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Microbiology Flashcards

1
Q

What is the gram stain?

A

Gram + is purple, and Gram - is red or pink

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2
Q

What is Giemsa stain?

A

1) Chlamydia
2) Borrelia
3) Rickettsia

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3
Q

What is the periodic acid-schiff stain?

A

Diagnose Whipple disease

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4
Q

What is the Ziehl-Neelsen Stain?

A

1) Acid fast bacteria

2) Mycobacteria

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5
Q

What is the India ink stain?

A

Cyptococcus

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6
Q

what is the Silver Stain?

A

Fungi

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7
Q

What is the selective media?

A

1) Favors growth of particular organisms (and prevents others)

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8
Q

What is an indicator media?

A

1) Color change in response to metabolism of certain organism.

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9
Q

What is the media fo H influenzae?

A

Chocolate agar

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10
Q

Culture for gonorrhea?

A

Thayer-Martin

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11
Q

Culture for pertusis?

A

Bordet-gengou

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12
Q

Culture for c, diptheriae?

A

Tellurite agar

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13
Q

Culture media for tuberculosis?

A

Lowenstein-Jensen

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14
Q

Culture for pneumonia?

A

Eaton agar

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15
Q

Culture for lactose-fermenting enterics?

A

MacConkey agar

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16
Q

What is culture media for e coli?

A

Eosin-methylene blue

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17
Q

What is culture for legionella?

A

Charcoal yeast

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18
Q

What is the culture for fungi?

A

Sabouraud agar

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19
Q

Why are anaerobes difficult to culture?

A

They produce gas in tissue (CO2 and H2)

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20
Q

What are the obligate intracellular bugs?

A

Stay inside cells when it`s really chilly and cold

Ricketsettsia, Chlamydia, Coxiella

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21
Q

What are the facultative intracellular bugs>

A 
Some Nasty Bugs May live Faculatatively
Salmonella
Neisseria
Brucella
Mycobacterium
Listeria 
Francisella
Legionella
Yersina pestis
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22
Q

What are examples of encapsulated bacteria?

A

1) Pesudonomas
2) Stretocoocus
3) E coli
4) Salmonella
5) Klebsiella

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23
Q

What are the encapsulated bacteria vaccine?

A

1) Pneumococcal vaccine
2) H influenzae
3) Meningococcal vaccine

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24
Q

What are urease postive organisms?

A

They hydrolze urea and release ammonia

1) Proteus
2) Cryptococcus
3) H. Pylori
4) Ureaplasma
5) S. epidermis

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25
Q

What are catalase-postive organisms?

A

Catalase degrades H2O2 into H20 and bubbles of O2

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26
Q

What are pigment producing bacteria?

A

1) Actinomyces: yellow
2) S. Aureus: yellow
3) P. aeruginosa: blue-green
4) Serratia: red

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27
Q

Which bacteria produce biofilm, and what is the likely cause?

A

1) S epidermis: catheter and prosthetic device
2) Viridens : dental plaques, infective endocarditis
3) P aeruginosa: respiratory tree
4) H influenza: ottis media

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28
Q

What are bacterial virulence factors?

A

1) Protein A (binds Fc region of IgG and prevents opsonization)
2) IgA protease (cleves Iga)
3) M protein (prevent phagocytosis)

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29
Q

What is transformation of a bacteria?

A

Can take up new DNA (S. Pneumonae, H. influenxae, Neisseria

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30
Q

What is transposition?

A

A segment of DNA can jump to another (can have excision and reintergration) even to another type of bacteria

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31
Q

What are spores?

A

Bacteria can form spores at the end of stationary phase, when nutrients are limited.

Highly resistant to heat, can be killed by steaming to 121 C

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32
Q

What are examples of bacteria that

A

1) Antracis
2) Bacillus cereus (food poisoning)
3) Botulism
4) C. Difficile (pseudomembrane colitis)
5) Perfingens: gangrene
6) Tetani: tetanus

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33
Q

What are key characteristics of exo vs endotoxin?

What are the typical diseases?

A

Exotoxin

1) Very fatal
2) Heat destroys art 60 degrees
3) Typical disease Tetanus, botulism, diptheria

Endotoxin

1) Fever shock and hypotension
2) Stable at 100 degress
3) Meinococemia

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34
Q

What disease are caused by corynebacterium?

A

Pharyngitis
Pseudomonas
Lympadenopathy

(diptheria endotoxin)

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35
Q

What is pseudomonas cause?

A

Host cell death (exotoxin A)

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36
Q

What diseases caused by Shigella?

A

1) Shiga toxin

2) GI mucosa damage, dysentry (Hemolytic uremic syndrome)

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37
Q

What disease caused by Enterohemorraghic e Coli?

A

1) Shiga-like toxin
2) Causes hemolytic uremic syndrome)
3) Does not invade cells.

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38
Q

What causes enterotoxigenic e-choli?

A

water diarrhea

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39
Q

What toxin is released by bacillus anthracis?

A

1) edema toxin

2) Causes black eschar around cutaneous

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40
Q

What does vibrio cholera cause?

A

1) Voluminous rice-water diarrhea

2) Cholera toxin

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41
Q

What does bordella pertusis cause?

A

1) whooping cough

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42
Q

How does the clostridium tetani cause?

A

1) Toxin is tetanospasmin

2) Causes paralysis , lockjaw ( prevents release of inhibtatory GABA)

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43
Q

How does clostridium botulism cause>

A

1) Botulism toxin

2) Prevents release of ACh stimulatory (flaccid paralysis)

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44
Q

How does clostridium perfringens cause disease?

A

1) Alpha toxin

2) Myonecrosis (gas gangrene) with hemolysis

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45
Q

How does streptococcus pyogenes cause disease?

A

1) Streptolysin O

2) Lysis of RBC with B-hemolysis

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46
Q

How does staph aureus work?

A

1) TSST-1 toxin

2) Toxic shock that causes fever, rash, shock

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47
Q

What are the 3 mechanisms of endotoxins?

A

1) Macrophage activation
2) Complement activation
3) Tissue factor activation

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48
Q

What are the symptoms caused by macrophage activation?

A

1) Fever

2) Fever and hypotension

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49
Q

What symptoms are caused by complement activation?

A

1) Hypotension

2) edema

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50
Q

What symptoms are caused by tissue factor activation?

A

DIC

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51
Q

What bacteria are susceptible to novobiocin? (Staph)

A

1) Saprophyticus resistant

2) Epidermis is sensitive

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52
Q

What bacteria are sensitive to optochin? (strep)

A

1) Virdens is resistant

2) Pneumonia is senstive

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53
Q

What is sensitive to bacitracin?

A

1) Group B is resistant

2) Group A is sensitive

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54
Q

What are the characteristics of staphlococus spaorphyticaus?

What part of normal flora?

What does it cause?

A

1) Gram +
2) Catalase +
3) Coagulase -

4) Genital and perineum flora
5) Second cause of uncomplicated UTI

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55
Q

What are characteristics of staph pneumonae?

What diseases does it cause?

A

1) Gram +
2) Diplococci
3) encapsulated

Disease caused: 
Meningitis
Otitis Media
Pneumonia
Sinusitis
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56
Q

What medical procedure is associated with strep pneumonae?

A

1) Patients with sickle cell disease and splenectomy

2) No virulence without the capsule.

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57
Q

What are the characteristics of step. viridens?

Broadly called viridens

A

1) Gram +
2) alpha hemolytic
3) Strep viridens sanguinis (produces fibrin aggregates on damaged heart valves
4) Viridens in the mouth (dental procedures)

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58
Q

What are some diseases that streptococcus pyrogenes produce?

A

1) Pharyngitits, cellulitis, impetigo,
2) Toxigneic-scarlet fever, toxic shock, necrotizing pharyngitis
3) Immunologic, rheumatic fever

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59
Q

What are critieria for acute rheumatic fever?

A

1) Joints-polyarthritis
2) Carditis
3) Nodules (subcutaneous)
4) Erythemia
5) Sydenham chorea
6) Pharyngitis

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60
Q

What are signs of scarlet fever?

A

1) Blanching, sandpaper-like rash

2) Strawberry like tongue

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61
Q

What are characteristics of streptococus agalactia?

A

1) Gram +
2) Cocci
3) Bacitracin resistent
4) B hemolytic
5) Colonizes the vagina

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62
Q

What are the clinical implications of agalactae?

A

1) Meningitis and sepsis in babies
2) Hippurate test +
3) Screen pregnent woman at 35-37 weeks
4) If are +, then give penicciline prophylaxis

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63
Q

Where is streptococcus bovis found?

What are the properties of the organism?

A

1) Gram + Cocci
2) Boivis found in the blood
3) Linked to cancer of the colon.

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64
Q

What are the properties of enterococci?

What do they cause?

A

1) Gram + coci
2) Enterococci are normal colonic flora
Pen G persistent
UTI
Bilary tract ingections
Suacute endocarditis

NOTE:
Entero: intestinal
Faecalis: feces

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65
Q

What are the characteristics of antracis?

A

1) Gram +
2) Spore forming
3) Have a polypeptide capsule that contains D-glutamate

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66
Q

What are the characteristic lesions of cutaneous anthrax?

A

1) Painless papule surrounded by vesicles
2) Ulcer with black eschar
3) Painless and necrotic
4) Leads to bacteremia and death

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67
Q

What are the signs of pulmonary anthrax?

A

1) Inhalation of spores

2) Flu-like symptoms that are fever, and pulmonary hemorrhage, mediastinitis and shock

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68
Q

What are characteristics of Bacillus cerus?

What is the clinical picture associated with it?

A

1) Gram + rods
2) Reheating rice (spores aren’t killed by cooking rice(
3) Cause nausea and vomiting within 1-5 hours
4) Caused by cereulide (preformed toxin)
5) Causes diarrehea, nonbloody, and GI pain within 8018 hours.

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69
Q

How does C tetani cause symptoms?

A

1) Blocks the release of GABA neurotransmittors from Renshaw cells in the spinal cord

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70
Q

What are the signs of C. Tetani?

A

1) Paralysis
2) Trismus lockjaw
3) Sardonicus (raised eyebrow and open grin)

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71
Q

How to treat the C. tetani?

A

1) Antitoxin
2) Vaccine + booster
3) Diazepam for muscle spasm
4) Wound debridement

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72
Q

What does C perfringens cause?

A

1) Produces alpha lecithinase
2) Give gas gangrene
3) Enterotoxi can survive undercooked food

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73
Q

What are the types of toxin secreted by C didficile?

A

1) Two types: toxin A, and enterotoxin (binds to border of gut)

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74
Q

what is the cause of C difficile?

A

1) After taking clindamycin

2) Can be associated with PPI

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75
Q

How is C. difficile diagnosed?

A

1) Detecting the toxins in stool by PCR

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76
Q

How to treat the C.Difficile diarrhea?

A

1) Metronidazole
2) Vancomycin
3) Fidaxomicin
4) Fecal microbiota transplant.

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77
Q

What is the effect of corynebacterium diptheriae?

A

1) Gram + rod
2) Cause pseudomembraneous (grayish-white membrane)
3) Elek test of toxin

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78
Q

What are the properties of listeria monocytogens?

A

1) They are gram + intracellular rods

2) They can be acquired by ingestion of dairy products transplacental transmission, or vaginal transmission

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79
Q

What are the diseases associated with listeria?

A

1) Amnionitis
2) Speticemia
3) Spontaneous abortion
4) Meninggitis (immunocompromised)
5) Gastroenteritis

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80
Q

How is listeria treated?

A

Ampicilline within infants

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81
Q

What are the differences between the no cardia and the actinomyces?

A 
Nocardia:
1) Aerobe
2) Acid fast
3) Found in soil
Cause pulmonary inection in immunocompromised

Actinomyces:

1) Anaerobe
2) Not acid fast
3) Found in oral, reproductive and GI flora
4) Cause oral, and facial abcesses that drain through the sinus tract

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82
Q

How are infections with Nocardia treated?

A

1) With septra

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83
Q

How are actinomyces treated with?

A

1) Penicillin

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84
Q

what is the difference in PPD test, if have primary vs secondary tuberculosis?

A

1) PPD + (current infection or past exposure)

2) PPD- if no infection, and in sarcoidosis

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85
Q

What is the physiopathology of primary tubercuosis?

A

1) exposure to the mycobacterium
2) Presence of hilar nodes
3) Presence of Ghon focus

(infection)
There are then two pathways:
Pathway A:
a) > 90% Healig by fibrosis , calcification, and are tuberculin +

b) then you have reactivation
c) Secondary tuberculosis (fibrocaseous cavitary lesions, in the upper lobes)

c) Leads to localized, destructive disease

Pathway B:

1) There is no healing of the fibrosis or calcification
2) There is progressive, primary tuberculosis (AIDS/malnutrition)
3) Results in bacteremia, miliary tuberculosis

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86
Q

What are characteristics of miliary tuberculosis?

A

1) Lungs
2) Liver
3) Spleen
4) Adrenal glands
5) Joints and long bones

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87
Q

What are the different types of Mycobacteria (and what diseases do they cause)

A

1) Mycobacterium tuberulosis (often resistant to multiple drugs)
2) M avium-intracellulaire: dessiminated non-TB in aids (often resistant to multiple drugs)
3) Mycobacterium scrofulaceum: cervical lyphadenitis in children
4) Mycobactrium marinum: hand infection within handlers

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88
Q

What bacteria causes leprosy?

A

1) Mycobacterium leprae (acid fast bacillus)

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89
Q

What are the two form of leprosy?

A

1) Lepromatous: Presents diffusely over the skin, with lion-like facies
2) Tuberculoid: hairless plaques with high cell mediated immunity

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90
Q

What is the treatment for different types of leprosy?

A

1) Lepromatous form: clofazimine

2) Tuberculoid: rifampin and dapsone

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91
Q

What are examples of lactose producing bacteria?

A

1) Klebsiella
2) E coli
3) Eneterobacteria
4) Serratia

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92
Q

What type of agar should lactose bacteria grow on?

A 
MacConKee (k=kelb, e=Ecoli, E=entero)
OR
EMB Agar (this turns purple, while E Coli in this agar, turnsgreen)
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93
Q

What are the differences between nesseria gonococci and meningococci?

A

Gonocci:
No polysaccaride capsule
No vaccine
Causes gonorrhea, septic arthritis, pelvic inflammatory disease and Fitz-Hugh syndrome

Meninococci
1) Polysccaride capsule
2) Maltose fermentaion
3) Causes meningococcemia with petechial hemorrahe and gangrene of toes
Waterhouse-friderichsen syndrome: adrenal insufficiency, fever, DIC

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94
Q

What is the treatment for gonococi vs meningococci?

A

1) Gonococci: Ceftriazone, azithromycine (eye ointment in new borns prevents blindness)

2) Meningococci:
Rifampin, ceftriaxone, ciprofloxacin

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95
Q

What gram is H.Influenzae?

A

1) Gram -

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96
Q

What type of infection does H. Influenzae cause?

A

1) Ottitis media
2) Conjunctivitis
3) Bronchitis
4) Epiglottis (cherry red in children)
5) Penumonia
6) Meningitis

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97
Q

What is the agar for H. influenzae?

A

1) Chocolate agar

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98
Q

What is used to treat H. influenzae?

A

1) Amoxicilline

2) Clavuline

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99
Q

When is the H. Infulenzae vaccine given?

what does it consist of?

A

1) Capsular polysaccharide

2) 2-18 months of age

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100
Q

What are the characteristics of bordella pertusis?

A

1) Gram -

2) Aerobic cocobacillus

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101
Q

What disease is caused by bordella pertusis?

A

1) The whopping cough

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102
Q

What type of medium does legionella grow on?

What gram and shape is it?

A

1) Uses silver, and grows on charchol

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103
Q

How is legionella transmitted?

A

1) Not by person to person

2) Aerosol transmission, from water source habitat

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104
Q

What are the 2 diseases that are caused by legionelle pneumophila?

A

1) Legionnaires disease: severe, lobar pneumonair (unilateral), fever, GI
- common in smokers and chronic lung disease
2) Pontiac fever: mild-flu like syndrome

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105
Q

What are microbiological characteristics of pseydonomas?

A

1) Gram -
2) Rod
3) Produce blue-green pigment
4) Endotoxin (fever, shock)
5) exotoxin A (inactivates EF2)

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106
Q

What are diseases of pseudomonas?

A

1) Pneumonia
2) Sepsis
3) UTI
4) Diabetes
5) OSteomyletis
6) Otits externa (swimmers ear)
7) Nosocomial infections (Catheter)

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107
Q

What are possible treatments of pseudomonas?

A

1) Carbapenems
2) Aminoglycosides
3) Monobactams
4) Fluoroquinolones: cipro and leve

Aeruginosa -aerobic

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108
Q

what is Ecthyma gangrenosum?

A

1) Caused by pseudomonas gangrenosum

2) Necrotic cutaneous lesion, seen in immunocompromised patients

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109
Q

Name all the strains of E.Coli, and the presentation?

A

1) EIEC: I (invasive dysentry), invades intestinal mucosa and causes necrosis and inflammation)
2) ETEC: traveler’s diarrhea
3) EPEC: Pediatrics (watery diarrhea)
4) EHEC: O157: H7 (usually in leafy vegetales of uncooked meat)

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110
Q

What are the microbiological characteristics of Klebsiella?

A

1) Gram -

2) Rods

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111
Q

What are the diseases caused by Klebseilla?

A

1) Apiration pneumonia
2) Abcess of the lungs
3) Alcoholics
4) Diabetes

(tends to have currant Jelly sputum)

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112
Q

What are the microbiological characteristics of campylobacter jejuni?

A

1) Gram -

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113
Q

How is campylobacter jejuni transmitted?

A

1) Fecal oral contraimination
2) Person to person contact
3) Undercooked poultry or meat
4) Contact with infected animals: dog, cats

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114
Q

What disease is associated to Campylobacter jejuni?

A

1) Guilliain Barre syndrome

2) Reactive arthritis

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115
Q

What are the different characteristics between salmonella typhi and salmonella and shigella

A

Salmonella typhi vs salmonella species vs shigella

1) Reservoir: Human only vs. human and animal. vs human only
2) Infectious dose: high ve highvs low
3) GI manifestations: Constiptation followed by diarrhea vs. Diarrhea vs. Bloody diarrhea
4) Vaccine: oral vaccine with attenuated S.Thyphi vs no vaccine vs no vaccine
5) Unique properties: causes typhoid fever (treat ceftriaxone or fluoroquinone vs. poultry, eggs, pets, vs. fingers, food, feces and flies

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116
Q

What are the microbiological characteristics of cholerae?

A

1) Gram -

2) Flagellated

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117
Q

What are the clinical symptoms?

A

1) Rice water diarreha through enterotoxin
2) Sensitive to acid bile
3) Requires prompt rehydration

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118
Q

Where is Yersina enterocolitica usually found?

A

1) Transmitted from pet feces

2) Contaminated pork

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119
Q

What does Yersina enterolitica cause?

A

1) Acute diarrhea

2) Pseudoappnedicitis (mesenteric adenitis or ileitis)

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120
Q

What are characteristics of H. pylori?

A

1) Gram - rod

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121
Q

How is H. pylori diagnosed?

A

Urease breath test, or fecal antigen test

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122
Q

What does H pylori cause (disease)?

A

1) Ulcer disease

2) gastric adenocarcinoma

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123
Q

How is H. Pylori treated?

A

1) Clarithromycin

2) Proton pump inhibitor

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124
Q

What do leptospira interrogans?

A

1) Myalgias
2) Jauedice
3) Photophobia
4) Weil disease: severe jaunedice, and kidney dysfunction, fever, hemorrhage

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125
Q

What disease does Borrelia burgdorferi?

A

Lyme disease

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126
Q

What is the natural resevoir of borrelia burgdorfei?

A

1) Resevoir is the mouse

2) The vector is the ixodes deer tick

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127
Q

What are the stages of Lyme disease?

A

Stage 1: localized erythema, flu like symptoms
Stage 2: Early dessiminated carditis, AV block, facial nerve palsy
Stage 3: late encephalopathies, chronic arthritis.

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128
Q

What bacteria causes syphilis?

A

Treponema pallidum.

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129
Q

What are the symptoms of primary syphilis?

How to diagnose?

A

1) Painless chancre
2) Dark field microscopy will see treponemes
3) Will be VDRL +

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130
Q

What are the signs of secondary syphilis?

A

1) constitutional symptoms
2) Condylomata lata (looks like a wart on genitals)
(Systemic)

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131
Q

How to diagnose secondary syphilis?

A

1) VDRL/RPR

2) FTA-ABS to confirm the diagnosis

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132
Q

What are the characteristics of tertiary syphilis?

A

1) Chronic granulomas
2) Aortitis (vasa vasorum destruction)
3) Neurosyphilis (protitute sign with pupil that accomodates but doesn’t react)

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133
Q

What are tests that are positive (clinically for neurosyphilis)?

A

1) Broad based ataxia
2) Romberg +
3) Charcot joint
4) Stroke and HTN

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134
Q

How to test for neurosyphilis?

A

1) Spinal fluid with VDRL
2) FTA-ABS
3) PCR

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135
Q

What are signs of congenital syphilis?

A

1) Facial abnormalities such as rhagades (linear scars at angle of the mouth)
2) Saddle teeth (gap between the two front teeth)
3) Nasal discharge
4) Short maxilla
5) Saber shins
6) CN VII deafness

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136
Q

How to prevent congenital syphilis?

A

Treat in the first trimester (has placental transmission)

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137
Q

What are causes of false postsitive VDRL?

A

1) Viral infection (EBV, hepatitis)
2) Drugs
3) Rheumatic fever
4) Lungs and leprosy

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138
Q

What is a Jarisch-Herxheimer reaction?

A

1) Flu-like syndrome (fever, chills, headache, myalgia) after antibiotics have killed bacteria (usually spirochetes) and it releases toxins.

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139
Q

For the following bacteria (zoonosis: transmission between animals and humans) name the disease and the animal?

1) Anaplasma
2) Bartonella
3) Borrlia burgdorferi
4) Borelia recurrentis
5) Brucella recurrentis
6) Campylobacter
7) Chlamdophila psottaci
8) Coxiella burnetii
9) Ehrlichia chaffeensis
10) Francisella tularensis
11) Leptospira
12) Mycobacterium leprae
13) Pasturella multicoda
14) Rickettsia prowazekii
15) Ricketsettia typhi
16) Salmonella
17) Yersina Pestis

A

1) Anaplasma: Anaplasmosis, Ixodes ticks on deer and mice
2) Batonella: Cat scratch, bacillary angiomatosis, cat
3) Borrelia burgdorferi, Lyme disease, Ixodes ticks (deer and mice)
4) Borrelia recurrentis: relapsing fever, Louse
5) Brucella: Brucellosis/undulant fever (unpasterized dairy)
6) Campylobacter: bloody diarrehea, feces from infected pets, or contaiminated meat/foods/hands
7) Chlamydophilia psittaci: Psittacosis, parrots and other birds
8) Coxiella burnetil: Q fever, aerosols and sheep amniotic fluid
9) Ehrilichia chaffeenis: Ehrlichiosis, Lone star Tick
10) Francisella tularensis: Tularemia, Ticks, Rabbits, deer flies
11) Leptospira: Leptospirosis, animal urine in water
12) Mycobacterium leprae: Leprosy, humans with lepromatous leprosy
13) Pasterella mutlocida: cellulitis, osteomylitis, animal bites, cats and dogs.
14) Rickesettia prowazekii: endemic typhus, human to human via body louse
15) Rickettsia rickettsii: Rocky Mountain spotted fever, Dog tick
16) Rickettsia typhi: endemic typhus, fleas
17) Salmonella: Diarrhea, reptiles and poultry
18) Yersina Pestis: Plague, rats

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140
Q

What are characteristics of gardneralla vaginalis?

A

1) Gram variable rod
2) Presents as gray, vaginal discharge with fishy smell
3) Associated with sexual activity (but not sexually transmitted)
4) Fishy smell, grey discharge

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141
Q

How is gardneralla vaginalis diagnosed and treated?

A

1) Metronidazole or clindamycin

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142
Q

What are the characteristics of Rocky Mountain Spotted fever?

A

1) Rash on palms and soles

2) INfection (hand, foot, mouth)

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143
Q

What are clinical characteristics of typhus?

A

Rickettsia Typhi

The rash starts centrally and spreads out

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144
Q

What are characteristics of Q fever?

A

1) Coxiella burneii
2) Present as pneumonia
3) Common cause of culture negative endocarditis.

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145
Q

What are the two types of Chlamydia?

A

1) Chlamydia tachomatis: Reactive arthritis (Reiter syndrome), follicylar conjunctivitis, non gonococcal arthritis
2) Chlamydophilia pneumoniae: pneumonia

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146
Q

How to treat Chlamydia?

A

1) Azithromycine, and doxycylcine

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147
Q

What are the different chlamydia serotypes, and what do they cause?

A

1) A, B, C : chronic infection, and blindness, follicular conjunctivitis
2) Types D-K: Urethritis,PID, eosinophilia, neonatal conjunctivitis

3) Type L1, L2, L3: lymphgranuloma venereum
(painless, swollen ulcers)

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148
Q

What are the clinical presentation of mycoplasma pneumonia?

A

1) Insidious onset
2) Headache
3) Non-productive cough
4) Patchy or diffuse infiltate
5) X-ray looks worst then the patient

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149
Q

What happens with the mycoplasma cold agglutinins?

A

1) High titers which can agglutinate or cause lysis of RBC

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150
Q

What are the characteristics of systemic mycoses?

A

1) Caused by dimorphic fungi mold, and yeast

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151
Q

How to treat systemic mycosis?

A

1) Local: flucanozole or itraconozole

2) Systemic: amphotercin B

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152
Q

Where is histoplasmosis found?

A

1) Ohio and Mississippi Valley

2) Bird or bat droppings

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153
Q

What does Blastomycosis cause?

Where can it be found?

A

1) Eastern United States and Central America
2) Inflammatory lung disease (desiminate to skin and bone)
Forms granulomatous nodules

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154
Q

Where is coccidoidomycosis found?

What does coccidomycosis cause?

A

1) Pneumonai and meningitis
2) Diseeminate to skin and bone
3) Spores thrown up after earthquakes
4) Found in San Joaquin Valley Fever
5) Cause erythem nodosum
6) Can cause arthralgias

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155
Q

How does paracocidiomycosis look on microscopy?

Where does it come from?

A

1) Resembles a captain’s wheel

2) Comes from Latin America

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156
Q

What does Tinea dermatophyte cause?

How to diagnose?

A

1) Cutaneous fungi

2) KOH stain

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157
Q

What is tinea capitis?

A

Fungus on the head, can cause alopecia and scaling

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158
Q

What is tineas corporis?

A

On torso, and scaling ringworms

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159
Q

What is tinea curis?

A

Inguinal area

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160
Q

What are the 3 types of Tinea pedis?

A

1) Interdigital
2) Mocassin
3) Vesicular type

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161
Q

What is Tinea unguium?

A

Onychomycosis occurs on the nail

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162
Q

What is tinea versicolor?

A

1) Causes pale patches of the skin (damages malanocytes)
2) Usually occurs in hot, humid weather
3) Treatement: selenium sulfide, or antifungal medication
4) On microscopy looks like spagetthis and meatball.

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163
Q

What can candida albicans cause?

A

1) Systemic or superficial fungal infection
2) Diaper rash
3) endocarditis
4) Disseminated candidas

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164
Q

How to treat candida albicans?

A

1) Nystatin
2) Flucanozole
3) Caspofungin
4) Amphotericin B

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165
Q

What does apergillus fumigatus cause?

A

1) Invasive aspergillosis in immunocomporomised with chronic granulomatous disease
2) Especially susceptible if have chronic lung disease (such as tuberculosis)

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166
Q

What substance secreted by the aspergillus is associated with heptocellular carcinoma?

A

Alfatoxins

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167
Q

What is allergic bronchopulmonary aspergillos?

A

Hypersensitivity response associated with asthma and cystic fibrosis (can have bronchiectasis and eosinophilia)

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168
Q

Where is cryptococcus neoformans found? What disease does it cause?

A

1) Found in the soil and in pigeon droppings
2) Acquired through inhalation with hematological spread
3) Causes crytococcus meningitis, encephalities, usually in immunocompromised patient

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169
Q

Who does Mucor and Rhizopus attack? What does it cause?

A

1) Usually in ketoacidotic diabetic or neutropenic patients (leukemia)
2) Cause abcess in the brain and sinus thrombosis
3) Can lead to headache, facial pain, and black eschar on face

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170
Q

What is the treatment for Mucor and Rhizpus attack?

A

Surgical debridement and amphotericin B

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171
Q

What disease does pneumocystitis jirovecii cause?

A

1) Pneumocyctis pneumonia (diffuse, intersitital)
2) Yeast-like
3) Diffuse ground glass on chest or CT scan
4) Diagnosis by lung biopsy or lavage

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172
Q

What is the treatment for pneumocystitis?

A

1) TMP-SMX
2) Pentamidine
3) Dapsone

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173
Q

In HIV, when should prophylaxis of pneumocytitis start?

A

When cells drop

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174
Q

What disease does sporothrix scheneckii cause?

How is the diease treated

A

1) Usually caused by a rose thron
2) Causes a pustule or an ulcer
3) Treated with itraconazole

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175
Q

The parasite Giardia lambia, disease, transmission, diagnnosis?

A

1) Giardiasis: bloating, flatulence, foul smelling diarrhea
2) Transmission: Cysts in the water
3) Diagnosis: trophozoites or cysts in the stool
4) Treatement: Metronidazole

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176
Q

What are the disease, transmission, diagnosis, treatment of Entamoeba histolytica?

A

1) Amebiasis: bloody diarrhea, lover abcess and pain
2) Transmission: cysts in water
3) Trophozoites in the RBC
4) Treatment: metronidazole, iodoquinol for assymptomatic cysts

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177
Q

What does cryptosporidium cause, transmission, diagnosis, and treatment?

A

1) Severe diarrhea in patients with AIDS
2) Mild watery in immunocompetent hosts
3) Transmission: oocysts
4) nitazonxanide

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178
Q

What does toxoplasma cause, transmission, diagnosis, and treatment?

A

1) Congenital toxoplasmosis: chorioetinitis, hydrocephalus, intracranial calcifications, reactivation of AIDS, brain abcess
2) Transmission: cysts in mean, oocysts in cat feces, crosses placenta
3) Diagnosis: serology and biopsy
4) Treatment: Sulfadiazine

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179
Q

What does Naegleria fowleri cause, transmission, diagnosis, and treatement?

A

1) Rapidly fatal meningoencephalitis
2) Transmission: freshwater lakes
3) How to diagnosis: Amoebas in the spinal fluid
4) Treatement: ampotericin B

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180
Q

What does Trypanosoma brucei cause, transmission, diagnosis, and treatment?

A

1) African sleeping sickness (recurring fever, coma)
2) Transmission: Tsetse fly
3) Trypomastigote in blood smear
4) How to treat: Suramin for blood borne disease
5) Melarsoprol for CNS penetration.

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181
Q

What disease are caused by Plasmodium? Transimission, diagnosis, and treatment?

A

1) Disease is malaria: fever, headache, anemia, splenomegaly
2) Transmision: mosquito
3) Diagnosis: Trophozoite ring within the RBC
4) Treatment: Chloroquine, Plasmodium heme, IV mefloquine, atovauone, if life threatening artesunate

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182
Q

What are the different species of plasmodium, and what is the effect clinically?

A

1) Vivax/ Ovale48 hour cycle of fevers
2) Falcipurum: irregular patterns (parasitized RBC occlude capillaries in the brain
3) Malariae: 72 hour cycle

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183
Q

What are cause, transmission, and treatment of Babesiosis?

A

1) Causes fever an hemolytic anemia in northwestern United States
2) Transmission: Ixodes tick
3) Diagnosis: blood smear
4) Treatment: Atovaquone + azithromycin.

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184
Q

What does trypanosoma cruzi cause, transmission, diagnosis, treatment?

A

1) Chagas disease (dilated cardiomyopathy, megacolon, megaesophagus, in South America)

PERIOMBILICAL swelling is characteristics

2) transmission: Eduviid bug (kissing), feces, painless bite
3) Diagnosis: Trypomastigot blood smear
4) Treatment: Benznidazole, nifirtimox,

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185
Q

What are characteristics of leishmanias, transmission, diagnosis, and treatment?

A

1) Spiking fevers
2) Heptaosplenomagealy, pancytopenia
3) Cutaneous leishmaniasis (skin ulcers)
4) Diagnosis: macrophages with amastigotes
5) Treatement: Amphotericin B (sodium stiboglucose)

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186
Q

What are causes, transmission and diagnosis of Trichmonas vaginalis?

A

1) Vaginitis: foul smelling and greenish discharge with itching and burning
2) Sexual transmission
3) Diagnosis: trophozoites
4) Treatment: metronidazole

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187
Q

What are the nematode method of infection?

A

1) Usually through ingestion (enterobius, ascaris, toxocara, trichinella)
2) Cutaneous: stronyloides, ancylostoma
3) Bites: loa, onchocerca volvulus

188
Q

What type of immune response to helminths?

A

1) Esonopilstype 1 or type 2 hypersensitivity
2) Type 1: neutralize of histamines and leukotrienes
Type 2: esonophils attach to surface of helaminths via IgE

189
Q

What disease enterobius vermicularis cause, transmission, and treatment?

A

1) Infection that causes pruritis
2) Diagnosis with seeing the egg,and via the tape test
3) Transmitted by fecal-oral
4) Trreatment with bendazoles

190
Q

Disease, transmission, and treatment of ascaris lumbridoides?

A

1) Intestinal infection with obstruction of ileocecal valve
2) Fecal-oral in feces
3) Bendazoles

191
Q

What is disease, treatment, and transmission of stronguloides stercoralis?

A

1) Intestinal infection causing vomiting, diarrhea, and epigastric pain

2) Transimission: larvae in the soil, penetrate the skin
3) Treatment: lvermectin or bendazoles

192
Q

What disease, transmission,caused by Ancylostoma duodenale, necator americanus (hookworms)?

A

1) Intestinal infection causing anemia and sucking blood
2) Transmission by walking barefoot in the beach
3) Larvae penetrate the skin
4) Benzaoles nad pyrantel

193
Q

What is the disease, transmission, and treatment of trichinella spirais?

A

1) Intestinal infection with larvae, that encyst withing the muscle cells and cause inflammation
2) Sympoms of fever, vomiting, nausea, and myalgia
3) Transmission: fecal-oral and undercooked meat
4) Treatment: Benzaoles

194
Q

What is disease, transmission, and treatment of toxocara canis?

A

1) Nematodes migrate through blood, and cause inflammation and damage
2) Organs affected inclode heart, liver, and CBS (seizures)
3) Fecal-oral transmission
4) Bendazoles (treatment)

195
Q

What is disease, transmission, for onchocera volvulus?1)

A

1) river blindness
2) Skin changes
3) Allergic reaction to microfilaria
4) Transmission by the female blackfly
5) Treatment by ivermectin)for liver blindness)

196
Q

What is disease of loa loa?

A

1) Swelling of skin, and worms in conjunctiva
2) Transmission by deer fly, horse fly, and mango fly
3) Treatment by diethylcarbamazine

197
Q

What disease by Wuchereria bancrofti?

A

1) Elephantiasis (worms imvade the lymph nodes and cause inflammation)
2) Transmission: female mosquito
3) Treatment:dietylcarbamzine

198
Q

What are the 3 types of cestodes? (Tapeworms)

A

1) Taenia Solium
2) Diphyllobothrium latum
3) Echinococcus granulosus

199
Q

What is disease of Taenia solium?

A

1) Intestinal tapeworm
2) Transmission by larvae encysted in undercooked pork
3) Treatement: Praziquntel

200
Q

what is the disease of cestode diphyllobothrium latum?

A

1) Vitamin B deficinecy, the tapeworm competes for B12 in the intestine causing megaloblastic anemia
2) Treatment: praziquantel

201
Q

What is the disease and treatment ofechinococcus granulosus?

A

1) Hyatid cysts in the liver
2) Can have anaphylaxis if antigen is released
3) Need to inject the cyst with ethanol or hypertonic saline to kill daughter cysts.
4) Transmission: ingestion of eggs from dog feces

202
Q

What are the two types of trematodes?

A

1) Schistosoma

2) Clonorchis sinensis

203
Q

What are the disease, transmission, and treatment of schistoma?

A

1) liver and spleen enlargement, fibrosis and inflammation
2) Transmission by snails
3) Treatement: praziquantel

204
Q

What can S. Haematobium cause?

A

Squamous cell carcinoma of the bladder and pulmonary hypertension

205
Q

What does clonorchis sinesis cause?

A

1) Bilary tract inflammation
2) Pigmented gallstones
3) Cholangiocarcinoma

206
Q

What do scabis cause ? (sarcoptes scabiei)?

A

1) Mites that burrow into the stratum corneum and cause pruritis
2) Usually in webspace of the hands and feet
3) Treatment: permthrin cream (washing the bedding)

207
Q

What does lice (pediculus humanus cause)?

A

1) Blood sucking insects that live in clothing (puritis, pink macules and papules)
2) Treatment: pyrethroids, malathion or ivermectin lotion and combing

208
Q

Viral genetics, meaning of recombination?

A

exchange of genes between 2 chromosomes with significant sequence homology

209
Q

Viral genetics, reassortement?

A

Virus with segmented genome (influenza virus) exchange of genetic material (H1NI influenzae)

210
Q

Viral genetics, complementation?

A

Have two viruses.
1 infects the cell with a non-functioning gene
The second has that gene functioning, and produces the missing protein

211
Q

Viral genetics, phenotypic mixing?

A

When have simultaneous infection of a cell with 2 viruses. GenomeA, then coated with virus B antigens

212
Q

What are the examples of the live, attenuated virus?

A

1) Small pox
2) Yellow fever
3) Chicken pox
4) Sabin
5) MMR (measles, mumps, rubella)
6) Influenza (intranasal)

213
Q

Who should not be given live vaccine?

A

1) Immunocompromized patients

2) HIV can be given if no signs of immunocompromised patient.

214
Q

Which vaccines are dead?

A

1) Rabies
2) Influenza
3) Salk, polio
4) Hepatitis A

215
Q

Which are subunit vaccines?

A

Hepatitis B

216
Q

Which DNA virus is NOT double stranded?

A

Parvovirus

217
Q

Which RNA virus are NOT single stranded?

A

Reoviridae

218
Q

Which viral genome is infective?

A

Purified nucleic acid of most doublestranded DNA (except HBV) is infectious

Naked ssRNA and dsRNA are usually not infectious

219
Q

Where do DNA virus replicate?

A

In the nucleus

220
Q

Where do RNA virus replicate?

A

In the cytoplasm

221
Q

What are some general rules about DNA virus?

A

1) HHAPPY (hepna, herpes, adeno, pox, parvo, papilloma, plyoma
2) Doubles stranded except parvo
3) Have linear genomes
4) Are icosahedral
5) Replicate in the nucleus

222
Q

What do the following viruses cause?

1) Poxvirus
2) Hepadnavirus
3) Adenovirys
4) Papillomavirus
5) Polyomavirus
6) Parvovirus

A

1) Poxvirus: small pox, molluscum contagiosum (flesh coloured papule)
2) Hepadnavirus: Acute or chronic hepatitis
3) Adenovirus: febirl pharyngitits, pneumonia, conjunctivitis
4) Papillomsvirus: HPV warts
5( Polyomaviurs: leuckoencephalopathy in HIV
6) Parvovirus: Aplastic crisis in sickle cell disease, RBC desturction leading to hydrops fetalis, and rheumatoid arthritis and aplastic anemia in adults.

223
Q

What are the types of herpes virus?

What diseases do they cause?

A

1) Herpes simplex 1: giniovstomatitis, keratoconjuntivitis, can cause sporadic encephalitis
2) Herpes simplex 2: herpes genitalis, remains latent in sacral gaglia
3) Varicella Zoster (chicken box, shingles, encephalitis), latent in dorsal root or trigeminal ganglia
4) Epsetien Barr (kissing disease) mono (heptosplenomegaly and lymphadenopathy), associated with lymphoma, Burkitts and nasopharyngeal lymphoma
5) Cytomegalovirus (Mono) in patients, and causes retinitis inHIV patients
6) Human herpes virus 6 and 7 (Roseola infantum( high fevers with seizures
7) Herpes virus 8: Kaposi sarcoma ( HIV, transplant patients), can affect GI and lungs

224
Q

What is the monospot test?

A

Heterophile antiboddies are detected by agglutination of sheep or horse RBC

225
Q

How is HSV identification done?

A

1) Viral culture for skin/genitilia

2) CSF or PCR for herpes encephalitis

226
Q

Disease for coltivirus?

A

Colorado tick fever

227
Q

Disease for rotavirus?

A

Most common cause of fatal diarrhea in children

228
Q

Disese for norovirus?

A

viral gastroenteritis

229
Q

Diseases for flavivirus?

A

1) HCV
2) Yellow fever
3) Dengue
4) St-Louis encephalitis
5) West nile virus

230
Q

Diseases for togavirus?

A

1) Rubella
2) Eastern equine encephalitis
3) Western equine encephalitis

231
Q

Diseases for reterovirus?

A

1) HIV

2) HTLV

232
Q

Diseases for coronovirus?

A

common cold

233
Q

Disease for orhomyoxovirus?

A

influenzae

234
Q

Disease for paramyxovirus?

A

1) Paraninfluenzae
2) respiratory virus
3) Measles, mumps

235
Q

Disease with Rhabdovirus?

A

Rabies

236
Q

Disease Filovirus?

A

1) Ebola
2) Marburg

Hemorraghic fever

237
Q

Disease arenavirus?

A

1) LCMV (lymphocytic choriomeningitis)

2) Lassa fever

238
Q

Disease Bunyavirus?

A

1) California encephalitis
2) Sandfly/Rift Valley
3) Crimean-Congo hemorraghic fever
4) Hantavirus : hemorraghic fever, pneumonia

239
Q

Disease associated with Rhinovirus?

A

1) Runny nose

2) Acid labile, destroyed by the stomach acid

240
Q

What is the mosquito for yellow fever?

What are the symptoms?

A

1) Aedes mosquito

2) High fever, black vomit, jaunedice

241
Q

What does the rotavirus due to intestinal?

A

1) Villous destruction which leads to atrophy and decreased absorption of Na+ and loss of K+

242
Q

What are the two types of influenza virus?

A

1) Live attenuated vaccine (intra-nasal)

2) Killed vaccine

243
Q

what does the flu shot contain?

A

Viral strains

244
Q

What phenomenon causes pandemics?

A

Genetic / antigenic shift (reassortment of the viral genome)

245
Q

What phenomen causes epidemics?

A

Antigenic drift (compared to SHIFT) for pandemics

246
Q

What are the characteristics of rubella virus?

A

1) Fever
2) Postauricular and lymphadenopathy
3) Arthalgias
4) Starts at the face and trunk and moves outward.

247
Q

What types of diseases does the paramyxovirus cause?

A

1) Mumps
2) Measles
3) Parainfluenza croup (seal like barking)
4) Respiratory tract infection (bronchiolitis and pneumonai)

248
Q

What does croup (acute laryngotracheobronchitis) cause?

A

1) Narrowing of the upper trachea that is seen onx-ray

2) Can have pulsus paradoxus due to airway obstruction

249
Q

What are the clinical sign of rubeola?

A

1) Cough
2) Coryza
3) Conjunctivitis

4) Usually starts with Koplik spots (bright spots on the buccal mucosa) and then followed by maculipapular rash
5) Can cause encephalitis, and giant cell pneumonia

250
Q

What are signs of mumps?

A

1) Paroitis: (swelling of paritid gland..neck)
2) Inflammation of testes
3) Orchitisi

251
Q

What are characteristics of rabies?

A

1) Found in Purkinje cells of cerebellum
2) Long incubation
3) Prophylaxis: wound cleaning and immunization with vaccine
4) Has passive-active immunity

252
Q

What is progression of the disease of rabies?

A

1) Fever, malaise
2) Agitation
3) Photphobia
4) Excessive hypersalivation
5) Paralysis
6) Coma
7) Death

253
Q

Which animals can transmit rabies?

A

1) Bats
2) Raccons
3) Skunks
4) Dogs

254
Q

Hoe does Ebola virus work?

A

1) Targets endothelial cells, phagocytes, heptocytes
2) Incubation is 21 days
3) Flu symptoms, DIC, and hemorrage

255
Q

How is Ebola transmitted?

A

1) Direct contact with bodily fluids, fomits, and primates, and bats

256
Q

How is Ebola treated?

A

Supportive care (isolation)

257
Q

What are signs of hepatitis?

A

Fever
Jaunedice
Increased ALT and AST

258
Q

What is the transmission, incubation, clinical course, prognosis, hepato caricnoma risk, liver biopsy and carrier state of Hep A

A

1) Fecal-oral shellfish transmission
2) Short incubation (only a few weeks)
3) Asymptomatic clinical course
4) Prognosis: good
5) No carcinoma risj
6) Liver biopsy: have heptocyte swelling, infiltation
7) There is no carrier state

259
Q

What is the transmission, incubation, clinical course, prognosis, hepato caricnoma risk, liver biopsy and carrier state of Hep B?

A

1) DNA virus
2) Blood transmission, sexual, and mother to child
3) Long incubation
4) Fever, rash, and may progress to carcinoma
5) Prognosis: most adults have full resolution, minority have chronic infection
6) There is HCC risk
7) Liver biopsy has ground glass appearnace, cytotoxic T cells
8) Carrier state uncommon

260
Q

What is the transmission, incubation, clinical course, prognosis, hepato caricnoma risk, liver biopsy and carrier state of Hepatitis C?

A

1) Primarily after blood transfusion
2) Long incubation
3) May progress to cirrhosis and carcinoma
4) Majority have stable, chronic hep C
5) Have carcinoma risk
6) Liver biospsy: lymphoid aggregates with macrovesicular steatosis
7) Carrier state is common

261
Q

What does Anti-HAV (IgM) and Anti-HAV (IgG) show?

A

1) IgM antibody to HAV, best to detect acute hepatitis A

2) Anti-HAV (IgG) prior HAV infection, or prior vaccination (protects against reinfection)

262
Q

What does HBsAg show?

A

Antigen found on surface of HBV, indicates hepatitis B infection

263
Q

What does Anti-HB show?

A

Antibody to HBsAg, indicates immunity to hepatitis B

264
Q

What does HBcAg show?

A

Antigen associated with core HBV

265
Q

What does Anti-Hbc show?

A

1) Antiody to HBcAg IgM (acute infection)

2) Antibody to HBcAg IgG: prior exposure or chronic infection

266
Q

What does HbeAg show?

A

1) (envelope) secreted by the infected hepatocyte into circulation.
2) Indicates active viral replication

267
Q

What does anti-HBe show?

A

Antibody to HBeAg indicates low transmissbility

268
Q

How is the HIV diagnosis made?

A

1) ELISA (sensitive but high false positive rate RULE OUT)

2) Results are confirmed with Western blot assay (specific, low false positive)

269
Q

For ELISA/Western blot, why are there false negatives in the beginning?

A

1) 1-2 months false positive, because they look for antibodies to the viral proteins
2) Can be falsely negative in first few months
3) Can be falsely + in new born babies (anti gp120 crosses the placenta)

270
Q

What is the criteria for AIDS diagnosis?

A
271
Q

What are the 4 stages of untreated infection?

A

1) Flu-like (acute)
2) Feeling fine (latent) …….during latent phase, virus replicates in lymph
3) Falling count
4) Final crisis

272
Q

What are the results of decreasing CD4 count?

A

1) Reactivation of TB. HSV, shingles
2) Bacterial infection
3) Non-hodgekin’s

273
Q

What are infections associated with CD 4 less then 500?

A

1) Candida albicans (oral thrush)
2) EBV (oral hairy leukoplakia), white plaque on lateral tongue
3) Bartonella (bacillary angiomatosis, neutrophillic
4) HHV-8; kaposi sarcoma
5) Cryptosporidium: diarrhea
6) HPV: squamous cell carcinoma

274
Q

What are infections after CD4

A

1) Dementia
2) JC virus (reactivation) multifocal leukoencephalopathy (signs of demylination)
3) Pneumocystis jirovecii: ground glass opacities

275
Q

What are infections after CD 4

A

1) Apergillos (hemoptysis and pleuritic pain, infiltrates and cavities on chest x-ray)
2) Cryptococcus neoformans: meningitis (encapsulated yeast on india ink stain)
3) Candida albicans:esophalitis (white plaque on endoscoy)
4) CMV: retinitis, esophagitis, colitis, penumoitis, encephalitis (linear ulcers on endoscopy, cotton wool on fundascopy)
5) EBV (B cell lymphoma)
6) Histolasma capsulatuym: fever, weight loss, cough, dyspnea
7) Mycobacterium avium: fever, night sweats
8) Toxoplasma gondii: brain abcess (seen on MRI)

276
Q

What is prion disease? Transmission?

A

1) Prion protien PrPc
2) Transmitted through CNS related tissue or contaminated BSE (varient of CJD)
3) Resistant to sterilizing procedures and standard autoclaving

277
Q

What are the 3 varients of CJD?

A

1) CJD: rapidly progressing demntia (familial)
2) Boivine spongiform encephalopathy: mad cow disease
3) Kuru: acquired prion disease by tribal populations practicing human cannibalsim.

278
Q

What is the normal flora for the following human areas?

1) Skin
2) Nose
3) Oropharynx
4) Dental plaque
5) Colon
6) Vagina

A

1) S. epidermis
2) S epidermis colonized by S.Aureus
3) Oropharynx viridans
4) Dental plaque : S. mutans
5) Colon: B. Fragilis
6) Vagina: lactobacillus

279
Q

What are bugs that cause food poisoning? And where do they come from?

A

1) B cereus: reheated rice,
2) C. Botulinum: improperly canned food toxins, raw honey
3) C. perfringens: reheated meat
4) E Coli: undercooked meat
5) Salmonella: poultry, meath and eggs
6) S. Aureus: meats, mayo, and custard
7) S parahaemolyticu and vulnificus: contaminated seafood.

280
Q

What are the bugs that cause bloody diarrhea? And defining characteristics?

A

1) Cambylobacter: S or comma shaped, growth at 42 degrees
2) E. Histolytica: Protozoan, amebic dysentry, liver abcess
3) Enterohemorraghic E Choli: Causes HUS, Shiga-like
4) Eneroinvasive E choli: traveler’s diarrhea
5) Salmonella: Lactose -, has animal resevoir (poulty and eggs)
6) Shigella: shiga toxin
7) Y. Enterocolitica: day care outbreak, pseudo olympics

281
Q

what are the bacteria responsible for watery diarrhea?

A

1) C. Difficile: pseudomembraneous colitis, caused by antibiotics
2) C perfrinegens: also causes gas gangrene
3) Enterotoxigenic ecoli: Travellers diarreha (heat labelled and heat stabile toxins)
4) Protozoa: Giardia, Cryptosporidium
5) V Cholera: Comma shaped organism, rice watr diarrhea
6) Viruses: Rotavirus, norovirus, adenovirus

282
Q

What are common cause of pneumonia in neonates

A

1) Group B stretococi

2) E Choli

283
Q

Most common cause of pneumonia children 4 weeks o 18 years old?

A

1) RSV virus
2) Mycoplasma
3) C. Trachomatis
4) C. Pneumoniae
5) S penumonaie

284
Q

What are main causes of pneumonae 18-40 years old?

A

1) Mycoplasma
2) C. Pneumonaie
3) S. Pneumonaie

285
Q

What are main causes of pneumonae 40-65 years?

A

1) S. pneumonia
2) H. Influenzae
3) Anaerobes
4) Virus

286
Q

What are main causes of pneumoniae in the elderly?

A

1) S. pneumoniae
2) Influenza virus
3) Anaerobes
4) H. Influenzae

287
Q

Main cause of pneumonia ETOH?

A

1) Klebsiella, anaerobes

288
Q

Main cause of pneumonia IV drug user?

A

1) S. pneumonaie, S. Aureus

289
Q

Main cause of pneumonia Aspiration?

A

1) Anaerobes

290
Q

Main cause of pneumonia atypical?

A

1) Mycoplasma, legionella

291
Q

Main cause in cystic fibrosis?

A

1) Pseudomonas
2) S. aureus
3) S. pneumonaie

292
Q

Main cause of pneumonia in immunocompromised?

A

1) S. Aurus

2) Gram -

293
Q

Main cause of pneumonia in hospitalized?

A

1) S. Aureus

2) Pseudomonas, gram -

294
Q

Main cause of post viral pneumonia?

A

1) S. Pneumonia

2) S. Aureus

295
Q

Cause of meningitis newborn?

A

1) Strep B
2) E choli
3) Listeria

296
Q

Mengitis 6 months-6 years?

A

1) S. Pneumonia
2) N. Meningitiidis
3) H. Influenzae

297
Q

Meningtitis: 6- 60 years old

A

1) S. penumonaia

2) N meningitidis (#1 in teens)

298
Q

Meniningitis in 60 year olds and older?

A

1) S. pneumoniae

299
Q

What is the emperical treatment for the meningitis?

A

1) Ceftriaxone and vanco

2) If suspect literia : add ampicilline

300
Q

What are the viral cause of meningitis?

A

1) enterovirus (coxsackie virus)

301
Q

What are the findings in CSF?

A

Opening pressure Cell type Protein Sugar
Bact. high incre PMN Increase dec
Fungal high inc. lymhocyte inc. dec
Viral normal inc. lymphp incre normal

302
Q

What are infections that cause brain abcesses?

A

1) Strep viridens

2) Staph aureus

303
Q

what are common pathways from the brain abcess?

A

Otitis media— to mastoiditis —– temporal cerebellum

OR:

Dental infection—frontal lobe

304
Q

Most common cause of osteomyelitis?

A

Most common: S. Aureus

305
Q

Cause ostromyelitis if sexually active?

A

Nesseria gonorrheae

306
Q

Cause osteomyltis if sickle cell disease?

A

Salmonell and S. Aureus

307
Q

Cause osteomyelitis if prosthetic joint replacement?

A

S. Aurues

S. Epidermis

308
Q

Cause osteomyletis if vertebral involved?

A

S. Aureus

309
Q

Cause osteomyelitis if cat/dog bites?

A

Pasteurella multicida

310
Q

Osteomyletis if IV drug abuse?

A

Pseudomonas, Candida

311
Q

What are some clinical signs of osteomyletitis?

A

1) Elevated CRP and ESR
2) MRI
3) x ray good for chronic osteo but not acute.

312
Q

What are risks for UTI?

A

1) women have shorter urethera
2) Kidney surgery
3) GU malformation
4) Diabetes
5) Pregnancy

313
Q

What dipstick tests show the presence of UTI?

A

1) Leucocyte esterase
2) Nitrite positive
3) Urease test

314
Q

What are common bugs causing UTI, what characteristics do they have?

A

1) E choli: green on EMB agar
2) Staphulococcus saprophyticus: second cause in women
3) Klebsiella pneumonaie: large mucoid capsules
4) Serratia Marceans: Red pigment, and often resistant
5) Enterococcus: nosocomial and drug resistant
6) Proteus mirabilis: swarming on agar
7) Pseudomonas: blue green, and fruity. Nosocimal and drug resistant

315
Q

Symptoms, labs, treatment of vaginosis?

A

1) Thin white discharge with fishy odor
2) Clue cells with pH > 4. 5
3) Metronidazole

316
Q

Symptoms, labs, treatment of trichomonas vaginitis?

A

1) Strawberry cervix
2) Mobile trichomonads
3) Ph > 4.5
4) Metronidazole (and treat sexual partners)

317
Q

Symptoms, labs, treatment of candida vulvaginitis?

A

1) Inflammation + cottage cheese discharge
2) Pseudohyphe ph 4.0-4.5
3) Treatment: azoles.

318
Q

What are TORCHES infections?

A

1) Microbes passed on from mother to fetus
2) Transplacental
3) Toxoplasma gondii, Rubella, Cytomegalovirus, HIV, Herpes Simplex Virus 2, Syphilis

319
Q

What are the viruses responsible for rashes in children?

A

1) Coxsakievirus (Hand-foot-mouth disease)
2) Human herpesvirus 6 (Roseola exanthem subitum)
3) Measles virus (Measles rubeola)
4) Parvovirus b19: erythema infectiosum
5) Rubella virus (rubella)
6) Streptococcus pyrogenes: Scarlet fever
7) Varicelle Zoster: Chicken pox

320
Q

What is the clinical presentation of Coxsakie?

A

Oval shaped vesicles on palms and soles (vesicles and ulcers in the oral mucosa)

321
Q

What is clinical presentation of human herpesvirus 6?

A

Rose colored macules appear on the body after several days of high fever (can have febrile seizures)

322
Q

What are characteristics of meseles virus?

A

1) Have a rash starting at the head

2) Koplik spots on the mucosa

323
Q

What are the characteristics of parvovirus B19?

A

1) Slapped cheek rash on the face

2) Hydrops fetalis in pregnent women

324
Q

What are the characteristics of rubella?

A

1) Pink macules at the head and then move down
2) Fine desquamating truncal rash
3) Post auricular lymphadenopathy

325
Q

What are streptococcus pyogenes?

A

1) Sandpaper like rash

2) Fever and sore throat.

326
Q

What does the varicella zoster virus clinical?

A

1) Vesicular rash on the trunk

2) Spreads to the extremities

327
Q

What are clinical features of HIV?

A

1) Opportunistic infections
2) Kaposi sarcoma
3) Lymphoma

328
Q

Clinical features of Chancroid?

A

1) Genital ulcer with exudate

2) Inguinal adenopathy

329
Q

Clinical features of chlamydia?

A

1) Uretitis
2) Cervicitis
3) Epididymitis
4) Conjunctivitis

330
Q

Clinical features of condylomata acuminata?

A

1) Genital warts, koilocytes

2) Organizime: HPV-6 and 11

331
Q

Clinical features of genital herpes?

A

Painful penile, vulvar, or cervical vesicles and ulcers. Can cause systemic symptoms such as fever, headache, mylagia

332
Q

Clinical features of gonorrhea?

A

1) Urethritis, cervivitis, epididymitis, conjunctivitis, reactive arthritis
2) Caused by Chylamydia trachomatis

333
Q

Clinical features of hepatitis B?

A

1) Jaunedice

334
Q

Clinical features of lymphogranuloma venereum?

A

1) Infection of lymphatics
2) Painless genital ulcers
3) Painful lymphadenopathy

335
Q

What are the clinical of primary syphilis?

A

Painless chancre

336
Q

What are clinical signs of secondary syphilis?

A

Fever, lympadenopathy, skin rash

337
Q

what are clinical signs of secondary syphilis ?

A

1) Fever
2) Lymphadenopathy
3) Skin rashes

338
Q

Clinical signs of tertiary syphilis ?

A

1) Gummas
2) Tabes dorsalis
3) General paresis

339
Q

What is the Fitz-High Curtis syndrome?

A

1) Infection of the liver capsule and violin string

340
Q

What are the main nosocimial infections?

A

E Coli and Staph aureus (wound infection)

341
Q

Main bugs associated with aspiration?

A

Polymicrobial

Gram negative

342
Q

Bug associated with surgical wounds and decubitus ulcer?

A

S. Aureus

343
Q

Infection of catheter?

A

S. Aureus

344
Q

Pneumonia after endothracheal intubation ?

A

1) Pseudonomas aeruginsosa, Klebsiella

345
Q

What are clinical features of legionella?

A

1) Signs of pneumonia
2) GI symptoms
3) Neurological abnormalities

346
Q

Which bugs affect unvaccinated children?

A

Rubella, and Measles

347
Q

Which bug causes epiglottis and pharyngitis?

A

1) H. influenzae

2) Cornyebacterium diphtheriae

348
Q

What bugs affect asplenic patients?

A

SHIN
S. pneumonae
H. influenzae
N meningitis

349
Q

What has branching rods in oral infections? and sulfur granules?

A

actinomyces

350
Q

BUg for chronic granulomatous disease?

A

Catalase microbes

351
Q

Bug for currant jelly sputam?

A

Klebsiella

352
Q

What are dog or cat bite bugs?

A

Pasterlle multicoida

353
Q

What are causes for facial nerve palsy?

A

Borrelia burgdorferi

354
Q

Bug for fungal infection in diabetic?

A

Mucoror Rhizopus

355
Q

Bugs associated with neutropenic patients?

A

Candida albicans

356
Q

Bugs associated with organ transplant ?

A

CMV

357
Q

Bugs associated with clostridium perfringens?

A

Clostridium perfringens

358
Q

What are categories of penicillin?

A

1) Pen G (IV and IM form), and pen V (oral)

359
Q

What is the clinical use of penicillin?

A

1) Usually gram +

2) Gram - cocci (N. meningitidis)

360
Q

What are the adverse effects of Penicillin?

A

1) Hypersentitivty reactions
2) Direct coombs +
3) Hemolytic anemia

361
Q

How is resistence to penicillin occur?

A

Penicillinase in bacteria (B-lactamase destroyed)

362
Q

What are examples of penicillinase-sensitive penicillins?

A

1) Amoxcillin
2) Ampicllin
3) Aminopenincillines

363
Q

what is the difference between penicillinase-sensitive penicillins?

A

They have a wider spectrum.

Combine with Clavulanic acid to protect against destruction of B-lactamase

364
Q

What are the clinical use of amped-up penicillins?

A

1) H. Influenzae
2) H. Pylori
3) e. Coli
4) Listeria monocytogens
5) Proteus mirabilis
6) Salmonella
7) Shigella
8) Enterococci

365
Q

What are the adverse effects of amped-up penincillinase ?

A

1) Hypersensitivity

2) Pseudomembraneous colitis

366
Q

What is penicillinase?

A

1) Produce by the bacteria and cleves the B lactam ring, which renders the penicillin useless

367
Q

What are penicillinase resistant penicillins?

A

1) Dicloxacillin
2) Nafcillin
3) Oxacillin

368
Q

Which are the penicillinase-resistant penicillin used for?

A

S. Aureus except for MRSA resistant

369
Q

What is the spectrum of penicillinase resistant penicillin?

A

More narrow then regular penicillin

370
Q

What are possible reactions to penicillinase-resistant penicillins?

A

1) Hypersensitivity

2) Interstitial Nephritis

371
Q

What are the antipseudomonal penicillins?

A

1) Piperacillin

2) Ticarcillin

372
Q

What are anti-pseudomonal penicillins used for?

A

Pseudomonas and gram -

373
Q

What are B-lactamase inhibitors?

A

1) Clavulanic acid
2) Tazobactam
3) Sulbactam

374
Q

What is the mechanism of cephalopsporins?

A

B-lactam drugs that inhibit cell wall synthesis

375
Q

Which organisms are covered by cephalosporins?

A 
1) LAME 
Listeria
Atypicals (chlamydia)
Mycoplasma
MRSA (5th generation) 
Enterococci
376
Q

What are examples of 1st, 2nd, 3rd, 4th and 5th generation cephalosporin?

A

1) Cephalexin, Cefazolin (Proteus,E Coli, Klebsiella)
2) Cefacir, Cefoxtin, Cefuroxime: Gram + cocci (H. Influenzae, Enterpbacter, Neisseria, Serratia)
3) Ceftraixone, Cefotaxime, Ceftazidine: gram -
4) Cefepime: gram -
5) Ceftaroline: Broad gram + (MRSA) but NOT pseudomonas

377
Q

What are the adverse effects of cepahlosporins?

A

1) Hypersensitivity
2) Autoimmune anemia
3) Dislfiriam-like reasction
4) Vitamin K deficiency
5) Nephortoxicity

378
Q

What are examples of carbopenems?

A

1) Imipenem, meopenem, ertapenem, doripenem.

379
Q

What compound is the imipenem adminstered with?

A

Cilastin, to prevent inactivation of the drug in the renal tubules

380
Q

What is an example of Monobactams?

A

Aztreonam

381
Q

What is specific about Monobactams?

A

1) No crosssensitivity to penicilline
2) Less susceptible to B-lactamases.
3) Only acts on gram - NOT grams +

382
Q

Side effects of Monobactams?

A

1) Occasional GI upset.

383
Q

What is the property of vancomycin?

A

1) Inhibits cell wall peptidogycan formation

2) Not susceptible to B-lactamases

384
Q

What are the clinical uses of vancomycin?

A

Gram + bugs only (serious, multi drug resistance)

MRSA, S epidermis, enterococcus, C.Dif

385
Q

What are side effects associated with vancomycin?

A

1) Nephrotoxicity
2) Ototoxicity
3) Thrombophlebitis
4) Flushing- red man syndrome

386
Q

What are examples of aminoglycosides?

A

1) Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

387
Q

What is the mechanism of aminoglycosides?

A

Inhibitiono of RNA, blocks transolcation.

388
Q

What are the uses for the aminoglycosides?

A

Gram - infections

Synergistoc B-lactam

389
Q

What are the side effects of aminoglycosides?

A

1) Nephrotoxicity
2) Neurotoxicity
3) Ototoxicity
4) Teratogen

390
Q

What are some examples of tetracyclines?

A

1) Tetracycline
2) Doxycycline
3) Minocycline

391
Q

What conditions are treated by tetracyclines?

A

1) Borrelia burgdorfei

2) M. Pneumoniae

392
Q

What are side effects of tetracyclines?

A

1) GI distress
2) Discolartion of teeth
3) Photosensitivity
4) Contraindicated in pregnancy

393
Q

What is chloramphenicol uses?

A

1) Meningitis treatment (H. Influenzae, N. Meninigitis, Strep Pneumonae.

394
Q

What are some adverse effects?

A

1) Anemia (dose dependent)

2) Aplastic anemia

395
Q

What are mechanisms of Clindamycin?

A

Block translocation of ribosomal subunit

396
Q

What are the uses of Clindamycin?

A 
Anaerobic infections (Clostridium perfringens) 
Aspiration pneumonia 
Lung abcess
Oral infections 
Strep A
397
Q

What are side effects on clindamycin?

A

Pseudomonas colitis
Fever
Diarrhea

398
Q

What are oxazolidinones?

A

Linezolids

399
Q

What is the use for linezolid?

A

Gram + including MRSA and VRE

400
Q

What are examples of macrolides?

A

1) Azithromycin
2) Clarithormycin
3) Erythromycin

401
Q

What are the clinical uses of macrolides?

A

1) Mycoplasma
2) Chlamydia
3) Legionella

402
Q

What are the adverse effects of macrolides?

A

GI motility
Arrythmia due to long QT syndrome
Rash
Eosinophilia

403
Q

What are sulfonamides?

A

Sulfamethoxazole (SMX)

404
Q

What are the bacteria it is used for?

A

Gram + and gram - (No cardia, Chlmydia) SMX for UTI

405
Q

What are side effects of sulfonamides?

A

1) Nephrotoxicity
2) Photosensitivty
3) Kernicterus

406
Q

What to use Dapsone for?

A

Similar to sulfonamides but structurally distinct

Used for leprosy

407
Q

What is trimethorpim for?

A

Used in combination with TMP-SMX

1) Shigella
2) Salmonella
3) Pneumocyctis jiroveceii

408
Q

What are side effects of Trimethorpim?

A

1) Megaloblastic anemia
2) Leulopenia
3) Granulocytopenia
* TMP treats marrow poorly*

409
Q

What are examples of fluroquinones?

A

1) Cipro
2) Norfloxacin
3) Levofloxacin
4) Ofloxacin

410
Q

What are the clinical uses of fluoroquinones?

A

1) Gram - rods for urinary

2) Psuedomonas

411
Q

What are the adverse effects of fluroquinones?

A

1) GI upset
2) Skin rashes
3) Myalgias
4) Not for pregenent women
5) May prolong QT interval

412
Q

What are the diseases treated by metronidazle?

A

1) Giardia
2) Entamoeba
3) Trichomonas

413
Q

What drugs are used to treat tuberculosis?

A

1) M. Tuberculosis: rifampin, isoniazid, Pyraziminde, Ethambutol

414
Q

What is used to treat M. Avium-intracellulaire?

A

Azithromycin, rifabutin

415
Q

What is used to treat M. Leprae?

A

1) Rifampin if tuberculoid form

2) Clofaszimine for lepromatous form.

416
Q

What are examples of rifamycins?

A

1) Rifampin, rifabutin

417
Q

What are the clinical uses of rifamycins?

A

1) M. Tuberculosis: delay resistance of dapson when used with leprosy
2) Used for meningococcal prohylaxis and chemoprophylaxis with H. Influenzae

418
Q

What are the 4 R’s of Rifampin?

A

1) RNA polymerase
2) Red/orange body fluids
3) Rapidresistance if used alone

419
Q

What are the adverse effects of rifampin?

A

1) Hepatotoxicity
2) Orange body fluids
3) Rifabutin over rifampin isbetter for HIV infection.

420
Q

What is the isoniazid used to treat?

A

1) TB (solo prophylaxis or monotherapy to treat)

421
Q

What are the sideffects of isoniazid?

A

1) Hepatoxicity
2) Drug induced SLE
3) Vitamin B deficiency
GIVE pyridoxine B6

422
Q

What is Pyrazinamide used for?

A

1) Mycobacterium tuberculosis

423
Q

What are side effects of pyrazinamide?

A

1) Hyperuricemia

2) Hepatoxicity

424
Q

What is ethambutol used for?

A

Mycobacterium tuberculosis

425
Q

What are adverse effect of ethambutol?

A

Optic neuropathy

426
Q

What are the adverse effects of streptomycin?

A

1) Tnnitus
2) Vertigo
3) Ataxia
4) Nephorttoxicity

427
Q

What is the prophylaxis for endocarditis?

A

Amoxacillin

428
Q

Prophylaxis for gonorrhea?

A

Ceftriaxone

429
Q

Prophylaxis for reccurent UTI?

A

TMP-SMX

430
Q

Prohpylaxis for meningococcal infection ?

A

Ceftriaxone, cirpofloxacin, rifampin

431
Q

Prophylaxis for pregnent woman carrying group B strep ?

A

1)Penicillin G or ampicillin

432
Q

Prevention gonoccal conjuntivitis in newborn?

A

erythromycin ointment on the eyes

433
Q

What to do about post surgical infection due to S aureus?

A

Cefazolin

434
Q

Prohylaxis for strep pharyngitis prior rheumatic fever?

A

Pen G or oral Pen V

435
Q

Exposure to syphilis?

A

Pen G

436
Q

When to do prophylaxis for HIV?

A

1) CD4

437
Q

What is treament of MRSA?

A

1) Vancomycin
2) Linezoid
3) Tigecycline
4) ceftraoline

438
Q

Treatement of VRE?

A

1) Linezolid, steptogramins

439
Q

Treament of multi drug resistant P. Aeruginosa?

A

1) Polymyxins B

2p[-=) Colistins

440
Q

What are cellular mechanisms of antifungal therapy?

A

1) Lanosterol synthesis: terbinafine
2) Ergisterol syntheis:
Clotrimazole
Flucanozole
Itracanazole
Ketoconazole
Miconazole
Voricanozole

3) Cell wall synthesis:
Anidulafungins
Caspofungin
Micafungin

4) Nucleic acid synthesis
flycytosine

441
Q

When should amphotericin be used? Sideeffects?

A

1) Serious, systemic mycosis
2) Side-effects ares: K+ Nad MG decreased
3) Fever and chills
4) Hypotension
5) Nephortoxicity

442
Q

When is nystatin used?

A

Topical only

swish and swallow (oral, or vaginal )

443
Q

When is flucytosine used? Side-effects

A

1) Systemic infection (fungus) cryptococcus

444
Q

What are examples of azoles? What are they used for? Sideeffects?

A

1) Clotrimazole, flucanozole, itaraconazole, voricanazole
2) For local and less systemic mycoses
3) Chronic suppression of cryptococcal meningitis in AIDS patients with candidal infections
4) Sideeffects include gynecomastia, and liver dysfunction

445
Q

What is terbinafine used for? What are the sideeffects?

A

1) Onchymosis (fungal infection of finger or toe nails)

2) Adverse effects include GI upset, hepatotoxicity, taste disturbance.

446
Q

When are echinocandins used? What are the sideeffects?

A

1) Examples include anidulafungin, caspofungin, micafungin
2) Treat invasive aspergillos
2) GI upset, flushing (histamine release)

447
Q

What are examples of grisofulvin?

A

1) They interfere with microtuble function and disrupt mitosis
2) Superficial infections and inhibits growth of dermatophytes
3) What are the adverse effects: teratogenic, carcinogenic, confusion and headaches.

448
Q

What is used to treat mite and louse? What are the side effects?

A

1) Permethrin, Malathion, Lindane

2) Neurotoxicity

449
Q

What is chloroquine used to treat?

A

1) Plasmodium falciparum (by blocking detoxification of heme) heme is toxic to plasmodia
2) Sideeffects include retinopathy,purtis

450
Q

What is antihelminthic therapy?

A

1) Mebendazole (microtibule inhibitor)

451
Q

What is used to treat influenzae A and B?

A

1) Oseltamivir

2) Zanamivir

452
Q

What is used to treat HSV and VZV? What are the side effects of these drugs?

A

1) Acyclovir, famiciclovir, valacylovir

2) Nephropathy

453
Q

What is used to treat CMV? what are the sidffects

A

1) Ganiciclovir

2) Adverse effects: leukopenia, neutropenia, and thrombocytopenia

454
Q

What is foscarnet used to treat? And side effects?

A

1) DNA and RNA polymerase inhibitos
2) Used to treat CMV retinitis in immunocompomised patients (HIV)
3) Sideffects include nephortoxicity, electrolyte abnormalities

455
Q

What is Cidofovir used to treat? what are the adverse effects?

A

1) CMV retinitis in immunocompromised patients
2) Long half life
3) Adverse effects include nephrotoxicity

456
Q

When is HIV therapy started?

A

1) At the time of HIV diagnosisn

2) Strongest indication is for patients with AIDS defining illness (Low CD4+ cell count

457
Q

What are examples of NRTI? What are they used for? What are side effects?

A

1) Abacavir (ABC)
2) Didanosine (ddl)
3) Emtricitabine (FTC)
4) Lamivudine (3TC)
5) Stavudine (d4t)
6) Tenofovir (TDF)
7) Zidovudine

Used as of the triple therapy for HIV

458
Q

What are examples of NNRTI? what are the side effects?

A

1) Delavirdine
2) Efavirenz
3) Nevirapine

Bind reverse transcriptase at site different from NRTI

4) Can cause rash and heptatoxicity

459
Q

What are protease inhibitors? what are they used to treat? What are the sideeffects?

A

1) Atazanavir
2) Darunavir
3) Fosamprenavir
4) Indinavir
5) Lopinavir
6) Ritonavir
7) Saquinavir

Sideeffects: nephropathy

460
Q

What are integrase inhibitors? what is it used to treat? What are the sideffects?

A

1) Raltegravir
2) Elvitegravir
3) Dolutegravir

4) For HIV
5) Will increase the creatine kinase

461
Q

What are the fusion inhibitors?

A

1) Enfuvirtide
2) Maraviroc

Can cause skin reaction at the injection site

462
Q

What are interferons? what are they used to treat?

A

1) Have antiviral and anti-tumor properties
2) IFN - alpha chronic hepatits B and hepatitis C
3) IFN B: multiple sclerosis
4) IFN- gamma: Chronic granulomatous disease

463
Q

What are the treatments for Hepatitis C therapy?

A

1) Ribavirin: inhibits synthesis of guanine nucleotides
2) Sofosbuvir
3) Simeprevir

464
Q

What is autoclave?

A

Steam at > 120 degrees C, may be sporicidal

465
Q

What do alcohols do for infection control?

A

Denature proteins and disrypt cell membranes (not sporicidal)

466
Q

What does chlorhexidine do?

A

1) Denautre proteins, and disrupts cell membranes. Not sporicidal

467
Q

What are antimicrobials to avoid during pregnancy?

A

1) Sulfonamides: kernicterus
2) Aminoglycosides: ottotoxicity
3) Fluoroquinlones: cartilage damage
4) Clarithromycin: embryotoxic
5) Tetracycline: discolored teeth, inhibition of bone growth
6) Ribavirin: teratogenic
7) Grisoflulvin: teratogenic
8) Chloramphenicol: gray baby

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