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Professional Development > Part 10 > Flashcards

Part 10 Flashcards

1
Q

Amphotericine B mechanism of action

A

Bind ergosterol and disrupt fungal cell membrane by making it leak intracellular content especially K+

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2
Q

Azoles mech of action and ADR’s

A

Inhibit synthesis of ergosterol disrupting fungal cell wall, inhibit hepatic p450 enzyme increasing serum concentration of other drugs

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3
Q

echinocandin drugs (3) and their MOA and use

A
  • anidulafungin
  • caspofungin
  • microfungin
    disrupt cell wall, used in IV for invasive aspergillosis and candida
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4
Q

Herpesvirus group and ones there is treatment for

A
  • Herpes simplex
  • Varicella zoster
  • cytomegalovirus
  • epstein barr (no treatment)
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5
Q

Acyclovir

A

Agent of choice for herpes symplex and varicella zoster virus functions to inhibit viral DNA poly and incorporate into strand of viral DNA blocking further growth through cell conversion into acyclo-GMP

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6
Q

valacyclovir use and ADR (rare) and advantage of acyclovir

A

More popular prodrug form of acyclovir, approved for PO therapy in immunocompetent host, can cause thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) in very immunocompromised hosts, advantage is dosing is less often (2x per day opposed to 5 for acyclovir

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7
Q

Docosanol

A

OTC treatment for herpes labialis, inhibits fusion btwn plasma membrane and viral envelope increasing healing with first sign of coldsore

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8
Q

Ganciclovir and the prodrug version valgancyclovir that can be used oral has use against what?

A

cytomegaolvirus,particularly CMV retinitis

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9
Q

Direct acting antivriral drugs (DAAs)

A

Target specific steps in HCV replication without damage to healthy cells, often used in combination to decrease viral resistance

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10
Q

Triple therapy regimen

A

Original standard of care for HepC until DAA development, includes pegylated interferon alfa (notorious for causing damage to host cell), protease inhibitor, and ribavirin

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11
Q

Unlike Hep C, for Hep B and A we have a preventative …

A

..vaccine

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12
Q

Neuraminidase Inhibitors and most common example and how soon does this need to be started

A

Modestly suppress influenza A AND B, prophylacitc and treatment, oseltamivir, within 48 hours

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13
Q

amantadine and rimantidine MOA and function

A

dopaminergic agonist and noncompetitive NDMA antagonist, and antagonistm against release of viral injection of material by influenza A but most have resistance now, indicated for drug induced parkinsonism, tardive dyskinesthia, and parkinsons

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14
Q

HART therapy for HIV can be hard on this drug metabolizing system

A

cytochrome p450 causing toxicity with other drugs

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15
Q

Gram + cocci catalase test results

A

Positive is staph, negative is strep

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16
Q

Gram + cocci coagulase test results

A

Positive is staph aureus, negative is staph epidermidis

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17
Q

Localized staph aureus infections with systemic effects (2)

A
  • Scalded skin syndrome
  • toxic shock syndrome
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18
Q

MRSA outpatient options (3) and inpatient treatment

A

Outpatient - clindamycin, bactrim, doxycycline
inpatient - vancomycin

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19
Q

Staph saprophyticus is a common cause of this….

A

….UTIs in young women

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20
Q

S. pyogenes common localized infections

A

Impetigo (not as common as with s. aureus), necrotizing fasciitis, gangrene, erysipelas

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21
Q

S. pyogenes common invasive infections

A 
Bacterial pharyngitis
Scarlett fever
throat abscesses
Rheumatic fever
Glomerulonephritis
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22
Q

S. agalactiae medical significance

A

Group B B hemolytic strep number one cause of death in newborns causing neonatial sepsis and postpartum infections, rarely adult infections

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23
Q

Strep pneumoniae common invasive infections

A

Pneumonia, ottitis media, sinusitis, meningitis

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24
Q

Strep viridans is known to be a causative agent of these 2 things…

A

Bacterial endocarditis and dental caries

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25
Q

Treatment option for VRE

A

Linezolid

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26
Q

Clostridium perfringens

A

Often source of wound and surgical infections that lead to gas gangrene

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27
Q

Corynebacterium diptheriae shape

A

Club or V shaped gives distinct appearance

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28
Q

Diptheria causes these symptoms (1 key one)

A

Upper respiratory tract illness characterized by fever, sore throat, and adherent membrane (key) on tonsils, pharynx, or nose

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29
Q

Endotoxin

A

Derived from the LPS protein layer on the outermost membrane of gram - organisms, released upon cell death to cause malaise but rarely fatal

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30
Q

Exotoxin

A

Substances released by living bacterium, can cause major damage to host and are fatal in large quantities

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31
Q

3 common features of hemolytic uremic syndrome

A
  • Hemolysis
  • Thrombocytopenia
  • Renal failure
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32
Q

Campylobacter

A

Leading cause of bacterial gastroenteritis, birds and poultry often reservoirs

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33
Q

Campylobacter treatment

A

Often preventative, disease self limiting

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34
Q

Vibrio cholerae infection

A

Secretory diarrhea from cholera toxin 24hrsr after -3 days , can cause rice stools with fishy odor, can kill within 6-12 hours of dehydration

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35
Q

Salmonellosis presentation and treatment

A

sometimes bloody diarrhea, fever, crmaps
Avoid antibiotics (highly resistant, unless bacteremia), avoid anti-diarrheal agents, supportive therapy

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36
Q

Typhoid fever presentation and causative agent

A

Incubation for 8-14 days, sustained high fever, chills, some develop rose spots, salmonella typhi

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37
Q

Shigellosis

A

Humans are only reservoir, spread fecal oral, common cause of bacterial gastroenteritis, highly contageous, bloody watery diarrhea, abdominal pain, tenesmus, self limiting

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38
Q

Klebsiella pneumoniae

A

Most healthy people do not get sick, can be nosocomial in a compromised immune system, part of normal flora, sometimes I see this in elderly UTI

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39
Q

Klebsiella pneumonia classic presentation

A

Thick purulent mucoid sputum (currant jelly), lung abscesses, acute cholangitis

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40
Q

Triad for acute cholangitis

A

fever, upper right quadrant abdominal pain, jaundice

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41
Q

Pseudomonas aeruginosa

A

Opportunistic, nosocomial often infection can also infect hot tubs or ears in healthy, highly virulent, has fruity grape odor

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42
Q

Legionella pneumophilia

A

Derived from stagnate man made water sources such as air cooling system in legionnaire convention, not contageous person to person, most common atypical pneumonia

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43
Q

Haemophilus 4 species

A

Haemophilus influenza A or B, ducreyi, haemolyticus

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44
Q

Haemophilus ducreyi classic disease caused

A

Chancroid forming, genital ulcer disease

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45
Q

Fitz hugh - curtis syndrome

A

Rare disease found almost exclusively in women, inflammation of membrane lining stomach and the tissues surrounding the liver sequealae from untreated pelvic inflammatory disease by gonorrhea or chlamydia

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46
Q

Niesseria meningitidis drug of choice

A

Vancomycin

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47
Q

Ascariasis presentation

A

Often asymptomatic disease following roundworm infection, abdominal cramping, dry cough, or seeing worm in stool are possibilities, can lead to obstruction of bowels follwoing roundworm (ascaris lumbricoides) infection

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48
Q

Ascariasis/necator amerricanus/enterobius vermicularis treatment options (3)

A

Mebendazole, pyrantel pamoate, albendazole

49
Q

Necator americanus causes what infection and course

A

Hookworm, 2nd most common helminth infection, buries thru skin in foot and then lays eggs in intestine causing bloody diarrhea, iron deficiency

50
Q

Trichinella spiralis source and disease course, diagnosis

A

Most often found in undercooked pork, enter into skeletal muscle and form spiral growths, manifests as muscle aches, fever, and abdominal pain, serum CK for muscle breakdown but muscle biopsy definitive

51
Q

Enterobius vermicularis disease course and diagnosis

A

Pinworm, unique in that it does NOT cause eosinophilia, often females lay eggs in anus at night causing itching in the evening, fecal oral or clothing food route… Scotchtape test - on anus in the morning, tape to a slide and bring in to look for eggs

52
Q

Wuchereria bancrofti disease course

A

Cause of filarial fever, sequelae elephantitis, transmitted via mosquito, causes eosinophilia, resides in lymphatic system

53
Q

Schistosomiasis diseae course

A

Blood fluke flat worm infection, egg passes from feces into fresh water, hatch and infect snails as host, leave and penetrate humans in water to mature and lay eggs

54
Q

Schistosomiasis treatmnet

A

Praziquantal for most

55
Q

Taenia solium

A

Tapeworms, can cause bloating, abdominal pain and diarrhea, intestinal obstruction, occasionally results in cysticercosis

56
Q

Taenia solium treatmneet

A

Praziquantal or niclosamide, surgery, albendazole or mebendazole

57
Q

Giardia lamblia disease course, treatment of choice

A

Flagellated protozoan, causes traveler’s diarrhea, waterborne, spread via person to person contact, diarrhea, bloating, distension, treatment of choice is metronidazole

58
Q

Pediuclosis and treatment

A

Body lice, permethrin cream

59
Q

Scabies course and treatment

A

Intense itching and rash with tunnel like course often in the folds of skin or interdigital webs, treatment is permethrin cream, crotamiton cream, and lindane cream

60
Q

4 stages of T. pallidum infection

A

Primary syphilis - painless chancre typically on genitals 10-90 days after exposure that disappears after 6 weeks
Secondary - rash and eruptions maculopapular rash on palms and feet, wart like lesions condyloma lata
Latent - seropositive but symptom negative
Tertiary - vascular and neurologic manifestations gummatous or neuro

61
Q

DOC for primary and 2ndary syphilis vs tertiary

A

PCN G vs aqueous crystiline PCN

62
Q

Borrelia burgdorferi

A

Causative agent of lyme disease, carried by tick bite, causes erythema chronicum migrans in early stage (bullseye rash)

63
Q

name 2 common spirochete infections

A

syphilis and lyme disease

64
Q

3 stages of lyme disease

A

Early stage - localized bullseye rash (erythema chronoicum migrans)
Disseminated stage - skin lesions, CNS facial nerve deficits
Late stage - persistent infection, rarely progresses to worse

65
Q

Lyme disease treatmnet options (2)

A

Doxycycline, amoxicillin, no preventative vaccine

66
Q

3 phases of TB

A

Primary - active symptoms, abnormal chest x ray and positive sputum smear, middle loung
Latent - no symptoms not contageous, positive PPD read
Reactivated - macrophages housing mycobacterium as reservoir allow for reactivation, immunocompetent low chance of reactivation, seen in upper lobes

67
Q

Primary TB is seen in the ___ lobe but reactivated in the ____

A

Middle lung, upper lung

68
Q

Miliary Tb

A

Widespread Tb that looks like a snowstorm on the x ray

69
Q

Langhans giant cells

A

recruited by macrophages in the lungs to engulf Tb and form a necrotic mass

70
Q

Ghon lesion

A

Necrotic mass of Tb, macrophages, and langhans giant cells on the lung tissue

71
Q

Ghon complex

A

Presence of a ghon lesion with lymphoadenopathy on the same side

72
Q

Ranke complex

A

Presence of a ghon lesion that has been calcified with lymphoadenopathy on same side

73
Q

TB transmission

A

Tiny droplets from one with active TB to another individual

74
Q

TB and HIV

A

TB is most commonc cause of death in patients with AIDS, AIDS patients won’t get positive ppd even if have active TB infection

75
Q

3 types of TB

A

Pulmonary - dry cough, fever
Extrapulmonary - other organs, pott’s disease
Miliary - disseminated

76
Q

Pott’s disease

A

Skeletal muscle disorder for spinal TB where a child comes in limping with a curve like scholiosis

77
Q

different methods of TB testing

A

PPD test can screen for exposure (induration diameter NOT redness), chest x ray, 3 sputum samples , quanti-feron tests, culturing still gold standard, AFB smear - positive for all mycobacterium

78
Q

Booster phenomenon of PPD

A

In 2 step ppd if 1st test is negative but 2nd is positive

79
Q

Quanti-feron test

A

Blood test specific and sensitive for TB done in a single visit with results available in 24 hours avoiding booster effect and prior BCG vaccination, but expensive, and low data

80
Q

Mycobacterium leprae

A

Hansen’s disease, spread exact same way as Tb via droplets, can treat contagiousness but not deformities, comes in 2 major forms tuberculoid impacting NS and lepromatous of the skin

81
Q

Mycobacterium avium

A

AIDS defining illness, nontuberculus mycobacteria that naturaly occur everywhere, opportunistic

82
Q

all mycobacterial infections require…

A

…multidrug therapy

83
Q

Dermatophytes definition

A

Include tinea (ringworms) capitus - head, barbe - beard, corperus - body, pedis - feet

84
Q

Dermatophytes diagnosis

A

KOH skin scrapings, wood’s light, culture

85
Q

Retroviruses

A

Class of RNA viruses that can produce double stranded DNA copies of their genome and then integrate into the chromosome of the host cell using reverse transcriptase, key example being HIV

86
Q

Influenza is what type of virus?

A

RNA virus

87
Q

Coronavirus is what type of virus?

A

RNA virus

88
Q

Rhinovirus is the most common cause of what…

A

Most common cause of common cold

89
Q

Rhinovirus is what type of virus?

A

RNA virus

90
Q

Adenovirus is what type of virus?

A

DNA virus

91
Q

Adenovirus symptoms

A

URI (it is considered in that class), conjunctivitis, GI symptoms

92
Q

Parainfluenza is also known as…

A

Croup

93
Q

What type of virus is parainfluenza

A

RNA

94
Q

Respiratory syncytial virus (RSV) is what type of virus?

A

RNA virus

95
Q

Buzzword of RSV

A

Bronchiolitis

96
Q

What type of virus is mumps?

A

RNA virus

97
Q

Major feature of mumps

A

Bilateral parotitis and orchitis

98
Q

Rotavirus is what type of virus

A

RNA virus

99
Q

Rotavirus is the leading cause of what….

A

…severe gastroenteritis in children

100
Q

Norovirus is what type of virus

A

RNA virus

101
Q

Norovirus is the most common cause of…

A

non bacterial gastroenteritis

102
Q

Coxsackievirus A frequently causes…

A

Hand-foot-and-mouth disease, fever and vesicles on mouth and hands and feet

103
Q

Poliovirus symptoms

A

Nonspecific, fever, malaise, neck and back pain, motor weakness and long term paralysis

104
Q

Rubeola virus causes…

A

Measles, most contagious disease known to humans

105
Q

Koplik spot

A

Small bluish white raised spots on oral mucosa indicative of measles rubeola virus presence

106
Q

What type of virus is rubeola?

A

RNA virus

107
Q

Herpes simplex virus is what kind of virus?

A

DNA

108
Q

Varicella zoster virus is waht type of virus?

A

DNA

109
Q

Varicella zoster virus classic rasih description

A

vesicular dew drops on rose petal rash

110
Q

Parvovirus B19 causes what disease and symptoms?

A

Fifth disease,
rash with erythematous color on cheeks looking slapped

111
Q

Parvovirus B19 is what type of virus?

A

DNA

112
Q

Epstein barr virus is what type of virus

A

DNA

113
Q

Cytomegalovirus is the leading cause of ____ in HIV patients

A

Blindness via retinitis

114
Q

Cytomegalovirus is what type of virus

A

DNA virus

115
Q

Human papilloma virus (HPV) is what type of virus?

A

DNA virus

116
Q

Flaviviruses

A

Zika, dengue, yellow fever and west nile

117
Q

Zika virus often causes what in pregnant women’s children?

A

Microcephaly

118
Q

Chikungunya often causes…

A

…Breakbone disease, intense joint pains

119
Q

As with all flaviviruses, until dengue has been ruled out, we should avoid ___, why?

A

NSAIDS, dengue can increase bleeding risk

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