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MICRO qs Flashcards

1
Q

Treatment for non falciparum malaria?

A

Chloroquine

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2
Q

Treatment for mild falciparum malaria

A

Artemisinin combination therapy

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3
Q

Treatment for severe falciparum malaria

A

IV artesunate

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4
Q

Characteristics of salmonella typhi

A

Multiplies in Peyers patches, constipation, rose spots, high prolonged fever

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5
Q

Treatment for salmonella typhi

A

IV ceftriaxone then PO azithromycin

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6
Q

Vector for dengue fever

A

Aedes mosquito

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7
Q

Features of dengue fever

A

Travel to Asian cities
Fever > sunburn rash/retro-orbital > recovery
DHF - reinfection

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8
Q

Treatment of dengue fever

A

None - SL

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9
Q

Vector of Lyme Disease

A

Ixodes tick

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10
Q

Features of Lyme disease

A

a/w hiking

bullseye rash > myocarditis, malaise, meningitis,

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11
Q

Treatment of Lyme disease

A

doxy

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12
Q

Features of leptospirosis

A

US canoeing, run-down, jaundice, fever, uveitis/conjunctivitis

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13
Q

Treatment of leptospirosis

A

doxy

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14
Q

vector of leptospirosis

A

sandfly

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15
Q

What is MIC?

A

minimum drug concentration that is required to inhibit the growth of the organism in a culture

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16
Q

Name some broad spectrum abx

A

Co-amox, tazocin, meropenem, ciprofloxacin

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17
Q

1st line treatment for CMV?

A

Ganciclovir

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18
Q

Features of a PCP pneumonia

A

SOBOE, HIV infection, ground glass opacities on CT, low sats

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19
Q

Treatment for PCP

A

Co-trimoxazole

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20
Q

Treatment for C diff colitis

A

Metronidazole 400mg PO TDS 14 days

OR vancomycin 125mg PO QDS 14 days

21
Q

What causes C diff colitis

A

abx like cephalosporins, ciprofloxacin, clindamycin

22
Q

What in the CSF do you look for to detect prion disease

A

14-3-3 proteins - marker of rapid neurodegeneration

23
Q

Briefly outline the pathogenesis of prion disease

A

A polymorphism of codon 129 of chromosome 20 causes the normal prion protein (an alpha helical structure) to misfold into the abnormal prion protein (beta pleated sheet) and unlike the normal isoform, the abnormal form is resistant to radiation and protease degredation. The abnormal protein encourages normal proteins to misfold as well.

24
Q

What are the different types of prion disease

A

Sporadic (CJD)
Acquired - Kuru, Variant CJD, iatrogenic
Genetic - familial fatal insomnia

25
Compare similarities and differences btwn Sporadic and Variant CJD
Sporadic - older age of onset (60s), rapidly progressive, dementia symptoms, tonsilar biopsy NOT done, spikes on EEG, increased signals in the basal ganglia on MRI Variant - younger onset (20s), progresses more slowly, psych/behavioural symptoms, tonsillar biopsy, 14-3-3 proteins not measured, spikes absent on EEG, pulvinar sign on MRI
26
What are the treatments for CJD
Symptomatic - clonazepam | Slowing progression - Quinacrine, Tetracycline, Pentosan
27
Treatment HEP B
Interferon alpha, tenofovir, lamivudine | Liver transplant
28
Treatment Hep C
Peginterferon alpha 2b for early treatment | interferon + ribavirin
29
Typical vs atypical pneumonia organisms
Typical - S pneumonia, H influenzae, staph aureus, klebsiella, moraxella catarrhalis Atypical - mycoplasma, legionella, coxiella (farm animals), chlamydia psittaci (birds)
30
How does treatment differ btwn typical and atypical pneumonia
Typicals - cell wall abx work like amox Atypicals - cell wall abx not effective so need protein synthesis inhibitor like macrolides (clarithro) or a tetracycline (doxy)
31
What symptoms of atypical pneumonia differ to those of typical
Extrapulmonary features like hyponatraemia and hepatitis | Flu like prodrome before the fever and SOB
32
Treatment of a HAP
Ciprofloxacin + vanc
33
What kind of fungal infection are immunocomp patients susceptible to?
Cryptococcus neoformans
34
What system does cryptococcus prefer to infect?
CNS
35
Treatment for cryptococcus
Amphotericin B (ambisome) + flucytosine 3 weeks
36
How to identify cryptococcus on microscopy
India ink stain - stains everything except the capsule around the yeast
37
What antifungals is Candida sensitive to
Echinocandins and fluconazole (nb that echinocandins are not effective for cryptococcus)
38
What antifungals are used for aspergillus
Ambisome (note that fluconazole not effective for moulds like aspergillus)
39
What are the risk factors and management of mucormycoses
Poorly controlled DM and immunocompromise | Manage with urgent ENT referral and high dose ambisome
40
How to distinguish between bacterial, viral and TB meningitis
Bacterial: low glucose, high protein, turbid appearance and primarily neutrophils Viral: normal glucose, low protein clear CSF and primarily monocytes TB: v similar cell types to viral but has a higher protein and lower glucose
41
Which classes of abx target the bacterial cell wall
``` Beta lactam (penicillins, cephalosporins, carbapenems) Glycopeptides (vanc, teicoplanin) ```
42
What abx are sensitive to beta lactamase and what can be done about it?
penicillin, amox, piperacillin, | add clavulanic acid to resist beta lactamase breakdown as in co-amox
43
ESBL organisms - which abx are susceptible and resistant to ESBL
Cephalosporins are susceptible to ESBL | Carbapenems resistant to it
44
What kind of abx have only G+ve coverage and why
Glycopeptides - molecule too big for G-ve cell walls
45
name the types of abx that target cell wall synthesis, list their targets and primary indication
Aminoglycosides (gent) - 30S subunit, psuedomonas aeruginosa tetracyclines - 30S subunit, intracellular organisms like chlamydia. Widespread resistance Macrolides (clarithro, azithro) - 50S subunit, mild staph or strep inf in patients who are pen allergic, Chloramphenicol - mainly for eye preparations Linezolid - 23S component of 50S subunit. MRSA
46
Which 2 classes of abx target DNA synthesis and what is the target
Fluoroquinolones (eg cipro, moxi) - binds alpha component of DNA gyrase - UTI, pneumonias Nitroimidazoles (metronidazole) -
47
What are the 4 mechanisms of abx resistance + give an example for each
Bypass antibiotic sensitive step Enzyme inactivation - Beta lactamase producing enzymes Accumulation of drug insufficient either by decreased absoprtion or increased excretion - ESBL resistance Altered target - MRSA resistance/macrolide resistance
48
Which human herpes virus is associated with post transplant lymphoproliferative disorder
CMV

PATH mock qs (3 decks)

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