Micro Flashcards
1
Q
ampicillin/amoxicillin coverage
A
G(+) and HELPSS Haemophilus E. coli Listeria Proteus Salmonella Shigella
2
Q
organisms not covered by cephalosporins
A
LAME Listeria atypicals (chlamydia, mycoplasma) MRSA Enterococci
3
Q
first gen cephalosporins
A
cefazolin, cephalexin
PEcK and G(+)
Proteus, E. coli, Klebsiella
4
Q
second gen cephalosporins
A
cefoxitin, cefaclor, cefuroxime HENS PEcK Haemophilus Enterobacter Neisseria (not gonorrhea) Serratia Proteus, E. coli, Klebsiella
5
Q
third gen cephalosporins
A
ceftriaxone (excreted in bile), cefotazime, ceftazidime
G(-) bad guys
meningitis and gonorrhea
ceftazidime for pseudomonas
6
Q
fourth gen cephalosporins
A
cefepime
good pseudomonas and broad G(+)
7
Q
toxicity of cephalosporins
A
increased nephrotoxicity with aminoglycosides
disulfiram like reaction
8
Q
given prior to surgery to prevent s. aureus infections
A
cefazolin (1st gen)
9
Q
side effects of vancomycin
A
red man syndrome (mast cell degranulation)
NOT: nephrotoxicity, ototoxicity, thrombophlebitis
10
Q
resistance to vancomycin
A
change of D-ala-D-ala to D-ala-D-lac
11
Q
protein synthesis inhibitors
A
Buy AT 30, CELL at 50
30s: aminoglycosides, tetracyclines
50s: chloramphenicol, clindamycin, erythromycin (macrolides), linezolid
12
Q
use for tetracyclines
A
VACUUM THe BedRoom vibrio cholera acne chlamydia ureaplasma urealyticum mycoplasma pneumoniae tularemia H. pylori Borrelia burgdorferi Rickettsia
13
Q
photosensitivity
A
SAT:
sulfonamides, amiodarone, tetracyclines
14
Q
what to avoid with tetracyclines
A
milk, antacids, iron because they inhibit the absorption of tetracyclines
15
Q
given for bowel surgery
A
neomycin
16
Q
toxicity of aminoglycosides
A
nephrotoxicity, ototoxicity, teratogenic
17
Q
clinical uses for macrolides
A
PUS
Pneumonia: mycoplasma, chlamydia, legionella
URI: strep pneumoniae, strep pyogenes
STD: chlamydia, gonorrhea
18
Q
resistance to macrolides
A
mehtylation of 23S RNA subunit of 50S
19
Q
clinical use for chloramphenicol and toxicity
A
use: meningitis (H. flu, N men, strep pneum)
tox: gray baby syndrome, aplastic anemia
20
Q
clinical use of clindamycin and toxicity
A
use: MRSA abscess
tox: C. difficile
21
Q
streptogramins
A
quinupristin and dalfopristin
bind 23s subunit of 50s
use: MRSA, VRE, staph and strep skin infections
SE: hepatotoxicity, pseudomembranous colitis, inhibits cP450 system
22
Q
what causes:
gray baby
gray man
red man
A
baby: chloramphenicol
man: amiodarone
red man: vancomycin
23
Q
prophylaxis for meningococcal infection
A
coprofloxacin
rifampin for children
24
Q
prophylaxis for gonorrhea
A
ceftriaxone
25
prophylaxis for syphilis
benzathine penicillin G
26
prophylaxis for history of recurrent UTI
TMP-SMX, nitrofurantoin, amoxicillin
27
prophylaxis for pneumocystic jiroveci
TMP-SMX if CD4<200, dapsone if sulfa allergic
28
prophylaxis for endocarditis (surgery or dental procedure)
penicillins, aminopenicillins, cephalexin
29
prophylaxis for pregnant women with Group B strep
ampicillin during pregnancy
30
prophylaxis for strep pharyngitis in child with prior rheumatic fever
oral penicillin
31
prophylaxis for postsurgical infection of s. aureus
cefazolin
32
prophylaxis for gonococal or chlamydial conjunctivitis in newborn
erythromycin ointment
33
antibiotics to avoid in pregnancy
```
SAFe Children Take Really Good Care
Sulfonamides (kernicterus)
Aminoglycosides (ototoxicity)
Fluoroquinolones (cartilage damage)
Clarithromycin (embryotoxic)
Tetracylines (discolored teeth)
Ribavirn (teratogenic)
Griseofulvin (teratogenic)
Chlorammphenicol (Gray baby)
also metronidazole (mutagenesis 1st trimester)
```
34
antiplatelet antibodies
ITP: immunothrombocytopenia
35
newborn with chronic diarrhea, failure to thrice, and chronic Candida
SCID
36
child with eczema, coarse facial features, and cold abscesses
heyperimmunogloculinemia E syndrome (Job syndrome)
37
child with partial albinism, peripheral neuropathy, and recurrent infections
Chediak-Higashi
38
oropharynx colonized by
viridans streptococci
39
dental plaque
strep mutans
40
colon
Bacteroides fragilis>E. coli
41
vagina
lactobacillus; E. coli and group B strep sometimes
42
common cause of pneumonia in neonates
Group B strep
E. coli
Tx: ampicillin and gentamicin
43
common cause of pneumonia in children
```
RSV
Mycoplasma
Chlamydia
S pneumoniae
Tx: azithromycin or ceftriaxone
```
44
common cause of pneumonia in adults (<40)
Mycoplasma
C. pneumoniae
S. pneumoniae
Tx: azithromycin and ceftriaxone
45
common cause of pneumonia in adults (40-65)
S. pneumoniae
H influenzae
Tx: clarithromycin
46
common cause of pneumonia in elderly
```
S. pneumoniae
influenza virus
anaerobes
H. influenzae
Tx: cephapime or carbapenam
```
47
common cause of pneumonia in IV drug users
S. pneumoniae, Klebsiella, Staphylococcus
48
common cause of pneumonia cystic fibrosis
Pseudomonas, S. aureus, S pneumoniae
49
atypical pneumonia
Mycoplasma, Legionella, Chlamydia
50
postviral pneumonia
Staphylococcus, H flu, S pneumoniae
51
common cause of meningitis 0-6 months
Group B strep, E. coli, Listeria
52
common cause of meningitis <6
Strep pneumoniae, N. meningitidis, H flu, enterovirus (coxsackie A)
53
common cause of meningitis 6-60
S pneumoniae, n. meningitids, enterovirus, HSV
54
common cause of meningitis over 60
S. pneumoniae, G- rods, Listeria
55
common cause of meningitis in HIV
cryptococcus
56
osteomyelitis
```
S. aureus
sexually active: N. gonorrhea
Db and IV drugs: Pseudomonas, serratia
Sickle cell: salmonella
prosthetic replacement: S. aureus, S epidermidis
vertebral disease: TB
cat/dog bite: Pasteurella multocida
```
57
CSF findings in meningitis
bacterial: increased pressure, PMN, protein and decreased glucose
fungal: increased pressure, lymphocytes, protein and decreased glucose
viral: normal or increased pressure, increased lymphocytes and protein, normal glucose
58
most common etiology of bacterial meningitis
Group B strep
59
most common etiology of bacterial meningitis in kids
strep pneumoniae
| n. meningitidis
60
most common bacterial meningitis in adults
S. pneumoniae
61
osteomyelitis in IV drug user
S. aureus or Pseudomonas
62
osteomyelitis in sickle cell
Salmonella
63
pt presents with vertigo, tinnitus, and hearing loss
Meneiere's disease
64
TORCHeS infections
```
Toxoplasma gondii
Other: parvovirus B19, meningitis
Rubella
CMV
Herpes 2/HIV
Syphilis
```
65
STD with clue cells
bacterial vaginosis
66
painless genital ulcer
syphilis
67
flagellated cells
trichomonas
68
strawberry cervix
trichomonas
69
most common reportable STD
Chlamydia
70
non-painful, indurated, ulcerated genital lesion
primary syphilis
71
painful, indurated, ulcerated genital lesion, with exudate
chancroid
72
stippled vaginal epithelial cells on a wet prep of vaginal discharge
bacterial vaginosis (clue cells)
73
common treatment for syphilis
penicillin G
74
common treatment for Trichomonas
metronidazole
75
common treatment for Chlamydia
doxycycline or azithromycin
76
common treatment for gonorrhea
ceftriaxone
77
toxoplasma gondii triad
chorioretinitis
hydrocephalus
intracranial calcifications
78
rubella triad
PDA
cataracts
deafness
79
CMV
hearing loss, seizures, blueberry muffin rash
80
vaginal discharge
young girl (puberty): physiological
cottage cheese: candidiasis
very itchy: trichomonas
fishy smell, clue cells: bacterial vaginosis
81
newborn nursery
CMV, RSV
82
urinary cath
E. coli, pseudomonas
83
respirator
Pseudomonas
84
renal dialysis
HBV
85
IV nutrition (hyperalimentation)
candida albicans
86
water aerosols
legionella
87
antibiotics safe during pregnancy
```
penicillins and aminopenicillins
piperacillin
cephalosporins
macrolides
metronidazole (after 1st trimester)
nitrofurantoin
```
88
RUQ pain and symptoms of PID
Fitz-Hugh-Curtis syndrome
| follows PID episode and is sudden onset RUQ pain and may show violin string adhesions on laparoscopy
89
do not take Gram stain
```
Treponema
Rickettsia
Mycobacteria (high lipid content)
Mycoplasma (no cell wall)
Legionella pneuomophila
Chlamydia
```
90
Giemsa stain
Chlamydia, Borrelia, Rickettsiae, Trypanosomes, Pasmodium
91
PAS (peiodic acid-Schiff) stain
stains glycogen, mucopolysaccharides
| Whipple's disease (Tropheryma whipplei)
92
Ziehl-Neelsen (carbol fuchsin)
acid fact organisms
| Nocardia and Mycobacterium
93
India ink stain
Cryptococcus neoformans
94
Silver stain
fungi, legionella, H. pylori
95
encapsulated bacteria
```
Strep pneumoniae
Haemophilus influenzae
N. meningitidis
E. coli
Pseudomonas
Klebsiella
Salmonella typhi
```
96
organism in balanitis
candida albicans
| balanitis is inflammation of glans penis
97
obligate aerobes
Nocardia, Pseudomonas, Mycobacterium tuberculosis, Bacillus
98
obligate anaerobes
Clostridium, Bacteroides, Actinomyces
| lack superoxide dismutase
99
endotoxin
```
ENDOTOXIN
edema
nitric oxide
DIC/death
outer membrane
TNF-a
O-antigen
eXtremely heat stable
IL-1
Neutrophil chemotaxis
```
100
transformation
take up naked DNA
101
conjugation
plasmid passing
102
transposition
transfer genes from plasmid to chromosome and vice versa
103
transduction
packaging of DNA in phages
104
what 7 bacteria secrete enterotoxins (exotoxins in GI system)
vibrio cholera, E. coloi, s. aureus, shigella, yersinia, c. difficile, clostridium perfringens
105
skin pathogen that infects indwelling foreign devices
s. epidermidis
106
organisms most likely in subacute endocarditis
viridans strep, enterococci, s. bovis, coagulase neg. staph and HACEK
Haemophilus, actinobacillus, cardiobacterium, eikenella, kingella
107
streptococcus pyogenes disease
superficial/invasive: pharyngitis, impetigo, cellulitis, blood strema
toxin-mediated: toxic shock syndrome
immune-mediated: post-streptococcal glomerulonephritis, rheumatic fever
108
causes scalded skin syndrome
s. aureus
109
gray-white membrane in posterior pharynx of an unvaccinated child
corynebacterium diptheriae
110
pharyngitis resulting in glomerulonephritis
group A strep (s. pyogenes)
111
most common cause of meningitis in G+
strep pneumoniae
112
most common G+ cause of osteomyelitis
s. aureus
113
serious newborn infections
Group B strep, listeria, E. coli
114
infant with poor muscle tone
clostridium botulinum
115
diarrhea after using antibiotics
clostridium difficile
116
respiratory distress in a postal worker
B. anthracis
117
otitis media in children
S. pneumoniae
118
cellulitis
s. aureus and s. pyogenes
119
one hour after eating potato salad, entire family is vomitting
staph aureus
120
susceptible to Listeria monocytogenes
infants, elderly, immunocompromised, pregnant
121
spore forming bacteria
bacillus and clostridium species
| also coxiella burnetti
122
branching, filamentous G+ rods with sulfur granules
actinomyces israeli
123
G- oxidase positive diplococci
N. gonorrhoeae or N. meningitidis
124
smoker has cough and sputum gram stain shows nothing. silver stain shows rods
legionella pneumophila
125
sepsis, DIC, adrenal hemorrhage and G-
N. meningitidis
126
5 year old with pharyngitis, drooling, and x-ray has thumb sign
H. influenzae
127
life threatening meningitis and purpura
N. meningitidis
128
septic arthritis in young, sexually active patients
n. gonoorhoae
129
antibiotics to treat c. difficile pseudomembranous colitis
metrinidazole and oral vancomycin
130
food poisoning as a result of mayonnaise sitting out too long
s. aureus
131
diarrhea caused by G- nonmotile organism that does not ferment lactose
shigella
132
diarrhea caused by an S-shaped organism
campylobacter jejuni
133
diarrhea transmitted from household pets
yersinia
134
food poisoning resulting from reheated rice
bacillus cereus
135
diarrhea caused by G- motile organism that doesn't ferment lactose
salmonella
136
most common cause of traveler's diarrhea
ETEC
137
food poisoning due to exotoxin
s aureus and bacillus cereus
138
osteomyelitis in sickle cell pt
salmonella
139
drugs cause Stevens-Johnson syndrome
penicillins, sulfas, allopurinol, seizure drugs (ethosuximide, lanotrigine, carbamazepine, phenobarbital, phenytoin)
140
most common cause of UTI
E. coli
staph saprophyticus
klebsiella
proteus mirabilis
141
most common medication used for UTI prophylaxis
TMP-SMX
142
most common bacteria in a patient with struvite kidney stones
proteus
143
standard treatment for T. pallidum
penicillin
144
cellulitis from a dog or cat bite
pasteurella multocida
145
non-painful, indurated, ulcerated genital lesion
chancre of 1 syphilis
146
moist, smooth, flat, white genital lesion
condylomata of late 2 syphilis
147
large bull's eye rash
erythema migrans of lyme disease
148
ghon complex
ghon focus (fibrosing nodule in lung) and hilar lymphadenopathy
149
negative PPD
never been exposed to TB
| immunocompromised, steroids, sarcoidosis, malnourishment
150
"keeps lungs healthy but I have to take b vitamin to keep from hurting nerves"
isoniazid
151
calcified granulomas in the lung, plus hilar lymphadenopathy
ghon complex
152
back pain, fever, night sweats, and weight loss
pott's disease
153
standard treatment regimen for TB
```
RIPE
rifampin
isoniazid
pyrazinamide
ethambutol
```
154
rickettsial triad
headache, fever, rash
155
antibiotic of choice for
mycoplasma pneumoniae
Rocky mountain spotted fever
bacterial vaginosis
macrolide or tetracycline
doxycyline
metronidazole
156
live vaccines
smallpox, yellow fever, herpes zoster, chickenpox, Sabin's poli (oral), MMR, nasal influenza
157
where does herpesvirus get envelope
nuclear membrane
158
unenveloped viruses
adenovirus, calicivirus, papilloma, parvovirus, picornavirus, polyomavirus, reovirus, hepevirus
159
where do viruses replicate
DNA in nucleus except poxvirus
| RNA in cytoplasm except influenza and retroviruses
160
virus ploidy
haploid except retroviruses are diploid
161
DNA viruses
normally double stranded, linear, icosahedral, and replicate in nucleus
162
treatment for herpes viruses
HSV-1, 2, zoster (VZV): acyclovir, valacyclovir, famciclovir
| CMV: ganciclovir, foscarnet
163
latent herpes infection sites in body
```
HSV-1: trigeminal ganglia
HSV-2: sacral ganglia
VZV: dorsal root or trigeminal ganglia
EBV: B cells
CMV: mononuclear cells
```
164
dark purple nodules on the skin in an HIV patient
Kaposi sarcoma
165
temporal lobe encephalitis
HSV-1
166
Owl's eye inclusions in organ tissue
CMV
167
intranuclear eosinophilic droplets
Cowdry A inclusions
| HSV, CMV
168
parvovirus B19
smallest DNA virus, ssDNA
aplastic crisis in sickle cell disease
"slapped cheek" rash in children (fifth disease)
hydrops fetalis and death in pregnancy
169
adenovirus
conjunctivitis: pink eye
| can cause diarrhea
170
poxvirus
smallpox
vaccinia: cowpox
molluscum contagiousm: dome lesions with central dimples
171
JC virus
PML (progressive multifocal leukoencephalopathy) in HIV
172
hand, foot, and mouth disease
coxsackie
173
break bone fever
dengue
174
common cold
rhinovirus and coronavirus
175
fever, jaundice, black vomit
yellow fever
176
meningitis in summer months
echovirus or coxsackievirus
177
Tourniquet test helps diagnose hemorrhagic disease
dengue
178
infects motor neurons of the anterior horn
west nile and poliovirus
179
infantile gastroenteritis
rotavirus
180
antiplatelet antibodies
ITP (immune thrombocytopenia)
181
painful, raised lesions on finger pads + fever
Osler's nodes in infective endocarditis
182
prophylaxis for influenza A
zanamivir and oseltamivir
183
treatment of chronic hepatitis C
ribavirin and IFN-a
184
first line for herpes simplex viruses or varicella-zoster virus
acyclovir, vancyclovir, fanciclovir
185
characteristic barking seal cough
parainfluenza virus (croup)
186
asthma-sounding infection in infants (esp premies)
RSV (Respiratory syncytial virus)
187
bronchiolitis with cough and wheezing in babies
RSV
188
Downey cells
seen in EBV
189
aseptic meningitis
enteroviruses (echovirus, coxsackievirus) and mumps
190
fever, runny nose, cough, conjunctivitis, and diffuse rash
measles (rubeola)
191
small irregular blue-gray spots on the buccal mucosa, surrounded by a base of red
Koplik's spots in measles
192
HIV genes
env (gp120 and gp41)
gag (p24: capsid protein)
pol (reverse transcriptase)
193
envelope proteins in HIV
gp120: attachment to host CD4 T-cell
gp41: fusion and entry into cell
194
dark purple nodule on skin in an HIV patient
kaposi sarcoma
195
treatment for CMV
ganciclovir
196
most common opportunistic infection in HIV patients
Pneumocystis jirovecii pneumonia
197
drug used to prevent pneumocystis pneumonia
TMP-SMX
198
when to start HAART
Highly active antiretroviral therapy is started with:
AIDS defining illness
CD4<350
high HIV viral load
199
components of HAART
2 NRTIs and
| 1 NNRTI or 1 protease inhibitor or 1 integrase inhibitor
200
protease inhibitors
```
-navir
GI intolerance
inhibit cytochrome P450 (esp ritonavir)
hyperlipidemia/hypertriglyceridemia
lipodystrophy
pancreatitis: ritonavir
nephrolithiasis: indinavir and atazanavir
increased bilirubin: atazanavir
```
201
NRTI
zidovudine, didanosine, stavudine, abacavir
zidovudine: bone marrow suppression
didanosine pancreatitis and peripheral neuropathy
hepatic steatosis: didanosine and stavudine
hypersensitivity rxn: abacavir
202
NNRTI
efavirenz, delavirdine, nevirapine
Rash is all
neuropsychotic symp, false positive drug test, teratogenic are all efavirenz
203
HIV drug SE pancreatitis
didanosine, ritonavir
204
HIV drug SE anemia
zidovudine
205
HIV drugs that interact with envelope proteins
enfuvirtide: gp41 (inhibits fusion to T cell)
maraviroc: gp120 (CCR5 antagonist)
206
fungus causes diaper rash
candida albicans
207
opportunistic mold with septate hyphae that branch at a 45 angle
aspergillus
208
opportunistic mold with irregular nonseptate hyphea that branch at wide angles (>90)
mucor, rhizopus (mucormycosis)
209
causes thrush in immunocompromised patients and vulvovaginitis in women
candida
210
causes pneumonia in immunocompromised
pneumocystis jirovecii
211
treatment for oral candidiasis
nystatin, fluconazole
212
most common opportunistic infection in HIV
pneumocystis jirovecii
213
prophylaxis for cryptococcus in AIDS
fluconazole
214
treatment for systemic candidiasis
fluconazole, amphotericin B, echinocandin
215
appearance of KOH skin scraping of tinea versicolor
spaghetti and meatballs
216
the tinea species (other than versicolor) have what type of lesion
pruritic lesion with central clearing resembling a ring
| KOH prep and are not dimorphic
217
organisms associated with birds
```
histoplasmosis
cryptococcus neoformans
chlamydophila psittaci
H5N1 influenza
west nile virus
```
218
found in rural Latin America
paracoccidioidomycosis
219
plant thorns and cutaneous injury
sporathrix schenckii
220
states east of Mississippi
blastomycosis
221
bird and bat droppings
histoplasmosis
222
mold form contains barrel-shaped arthroconidia
coccidioidomycosis
223
broad-based budding yeast
blastomycosis
224
multiple budding of yeast form
paracoccidioidomycosis
225
"swish and swallow" for oral candidiasis
nystatin
226
cell wall synthesis inhibitor used in invasive aspergillosis
caspofungin
227
most common treatment for onychomycosis
terbinafine, itraconazole, fluconazole
228
SE arrythmias and nephrotoxicity
amphotericin B
229
deposits in keratin-containing tissues
griseofulvin
230
drug of choice for sporotrichosis
itraconazole
231
severe diarrhea in AIDS
cryptosporidium
232
bloating flatulence, foul-smelling, fatty diarrhea
Giardia lamblia
233
bloody diarrhea with RUQ pain
entamoeba histolytica
234
cause of malaria
plasmodium
235
most common protozoal infection in US
trichomonas vaginalis
236
cause of chagas disease
trypanosoma cruzi
237
amoebic dysentery
entamoeba hystolytica
238
African sleeping sickness
trypanosoma brucei
239
transmitted in raw meat or infected cat feces
toxoplasma
240
transmitted by sandflies
Leishmania donovani
241
bloody diarrhea with cysts in stool
entamoeba hystolytica
242
diarrhea with RUQ pain and fever
entamoeba hystolytica
243
stages of malaria life cycle
injected form: sporozoite
replicating intracellularly: schizont
rupture of cells: merozoite
244
ring-enhancing brain lesion in an HIV patient
toxoplasma gondii
245
treatment for Trichomonas vaginalis
metronidazole
246
most common protozoal diarrhea
Giardia lamblia
247
most common helminthic infection in US
enterobius vermicularis (pinworms)
248
one-quarter of the world infected with
ascaris lumbricoides
249
second most common helminthic infection in US
ascaris lumbricoides
250
snail host, "swimmer's itch"
schistosoma species
251
most common predisposing factor for bladder cancer in third world countries
schistosoma haematobium
252
contracted by eating undercooked fish and causes an inflammation of the biliary tract
clonorhcis
253
soil -> enters through foot -> lungs -> swallowed after coughing
strongyloides
| ascaris is ingested initially
254
hookworms
ancylostoma, necator
255
giant roundworm
ascaris lumbricoides
256
contracted by eating undercooked crabmeat and causes inflammation of the lung
Pargonimus westermaris
257
pork tapeworm
taenia solium
258
responsible for lympatic filariasis
elephantitis caused by
| Wuchereria bancrofti
259
adult patient from Mexico with new onset seizures and brain calcifications
taenia solium
260
hematuria in patient from a developing country
schistosoma haematobium
261
med for most flukes and tapeworms
praziquantel
262
med for hookworms, pinworm, roundwom
benzimidazoles
263
med for chagas disease
benznidazole, nifurtimox
264
med for leishmaniasis
sodium stibogluconate or liposomal amphotericin B
265
treatment of pediculosis capitis and pubis
permethrin, pyrethrin
266
why is lindane not used for lice
neurotoxicity and resistance
