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Step 1 > Micro- System and Pharm > Flashcards

Micro- System and Pharm Flashcards

1
Q

What is the most common microbe in the colon?

A

B. fragilis

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2
Q

Commonly contaminates reheated meat dishes

A

C. perfingens

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3
Q

What causes psuedoappendicitis?

A

Y. enterocolitica (contam milk, daycare)

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4
Q

What kind of protozoan can cause bloody diarrhea?

A

E. histolytica

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5
Q

What is the most common cause of meningitis for all age groups but newborns, teens?

A

S. pneumoniae

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6
Q

What is the most common cause of meningitis in teens?

A

N. menigitidis

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7
Q

What is a common cause of meningitis in unimmunized children?

A

H. flu

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8
Q

What is the most common cause of osteomyleitis in diabetics and IVDU?

A

pseudomonas, serratia

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9
Q

What is the most common cause of osteomyelitis for cat and dog bits?

A

Pasteurella multocida

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10
Q

What type of UTI bug is associated with struvite stones?

A

Proteus mirabilis

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11
Q

What are 2 examples of urease+ UTI buts?

A

proteus, klebsiella

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12
Q

Congenital infection associated with PDA, cataracts, deafness

A

rubella

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13
Q

Congenital infection associated with hearing loss, seizure, petechial rash

A

CMV

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14
Q

Presents as vesicular rash on palms and soles; vesicles and ulcers in oral mucosa; common in children

A

Coxsackievirus type A

Hand-foot-mouth disease

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15
Q

Presents as erythematous, sandpaper-like rash with fever and sore throat

A

S. pyogenes

scarlet fever

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16
Q

Vesicular rash begins on trunk; spreads to face and extremities with lesions of different ages; common in children

A

chickenpox

VZV

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17
Q

Painful genital ulcer, inguinal adenopathy

A

chancroid

H. ducreyi

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18
Q

What is Hugh-Curtis syndrome

A

Infection of the liver capsule due to PID

“violin string” adhesions of peritoneum to liver

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19
Q

What are the 2 most common causes of nosocomial infeciton?

A

E coli- UTI

S. aureus- wound infection

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20
Q

What is a common infection associated with respiratory therapy equipment?

A

P. aeruginosa

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21
Q

Pneumonia with “currant jelly” sputum

A

Klebsiella

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22
Q

Infection of health care provider

A

HBV

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23
Q

Branching rods in oral infections

A

Actinomcyces israelii

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24
Q

What are toxicities of Penicillin G, V?

A

hypersensitivity, hemolytic anemia

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25
Q

What do Penicillin G, V cover?

A 
gram pos (strep, actinomyces)
also N. menigitidis, T. pallidum
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26
Q

What do ampicillin, amoxicillin cover?

A 
HELPSS kill enterococci
H. flu
E. coli
Listeria
Proteus
Salmonella
Shigella
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27
Q

What penicillins can be used to treat S. aureus?

A

Oxacillin
Dicloxacillin
Nafcillin

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28
Q

What antibiotic causes interstitial nephritis?

A

Nafcillin

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29
Q

What penicillins can be used to treat Pseudomonas?

A

Ticarcillin

Piperacillin

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30
Q

Sulbactam

A

B lactamase inhibitor

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31
Q

Tazobactam

A

B lactamase inhibitor

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32
Q

Oxacillin

A

S. aureus penicillin

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33
Q

Dicloxacillin

A

S. aureus penicillin

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34
Q

Ticarcillin

A

Pseudomonas penicillin

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35
Q

Piperacillin

A

Pseudomonas penicillin

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36
Q

What organisms are covered by first generation cephalosporins?

A

PEcK (+GPC)
Proteus
E. coli
Klebsiella

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37
Q

What organisms are covered by second generation cepahlosporins?

A 
HEN PEcKS (+GPC)
H flu
Enterobacter aerogenes
Neisseria
Proteus
E coli
Klebsiella
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38
Q

What are 3rd generation cephalosporins used for?

A

serious gram neg infecitons
Ceftriaxone- meningtis and gonorrhea
Ceftazidime- pseudomonas

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39
Q

What are 4th generation cephaolsporins cover? What is the 4th gen cephalosporin?

A

Pseudomonas and GP

cefepine

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40
Q

What do 5th generation cephalosporins cover?

What is the 5th gen cephalosporin?

A

broad spectrum GP, GN
including MRSA
doesnt cover Pseudomonas
Ceftaroline

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41
Q

What are important toxicities of cephalosporins?

A

Hypersensitivity, Vit K def

nephrotoxicity

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42
Q

What are the first generation cephalosporins

A

Cephalexin

Cefazolin

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43
Q

What are the 2nd generation cephalosporins

A

Cefuroxime
Cefaclor
Cefoxitin

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44
Q

What are the 3rd generation cephaolsporins?

A

Cefotaxime
Ceftazidime
Ceftriaxone

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45
Q

Aztreonam- mechanism and use

A

monobactam (resistant to blactamases)

GNR only, penicillin allergy and renal insufficiency

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46
Q

What must imipenem be coadminstered with? Why?

A

Cilastatin

decr inactivation of drug in renal tubules

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47
Q

What are the toxicities of carbapenems?

A

GI distress, skin rash, CNS toxicity

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48
Q

Meropenem- what is advantage?

A

carbapenem

decr risk of seizure, stable to renal dehydropeptidase I

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49
Q

What is the coverage of carbapenems?

A

Gram pos cocci, GNR, anaerobes
used for serious infections, when other drugs have failed
synergize with aminoglycosides

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50
Q

What is the mechanism of carbapenems?

A

b-lactamase resistant

inhibit peptidoglycan cross-linking

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51
Q

What are the toxicities of Vancomycin? (4)

A

Nephrotoxicity, Ototoxicity, Thrombophlebitis

Red man syndrome

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52
Q

What are 30S and 50S ribosome inhibitors?

A 
Buy AT 30, CCEl at 50
30S:
Aminoglycosides (cidal)
Tetracyclines
50S:
Chloramphenicol
CLindamycin
Erythromycin (macrolides)
Linezolid
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53
Q

Mechanism of aminoglycosides

A

inhibit formation of initiation complex, cause misreading of mRNA

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54
Q

Neomycin

A

aminoglycoside, used for bowel surgery

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55
Q

What is the clinical use of aminglycosides?

A

severe GNR infections (synergize with blactam)

56
Q

Gentamicin

A

Aminoglycoside

57
Q

Amikacin

A

Aminoglycoside

58
Q

Tobramycin

A

Aminoglycoside

59
Q

Streptomycin

A

Aminoglycoside

60
Q

What are the toxicities of aminoglycosides?

A

Nephrotoxicity (esp with cephalosporin)
Neurmuscular blockade
Ototoxicity
Teratogen

61
Q

What is the mechanism of resistance of aminogclycoside?

A

Inactivation of bacterial transferase enzyme by acetylation, phosphorylation or adenylation

62
Q

What is the mechanism of tetracyclines?

A

Prevent attachment of aminoacyl-tRNA by binding 30S

63
Q

How is doxycycline eliminated?

A

fecally (can be used with renal failure)

64
Q

What are tetracyclines used to treat?

A

Lyme, M. pneumoniae

Rickettsia, Chalmydia (accumulate intracellularly)

65
Q

What are the side affects of tetracycline

A

discolor teeth, inhibit bone growth in kids
GI distress
photosensitivity

66
Q

What is the mechanism of resistance for tetracyclines?

A

plasmid encoded transport pumps

67
Q

Axithromycin

A

Macrolide (50S)

68
Q

Clarithromycin

A

Macrolide (50S)

69
Q

Erythromycin

A

Macrolide (50S)

70
Q

What is the mechanism of macrolide Abx?

A

inhibit synthesis by blocking ranslocation

binds to 23S rRNA of 50S

71
Q

What are macrolides used to treat?

A

Atypical pneumonia, chlamydia, Strep (allergic to penicillin)

72
Q

What are the toxicities of macrolides

A

(MACRO) GI Motility, Arrhythmia- QT prolong, Cholestatic hepatitis, Rash, eOsinophilia

73
Q

What is the mechanism of resistance for macrolides?

A

Methylation of 23S rRNA binding site

74
Q

Chloramphenicol mechanism

A

Blocks peptidyltransferase at 50S ribosomal subunit

75
Q

Chloramphenicol use

A

Meningitis, Rickettsia

76
Q

Toxicity of chloramphenicol

A

Anemia, gray baby

77
Q

Resistance to chloramphenicol

A

plasmid-encoded acetyltransferase inactivates

78
Q

Clindamycin mechanism

A

Blocks pepdite transfer (translocation)at 50S

79
Q

What is clindamycin used for?

A

Anaerobic infections above the diaphragm (aspiratio pneumonia, oral infection, GAS)

80
Q

What is used to treat anaerobic infections?

A

Clindamycin- above diaphragm

Metronidazole- below the diaphragm

81
Q

Sulfonamides

A

inhibit folate synthesis PABA antimetabolite

82
Q

Sulfamethoxazole

A

Sulfonamide

83
Q

Sulfisozazole

A

sulfonamide

84
Q

sulfadiazine

A

sulfonamide

85
Q

What are the toxicities of sulfonamides?

A

nephrotoxicity, photosensitivity, kernicterus in infants, hemolysis of G6PD

86
Q

What is the mechanism of trimethoprim

A

inhibits bacterial dihydrofolate reductase

87
Q

What are the toxicities of TMP

A

megaloblastic anemia, leukopenia, granulocytopenia

88
Q

Mechanism of flouroquinolones

A

Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV

89
Q

What is the use of fluoroquinolones?

A

GNR of urinary, GI, Neisseria

90
Q

What are some of the toxicities of flouroquinolones?

A

superinfeciton, skin rash, dizziness, tendon rupture, QT prolong, cartilage damage

91
Q

What is the mechanism of metronidazole?

A

Forms free radical toxic metabolites in bacterial cell wall- damage DNA

92
Q

What is the mechanism of isoniazid

A

decr synthesis of mycolic acids; needs to be converted to active metabolite by bacterial catalase-peroxidase

93
Q

What is the form of prophyaxis for tb?

A

isoniazid

94
Q

What is the mechanism of Rifamycin

A

inhib DNA-dep RNA polymerase

95
Q

What is the toxicity of isoinazid?

A

Neurotoxicity (prevent by giving vit B6)

hepatotoxicity

96
Q

What is the advantage of rifabutin over rifamipin

A

Rifabutin doesnt stimulate P450 as much

97
Q

What is the prophlyaxis for AIDS patients?

A

<50= azithromycin (MAC)

98
Q

What is the mechanism of ethamutol?

A

decr carbohydrate polym of cell wall by blocking arabinosyltransferase

99
Q

What supplements are important to give with Amphotericin B?

A

K+ Mg2+ (altered renal tubule permeability)

100
Q

What is the mechanism of Amphotericin B?

A

binds ergosterol, forms membrane pores and allows leakage of electrolytes

101
Q

What is used for chronic suppression of cryptococcal meningitis in AIDS patients?

A

Fluconazole

102
Q

What is itraconazole used to treat?

A

Blastomyces
Coccidiodes
Histoplasma

103
Q

What is the mechanism of azoles?

A

inhibit fungal sterol synthesis by inhibiting P450 enzyme that covnerts lansterol to ergesterol

104
Q

Echinocandins mechanism? What are the used to treat?

A

inhibits cell wall synthesis via B-glucan

Invasive aspergillosis, candida

105
Q

What is the mechanism of flucytosine

A

converted to 5-FU via cytosine deaminase

106
Q

What is the use of flucytosine?

A

treat systemic fungal infxn with Amph B

107
Q

What is the mechanism of Terbinafine

A

inhibits squalene epoxidase

108
Q

What is terbinafine used to treat?

A

dermatophytes, esp onchomycosis

109
Q

Caspofungin

A

echinocandin

110
Q

What is the mechanism of griseofulvin? What is it used to treat?

A

interferes with microtubule function
deposited in keratin-containing tissue
dermatophytes

111
Q

What is the mechanism of chloroquine?

A

blocks detoxification of heme into hemozoin

accumulation of heme is toxic to plasmodia

112
Q

What is the toxicity of chloroquine?

A

retinopaty, pruritis

113
Q

What is ribavirin used to treat?

A

RSV, HCV

114
Q

What is the toxciity of ribavirin

A

hemolytic anemia, teratogen

115
Q

zanamivir

A

inhibits influenza neuraminidase

116
Q

oseltamivir

A

inhibits influenza neuraminidase

117
Q

Foscarnet mechanism and use

A

DNA polymerase inhib, pyrophosphate analog

CMV retinitis

118
Q

Cidofovir mechanism and use

A

Preferentialy inhibits viral DNA polymerase, dose not requirre phosphorylation
CMV retinitis

119
Q

What is the standard regimen of HIV therapy?

A

2 NRTIs+1NNRTI, 1 protease inhib or 1 integrase inhib

120
Q

What is a typical name for a protease inhibitor?

A

Ritonavir (ends in navir)

121
Q

Raltegravir

A

HIV integrase inhibitor

causes hypercholesterolemia

122
Q

Enfuvirtide

A

fusion inhibitor (gp41)

123
Q

Maraviroc

A

Fusion inhibitor (binds CCR5)

124
Q

Efavirenz

A

NNRTI, contraindicated in pregnancy

causes vivid dreams and CNS sx

125
Q

Nevirapine

A

NNRTI

126
Q

Delavirdine

A

NNRTI, contraindicated in pregnancy

127
Q

What are common side effects for protease inhibitors?

A

hyperglycemia, GI, lipodystrophy

128
Q

What are 2 important side effects for indinavir?

A

nephropathy, hematuria

129
Q

Tenofovir

A

NRTI, nucleotide, causes rash

130
Q

Zidovudine

A

NRTI, used for pregnancy, prophylaxis

131
Q

Didanosine

A

NRTI, causes pancreatitis

132
Q

What are the side effects of NRTIs?

A

Bone marrow suppression, peripheral neuropathy, lactic acidosis

133
Q

What are the side effects of NNRTIs

A

Rash, hepatotoxicity

134
Q

What is IFNb used for?

A

multiple sclerosis

135
Q

What is IFNg used for?

A

CGD

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