Micro

Question 1

HAV: name, transmission, carrier? Incubation, notes

Answer 1

Picorna, F-O, No, short (weeks), think “AAA, asymptommatic, acute, alone(not a carrier)

Question 2

HBV Name, transmission, carrier? Incubation, notes

Answer 2

Hepadna, parenteral, sex, maternal/fetal, YEs, long (months)

Question 3

HCV name, transmission, carrier? Incubation, notes

Answer 3

Flavi, blood, Yes, Long, think”CCCC, chronic, cirrhosis, carcinoma, carrier”

Question 4

HDV name, transmission, carrier? Incubation, notes

Answer 4

Delta, parenteral, sex, maternal/ fetal, Yes, superinfection (HBV then HDV) short while coinfection (HDV and HBV together) long, think “D, dependant on HBV”

Question 5

HEV name, transmission, carrier? Incubation, notes

Answer 5

Hepe, F-O with waterborne epidemics, No, short, think “EEE, enteric, expectant moms (fatal for pregnant women), epidemic”

Question 6

Classic signs of a hepatitis infection?

Answer 6

Fever, jaundice, increased AST,ALT

Question 7

Penicilin, antimicrobial/Antifungals? Mechanism. Clinical use

Answer 7

Penicillin G (Iv,IM) penicilin V(oral). antimicrobial. Binds to penicillin binding proteins ( transpeptidases) and block cross linking of peptidoglycan, activate autolytic enzymes. Mostly used for gram positive organisms (pneumoniae , pyogenes, actinomyces) also N. Meningitidis and t. Palladium. bacteriocidal for gram positive cocci, rods, and gram negative cocci and spirochetes

Question 8

Ampicillin, amoxicillin. Antimicrobial/Antifungals? Mechanism. Clinical use

Answer 8

Antimicrobial. Same mechanism and penicilin but wider spectrum. Combines with clauvanic acid to protect beta lactamase. Clinical use for Haemophilis influenza E, E. coli, Listeria monocytogenes, proteus mirabilis, salmonella, shigella. Think of ampicillin/amoxicillin HELPSS kill enterococci.

Note: ampicillin is an amped up penicillin
AmOxicillin has better Oral bioavailability

Question 9

Describe beta lactamase inhibitors

Answer 9

clauvanic acid, sulbactam, tazobactum. Think CAST. Often added to penicillin ABX to protect antibiotic form destruction of beta lactamase

Question 10

Cephalosporin. Antimicrobial/Antifungals? Mechanism. Clinical use

Answer 10

Antimicrobial. Beta lactam drugs that inhibit cell wall synthesis. Bacteriocidal. “Organisms typically not covered by cephalosporins are LAME: listeria, atypicals( chlamydia, mycoplasma), MRSA, ENterococci”there are several generations…

Question 11

Describe first gen cephalosporins. Mechanism. Clinic use

Answer 11

I.e. Inhibit cell walk synthesis by blocking proteoglycan cross linking. Cefazolin, cephalexin. Think PEcK: proteus mirabilis, E. coli, Klebsiella pneumoniae

Question 12

describe second gen cephalosporins. Mechanism. Clinic use

Answer 12

Cefaclor. Inhibit cell wall synthesis by inhibiting proteoglycan cross linking. Think “HEN PEcKS: Haemophilis, enterrobacter, neisseria, proteus mirabilis, E. coli, Klebsiella, serratia”

Question 13

Vancomycin. Antimicrobial/Antifungals? Mechanism, clinical use

Answer 13

Antimicrobial. Inhibit cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors. Bacteriocidal. gram positives only. RIsks: “are NOT trouble free: nephrotoxicity, otoxicity, thrombophlebitis”

Question 14

Which group of drugs responsible for inhibiting protein synthesis for antimicrobial therapy?

Answer 14

Chloramphenicol, clindamycin, linezoid, macrolides, aminoglycosides, tetracyclines, streptogramins

Question 15

Describe pathway to synthesis of ergo sterol. What is ergo sterol

Answer 15

Ergo sterol- cholesterol in animal cells. Fungi can’t survive without ergosterol.
Squalene– squalene epoxide– lanosterol– ergosterol

Question 16

Describe focuses for Antifungal therapy(5)

Answer 16

Lanosterol synthesis - terbinifine
Ergosterol synthesis- Azoles
Cell wall synthesis- echinocandins
Form membrane pores - polyenes
Nuclei can acid synthesis- 5- flucytosine

Question 17

Describe amphotericin B and nystatin. Mechanism. Clinical use

Answer 17

Binds ergosterol and forms membrane pores that allow leakage of electrolytes. Antifungal. Nystatin is same but topical bc too toxic for systemic use. Nystatin is swish and swallow for oral candidiasis (thrush).

Question 18

Envision the anti microbial therapy pic. What kinda of drugs are used for prevention?

Answer 18

Cell synthesis ( peptidoglycan synthesis or cross linking)
Folic acid synthesis
DNA topoisomerase
Damage DNA
MRNA synthesis
Protein synthesis
30s sub unit of ribosome.

Question 19

Envision Antifungal image. Describe area of targetted therapy.

Answer 19

Lanosterol synthesis
Ergosterol synthesis
Cell wall synthesis 
Forms membrane pore
Nuclei can acid synthesis.

Question 20

Envision antiviral therapy and describe areas of targeted therapy

Answer 20

FUSION
   Attachment
   Penetration 
REVERSE TRANSCIPTASE INHIBITORS
INTEGRASE INHIBITORS
PROTEASE INHIBITORS

Question 21

pharm Tx for C. Dificile? Gram +,-?

Answer 21

Gram +, spore former. Metronidazole or Vancomycin

Question 22

Describe BLT

Answer 22

Spirochetes- spiral shaped bacteria. Only borrelia can be visualized using aniline dyes.

Question 23

Describe Mycobacterium Leprae

Answer 23

Leprosy. Infects superficial skin and nerves “glove and stocking”. Poor cell mediated response (CMI)

1. Tuberculoid: lesser of the two. Th1 mediated. Causes hypopigmentation, skin plaques, hair follicle loss, decreased sensation
2. Lepromatous: most severe form. Impaired CMI(Th2 mediated ). Macrophages attack causing diffuse skin thickening, leonine face (lion face), glove and stocking lesions

Question 24

Borrelia Burgdorferi

Answer 24

Lyme dz. Trasmitted via Tick. “FAKE a key LIME pie” Facial nerve palsy, arthritis, kardiac block, erythema migrants. “Bulls eye rash” TX: Doxycycline, ceftriaxone