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FirstAID > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Which part of the bacterial structure contains Beta-lactamases?

A

Periplasm = space between cytoplasmic membrane and peptidoglycan wall in gram (-) bacteria
*note: Beta-lactamases = hydrolytic enzymes, resistant to antibiotics

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2
Q

Which bacteria contain sterols, but have no cell wall?

A

Mycoplasma

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3
Q

Which bacteria has a cell wall/membrane with mycolic acid and a high lipid content?

A

Mycobacteria

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4
Q

Bugs that don’t gram stain well?

A

“These Rascals May Microscopically Lack Color”

  • Treponema (too thin)
  • Rickettsia (intracellular)
  • Mycobacteria (high lipid content in cell wall; need acid-fast stain)
  • Mycoplasma (no cell wall)
  • Legionella (mostly intracellular)
  • Chlamydia (intracellular; and lacks muramic acid in cell wall)
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5
Q

Giemsa stain, stains:

A
  • Borrelia
  • Trypanosomes
  • Chlamydia
  • Plasmodium
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6
Q

PAS (periodic acid-Schiff): what structures does it stain? what’s it used to dx?

A

“PAS the sugar” –> it stains glycogen and mucopolysaccharides!
–dx Whipple’s disease (Tropheryma whippeli)

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7
Q

Ziehl-Neelson stain = carbol fushsin

A

stains acid-fast organisms (mycobacteria)

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8
Q

India ink–> what organism does it stain?

A

stains cryptococcus neoformas

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9
Q

silver stain:

A
  • Fungi (ie pneumocystis)

- Legionella

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10
Q

chocolate agar with factors V (NAD+) and X (hematin)

A

H. influenza

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11
Q

Thayer-Martin/VPN media (Vancomycin, Polymyxin, Nystatin)

A

N. gonorrhea

  • vancomycin –> inhibits gram +
  • polymyxin –> inhibits gram -
  • nystatin –> inhibits fungi
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12
Q

Bordet-Gengou agar (potato agar)

A

Bordetella pertussis

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13
Q

Lowenstein-Jensen agar

A

M. tuberculosis

–> takes 3-4 weeks to grow though! (can do acid-fast stain in mean time to help rule out…)

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14
Q

Eaton’s agar

A

Mycoplasma pneumonia

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15
Q

pink colonies on MacConkey’s agar

A

lactose-fermenters

  • MacConkey’s agar:
  • biosalts and crystal violet–> inhibit gram +
  • lactose–> only carb in agar
  • neutral red stain–> lactose fermenters take up lactose and neutral red; form pink colonies

**non-pink growth on MacConkey’s = gram (-), but not lactose fermenter

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16
Q

Tellurite plate, Loeffler’s media

A

C. diphtheriae

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17
Q

Sabouraud’s agar

A

Fungi

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18
Q

Obligate aerobes:

A

“Nagging Pests Must Breathe”

  • Nocardia
  • Pseudomonas
  • Mycobacterium tuberculosis
  • Bacillus
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19
Q

Obligate anaerobes:

A

“Can’t Breathe Air”

  • Clostridium
  • Bacteroides
  • Actinomyces
  • **Anaerobes lack catalase and/or superoxide dismutase, so susceptible to oxidative damage
  • **Aminoglycosides = ineffective against anaerobes!
  • **Treat anaerobes with:
    • Metronidazole
    • Clindamycin
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20
Q

Obligate intracellular bugs:

A

“stay inside (cells) when it’s Really Cold”

  • Rickettsia
  • Chlamydia
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21
Q

Facultative intracellular bugs

A

“Some Nasty Bugs May Live FacultativeLY”

  • Salmonella
  • Neisseria
  • Brucella
  • Mycobacterium
  • Listeria
  • Francisella
  • Legionella
  • Yersinia
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22
Q

bugs with a positive quellung rxn?

-who’s at increased risk of infection with these organisms?

A

encapsulated bacteria:

  • SHiN SKiS:
  • S. pneumonia
  • H. influenza
  • Neisseria meningitidis
  • Salmonella
  • Klebsiella pneumonia
  • group B strep

*asplenic pts –> increased risk of infection with encapsulated organisms

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23
Q

Catalase-positive organisms:

-which pts have recurrent infections with these organisms?

A
  • S. aureus
  • Serratia
  • Pseudomonas
  • Candida
  • E. coli

*pts with chronic granulomatous disease (NADPH oxidase deficiency) have recurrent infections with these organisms

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24
Q

Urease-positive bugs

A

“K-PUNCH”

  • Klebsiella
  • Proteus
  • Ureaplasma
  • Nocardia
  • Cryptococcus
  • H. pylori

*Urease splits urea into ammonium, which binds Mg and P –> forms stones –> stones deposited in renal calyces

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25
Q

Protein A

A

S. aureus virulence factor; binds Fc region of Ig; prevents opsonization and phagocytosis

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26
Q

IgA protease

A

virulence factor of SHiN: S. pneumonia, H. influenza, Neisseria
–> enzyme that cleaves IgA in order to colonize respiratory mucosa

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27
Q

M protein

A

virulence factor of Group A Strep: helps prevent phagocytosis

*Note: antibodies to M protein enhance host defenses against GAS, but can give rise to Rheumatic fever…

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28
Q

Which 2 bacteria produce a toxin that inhibits protein synthesis by inactivating elongation factor, EF-2?

A

C. diphtheriae –> Diphtehria toxin

Pseudomonas aeruginosa –> Exotoxin A

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29
Q

Which 2 bacteria produce a toxin that inhibits protein synthesis by inactivating the 60S ribosome by cleaving rRNA?

A

Shigella –> Shiga toxin

EHEC (including O157:H7) –> Shiga-like toxin

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30
Q

List 5 bacteria that produce an ADP-ribosylating A-B toxin:

A

1) Corynebacterium diphtheriae
2) Pseduomonas aeruginosa
3) ETEC
4) Vibrio cholerae
5) Bordetella pertussis

***Mechanism: B-binding component binds host cell surface receptor, enabling endocytosis; A-active component attaches ADP-ribosyl to disrupt host cell proteins

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31
Q

Which 2 bacteria produce a heat stable toxin? What’s the mechanism?

A

ETEC and Yersinia enterocolitica
*mechanism: increased cGMP –> decreased reabsorption of NaCl and H20 in gut –> increased fluid secretion

  • note:
  • ETEC –> watery diarrhea
  • Yersinia –> bloody diarrhea
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32
Q

Which E. coli has a toxin that functions by the same mechanism as the cholera toxin? What’s the mechanism?

A

ETEC - heat labile toxin
*mechanism: increased cAMP by permanently activating Gs –> increased Cl secretion in gut and H20 follows it –> so increased fluid secretion

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33
Q

Which bacteria has a toxin that mimics adenylate cyclase (toxin acts like the enzyme!)?

A

Bacillus anthracis: toxin= edema factor –> mimics adenylate cyclase –> increased cAMP –> increased fluid secretion

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34
Q

2 toxins produced by ETEC (enterotoxigenic E. coli) and their mechanisms?

A
  • heat labile toxin: increases adenylate cylcase–> increased cAMP–>iincreased Cl secretion in gut –> increased H20 secretion
  • heat stabile toxin: increases guanylate cyclase –> increased cGMP –> decreased reabsorption of NaCl and H20 in gut
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35
Q

Which 2 bacteria produce a toxin that cleaves SNARE protein required for neurotransmitter release (and thereby inhibit release of neurotransmitter)?

A

Clostridium tetani and Clostridium botulinum

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36
Q

Which bacterial toxin acts through this mechanism?
–> overactivates adenylate cyclase by inhibiting Gi–> increased cAMP –> thereby, impairs phagocytosis, permitting survival of microbe

A

Pertussis toxin (Bordatella pertussis)

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37
Q

Tetanospasmin toxin: which neurotransmitters does it affect and how? what are the manifestations?

A

-tetanospasmin prevents release of inhibitory neurotransmitters (GABA and glycine) –> get muscle rigidity and “lock jaw”

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38
Q

Botulinum toxin: which neurotransmitters does it affect and how? what are the manifestations?

A

botulinum toxin prevents the release of stimulatory (Ach) signals at neuromuscular junctions –> get flaccid paralysis, “floppy baby”

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39
Q

Which bacteria produces Alpha toxin/Lecithinase (degrades phophospolipids)

A

Clostridium perfringens

-degradation of phospholipids–> myonecrosis (gas gangrene) and hemolysis (double zone of hemolysis on blood agar)

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40
Q

Streptolysin O toxin: mechanism?

A
  • Streptococcus pyogenes (Group A strep)
  • toxin lyses RBCs, contributes to Beta-hemolysis
  • ASO antibodies can be used to dx rheumatic fever
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41
Q

Which 2 organisms have superantigens? what are the toxins? superantigen mechanism?

A
  • Group A strep (Strep pyogenes) –> Exotoxin A
  • Staph aureus –> TSST-1 (toxic shock syndrome toxin)

*superantigens bind MCH II and TCR simultaneously to stimulate a huge release of IL-2 and IFN-gamma –> results in shock; both can cause toxic shock syndrome (fever, rash, shock)

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42
Q

bacterial “competence”

-which bacteria are “competent?

A

competence = ability to take up DNA from environment = transformation (in bacterial genetics)
-many bacteria can undergo transformation, but especially common in SHiN (S. pneum, H. infl, Neisseria)

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43
Q

Conjugation: (F+ X F-) vs (Hfr X F-)?

A

(F+ X F-): only plasmid DNA can be transferred this way
(Hfr X F-): Transfer of plasmid AND chromosomal genes (because F+ plasmid can become incorporated into bacterial chromosomal DNA –> “Hfr cell”

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44
Q

Transduction:

A

bacterial genetic term –> spread of bacterial DNA via lytic (“generalized transduction”) or lysogenic (“specialized transduction”) bacteriophage (virus that infects bacteria)

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45
Q

What makes MRSA resistant to Beta-lactams?

A

Altered penicillin-binding protein

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46
Q

rusty sputum

A

pneumococcus! (strep pneumonia)

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47
Q

Strep pneumonia = most common cause of:

A
  • Meningitis
  • Otitis media (in kids)
  • Pneumonia
  • Sinusitis
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48
Q

Bacteria that causes acute bacterial endocarditis?

A

Staph aureus

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49
Q

Bacteria that causes subactue bacterial endocarditis at damaged valves?

A

-Strep sanguis (viridans group strep)

think of the sanguinistas in true blood :)

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50
Q

strawberry tongue

A

Scarlet fever –> toxigenic effect of group A strep

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51
Q

about 15% of colon cancer pts are colonized by which strep?

A

strep bovis (group D strep)

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52
Q

ABCDEFG of Corynebacterium diphtheriae

A 
ADP ribosylation
Beta-prophage (encodes exotoxin)
Corynebacterium
Diphtheria
Elongation
Factor 2
Granules (dx by gram + rods with metachromatic -blue and red- granules)

*exotoxin encoded by a beta-prophage–> exotoxin inhibits protein synthesis via ADP ribosylation of EF2

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53
Q

Spore-forming bacteria:

A

certain gram + rods:

  • main ones:
  • Bacillus anthracis
  • Clostridium perfringens
  • Clostridium tetani
  • also:
  • Bacillus cereus
  • Clostrium botulinum
  • Coxiella burnetti
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54
Q

Prevents glycine and GABA and glycine release from Renshaw cells in spinal cord?

A

Tetanospasmin (Clostridium tetani toxin) –> blocks inhibitory neurotransmitters, so causes spastic paralysis, trismus (lockjaw) and risus sardonicus

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55
Q

Treatment of C. difficile?

A

metronidazole or oral vancomycin (only case in which vancomycin is given orally!)

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56
Q

2 toxins produced by C. difficile, and how do they act?

A

Toxin A = enterotoxin: binds brush border of gut
Toxin B = cytotoxin: destroys cytoskeletal structure of enterocytes, causing necrosis of colon epithelium = pseudomembranous colitis

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57
Q

Only bacterium with a polypeptide capsule (that contains D-glutamate)?

A

Bacillus anthracis

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58
Q

move from cell to cell via “actin rockets”; bacteria is acquired by ingestion of unpasteurized milk/cheese and deli meats, or by vaginal transmission during birth

A

Listeria monocytogenes

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59
Q

treatment of actinomyces vs nocardia?

A

“ooooh SNAP!”

  • Sulfa for Nocardia
  • Actinomyces - use Penicillin
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60
Q

Langhans giant cells –> see multiple peripheral nuclei organized in the shape of a horseshoe

A

characteristic of TB caseating granulomas

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61
Q

Extrapulmonary tuberculosis:

A
  • CNS–> tuberculoma or meningitis
  • Pott’s disease in vertebral bodies
  • lymphadenitis
  • renal
  • GI
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62
Q

Ghon complex =

A

-TB granulomas
= Ghon focus (calcified scar, usually in lower lobes) + lobar and perhilar lymph node involvement; reflects primary infection or exposure

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63
Q

Mycobacterium kansasii

A

pulmonary TB-like symptoms; more common in pts with COPD (chronic bronchitis or emphesyma)

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64
Q

Prophylactic treatment for Mycobacterium avium-intracellulare?

A
  • Azithromycin

- ->MAI is often resistant to many drugs; causes disseminated disease in AIDS pts.

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65
Q

Reservoir in US is armadillos?

A

Mycobacterium leprae (Leprosy = Hansen’s disease)

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66
Q

Treatment for leprosy?

A
  • long term oral Dapsone (but, toxicity = hemolysis and methemoglobinemia)
  • alternatively: rifampin, or combination of clofazimine and dapsone
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67
Q

Lactose-fermenting bacteria (grow pink on MacConkey’s agar)…

A

macConKEES or CEEKS:

  • Citrobacter
  • Klebsiella
  • E. coli
  • Enterobacter
  • Serratia

*note: E. coli produces Beta-galactosidase–> breaks lactose into glucose and galactose!

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68
Q

Which class of bacteria are resistant to Penicillin G (or rather, which class can Penicillin G be used to treat)?

A

Gram (-) bacilli are resistant to Penicillin G (but, may be susceptible to penicillin derivatives)
Penicllin G and V are mostly used to treat gram (+) organsims, and syphilis!

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69
Q

Fitz-Hugh-Curtis syndrome

A

caused by N gonorrhea

–>stars in lower genital tract, ascends through upper genital tract, ultimately infects liver capsule

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70
Q

Treatment for N. gonorrhea?

A

ceftriaxone

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71
Q

Waterhouse-Friderichsen syndrome

A

caused by N. meningitidis

–>adrenal hemorrhage –> adrenal insufficiency –> hypotension + DIC + electrolyte abnormalities

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72
Q

Prophylaxis and treatment for N. meningitidis?

A
  • Vaccine available (not for type B)
  • Rifampin prophylaxis in close contacts
  • Treatment: ceftriaxone or penicillin G
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73
Q

Why can H. influenza be grown with Staph aureus?

A

H. infl requires Factors V (NAD+) and X (hematin) for growth; S. aureus provides factor V!

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74
Q

Prophylaxis for H. influenza?

Treatment for meningitis caused by H. infl?

A
  • Vaccine: type B capsular polysaccharide conjugated to diphtheria toxoid or other protein
  • Prophylaxis in close contacts: Rifampin
  • Treatment for meningitis: Ceftriaxone
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75
Q

Legionnaires disease vs Pontiac fever?

A

Both caused by Legionella pneumophila

  • Legionnaires’ disease = severe pneumonia and fever
  • Pontiac fever - mild flu-like syndrome

***suspect Legionella in pts with recent exposure to contaminated water (ie cruise ship, hotel, etc…)

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76
Q

pt with Cystic Fibrosis + Pneumonia?

A

Pseudomonas

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77
Q

PSEUDOM of pseudomonas (presentations):

A
  • Pneumonia (especially in cystic fibrosis pts)
  • Sepsis (black lesions on skin–> ecthyma gangrenosum = cutaneous necrotic disease, common in imm-compromised pts)
  • External otitis (swimmer’s ear)
  • UTI
  • Drug use endocarditis and Diabetic Osteomyelitis
  • Malignant otitis externa in diabetics
  • ->also: hot tub folliculits
  • assoc with wound and burn infections
  • water source
  • produces pyocyanin = blue-green pigment
  • grapelike odor
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78
Q

Treatment for Pseudomonas?

A

Aminoglycoside + extended-spectrum penicillin (ie piperacillin or ticarcillin)

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79
Q

E. coli virulence factors: What do they cause?

  • Fimbriae?
  • K capsule?
  • LPS?
A

Fimbriae –>cystitis and pyelonephritis
K capsule –> pneumonia, neonatal meningitis
LPS –> septic shock

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80
Q

Anemia + Thrombocytopenia + Acute Renal Failure?

A

HUS = hemolytic uremic syndrome (EHEC O157:H7)

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81
Q

Which E. coli strain is the only one that does not ferment sorbitol?

A

EHEC

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82
Q

Which E. coli strains cause bloody diarrhea?

A

EIEC and EHEC

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83
Q

Which E. coli strain normally causes diarrhea in children?

A

EPEC (P for pediatrics :))–> doesn’t produce toxin; adheres to apical surface, flattens villi, prevents absorption

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84
Q

Which E. coli strains produce a toxin (and what toxin is it?) Which do not produce toxin?

A

EIEC –> no toxin
ETEC –> heat labile and heat staible toxins
EPEC –> no toxin
EHEC –> shiga-like toxin

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85
Q

Which antibiotic should be used to treat Salmonella?

A

TRICK QUESTION! Do not treat Salmonella with antibiotics; antibiotics may prolong symptoms!

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86
Q

Osteomyelitis in a sickle cell patient?

A

Think Salmonella!

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87
Q

spots on abdomen + fever + headache + diarrhea?

A

Salmonella typhi (rose spots on abdomen)

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88
Q

Which is more virulent: Shigella or Salmonella?

A

Shigella is more virulent –> only takes

10^1 organisms for infection, vs Salmonella –> takes 10^5 organisms!

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89
Q

Which bacterial infection is associated with Reiter’s syndrome/Reactive arthritis?

A
  • Shigella flexneri

- Chlamydia

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90
Q

Causes mesenteric adenitis (which may mimc Crohn’s or appendicitis)?

A

Yersinia enterocolitica! (transmitted from pet fecies, contaminated milk, pork; outbreaks of diarrhea in daycare centers…)

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91
Q

Triple therapy for H. pylori treatment:

A

1) PPI
2) Clarithromycin (macrolide)
3) Amoxicillin or Metronidazole

  • **Quadruple Therapy:
    • Bismuth salicylate
    • Metronidazole
    • PPI
    • Tetracylcine
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92
Q

flulike symptoms, jaundice, and photophobia with conjunctivitis, in person who was in contact with animal urine?

A

Leptospirosis (Leptospira interrogans)

–> severe form = Weil’s disease

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93
Q

Weil’s disease

A

=Icterohemorrhagic Leptospirosis
–> severe form of Leptospirosis (Leptospira interrogans): jaundice and azotemia (from liver and kidney dysfxn); fever, hemorrhage, anemia

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94
Q

water contaminated with animal urine? Think:

A
  • Leptospira

- Hantavirus

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95
Q

Ixodes tick

A

vector for:

  • Lyme disease (Borrelia burgdorferi)
  • Babesia
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96
Q

3 stages of lyme disease:

A

“BAKE a key Lyme pie!” (Bell’s palsy, Arthritis, Kardiac block, Erythema migrans)

Stage 1: erythema chronicum migrans (bull’s eye rash), flu-like symptoms
Stage 2: Neurologic (bilateral or unilateral Bell’s palsy) and Cardiac (AV nodal block) manifestations
Stage 3: chronic monarthritis and migratory polyarthritis

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97
Q

Treatment for Lyme disease: at early stages (1 and 2)? Later disease?

A

Doxycycline –> for early stages

Ceftriaxone –> later disease

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98
Q

Treatment of choice for Syphilis?

A

Penicillin G!

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99
Q

primary syphilis:

A

painless chancre (localized)

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100
Q

secondary syphylis:

A

(secondary = systemic) disseminated disease with constitutional symptoms

  • maculopapular rash (palms and soles)
  • condyloma lata
  • visualize treponemes from chancres and condyloma lata by darkfield microscopy
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101
Q

tertiary syphilis

A
  • gummas (chronic granulomas)
  • aortitis (VASO VASORUM DESTRUCTION!)
  • neurosyphilis = tabes dorsalis
  • Argyll Robertson pupil
  • Signs: ataxia, + Romberg, Charcot joint, stroke but no HTN
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102
Q

FTA-ABS

A

test used to confirm syphilis (screening test = VDRL)

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103
Q

CN VIII deafness in a neonate?

A

Congenital syphilis (other signs = saber shins (ant bowing of tibia), saddle nose (flat nasal bridge), Hutchinson’s teetch (notching of upper incisors), mulberry molars)

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104
Q

What may cause a false positive VDRL (screening test for syphilis)?

A

Viruses (mono, hepatitis)
Drugs
Rheumatic fever
Lupus and Leprosy

  • note: VDRL detects a nonspecific antibody that reacts with beef cardiolipin
  • can confirm dx of syphilis with FTA-ABS
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105
Q

Transmitted by lice/louses?

A

Borrelia recurrentis and Rickettsia rickettsii

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106
Q

Transmitted by spores from tick feces and cattle placenta?

A

Coxiella burnetti –> causes Q fever

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107
Q

transmitted by animal/cat/dog bites? symptoms?

A

Pasteurella multocida –> cellulitis, osteomyelitis

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108
Q

Transmitted by fleas?

A

Rickettsia typhi, Yersinia pestis (Yersinia is also transmitted by rodents, prairie dogs…)

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109
Q

Treatment for all Rickettsial diseases?

A

Doxycycline

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110
Q

Headache + Fever + Rash that starts on palms and soles?

A

Rickettsia rickettsii = Rocky Mountain spotted fever (transmitted by tick)

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111
Q

Headache + Fever + Rash that starts centrally and spreads outward without involving palms or soles?

A

Rickettsia typhi = Rickettsia prowazekii (transmitted by louse) –> “Typhus on Trunk”

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112
Q

Q fever

A
  • presents as pneumonia
  • caused by Coxiella burnetti (part of Rickettsia)
  • “Queer” b/c:
  • no rash
  • no vector (transmitted by inhaling aerosoles from ticks feces or cattle placenta)
  • negative Weil-Felix
  • no “Rickettsia” in genus name
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113
Q

Weil-Felix Reaction

A

DX Rickettsia (not Coxiella though)–> mix pt’s serum (with anti-Rickettsial antibodies) with Proteus antigens –> antirickettsial antibodies cross-react to Proteus O antigens and agglutinate

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114
Q

Cytoplasmic inclusions seen on Giemsa or Fluorescent antibody-stained smear

A

Lab dx for Chlamydia

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115
Q

Treatment for Chlamydia?

A
  • 1st line = Azithromycin

- Or: Doxycyline

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116
Q

Chlamydia: What is associated with each types:

  • A, B, C:
  • D-K:
  • L1, L2, L3
A
  • A, B, C: blindness in Africa, chronic infection
  • D-K: urethritis, PID, ectopic pregnancy, neonatal pneumonia, neonatal conjuctivitis
  • L1, L2, L3: lymphogranuloma venereum (acute lymphadenitis)
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117
Q

3 main organisms that cause interstitial/atypical/walking pneumonia?

A
  • Chlamydia pneumonia
  • Mycoplasma pneumonia (most common)
  • Legionella pneumophila
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118
Q

RBC agglutination or lysis in cold temperatures?

A

Mycoplasma pneumonia –> cold agglutinins (IgM)
–> this happens b/c Mycoplasma pneumonia shares antigens with human RBCs, so when body mounts a response against antigens, it also lyses RBCs, leading to anemia; antibodies that cause this RBC destruction = cold agglutinins

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119
Q

only bacterial membrane that contains cholesterol?

A

Mycoplasma pneumonia

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120
Q

Treatment for Mycoplasma pneumonia?

A

tetracycline or erythromycin

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121
Q

5 Infections associated with birds:

A

1) Histoplasmosis –> pneumonia
2) Cryptococcus –> meningitis in AIDS pts
3) Chlamydia psittaci –> atypical pneumonia
4) Avian influenza
5) West Nile Virus

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122
Q

Exotoxin A

A

2 organisms have an exotoxin A:

  • Pseudomonas (similar to diphtheria toxin, inactivates EF2)
  • Group A Strep (similar to TSST1of Staph aureus –> superantigen, causes shock)

*note: there’s also an alpha toxin (lecithinase) that Clostridium perfringens has…

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123
Q

Pneumonia, after pt was in:

1) Mississippi or Ohio river valleys
2) States east of Mississippi River and Central America
3) Southwestern US, California
4) Latin America

A

1) Histoplasmosis
2) Blastomycosis
3) Coccicidomycosis
4) Paracoccidioidomycosis

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124
Q

Dimorphic fungi: List them. What do they all cause? What makes them dimorphic?

A
  • all cause pneumonia and can disseminate
  • dimorphic: mold in cold (20 degrees); yeast in heat (37 degrees); exception = coccidiomycoides = spherule (not yeast) in tissue
  • Includes:
    1) Histoplasmosis
    2) Blastomycosis
    3) Coccidioidomycosis
    4) Paracoccidioidomycosis
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125
Q

pneumonia-causing fungi that forms spherules filled with endospores in tissues (much larger than RBCs)

A

Coccidioidomycosis

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126
Q

meningitis, pneumonia, and dissemination to bone and skin following an earthquake?

A

Coccidioidomycosis

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127
Q

Budding yeast with “captain’s wheel” appearance?

A

Paracoccidioidomycosis

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128
Q

spaghetti and meatball appearance on KOH prep

A

Tinear versicolor (caused by Malassezia furfur); degrades lipids and produces acids that damage melanocytes –> so get hypopigmented and/or hyperpigmented patches

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129
Q

Dimorphic yeast: pseduohyphae and budding yeasts at 20 C; germ tubes at 37 C

A

Candida albicans

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130
Q

Branching septate hyphae that branch at acute angles, not dimorphic. Get a “fungus ball”

A

Aspergillus fumigatus (especially in immunocompromised pts or pts with Chronic granulomatous disease)

131
Q

Heavily encapsulated yeast (budding yeast form only); have wide capsular halos and unequal budding

A

Cryptococcus

132
Q

Meningitis in AIDS pt?

A

Cryptococcus

133
Q

“soap bubble” lesions in brain?

A

Cryptococcus

134
Q

How do you culture Cryptococcus? Stain?

A

Culture on Sabourad’s agar

Stain with India ink

135
Q

nonseptate hyphae that branch at wide angles?

A

Mucor and Rhizopus species (Mucormycosis)

136
Q

Fungus that causes a black necrotic eschar on face?

A

Mucor and Rhizopus

137
Q

Fungus that penetrates cribriform plate and enter brain –> get frontal lobe abscesses, headache, facial pain, maybe cranial nerve involvement?

A

Mucor and Rhizopus

138
Q

disk-shaped yeast on methenamine silver stain?

A

Pneumocystis jiroveci

139
Q

When do you start PCP prophylaxis in HIV pt?

A

when CD4 < 200 cells/mm3

140
Q

Dimophic, cigar-shaped budding yeast that causes ascending lymphangitis

A

Sporothrix schenckii = rose gardner’s disease

141
Q

Severe diarrhea in AIDS pt?

A

Cryptosporidium

142
Q

infant born with triad of: chorioretinitis, hydrocephalus, intracranial calcifications?

A

congenital toxoplasmosis

143
Q

transmission by Tsetse fly; painful bite

A

-Trypanosoma brucei (gambiense, rhodesiense); causing African sleeping sickness (enlarged lymph nodes, recurring fever, somnolence, coma)

144
Q

Transmitted by Anopheles mosquito

A

Plasmodium (malaria)

145
Q

When do you give Primaquine and why?

A

Give to pts with Plasmodium vivax/ovale –> because there’s a dormant form that lives in liver (hypnozoite) that chloroquine/mefloquine can’t get.

146
Q

“maltese cross” on blood smear?

A

Babesiosis (transmitted by Ixodes tick, same as Lyme disease)

147
Q

transmitted by Reduviid bug (painless bite)

A

Trypanosoma cruzi = Chaga’s disease

148
Q

Achalasia (dilated esophagus and absent peristalsis in esophagus), and dilated cardiomyopathy

A

Chagas disease (also may have megacolon)

149
Q

spiking fevers, hepatosplenomegaly, pancytopenia; and “amastigotes” within macrophages?

A

visceral Leishmaniasis = “kala-azar

150
Q

transmitted by sandfly?

A

Leishmaniosis

151
Q

most common nematode infection in US?

A

Enterobius vermicularis = pinworm! test with scotch tape test (best!!)

152
Q

1/3rd of world’s popl is infected with this worm?

A

Ascaris lumbricoides = giant roundworm

153
Q

Nematodes that can cause anemia?

A

Ancylostoma, Necator (hookworms)

154
Q

Treatment for Intestinal nematode infections?

A
  • bendazoles

- pyrantel pamoate

155
Q

transmitted by female blackflies?

A

-Onchocerca volvulus

156
Q

causes hyperpigmented skin and river blindness?

A

Onchocerca volvulus (blackflies, black skin, black visions)

157
Q

Treatment for Onchocerca volvulus?

A

Ivermectin (for river blindness!)

158
Q

can see worm crawling in conjunctiva?

A

Loa Loa

159
Q

Elephantiasis (appears about 1 year post bite by mosquito)

A

Wuchereria bancrofti

160
Q

Transmitted by eating larvae in pork: get cysticercosis and neurocysticercosis, mass lesions in brain (with swiss cheese appearanc) –> seizures, altered mental status, coma…

A

Taenia solium

161
Q

Ingest larvae in raw freshwater fish; causes B12 deficiency

A

Diphyloobothrium latum

162
Q

causes anaphylaxis if organism’s antigens are released from cysts (so must kill daughter cysts before attempting to remove surgically)

A

Echinococcus granulosus

163
Q

snails are the host

A

Schistosoma

164
Q

inflammation of spleen and liver; can lead to squamous cell carcinoma of bladder

A

Schistosoma

165
Q

Nematodes routes of infection:

  • ingested?
  • cutaneous?
A

Ingested: “EAT” these:

  • Enterobius
  • Ascaris
  • Trichinella

Cutaneous: get into your feet through the “SANd”

  • Strongyloides
  • Ancylost`oma
  • Necator
166
Q

Parasite hint: brain cysts, seizures

A

Taenia solium (cysticercosis)

167
Q

Parasite hint: liver cysts

A

Echinococcus granulosus

168
Q

Parasite hint: B12 deficiency

A

Diphyllobothrium latum

169
Q

Parasite hint: Biliary tract disease, cholangiocarcinoma

A

Clonorchis sinensis

170
Q

Parasite hint: portal hypertension

A

schisto

171
Q

Parasite hint: hematuria, bladder cancer

A

schisto

172
Q

Parasite hint: perianal pruritus

A

Enterobius

173
Q

Live-attenuated vaccines:

A

“Live! see Small Yellow Chickens get vaccinated with Sabin’s and MMR!”

  • smallpox
  • yellow fever
  • chickenpox (VZV)
  • Sabin’s (polio)
  • MMR
  • also: intranasal influenza vaccine
174
Q

Killed vaccines:

A

“RIP Always”:

  • Rabies
  • Influenza (intramuscular)
  • Polio – salk (SalK = Killed)
  • HAV
175
Q

Recombinant vaccines

A

HBV (recombinant HBsAg angtigen)

HPV (types 6, 11, 16, 18)

176
Q

What HPV strains are in the vaccine?

A

6, 11, 16, 18

177
Q

Only DNA virus that is ssDNA (the rest are dsDNA)

A

Parvovirus (part-of-a-virus)

178
Q

Only RNA virus that is dsRNA (the rest are ssRNA!)

A

Reovirus (“repeat-o-virus”)

179
Q

All viruses are haploid (1 copy of DNA or RNA) except?

A

Retroviruses: have 2 identical ssRNAs

180
Q

Where do DNA viruses replicate? exception?

A

Nucleus (except poxvirus replicates in cytoplasm)

181
Q

Where do RNA viruses replicate? Exception?

A

Cytoplasm (except influenza virus and retroviruses –> in nucleus)

182
Q

Naked/Non-enveloped viruses:

A

“Naked CPR and PAPP smears!” (PAPP=DNA; CPR = RNA)

  • Calcivirus
  • Picornavirus
  • Reovirus
  • Parvovirus
  • Adenovirus
  • Papilloma
  • Polyoma
183
Q

List the DNA viruses

A

DNA viruses are “HHAPPPPy!”

  • Hepadnavirus
  • Herpesvirus
  • Adenovirus
  • Parvovirus
  • Poxvirus
  • Polyomavirus
  • Papillomavirus
184
Q

General rules about DNA viruses (and exceptions):

A

All DNA viruses are:

  • dsDNA (except Parvovirus)
  • liner (except Polyoma, Papilloma, and Hepadna)
  • icosahedral (except Pox)
  • replicate in nucleus (except Pox)
185
Q

Acute hemorrhagic cystitis (hematuria + dysuria), febrile pharyngitis

A

Adenovirus

186
Q

Aplastic crisis in sickle cell pt?

A

Parvovirus B19

187
Q

Progressive multifocal leukoencephalopathy (PML) in HIV pts?

A

JC virus (Polyomavirus)

188
Q

flesh-colored dome lesions with central lesion; resolves on own (usually)

A

molluscum contagiosum (poxvirus)

189
Q

Where are these herpesviruses latent?:

  • HSV1
  • HSV2
  • VZV
  • EBV
  • CMV
A
  • HSV1–> trigeminal ganglia
  • HSV2 –> sacral ganglia (S2 and S3)
  • VZV –> trigeminal or dorsal root ganglia
  • EBV–> B cells
  • CMV –> mononuclear cells
190
Q

Cancers associated with EBV?

A
  • Burkitt’s lymphoma, Hodgkin’s lymphoma

- Nasopharyngeal carcinoma

191
Q

Roseola

A

HHV-6 “sixth disease”

–> high fevers for several days, followed by diffuse macular rash

192
Q

What are the atypical lymphocytes in EBV?

A

NOT infected B cells! They’re activated CD8+ cytotoxic T-cells–> “Downy cells” with foamy cytoplasm

193
Q

Which HPV strains are associated with warts? CIN, cervical cancer?

A

Warts: 1, 2, 6, 11

CIN/Cervical cancer: 16, 18

194
Q

1 cause of fatal diarrhea in kids? (fatal by dehydration)

A

Rotavirus (a Reovirus)

195
Q

List the Picornaviruses:

A 
"PERCH"
Poliovirus
Echovirus
Rhinovirus
Coxsackievirus
Hep A virus
196
Q

Norwalk virus

A

A calcivirus

–> viral gastroenteritis

197
Q

List the Flaviviruses:

A 
HCV
Yellow Fever
Dengue
St. Louis encephalitis
West Nile virus
(all are arboviruses, except for HCV)
198
Q

List the Togaviruses:

A

Rubella (German measles)
Eastern equine encephalitis
Western equine encephalitis

199
Q

What does Coronavirus cause?

A
  • Common Cold

- SARS

200
Q

Influenza virus is part of what viral family?

A

Orthomyoxvirus

201
Q

Paramyxoviruses

A

Parainfluenza = croup
RSV–> bronchiolitis in babies
Rubeola = Measles
Mumps

202
Q

Negative-stranded viruses:

A

have to transcripe (-) strand to (+); so, bring their own RNA-dep-RNA-pol. Includes: “Always Bring Polymerase Or Fail Replication”

  • Arenaviruses
  • Bunyaviruses
  • Paramyxoviruses
  • Orthomyxoviruses
  • Filoviruses
  • Rhabdoviruses
203
Q

Segmented viruses:

A

“BOAR”

  • Bunyaviruses
  • Orthomyxoviruses (influenza!)
  • Arenaviruses
  • Reoviruses
204
Q

Most common cause of viral aseptic meningitis?

A

Enteroviruses (the Picornaviruses, minus Rhinovirus; specifically: Echovirus and Coxsackievirus)

205
Q

Which part of spinal cord does poliovirus affect?

A

Affects MOTOR neurons of the ANTERIOR horn; causes paralysis

206
Q

Transmitted by the Aedes mosquito?

A

Yellow Fever virus (a Flavivirus)

207
Q

High fever + black vomitus (coffee-ground emesis) + Jaundice + red tongue with white center

A 
Yellow Fever (Flavivirus, transmitted by Aedes mosquito) 
--> black vomitus is from GI bleeding
208
Q

How does Rotavirus lead to diarrhea?

A

Villous destruction with atrophy, leads to decreased absorption of Na+ and H2O
–> it’s fatal by dehydration

209
Q

Hemagglutinin and Neuraminidase

A

Influenza antigens:

  • HA–> promotes viral entry
  • NA–> promotes progeny virion release
210
Q

F (fusion) protein

A

Surface protein of Paramyxoviruses –> causes respiratory epithelial cells to fuse and form multinucleated giant cells
–> Palivizumab = monoclonal antibody against F protein; prevents pneumonia in premature infants

211
Q

Low-pitched cough vs High-pitched cough

A

Low-pitched –> Seal-like barking cough = Croup = Paraifluenza

High-pitched –> RSV

212
Q

Palivizumab

A

monoclonal antibody against the F protein of Paramyxoviruses; given to premature infants to prevent pneumonia from RSV

213
Q

Cough + Coryza (nasal, cold symptoms) + Conjunctivitis

A

Measles

214
Q

Mumps causes:

A

“POM”

  • Parotitis
  • Orchitis
  • aseptic Meningitis

–> may lead to infertility after puberty

215
Q

cytoplasmic inclusions in Purkinje cells of cerebellum

A

Negri bodies of Rabies (commonly found in Purkinje cells of cerebellum)

216
Q

virus travels to CNS by migrating in a retrograde fashion up nerve axons

A

Rabies virus

217
Q

What kind of Polymerase does HBV carry?

A

DNA-dep-DNA-pol

218
Q

HBsAg

A

Hepatitis B infection

219
Q

anti-HBsAg

A

immunity to Hep B (vaccine or recovered from disease)

220
Q

HBeAg

A

active viral replication; high transmissibility

221
Q

anti-HBeAg

A

low transmissibility

222
Q

HBcAg

A

can’t see this in serum; but, indicates new disease

223
Q

anti-HBcAg: IgM? IgG?

A

IgM –> acute/recent infection
IgG –> chronic disease
*Positive during window period
*not present if vaccinated; only if have/had disease

224
Q

ALT:AST in viral hepatitis? alcholic hepatitis?

A

alcoholic hepatitis: AST>ALT

viral hepatitis: ALT>AST

225
Q

HIV envelope proteins:

A

gp120 and gp41: acquired from budding through host cell plasma membrane:

gp120–> attachment to host cell; “docking glycoprotein”
gp41–> fusion and entry; transmembrane glycoprotein

226
Q

HIV capsid protein

A

gag (p24)

227
Q

HIV pol protein:

A

Reverse transcriptase (synthesizes dsDNA from RNA)

228
Q

What does HIV bind on T-cells? on macrophages?

A

T-cells: HIV binds CXCR4 or CCR5 co-receptor and CD4

Macrophages: CCR5 and CD4

229
Q

Why do ELISA/Western blot tests often give false-positives in babies born to HIV-infected mothers?

A

Because anti-gp120 can cross the placenta

230
Q

HIV diagnosis: Which test is initially used? Then which test is used to confirm positive results?

A

1) ELISA –> high false positive rate (high sensitivity, low specificity; “Rule out” test)
2) Western blot assay (high false negative rate; high specificity, low sensitivity; “rule in” test)

231
Q

3 ways to dx AIDS:

A

1) CD4 < or = 200
2) AIDS indicator condition in HIV + pt: ie PCP
3) CD4/CD8 ratio < 1.5

232
Q

chronic watery diarrhea in AIDS pt

A

Cryptosporidium (see acid-fast cysts in stool, esp when CD4<200)

233
Q

Encephalopathy in AIDS pt

A

JC virus reactivation (get demyelination)

234
Q

Neuro Abscesses in AIDS pt

A

Toxoplasmosis (ring-enhancing lesions; CD4<100)

235
Q

Meningitis in AIDS pt

A

Cryptococcus (may also cause encephalitis; india ink stain –> see yeast with narrow-based budding and large capsule; CD4<50)

236
Q

Retinitis in AIDS pt

A

CMV (cotton-wool spots on funduscopic exam; may also have esophagitis; CD4<50)

237
Q

Dementia in AIDS pt

A

Directly associated with HIV; but, rule out other causes

238
Q

AIDS pt with superficial vascular proliferation: Biopsy shows neutrophilic inflammation? lymphocytic inflammation?

A
  • Neutrophilic inflammation –> “Bacillary angiomatosis” –> Bartonella henselae
  • Lymphocytic inflammation –> HHV-8 = Kaposi’s sarcoma
239
Q

low fevers, cough, hepatosplenomegaly, tongue ulcer (basically, systemic disease) in AIDS pt?

A

Histoplasmosis (see oval yeast cells within macrophages)

240
Q

Hairy leukoplakia (white stuff on lateral part of tongue) in AIDS pt

A

EBV

241
Q

Primary CNS lymphoma in AIDS pt

A

EBV

242
Q

Interstitial pneumonia (with intranuclear inclusion bodies on biopsy) or regular pneumonia (esp with CD4<200) in AIDS pts?

A
  • Interstitial pneumonia with owl’s eye inclusion bodies –> CMV
  • Pneumonia with CD4 PCP
243
Q

Pleuritic pain, Hemoptysis, infiltrates on imaging in AIDS pt

A

Invasive Aspergillosis

244
Q

TB-like disease in AIDS pts (esp CD4<50)

A

Mycobacterium Avium - Intracellulare

245
Q

3 bugs that can cause mesenteric adenitis (so may mimic appendicitis):

A
  • Yersinia enterocolitica
  • Campylobacter
  • non-typhoidal Salmonella
246
Q

Bloody Diarrhea…

A

is SEEECSY!

  • Salmonella
  • EHEC
  • EIEC
  • Entamoeba
  • Campylobacter
  • Shigella
  • Yersinia
247
Q

Causes of watery diarrhea?

A
  • ETEC
  • C. diff
  • C. perfringens
  • Cholera
  • Protozoa: Giardia and Cryptosporidium (in imm-compromised)
  • Viruses: Rotavirus, Adenovirus, Norwalk virus
248
Q

3 main causes of atypical pneumonia:

A
  • Mycoplasma
  • Legionella
  • Chlamydia
249
Q

Cause of osteomyelitis in most pts?

A

S. aureus

250
Q

Cause of vertebral osteomyelitis?

A

M. tb (Pott’s disease)

251
Q

Cause of osteomyelitis in Sickle cell pt?

A

Salmonella

252
Q

Elderly pt with delirium?

A

UTI or anti-cholinergic drugs side effects

253
Q

Positive nitrite test

A

Specific for gram (-) bacterial UTI

254
Q

Positive leukocyte esterase test

A

non-specific for bacterial UTI

255
Q

UTI -causing bug; motile, so “swarms” on agar; produces urease, and associated with struvite stones

A

Proteus

256
Q

Hydrops fetalis in utero cause?

A

Parvovirus B19

257
Q

neonate with chorioretinitis + hydrocephalus + intracranial calcifications?

A

congenital Toxoplasma

258
Q

Neonate with PDA (or pulmonary artery hypoplasia) + cataracts + deafness +/- “blueberry muffin” rash (purpura d/t thrombocytopenia)

A

congenital Rubella

259
Q

Neonate with unliateral hearing loss + seizures + petechial rash + “blueberry muffin” rash

A

congenital CMV

260
Q

Neonate with temporal encephalitis and vesicular lesions

A

congenital HSV-2

261
Q

often results in stillbirth, hydrops fetalis; if infant is born: facial abnormalities, CN VIII deafness, teeth issues… etc…

A

congenital Syphilis

262
Q

Rubella, Rubeola, Roseola

A
  • Rubella = “German measles” –> rash begins at head and moves down; have a truncal rash; post-auricular lymphadenopathy
  • Rubeola = Measles –> first: cough, coryz, conjunctivitis, Koplik spots on tongue; then: rash starts at head and moves down
  • Roseola = HHV-6: macular rash over body after several days of high fever; usually in infants
263
Q

Erythematous, sandpaper-like rash with fever and sore throat

A

Scarlet Fever (GAS)

264
Q

vesicular rash on palms and soles; ulcers in mouth

A

Hand-Foot-Mouth disease (Coxsackie A virus)

265
Q

strawberry-colored cervical mucosa, corkscrew motility on wet prep, vaginitis

A

Trichomoniasis

266
Q

Koilocytes

A

look like fried eggs! (squamous cells with perinuclear cytoplasmic clearing)
–> HPV 6 and 11

267
Q

Most common bacterial STD in US?

A

Chlamydia trachomatosis

268
Q

Antibiotics/anti-microbials that should NOT be taken during pregnancy:

A

“Countless SAFe Moms Take Really Good Care”

  • Clarithromycin
  • Sulfonamides –> kernicterus
  • Aminoglycosides –> ototoxicity
  • Fluoroquinolones –> cartilage damage
  • Metronidazole –> mutagenesis
  • Tetracyclines –> discolored teeth, inhibition of bone growth
  • Ribavirin (antiviral) –> teratogenic
  • Griseofulvin (anti-fungal) –> teratogenic
  • Chloramphenicol –> “gray baby”
269
Q

Side effects: Hyperglycemia, Lipodystrophy (deposition of fat on back and abdomen), Nausea, Diarrhea

A

HIV: Protease inhibitors (all end in “-navir”

270
Q

HIV drug that can cause nephrotoxicity and nephrolithiasis

A

Indinavir (protease inhibitor)

271
Q

HIV drug that can cause pancreatitis

A

Ritonavir (protease inhibitor)

272
Q

HIV drugs that lead to bone marrow suppression

A

NRTIs (nucleoside reverse transcriptase inhibitors) –> especially Zidovudine (ZDV), but all of them…

273
Q

HIV drug that can cause megaloblastic anemia

A

ZDV (Zidovudine), a NRTI

274
Q

Protease inhibitors mechanism:

A

Inhibit HIV-1-protease (pol gene) from cleaving the polypeptide products of HIV mRNA into functional parts, so can’t assemble virions –> prevent maturation of new viruses

275
Q

NRTIs vs NNRTIs

A
  • NRTIs–> COMPETITIVELY inhibit nucleotide binding to reverse transcriptase; must be phosphorylated by thymidine kinase to be active
  • NNRTIs –> NON-COMPETITIVELY bind to reverse transcriptase (site diff from NRTI’s); don’t need to be phosphorylate to be active.
276
Q

Antimicrobial drugs that act on 50S ribosomal subunit to block protein synthesis:

A
  • Chloramphenicol
  • Macrolides
  • Streptogramins
  • Clindamycin
  • Linezolid
277
Q

Antimicrobials that block protein synthesis AT 30S ribosomal subunit?

A
  • Aminoglycosides

- Tetracyclines

278
Q

Vancomycin and Bacitracin mechanism?

A

-block peptidoglycan synthesis

279
Q

Fluoroquinolone mechanism?

A

blocks DNA topoisomerase

280
Q

Penicillin mechanism of action:

A
  • block cell wall synthesis by inhibiting peptidoglycan cross-linking
  • bind PBPs (penicillin-binding proteins)
  • activate autoclytic enzymes
281
Q

Penicillinase-Resistant Penicillins:

  • list them
  • why are they resistant to penicillinase (Beta-lactamase)?
  • clinical use?
A
  • Methicillin, Nafcillin, Dicloxacillin
  • have a bulkier R group, so are resistant to penicillinase
  • used to treat S. aureus (but, not MRSA, b/c altered penicillin-binding protein target site)
282
Q

Clinical use for Aminopenicillins (Ampicillin and Amoxicillin):

A

“HELPSS kill Enterococci”

  • H. influenza
  • E. coli
  • Listeria
  • Proteus
  • Salmonella
  • Shigella
  • Enterococci
283
Q

Tibarcillin, Carbenicillin, Piperacillin

A

=Carboxypenicillins = anti-Pseudomonals
“Take Care of Pseudomonas”
-used to treat Pseudomonas!

284
Q

Beta-lactamase inhibitors: CAST

A
  • Clavulonic Acid
  • Sulbactam
  • Tazobactam

*can add to penicillinase-sensitive antibiotics to prevent destruction by Beta-lactamases (ie to aminopenicillins)

285
Q

Beta-lactamase inhibitors: CAST

A
  • Clavulonic Acid
  • Sulbactam
  • Tazobactam

*can add to penicillinase-sensitive antibiotics to prevent destruction by Beta-lactamases (ie to aminopenicillins)

286
Q

Antimicrobials that block cell wall synthesis by inhibiting peptidoglycan cross-linking:

A
  • Penicillin
  • Methicillin
  • Ampicillin
  • Piperacillin
  • Cephalosporins
  • Aztreonam
  • Imipenem
286
Q

Antimicrobials that block cell wall synthesis by inhibiting peptidoglycan cross-linking:

A
  • Penicillin
  • Methicillin
  • Ampicillin
  • Piperacillin
  • Cephalosporins
  • Aztreonam
  • Imipenem
287
Q

Antimicrobials that block peptidoglycan synthesis

A
  • Vancomyci

- Bacitracin

287
Q

Antimicrobials that block peptidoglycan synthesis

A
  • Vancomyci

- Bacitracin

288
Q

Antimicrobial that blocks nucleotide synthesis

A
  • sulfonamides
  • trimethoprim

***given together at TMP-SMX

288
Q

Antimicrobial that blocks nucleotide synthesis

A
  • sulfonamides
  • trimethoprim

***given together at TMP-SMX

289
Q

Antimicrobial that blocks DNA topoisomerases

A

Fluoroquinolones

  • contraindicated in pregnant women and kids, b/c may damage cartilage
  • only exception = can give fluoroquinolones to kids with CF
289
Q

Antimicrobial that blocks DNA topoisomerases

A

Fluoroquinolones

  • contraindicated in pregnant women and kids, b/c may damage cartilage
  • only exception = can give fluoroquinolones to kids with CF
290
Q

Antimicrobial that blocks mRNA synthesis?

A

Rifampin

290
Q

Antimicrobial that blocks mRNA synthesis?

A

Rifampin

291
Q

Antimicrobial that damages DNA?

A

Metronidazole

291
Q

Antimicrobial that damages DNA?

A

Metronidazole

292
Q

Antimicrobials that block protein synthesis at the 50S ribosomal subunit? 30S subunit?

A

“but AT 30, CCEL at 50”

  • 30S subunit:
  • Aminoglycosides
  • Tetracyclines
  • 50S subunit:
  • Chloramphenicol
  • Clindamycin
  • Erythromycin (macrolides)
  • Linezolid
292
Q

Antimicrobials that block protein synthesis at the 50S ribosomal subunit? 30S subunit?

A

“but AT 30, CCEL at 50”

  • 30S subunit:
  • Aminoglycosides
  • Tetracyclines
  • 50S subunit:
  • Chloramphenicol
  • Clindamycin
  • Erythromycin (macrolides)
  • Linezolid
293
Q

Are cephalosporins bacteriostatic or bactericidal?

A

Bactericidal

294
Q

Mechanism of Cephalosporins?

A

They’re Beta-lactam drugs that inhibit bacterial cell wall synthesis (like Penicillin, by inhibiting peptidoglycan cross-linking), but less susceptible to penicillinases
–>Bactericidal

295
Q

‘Which organisms are NOT covered by cephalosporins?

A

“LAME” organisms:

  • Listeria
  • Atypicals (ie Mycoplasma, Chlamydia)
  • MRSA
  • Enterococci
296
Q

Chlamydia treatment:

A

Azithromycin or Doxycycline

297
Q

N. meningitis treatment?

A

Ceftriaxone or Penicillin G

298
Q

Treatment for Pseudomonas:

A
  • Aminoglycoside + extended spectrum penicillin (ie an anti-pseudomonal: Ticarcillin, Carbenicillin, Piperacillin)
  • -> can also treat with a 3rd gen cephalosporin (Ceftazidime) or 4th gen cephalosporin (Cefepime)
299
Q

First generation cephalosporins coverage:

A
  • gram (+) cocci
  • “PEcK”
  • Proteus
  • E coli
  • Klebsiella
300
Q

Second generations cephalosporins coverage:

A
  • gram (+) cocci
  • “HEN PEcKS”
  • H. influenza
  • Enterobacter
  • Neisseria
  • Proteus
  • E. coli
  • Klebsiella
  • Serratia
301
Q

3rd generation cephalosporins coverage:

A
  • serious gram (-) infections that are resistant to other Beta-lactams
  • ceftriaxone: gonorrhea, meningitis, and late stage lyme disease (earlier, use doxycycline)
  • ceftazidime: pseudomonas
302
Q

4th generation cephalosporins coverage:

A

*increased activity against Pseudomonas and gram (+) organisms

303
Q

Cefepime

A

4th generation cephalosporin; good for both gram (+) and gram (-) coverage
–>can be used to treat Pseudomonas

304
Q

Ceftriaxone

A

3rd gen cephalosporin

-treats gonorrhea, meningitis, and late stage lyme disease

305
Q

Ceftazidime

A

3rd gen cephalosporin

-can be used to treat Pseudomonas

306
Q

Cefuroxime

A

2nd gen cephalosporin

307
Q

Cefazolin

A

1st gen cephalosporin

308
Q

cephalexin

A

1st gen cephalosporin

309
Q

cefoxitin

A

2nd gen cephalosporin

310
Q

cefaclor

A

2nd gen cephalosporin

311
Q

cefotaxime

A

3rd gen cephaolosporin

312
Q

3 Cephalosporin toxicities:

A
  • may cross react with penicillins
  • increased nephrotoxicity when given with Aminoglycosides
  • Disulfiram-like reaction when take with ethanol
313
Q

Mechanism and Clinical uses of Aztreonam:

A

*mechanism: inhibits cell wall synthesis by binding to PBP and inhibiting peptidoglycan cross-linking

  • Clinical uses:
  • ONLY gram (-) rods
  • ->give to pts who are allergic to penicillins or pts who can’t tolerate aminoglycosides (b/c renal insuficiency; b/c side effect of aminoglycosides = nephrotoxicy, and aminoglycosides also treat gram (-) rods)
314
Q

Imipinem:

A

broad-spectrum antibiotic

***Always given with Cilistatin (to prevent inactivation of Imipinem in renal tubules)

***only used for severe life-threatening conditions or after failure of other drugs, b/c has bad side effects (GI, CNS toxicities–> seizures)

315
Q

Drugs that binds D-ala D-ala on bacterial cell wall precursors?

A

Vancomycin

316
Q

Clinical use of vancomycin?

A

Gram (+) ONLY!

–>including: MRSA, C. diff (oral dose), enterococci

317
Q

Toxicites of Vancomycin:

A

“NOT the Red Man!”

  • Nephrotoxicity
  • Ototoxicity
  • Thrombophlebitis
  • Red man syndrome = diffuse flushing

FirstAID (24 decks)

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