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1
Q

MOA: Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine

A

Folate synthesis inhibition via inhibition of dihydropteroate synthase.
Bacteriostatic
Use: UTI

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2
Q

Toxicity of Sulfamethoxazole?

A

Hemolysis in G6PD deficient pt, Nephrotoxicity, Photosensitivity (SAT for a photo), Kernicterus in infants

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3
Q

MOA of Trimethoprim?

A

Inhibits dihydrofolate reductase

  • Used in combo with Sulfonamethoxazole (TMP-SMX) to treat UTI inxn,
  • Shigella, Salmonella infxn
  • Pneumocystis jirovecci pneumonia prophylaxis (AIDS pts, when CD4 count is <200)
  • Toxoplasmosis prophylaxis
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4
Q

AE of Trimethoprim sulfate?

A

Megaloblastic anemia, leukopenia, granulocytopenia (all due to low folic acid)
“TMP: Treats Marrow Poorly”

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5
Q

Name 3 Flouroquinolones

A

Ciprofloxacin, Levofloxacin, Moxifloxacin… “Floxacins”

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6
Q

MOA of Flouroquinolones

A

Inhibit DNA gyrase (topoisomerase II)

-Bactericidal

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7
Q

What must not be taken when on a flouroquinolone?

A

Antacids

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8
Q

When do we use flouroquinolones?

A

G- rods
UTI
GI infxn
Later generations (Levofloxacin, Moxifloxacin) used for G+ infxns (like s. pneumonia)

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9
Q

AE of Flouroquinolones

A

Damage to cartilage (tendon rupture)

“FlouroquinoLONES hurt attachment to your BONES)

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10
Q

MOA of Metronidazole

A

Forms free radical toxic metabolites in the bacterial cell that damage DNA
-Bactericidal, antiprotozoal

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11
Q

What bugs do you treat with metronidazole?

A

Giardia, Entamoeba, Trichomonas, Garnerella vaginalis, Anaerobes (Bacteroides, C. dificile), H. Pylori
“GET GAP on the metro with Metronidazole”
-Part of triple therapy for H. pylori (PPI, Clarithromycin, Metronidazole or Amoxicillin)

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12
Q

Why can’t you drink alcohol with metronidazole?

A

Disulfiram-like reaction (flushing, tachycardia, hypotension, headache)

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13
Q

MCC of UTI?

A
  1. E. coli
  2. Staph saprophyticus
  3. Klebsiella
  4. Proteus mirabilis
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14
Q

MC med used for UTI prophylaxis?

A

TMP-SMX

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15
Q

MC bacteria in a pt with Struvite kidney stone

A

Proteus mirabilius

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16
Q

Name 3 Spirochetes

A

Borrelia, Leptospira, Treponema

“BLT”

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17
Q

What do surfers get when they swim in dolphin pee?

A

Leptospira interrogans

  • water contaminated with animal urine
  • Leptospirosis: flu symptoms, jaundice, photophobia, conjunctival suffusion
  • Prevalent among surfers and tropics
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18
Q

What causes Weil disease?

A

Leptospira interrogans

  • ictohemorrhagic leptospirosis
  • severe from with jaundice and azotemia from liver and kidney disfunction; fever; hemorrhage, and anemia
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19
Q

What is vector for Borrelia burgdorferi?

A

Ixodes tick

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20
Q

What is Borrelia burgdorferi’s natural reservoir?

A

Mouse

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21
Q

Initial symptoms of Lyme dz?

A

Erythema chronicum migrans, flu symptoms, +/- bilateral bell’s palsy

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22
Q

Later symptoms of Lyme dz?

A

Monoarthritis (painful knee), Migratory polyarthritis, AV nodal block, Bilateral bell’s palsy
“FAKE a key Lyme pie”
Facial nerve palsy, Arthritis, Kardiac block, Erythema migrans

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23
Q

Tx for Lyme dz

A

Doxycycline, ceftriaxone

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24
Q

Bacterial overgrowth, fishy smell, Clue cell

A

Gardnerella vaginalis (bacterial vaginosis)

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25
Q

Fever, Rash on palms and soles, Tick

A

RMSF

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26
Q

Fever, Tick, Central rash that spreads outwards

A

Rickettsiae prowazekii and typhi

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27
Q

Ectopic pregnancy, urethritis, infertility

A

Chlamydia trachomatis

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28
Q

Transmitted via aerosol, treated with doxycycline or azithromycin, interstitial pneumonia

A

M. pneumonia, Chlamydia pneumonia

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29
Q

Q fever, spore former, negative Weil Helix

A

Coxiella burnetti

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30
Q

Man w/ pneumonia has sputum that doesn’t gram stain. Silver stain identifies a G- rod. Causative organism?

A

Legionella pneumophila

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31
Q

Common cause of pneumonia in immunocompromised pts

A

Pneumocystis jeroveci

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32
Q

MCC of atypical (walking) pneumonia

A

Mycoplasma pneumoniae

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33
Q

Common cause of pneumonia in alcoholics

A

Klebsiella pneumoniae

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34
Q

Bird handler with interstitial pneumonia

A

Chlamydia psittaci

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35
Q

Bat droppings in caves

A

Histoplasma

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36
Q

Cause of pneumonia in pt who has visited Southern California, New Mexico or West TX

A

Coccidioides

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37
Q

Pneumonia with “currant jelly” sputum

A

Klebsiella

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38
Q

Q fever

A

Coxiella burnetii

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39
Q

Pneumonia from an AC unit

A

Legionella pneumophila

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40
Q

MCC of pneumonia in child <1 y/o

A

RSV

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41
Q

MCC of pneumonia in the neonate (birth-28 days)

A

GBS, E. coli

42
Q

MCC of pneumonia in children and young adults

A

Mycoplasma pneumonia

43
Q

MCC of viral pneumonia

44
Q

Causes Wool-sorter’s dz

A

Bacillus anthracis

45
Q

Common pneumonia in ventilator pts and those with cystic fibrosis

A

Pseudomonas auruginosis

46
Q

Pontiac fever

A

Legionella

47
Q

How do Cephalosporins work?

A

Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases than the penicillins

48
Q

Which has greater effect on G+ organisms, 1st gen cephalosporins or 4th gen cephalosporins?

A

1st gen have more G+ effect, 4th gen has more G- effect

49
Q

What are the 1st generation cephalosporins?

A

Cefazolin, Cephalexin

50
Q

What bugs are the 1st gen cephalosporins used to treat?

A

“PEcK”
Proteus mirabilis
E. coli
Klebsiella

51
Q

What are the 2nd generation cephalosporins?

A

Cefoxitin, Cefaclor, Cefuroxime

52
Q

What bugs do the 2nd gen cephalosporins treat?

A 
"HENS PEcK"
Haemophilus influenzae
Enterobacter aerogenes
Neisseria spp
Serratia marcescens
Proteus mirabilis
E. coli
Klebsiella
53
Q

What are the 3rd generation cephalosporins?

A

Ceftriaxone, Cefotaxime, Ceftazidime

54
Q

What are 3rd gen cephalosporins used for?

A

Serious G- infections resistant to other beta-lactams

55
Q

What illnesses are Ceftriaxone used for?

A

Meningitis, Gonorrhea infxn

56
Q

What bug is Ceftazidime used to treat?

A

Pseudomonas

57
Q

What is the 4th generation cephalosporin?

58
Q

WHat is the 5th gen cephalosporin?

A

Ceftaroline

59
Q

What organisms are typically not covered by cephalosporins?

A 
"LAME"
Listeria
Atypical bacteria (Chlamydia, Mycoplasma)
MRSA (except Ceftaroline)
Enterococci
60
Q

What are the bacterial protein synthesis inhibitors that target the 30S ribosomal subunit?

A

“Buy AT 30, CCEL (sell) at 50”
30S inhibitors:
Aminoglycosides
Tetracyclines

61
Q

what are the 50S bacterial protein synthesis inhibitors?

A 
"Buy AT 30, CCEL at 50"
Chloramphenicol
Clindamycin
Erythromycin
Linezolid
62
Q

What drugs comprise the Aminoglycosides?

A 
"Mean GNATS caNNOT kill anaerobes"
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin

Nephrotoxicity
NM toxicity
Ototoxicity
Teratogen

63
Q

What drug causes Gray baby syndrome?

A

Chloramphenicol

64
Q

What drug causes Gray man syndrome?

A

Amiodarone

65
Q

What drug causes Red man syndrome?

A

Vancomycin

66
Q

What are the clinical uses of the macrolides?

A

“PUS”
Pneumonia
URI
STDs

67
Q

Prophylaxis for meningococcal meningitis

A

Ciprofloxacin (flouroquinolone)

Rifampin for kids (cipro damages cartilage in kids)

68
Q

Prophylaxis for gonorrhea

A

Ceftriaxone (3rd gen cephalosporin)

69
Q

History of recurrent UTI

70
Q

Prophylaxis for endocarditis following dental procedure

A

Penicillin (think strep veridans with dental procedures)

71
Q

What do we give a pregnant woman with GBS infxn?

A

Ampicillin during labor to prevent transmission to the baby

72
Q

Gonoccal or chlamydial conjunctivitis in newborn

A

Erythromycin ointment (Macrolide)

73
Q

What’s the DOC for anthrax infxn?

A

Ciprofloxacin

74
Q

What drug types are useful against Pseudomonas?

A

Flouroquinolones, Extended spectrum penicillins, 3rd generation cephalosporins, Cefepime, Aztreonam, aminoglycosides, polymixin

75
Q

Pneumonia in neonate

A

E. coli, GBS

76
Q

What are the associated symptoms with Toxoplasma infection of a newborn?

A

(ToRCHeS infxn)

Triad: Chorioretinitis, hydrocephalus, intracranial calcifications

77
Q

What is the classic triad of symptoms for rubella infection?

A

(ToRCHeS)

Triad: PDA, cataracts, deafness

78
Q

What is the MC ToRCHeS infxn?

79
Q

CMV neonatal infxn

A

**Unilateral hearing loss

Seizures, chorioretinitis, hydrocephalus, intracranial calcifications

80
Q

What complication can Parvovirus B19 cause in a fetus?

A

Hydrops fetalis

81
Q

What are the ToRCHeS infections?

A 
Toxoplasma
Other-ParvoB19
Rubella
CMV
Herpes/HIV
Syphilis
82
Q

MCC of UTI in hospitalized pt

83
Q

Clue cells

A

Bacterial vaginosis (Gardnerella)

84
Q

Painless genital ulcer

A

Syphilis chancre

85
Q

Strawberry cervix caused by flagellated cells

A

Trichomonas

86
Q

Inhibits 50S peptidyltransferase

A

Chloramphenicol

87
Q

Binds 50S, blocking translocation

A

Macrolides, Lincomycin, Clindamycin, Streptogramins

88
Q

Binds 30S, prevents attachment of tRNA

A

Tetracyclines

89
Q

Inhibits prokaryotic RNA polymerase

90
Q

Inhibits Prokaryotic topoisomerase

A

Fluoroquinolones

91
Q

inhibits prokaryotic DHFR

A

Trimethoprim

92
Q

Where are mRNA and tRNA synthesized

A

Nucleoplasm (liquid portion of the nucleus)

93
Q

where is rRNA synthesized?

94
Q

Dark purple nodules on the skin of an HIV patient

A

Kaposi Sarcoma (HHV-8)

95
Q

Temporal lobe encephalitis

96
Q

Owl’s eye inclusions in organ tissue

A

CMV infxn (don’t get these confused with Reed Sternberg cells seen w/ Hodgkins lymphoma)

97
Q

Intranuclear eosinophilic droplets

A

Cowdry bodies (HSV, CMV)

98
Q

What test is used to diagnose HSV-1, HSV-2 and VZV

A

Tzanck test (Tzanck heavens I don’t have herpes!)

99
Q

Aplastic anemia in a sickle cell patient

100
Q

Child with fever and “slapped cheek” rash on the face that spreads to his body

A

Fifth dz (ParvoB19)

101
Q

Fever, runny nose, cough, conjunctivitis, and diffuse rash

A

Measles (Rubeola>Cough, Conjunctivitis, Coryza)

102
Q

Small, irregular blue-gray spots on the buccal mucosa, surrounded by a base of red

A

Koplick’s spots (measles)

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