infectious Disease, Bacteriology and Vaccines Flashcards

1
Q

Microorganisms are _____ inside everyone. However, if they _______, that’s when there can be problems.

A

Normally

Overgrow

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2
Q

T or F: can normal gut flora cause infectious?

A

True

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3
Q

Some ways normal gut flora can cause infectious disease?

A

Translocation to an area they’re not supposed to be (often from a break in the skin - our body’s first line of defense)

Overgrowth in areas by elimination of the good bacteria

Bacteria spread by food, animal bites, hospital or community transmission, etc.

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4
Q

Which bacteria are mostly found on the skin?

A

Staph and Strep

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5
Q

What is a different kind of bacteria found on the skin that is most responsible for acne?

A

Proprionibacterium acnes

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6
Q

Which bacterium often colonizes catheters and medical devices that penetrate the skin?

A

Staph epidermidis

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7
Q

Environment of the skin?

A

Dry, slightly acidic, aerobic

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8
Q

What limits the eye from bacterial colonization?

A

Lysozymes found in tears keep the eye sterile

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9
Q

Which bacteria, if they do, can colonize the conjunctiva and the eye?

A

Same as those on the skin: staph and strep

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10
Q

Which bacterium is largely responsible for plaque formation on the teeth?

A

Strep mutans

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11
Q

What do we worry about with dental surgeries (in regards to bacteria?)

A

That bacteria (strep mutans) may enter the bloodstream

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12
Q

Which bacteria can be responsible for infective endocarditis and how?

A

Step. mutans, because it can colonize damaged or prosthetic heart valves

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13
Q

Which bacteria can cause bacterial pneumonia?

A

Strep pneumoniae

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14
Q

When does strep pneumoniae often strike?

A

Following a respiratory viral infection due to impaired immune system

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15
Q

Where do gram pos anaerobes live in the mouth?

A

Underneath the gingiva, at the root of the teeth

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16
Q

What types of bacteria are found in the mouth?

A

gram pos

anaerobes

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17
Q

What types of bacteria are found in the gut?

A

gram neg
anaerobes
(gram pos, too, but they’re virutally everywhere)

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18
Q

Where in the intestines is are the most microorganisms found?

A

colon

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19
Q

Where in the alimentary canal is the least amount of mircroorganisms?

A

stomach

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20
Q

20% of fecal mass is what?

A

Bacteria

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21
Q

Which species of bacteria constitiutes the most % in the colon?

A

Anaerobic Bacteroides species

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22
Q

Which bacteria is primarily found in the vagina? and why?

A

Lactobacillus species

Helps maintain low pH

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23
Q

Antibiotics do what to the normal vaginal flora?

A

Decrease lactobacillus populations, therefore increasing the pH and causing an overgrowth of pathogens (like candida)

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24
Q

Which bacteria are found in the urogenital tract?

A 
Gram neg (because of the proximity to the anus)
Some anaerobes
Gram pos (staph has one of the more common bugs; from translocation of the skin into the urinary tract)
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25
Q

Some beneficial functions of normal flora?

A

Helps get rid of waste, provides nutrients, some produce antimicrobial substances, they outcompete harmful pathogens, aid in digestion and nutrietn absorption

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26
Q

Communicabilty ease of cholera vs botulism?

A

Cholera is highly communicable, botulism is noncommunicable

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27
Q

Which are some viruses we can treat?

A

Hep C, HIV, HSV, BCV

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28
Q

What is one of the best ways to figure out what bugs are on an area?

A

Gram staining

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29
Q

What does gram staining do?

A

Helps identify whether the bacteria is pos, neg, or variable
Helps identify the shape

All so that we can better choose which antibiotics to use

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30
Q

Which lab test is used to identify mycobacteria species?

A

Ziehl-Neelsen staining: Acid-fast bacilli

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31
Q

What stains detect fungi?

A

KOH, India ink, Giemsa stains

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32
Q

What does culture negative endocarditis mean? And why does that happen?

A

The bacteria doesn’t grow on the agar for gram stains, so you get a neg culture. Because this bacteria doesn’t grow, you need to do other staining techniques to better identify which bugs are present

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33
Q

RDT can identify pathogens in how long?

A

3 hours

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34
Q

What is the most definitive method for diagnosis and treatment of an infection?

A

Culture

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35
Q

How long does a culture take?

A

24-72 hrs

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36
Q

Which bugs are generally slower to grow on a culture?

A

Gram neg

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37
Q

What does an MIC tell us?

A

The lowest concentration of a drugs that will inhibit visible bacterial growth

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38
Q

What is bactericial and bacteriostatic?

A

Bactericidal - kills the bacteria

Bacteriostatic - inhibits its growth (so this requires a good immune system to finish off the infection)

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39
Q

Which type of medicaitons (bactericidal or bacteriostatic) will get rid of the bug, and therefore, the infection sooner?

A

Bactericidal medications

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40
Q

What are some examples of bacteriostatic antiobiotics?

A 
Chloramphenicol
Erythryomycin
Clindamycin
Sulfonamides
Trimethoprim
Tetracylcines
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41
Q

What are some examples of bactericidal antibiotics?

A 
Aminoglycosides
Beta-lactams
Vancomycin
Quinolones
Rifampin
Metronidazole
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42
Q

What is a breakpoint in terms of antibiotic susceptibility?

A

The concentration at which antibiotic/bacteria is considered susceptible, intermediate, resistant

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43
Q

What is a breakpoint in terms of MIC?

A

The MIC concentrations of an antibiotic that separate the susceptibility categories, or concentration at which antibiotic/bacteria is considered susceptible, intermediate, resistant

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44
Q

What does susceptible mean?

A

Bacteria tested will have low MIC and will most likely be eradicated since the concentrations are easily achievable by standard dosing

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45
Q

What does intermediate mean?

A

Bacteria tested has a higher MIC and thus successful treatment may or may not occur or might need a higher dose

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46
Q

What does resistant mean?

A

Bacteria tested has a very high MIC that exceeds the achievable serum concentration of the antibiotic even if high doses are used and poor patient response would be expected

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47
Q

T or F: If an antibiotic has the lowest MIC, that’s usually the best antibiotic for treatment.

A

No, there are lots of other factors (like location of the infection, etc.) so we don’t target a specific MIC

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48
Q

An antibiogram shows what?

A

Report of the antimicrobial susceptibility profiles of the organism isolated with a hospital and surrounding community

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49
Q

What is a primary resistance?

A

Naturally-occurring trait of the organism

ex: Vacomycin resistance in E. coli

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50
Q

What is acquired resistance?

A

Spontaneous mutation of the target enzymes, or a transfer or genetic resistance determinants from other organisms

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51
Q

What is an example of acquired resistance?

A

VRSA, or MRSA

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52
Q

What bacteria have a high resistance?

A

Enterobacteriaceae

Staph aureus, strep pneumoniae, enterococci, psuedomonas aeruginosa, acinetobacter, C. diff

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53
Q

Which rapid diagnostic testing is used for MRSA?

A

mecA PCR

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54
Q

What is an example of a time-dependent killing antibiotic?

A

Beta lactams - penicillin, cephalosporins, carbapenem

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55
Q

What does it mean if an antibiotic is time-dependent killing?

A

The longer the serum concentration of the drug is over the MIC, the better it works

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56
Q

What is does it mean if an antibiotic is concentration-dependent killing?

A

Higher doses will kill the bacteria more

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57
Q

When would non-specific inflammatory markers like ESR and C-reactive proteins be used?

A

To check inflammation trends

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58
Q

Procalcitonin tends to rise in what kind of infections?

A

Bacterial

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59
Q

What is the half life of procalcitonin?

A

~24hrs

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60
Q

What’s the most important thing to consider when managing infections?

A

Source control, if we can’t do that, we’ll delay how fast we can treat the infection and increase morbidity and mortality

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61
Q

When do systemic effects from a bacterial infection happen?

A

When the bacteria gets into the bloodstream

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62
Q

What are the steps for a systematic approach to select antimicrobials?

A
  1. Confirm presence of infection (s/s, fever, predisposing factors)
  2. Identifying the pathogen (collection of infected material, stains, serology, culture)
  3. Selection of presumptive therapy (host and drug factors)
  4. Monitor therapeutic response (clinical assessment, laboratory tests, assessment of therapeutic failure)
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63
Q

What could mask a fever from an infection?

A

Antipyretics (Tylenol, NSAIDs)

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64
Q

Community-acquired infection?

A

Infection that originates int he outpatient or community setting or could be present on admission

The patient has NOT had a recent hospitalization or invasive medical procedure

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65
Q

Healthcare-associated infection?

A

Infection associateed with a medical or surgical intervention; includes long-term care and skilled-nursing facilities

includes terms such as “nosocomial” and “hospital-acquired”

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66
Q

Definition of colonization?

A

Organisms do not invade the host, but are a part of the normal flora of the site

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67
Q

Definition of infection?

A

Organisms invade the host and the patient has signs and symptoms of infectious process

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68
Q

What is empiric treatment?

A

Before we know the infectious organism - in this case, usually a broad-spectrum antibiotic

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69
Q

What is definitive treatment?

A

Treatment aimed at the diagnosis and positively-cultured bacterium

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70
Q

What is prophylactic treatment?

A

Preventative treatment against infection; in this case it is often done secondarily to prevent a follow up infection

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71
Q

When is a broader spectrum antibiotic required?

A

When covered multiple, mixed organisms involved in the infection

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72
Q

What could result because of the overuse of broad-spectrum antibiotics?

A

Superinfection

73
Q

What is antagonism?

A

When we kill our normal flora, allowing the bad bacteria to proliferate

74
Q

Some signs that an infection is improving?

A

WBC and temperature normalizes
Lab values decrease
Physical complaints/symptoms from patient should diminish
Appetite should improve

75
Q

What most often causes antibiotic failure?

A

Using the wrong drug or resistance

76
Q

What bugs often cause UTIs?

A

E. coli
Enterobacteriaeceae
Staph saprophyticus
Psuedomonas aeruginosa

77
Q

What bugs often cause URIs?

A

Strep. pyogenes

H. influenza

78
Q

What bugs cause gastritis?

A

Helicobacter pylori

79
Q

What bugs can cause eye infections?

A

Staph. aureus
Neisseria gonorrhoeae
Chlamydia trachomatis

80
Q

What bugs can cause food poisoning?

A 
Campylobacter jejuni
Salmonella
Shigella
Clostridium
Staph aureus
E. coli
81
Q

What bugs cause sinusitis?

A

Strep. pneumoniae

H. influenzae

82
Q

What bugs cause skin infections?

A

Staph. aureus
Strep pyogenes
Pseudomonas aeruginosa

83
Q

What bugs often cause community-acquired pneumonia?

A

Strep pneumoniae
H. influenzae
Staph aureus

84
Q

What atypical bugs can cause pneumonia?

A

Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumonphila

85
Q

What bug causes TB?

A

Mycobacterium tuberculosis

86
Q

What bug causes otitis media?

A

Strep pneumoniae

87
Q

What bugs can cause bacterial meningitis?

A 
Strep pneumoniae
Neisseria meningitidis
H influenzae
Step agalactiae
Listeria monocytogenes
88
Q

What are gram pos bacteria?

A

Staph
Strep
Enterococcus
Corynebacterium diptheriae

89
Q

What staph species are Coagulase negative?

A

Staph saprophytics and staph epidermidis

90
Q

What strep species is responsible for strep throat?

A

Strep pyogenes

91
Q

What are the two Enterococcus species we’re worried about?

Which is easier/harder to treat and why?

A

E. faecalis (easier to treat)

E. faecium (hardt to treat - more likely to have resistance)

92
Q

Where is corynebacterium usually found?

A

Normal skin flora

93
Q

What is the most common pathogen for virtually every infection?

A

Staph

94
Q

What are some common infections associated with staph?

A

Cellulitis, endocarditis, osteomyelitis, bacteremia

95
Q

How do you differentiate between staph aureus from staph saprophyticus or epidermis?

A

Coagulase test (staph aureus is the only pos)

96
Q

Which bug has the most potential to cause endocarditis?

A

Strep infections (mostly mutans)

97
Q

What are some gram neg bugs?

A 
Klebsiella pneumoniae
Proteus mirabilis, proteus vulgaris
Pseudomonas aeruginosa
E. coli
Moraxella catarrhalis
H. influenzae
Neisseria gonorrhea, meningitides
Citrobacter
Campylobacter jejuni
Salmonella
Serratia marcescens
H. pylori
Shigella
Vibrio cholerae
Acinetobacter
Enterobacter cloacae
Bordatella pertussis
Pasteurella multocida
Providencia species
98
Q

What bug is most common in GI infections?

A

campylobacter jejuni

99
Q

citrobacter is usually found where, but can be pathogenic where?

A

normal gut flora

Can be pathogenic in UTIs, pneumonia

100
Q

Where is moraxella catarrhalis often found?

A
101
Q

Klebsiella pneumonia is commonly found in what kind of infections?

A

UTIs and URIs

102
Q

proteus infections are often found where?

A

UTIs

103
Q

Pseudomonas aeruginosa is often found in what infections?

A

VAP/HAP, respiratory, UTIs, and SSTI in swimming pools

104
Q

What is the most common pathogen in UTIs?

A

E. coli

105
Q

What infections is salmonella found?

A

GI and typhoid fever

106
Q

What infections are caused by serratia marcescens?

A

Nosocomial infections in UTIs, bacteremia

107
Q

What does shigella cause?

A

dysentery, gastroenteritis

108
Q

Vibrio cholerae causes what? What is it found in?

A

Chloera and bacteremia in immunocompromised patients

salt water sources, raw fish

109
Q

What bug is common gut flora? When can it get pathogenic?

A

enterobacter cloacae

UTIs, respiratory infections

110
Q

What bug is responsible for “whooping cough?”

A

bordatella pertussis

111
Q

What is the most common bug found in animal bites?

A

pasteurella multocida

112
Q

What are the more common anaerobes we’ll see?

A 
Bacteroides fragilis
Clostridium species (C. diff, C. tetani, C. botulium)
113
Q

What bug causes botulism?

A

C. botulinum

114
Q

What bug cauess C. diff?

A

C. difficile

115
Q

What bug causes tetanus?

A

C. tetani

116
Q

What bug causes gas gangrene?

A

C. perfringe

117
Q

Where is bacteroides fragilis often found?

A

Common gut flora

118
Q

When can bacteroides fragilis become pathogenic?

A

perforated bowel, trauma, intraabdominal infections

119
Q

Atypical bacteria?

A

Chlamydia pneumoniae
Legionella pneumophila
Mycoplasma pneumoniae

120
Q

Which bacteria can come from HVAC systems, freezers, refrigeration and swimming pools and is a respiratory pathogen?

A

Legionella pneumophila

121
Q

What bug is responsble for walking pneumonia?

A

mycoplasma pneumoniae

122
Q

What is often found as a cause of atypical pneumonia?

A

Chlamydia pneumoniae

123
Q

What bug is associated with Lyme Disease?

A

borrelia burgdorferi

124
Q

What bug is associated with syphilis?

A

Treponema pallidum

125
Q

How do you treat stenotrophomonas infection?

Opportunistic bug that causes bacteremia, PNA, UTIs (can be multi-drug resistant)

A

Bactrim!

126
Q

What bug is responsible for Rocky Mountain Spotted Fever?

A

Rickettsia ricketsii

127
Q

What bug is responsible for anthrax?

A

Bacillus anthracis

128
Q

What bug is responsible for the bubonic plague?

A

yersinia pestis

129
Q

When is a Hep A vaccine indicated?

A

Travelers or in areas with a local outbreak

130
Q

How often is a Hep A vaccine treatment?

A

2 doses 6 months apart

131
Q

Typically, a Hep A infection is _______?

A

self-limiting

132
Q

What is the first vaccine given after birth?

A

Hep B

133
Q

About 10% of those who get a Hep B vaccine are what? Why does this happen?

A

nonresponders

They don’t develop antibodies

134
Q

How do we treat Hep B nonresponders?

A

As if they’ve never gotten the vaccine at all - they get an immune globulin if they were exposed

135
Q

Is Hep B curable?

A

No

136
Q

What bug is the most common cause of acute gastroenteritis in kids?

A

rotavirus

137
Q

When is rotavirus vaccine contraindicated and why?

A

infants with immunocompromised hx and in those with a history of intussusception

138
Q

Is the rotavirus vaccine inactive or live?

A

live

139
Q

When is the first dose of the rotavirus vaccine given?

A

2 months

140
Q

Live vaccines are contraindicated in what kind of patients?

A

Pregnant and immunocompromised

141
Q

What do the capital letters indicate in DTaP, Tdap, Td, DT, DTap?

A

There’s more antigens for those bugs whose letters are capitalized.
T = tetanus
D = diphtheria
aP = acellular pertussis

142
Q

Which vaccine is a 5 dose series?

A

DTap, starts at 2 months, ends at 4-6 yo

143
Q

When are vaccines without pertussis indicated?

A

In kids with encephalopathy after initiall doses

144
Q

How often should you get your Tdap, Td?

A

every 10 years; and Tdap at each pregnancy

145
Q

What drug is a common cause of bacerial meningitis, respiratory illness in peds?

A

H. influenzae

146
Q

When do kids start their H. influenzae vaccine? How many shots is it?

A

about 2 months; 2-3 doses

147
Q

What H. influenzae vaccine allows for a prolonged immune response?

A

Type B conjugate vaccine (Hib)

148
Q

PCV, PCV13, and PPSV are vaccines to prevent which bug?

A

Step pneumoniae

149
Q

When is the PCV13 pneumococcal drug started?

A

Pediatric patients starting at 2 months

150
Q

Which of the pneumococcal vaccines are given between the ages of 18-65yo and why?

A

PCV, to elicit prolonged immune response due to priming of the immune system

151
Q

PPSV23 pneumococcal vaccine is given how often and to what age group?

A

2 doses before and after the age of 65

152
Q

For the flu vaccine, what’s the difference between live and inactivated vaccines?

A

There doesn’t seem to be much of a difference between the two, except that the live may be inferior?

153
Q

For those pts older than 65, which flu shot is preferred?

A

FluZone (because of its high dosing)

154
Q

H1N1 is included in _______?

A

Flu vaccines

155
Q

When should you get your flu vaccine? Initial dosing?

A

Every year after 6 months of age; Initial series is 2 doses given 4 weeks apart

156
Q

MMR is a live or inactive vaccine?

A

Live

157
Q

You should avoid becoming pregnant for how many days after an injection from MMR?

A

28 days

158
Q

Is the chickenpox vaccine live or inactive?

A

live

159
Q

How many doses is the chickenpox vaccines and when should you start them?

A

2 doses; start as early as 12 months

160
Q

For whom is the zoster vaccine indicated?

A

For pts >50yo

161
Q

Which zoster vaccine seems to have the higher efficacy?

A

Shingrix - inactive

162
Q

T or F: the Zoster vaccine is recommened even if there is no history of chickenpox

A

T

163
Q

T or F: HPV vaccine is one of the few vaccines actually proven to reduce the risk of cancer

A

T

164
Q

Should males or females get the HPV vaccine?

A

Both!

165
Q

For what age groups shoule the HPV vaccine be given?

A

Between 9 and 45

But for those > 27, it’s dependent upon risk factors

166
Q

How many doses is the HPV vaccine?

A

2-3

167
Q

Which strains of HPV are most implicated in causing cervical cancer?

A

16, 18

168
Q

What strains of HPV are implicated at causing anogenital warts?

A

6, 11

169
Q

Which bug does the meningococcal vaccine prevent against?

A

Neisseria meningitidis

170
Q

For what age group is the meningococcal serogroup B vaccine (MenB) indicated?

A

college age (they have the highest risk)

171
Q

The Quadrivalent ACWY vaccine is how many doses and at what age group is this given to prevent neisseria meningitidis?

A

2 doses given starting at age 11

172
Q

At what age is the COVID vaccine indicated?

A

Now as young as 5 yo

173
Q

What are the 3 FDA approved COVID vaccines and their dosing?

A

Pfizer (mRNA-based) 2 doses + booster
Moderna (mRNA-based, has a higher antigen load) 2 doses + booster
Janssen (J&J - adenoviral vector) 1 dose + booster

174
Q

Which COVID vaccine has shown a higher incidence of Guillaine-Barre and thrombosis?

A

Adenoviral vector borne (Janssen, J&J)

175
Q

T or F: Mixing COVID vaccine types is bad

A

F

176
Q

How soon after COVID infection can you get a COVID vaccine?

A

90 days, and you have to be feeling “well”

177
Q

T or F: In general, non-live vaccines should never be administered together

A

F

178
Q

Live vaccines, if they are not given on the same day, must be separated by how many weeks?

A

4

179
Q

T or F: Live and non-live vaccines can be administered together.

A

T

*Except for meningococcal and pneumococcal, they should be separated by ~4 weeks in immunocompromised pts

Pharmacology (6 decks)

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