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SPM > Week 11 > Flashcards

Week 11 Flashcards

1
Q

What are the 4 characteristics of prokaryotes that distinguish them from eukaryotes?

A

Prokaryotes

  • Single-celled, free-living organisms
  • Reproduce by binary fission with ss-circular DNA (only have one chromosome)
  • Lack intracellular organelles
  • Cell membrane = site of respiration
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2
Q

What is the gram stain process and what are the ultimate stain colors of gram positive/negative?

A
  • Gram Stain
    • Cell wall structure determines how stain interacts with the bacterium
    • Process: bacteria are fixed to a slide → crystal violet → iodine → alcohol (Gram- are destained) → counter-stain with safranin
    • Gram negative: red/pink
    • Gram positive: violet
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3
Q

What are the three main types of morphology of bacteria?

A
  • Morphology
    • Coccus – spherical
    • Bacillus – rod-like
    • Spirillum – squiggly
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4
Q

What is a general classification method used to identify bacteria?

A
  • Classification: staining → morphology → respiration → grouping (clusters, pairs, spores…) → Genus
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5
Q

What are the naming conventions/format of bacteria?

A
  • Bacteria are mostly classified according to genus and species
  • Names are italicized
  • Genus species
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6
Q

What are the 5 parts of the bacterial envelope?

A
  • Flagella
  • Axial filaments
  • Fimbriae
  • Pili
  • Capsule and slime layer
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7
Q

For flagella:

  • What antigen is a target for drugs/immune system?
  • What is the function of the flagella and what forms the flagella?
A
  • Flagella
    • H antigen (flagellar filament) – target for drugs/immune system
    • Propeller for swimming
    • Basal body is protein complex between cell wall and cytoplasmic membrane
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8
Q

What are the motions of axial filaments?

A

Corkscrew motion

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9
Q

What is the function of fimbriae, what gram stain are they more common on, and what type of molecule do they have?

A
  • Fimbriae
    • Common on Gram- bacteria
    • Act as adhesion factor to bind to cell surfaces
    • “Lectin” (sugar-binding) function
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10
Q

What is the function of the pilus?

A
  • Pili
    • Transfer of genetic material via “sex pilus”
    • Twitching motility on surfaces
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11
Q

What is the function of the capsule and slime layer?

A
  • Capsule and slime layer
    • Coat outer layer of bacteria
    • Often an immune escape mechanism, contributing to virulence
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12
Q

For the cell wall:

  • What is it composed of?
  • What is targeted by drugs/immune system? What does this antigen lie on?
A
  • Cell wall
    • Composed of peptidoglycans
      • O antigen (lipopolysaccharides (LPS)) – target for drugs/immune system
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13
Q

What kind of membranes do bacteria have? If relevant, which gram stains have what type of bacteria?

A
  • Membrane(s)
    • Cytoplasmic (inner) membrane
    • Outer membrane (Gram- only)
      • Creates periplasmic space
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14
Q

Distinguish between gram positive and gram negative with the following:

  • Layers (components of these layers)
  • Color of gram stain
  • Lipid content
  • Presence of endotoxins (what endotoxin if relevant)
  • Presence of periplasmic space
  • Presence of porin channels
  • Vulnerability to lysozyme/penicillin attack
  • Production of spores
A
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15
Q

What is the function of teichoic acid?

A
  • In Gram+, teichoic acid activates innate immune system → septic shock
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16
Q

What is the function of lipid A?

A
  • In Gram-, lipid A (works as membrane anchor for lipopolysaccharide (LPS)) → septic shock
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17
Q

What genus is neither Gram+ or Gram-? What susbtance do they carry?

A
  • Neither Gram+ or Gram-
    • Mycoplasma have no cell wall
    • Mycobacterium have complex cell wall structure (TB)
      • Mycolic Acid
      • Waxy surface does not stain well
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18
Q

What is the process of petidoglycan synthesis?

A
  • L-lysine on MurNAc attacks peptide bond between two alanine on neighboring MurNAc2 → release of terminal alanine → builds network of sugar-peptide chains
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19
Q

What drugs attack the peptidoglycan synthesis?

A
  • Penicillin-binding proteins are enzymes that catalyzes these steps
  • Ala—Ala peptide bond is site of attack by beta-lactam and vancomycin
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20
Q

Define a spore (in terms of bacteria).

What genus are they characterisitic of?

In what situation are they produced?

A
  • Spore – a dehydrated, multi-shelled structural form of protection
  • Characteristic of Clostridium and Bacillis Gram+ species
  • Vegetative cells are bacteria cells that are nutrient deprived → spore-formation
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21
Q

What are two important characteristics of spores?

A
  • Characteristics
    • Highly resistant to degradation
    • Dormant (survive for decades)
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22
Q

What is the general structure of a spore?

A
  • Structure
    • Two peptidoglycan layers and outer protein coat
    • Dipicolinic acid – high concentration in interior of spore to protect genome
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23
Q

Define microbiota.

  • Define:
    • Normal flora
    • Opportunists
    • Pathogens
A
  • Microbiota – ecological community of microorganisms found in and on our bodies
    • Normal flora / indigenous microbiota – peaceful co-existence with our cells
    • Opportunists – normally present and cause no disease but capable of causing disease when defenses are breached
    • Pathogens – infectious organisms that almost always have potential to cause disease
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24
Q

Compare colonization vs infection.

A
  • Colonization: presence of community of bacteria with or without evidence of disease
  • Infection: invasion/multiplication of microorganisms with may be clinically unapparent or result in cellular injury
    • Local infection can lead to disease state
    • May become systemic when they gain access to lymphatic/vascular system
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25
Q

What are the three things that can occur when you are exposed to a new organism?

A
  • Clearance: no symtoms
  • Persistence with no pathology
  • Disease state with symptoms
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26
Q

In the human body, the flora increase as you…

A

go down the digestive tract. The stomach barely has any bacteria, while the large intestines has a lot!

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27
Q

Define microbiome and metagenomics.

What things may change the microbiota in our body?

A
  • Microbiome – collective genomes of microbiota at a particular site
    • Microbiota differ between healthy individuals and patients
      • Vary site-to-site, newborns have simple microbiota, affected by diet/antibiotics
  • Metagenomics – study of genetic material from samples
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28
Q

Define dysbiosis and what can cause it?

A
  • Dysbiosis – imbalance of host defense factors and bacterial capabilities
    • Balance can be perturbed by changes in diet, infection, antibiotic use
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29
Q

Define probiotics and what their function is?

A
  • Probiotics – microorganisms administered in attempt to manipulate the microbiota
    • Enhances epithelial barrier with increased mucous or defensin production
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30
Q

Define prebiotics.

A
  • Prebiotics – nutrients taken to promote maintenance of beneficial microbiota
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31
Q

What are three types of chemicals secreted by by epithelial surfaces?

  • Provide examples of each type.
A
  • Antimicrobial acids – sapienic acid, linoleic acid
  • Defensins – highly charged, cationic peptides that create pores in bacterial membranes and lyse ‘em
    • Alpha-defensins – intestinal tract
    • Beta-defensins – respiratory tract
  • Lysozymes – secreted in mucus, tears, saliva
    • Breaks peptidoglycan bonds
    • Leads to lysis of bacterial cell
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32
Q

What is a mechanism normal flora use to stay alive?

A

Fimbriae attachment to epithelial cells to prevent secretion

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33
Q

What are 4 mechanisms of evasion from macrophages and how do they work?

A
  • Polysaccharide capsule or slime covers bacteria surface to act as camouflage
  • Biofilms – aggregation of bacteria bound in polysaccharide/protein matrix
  • Sabotage – certain bacteria can block innate response pathway
  • Staphylococcus aureus produces protein factor.
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34
Q

What 3 bacteria species use the sabotage method to evade macrophages and how do they function?

A
  • Salmonella spp. blocks NFkB nuclear translocation
  • Yersina spp. sequesters NFkB in cytoplasm
  • Bacteroides thetaiotaomicron blocks NFkB ability to transcribe genes
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35
Q

What three protein factors are produced by Staphylococcus aureus?

A
  • Cytolytic toxins
  • Protein A – binds Fc portion of ABs
  • CHIPS – chemotaxis inhibitory protein of Staph
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36
Q

What are the mechanisms of pathogenic evasion and survival in macrophages of the following bacteria?

  • M. tuberculosis
  • Listeria monocytogenes
  • Salmonella sp.
  • S. aureus
A
  • M. tuberculosis inhibits lysosomal fusion
  • Listeria monocytogenes escapes the endosome
  • Salmonella sp. produce factors that modify the phagosome environment
  • S. aureus produces catalase and superoxide dismutase to neutralize ROS
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37
Q

Describe bacterial genomes and what extra choromosomal elements may be involved?

A
  • Bacterial genomes
    • Circular, single-stranded DNA
    • One chromosome
    • Extra-chromosomal elements contain bacteriophages and plasmids
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38
Q

What are some mobile DNA elements?

A
  • Mobile DNA elements
    • Bacteriophages (extra-chromosomal elements)
    • Plasmids (extra-chromosomal elements)
    • Insertion and transposon activity mediate “jumping” between sequences of bacteriophages, plasmids, and the chromosome
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39
Q

What are the 4 modes of genetic exchange and define each one?

A
  • Modes of genetic exchange: can cause antibiotic resistance
    • Transformation – released DNA taken up directly by neighboring cells, integrated by recombination
    • Transduction – phages carry DNA to a new cell, either the bacteriophage or pieces of bacterial chromosome
    • Conjugation – plasmid or chromosomal DNA is transferred to new cell via sex pilus
    • Transposition – gene clusters hop between chromosome, bacteriophage, and plasmid DNAs
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40
Q

What is an example of transposition (provided in class)?

A
  • Pathogenicity island – mobile gene cluster carrying functionally related genes
    • LEE island on E. coli
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41
Q

What are the 4 phases of bacterial growth and what occurs at each step?

A
  • Exponential growth of bacteria (most divide in 20 minutes)
    • Lag phase – bacteria adapts to environment with no growth
    • Log phase (exponential phase) – bacteria multiplies
    • Stationary phase – exhaustion of nutrients with lack of growth; spore formation
    • Decline – bacterial death due to exogenous/endogenous reasons
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42
Q

In terms of oxygen requirements, define the following:

  • Obligate/strict aerobe
  • Faculative
  • Microaerophilic
  • Obligate/strict anaerobe
A
  • Oxygen requirements
    • Obligate/strict aerobe – O2 required
    • Facultative – growth with or without O2
    • Microaerophilic – requires small concentration of O2
    • Obligate/strict anaerobe – O2 is fatal
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43
Q

Compare and contrast aerobic respiration and anaerobic respiration in terms of ATP and what occurs.

A
  • Aerobic respiration – 38 ATP produced
  • Anaerobic fermentation – pyruvate is shunted to produce a variety of C1 to C4 products
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44
Q

LIST the 8 types of virulence factors?

A

CITI(ES)2

  • Cytolysins
  • Invasins
  • Teichoic acids
  • Iron scavenging factors
  • Exotoxins
  • Endotoxin
  • Superantigen
  • Secreted enzymes
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45
Q

Define the following:

  • secreted enzymes (in terms of virulence factors)
  • invasins
  • iron scavenging factors
  • cytolysins
A
  • Secreted enzymes – cause tissue damage
  • Invasins – bacterial factors that promote penetration into cells
  • Iron scavenging factors
    • Infection leads to tissue damage → iron leaks out of cell → chemicals released by bacteria with lots of hydroxyl groups bind iron → bacteria take up iron
  • Cytolysins – protein on bacterial cell surface that cause cell lysis
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46
Q

Define superantigen and what occurs in result?

A
  • Superantigen – bridges T cell receptor and MHC class II without need of antigen
    • Uncontrolled immune activation is highly destructive
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47
Q

Define endotoxin, what physiology occurs as a result, and provide an example.

A
  • Endotoxin – lipid A in LPS
    • Activates innate immune response (fever, leukocytosis, activation of complement, thrombocytopenia, disseminated intravascular coagulation (DIC), shock)
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48
Q

Define exotoxins.

  • What roles do the “B” and “A” subunit play here?
  • What 4 bacteria have an exotoxin function and how do they each work and what occurs as a result of each one?
A
  • Exotoxins – proteins secreted by bacteria that cause direct cellular and tissue injury (B subunit binds to cell and A subunit causes toxic effect)
    • C. diptheriae
      • Diphtheria toxin blocks EF2, inhibiting protein synthesis
    • V. cholerae
      • Cholera toxin increases cAMP → loss of electrolytes and water → diarrhea
    • C. tetani
      • Blocks end plate inhibitor → continuous stimulation → spastic paralysis
    • C. botulinum
      • Blacks release of ACh vesicle → stimulation blocked → flaccid paralysis
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49
Q

Define toxoids.

A
  • Toxoids = inactivated bacterial toxin (vaccines)
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50
Q

Define biofilm and Quorum sensing.

A
  • Biofilm – multi-species population enmeshed in a matrix of protein and polysaccharide
    • Growth on teeth (dental plaque) and steel
  • Quorum sensing – bacteria sense each other’s presence to regulate group behaviors needed for biofilm formation and/or coordinated production of virulence factors
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51
Q

Generally, how are bacteria samples cultured?

A

Several mL of blood are inoculated into liquid broth in bottles and grown until CO2 is detected

Liquid from bottles are placed on plates

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52
Q

What is the function of a blood agar plate?

A
  • Blood agar plates: selective agar that reveals hemolysis to identify Strep (alpha/beta) or Enterococcus (gamma)
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53
Q

What is the function of MacConkey agar plates?

A
  • MacConkey agar plates: selective agar that permits only GNRs to grow and differentiates between lactose fermenters (EEK) and lactose non-fermenters (P’s and S’s)
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54
Q

What bacteria are associated with the following infection?

  • Otitis Media (ear infection) - 3 types
A

Strep pneumoniae, H. flu, Moraxella catarrhalis

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55
Q

What bacteria are associated with the following infection?

  • Bacterial Meningitis - 4 types
A
  • Bacterial Meningitis
    • Strep pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes
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56
Q

What bacteria are associated with the following infection?

  • Community Acquired Pneumonia (CAP)
    • generalized pneumonia (1 type)
    • atypical pneumonia (3 types)
    • post-influenza pneumonia (1 type)
A
  • Community Acquired Pneumonia (CAP)
    • Strep pneumoniae
    • “Atypical” pneumonias
      • Mycoplasma pneumoniae
      • Legionella pneumophila
      • Chlamydophila pneumoniae
    • Staph aureus (post-influenza)
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57
Q

What bacteria are associated with the following infection?

  • Hospital-Acquired Pneumonia (HAP) - 2 types
A
  • Hospital-Acquired Pneumonia (HAP)
    • GNRs (Pseudomonas), Staph aureus
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58
Q

What bacteria are associated with the following infection?

  • Abdominal Infections (two classes of bacteria)
A
  • Abdominal Infections
    • GNRs AND anaerobes
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59
Q

What bacteria are associated with the following infection?

  • Non-purulent cellulitis (just erythematous)
  • Purulent cellulitis (skin abscesses)
A
  • Cellulitis
    • Non-purulent cellulitis (just erythematous)
      • Most likely Strep pyogenes
    • Purulent cellulitis (skin abscesses)
      • Either Staph aureus or Strep pyogenes
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60
Q

Define minimal inhibitory concentration (MIC) and antibiotic suscpetibility testing.

  • What is another name for antibiotic susceptibility testing?
A
  • Minimal inhibitory concentration (MIC) – the lowest abx concentration that prevents visible growth
  • Antibiotic susceptibility testing – tests an abx’s effectiveness on a bacteria from a particular patient
    • Kirby Bauer (disk diffusion)
61
Q

Define bacteriostatic and bactericidal.

A
  • Bacteriostatic – abx that inhibits growth of bacteria
  • Bactericidal – abx that kills bacteria
62
Q

What are 5 general mechanisms of bacterial resistance?

A
  • Mechanisms of resistance
    • Enzymatic inhibition
    • Decreased uptake
    • Increased export
    • Altered target
    • Metabolic bypass
63
Q

Define antimicrobial stewardship.

A
  • Antimicrobial stewardship
    • Involves rationing of antimicrobial treatments to slow resistance
64
Q

Which antibiotics are bacteriostatic? There are three main types.

A
  • tetracyclines
  • macrolides
  • clindamycin
65
Q

Which antibiotics are bactericidal? There are six main types.

A
  • penicilins
  • cephalosporins
  • vancomycin
  • quinilones
  • metronidazole
  • aminoglycosides
66
Q

Comapre the normal process and the mechanism of action of beta-lactams?

A
  • Normal: transpeptidase (PBP) cleaves alanine-alanine peptide bond of peptidoglycan monomers → peptidoglycan polymer
  • Beta-lactam drugs: BINDS to transpeptidase (PBP) and inhibits activity → weakened cell wall of bacteria
67
Q
  • What are penicillin toxicities?
A
  • Type I hypersensitivity reaction including mild rash or anaphylaxis
68
Q
  • What is a beta lactamase and what is the mechanism of action of beta-lactamase inhibitors (clavulanate, sulbactam, and tazobactam)?
A
  • Beta-lactamase: enzyme produced by staphylococci that cleaves the beta-lactam rings
  • Inhibit beta-lactamase and expand coverage to anaerobes and MSSA
69
Q

What are cephalosporin toxicities?

A

Type I hypersensitivity reaction including rash or anaphylaxis

70
Q
  • What are carbapenem toxicities?
A
  • Seizures
  • Type I hypersensitivity reaction
71
Q
  • What is the mechanism of action of vancomycin?
A
  • BINDS to alanine-alanine motif → blocks transpeptidase (PBP) from binding
72
Q
  • How can bacteria resist vancomycin?
A
  • Caused by a change in the peptide component from ala-ala to ala-lactate, which doesn’t allow the drug to bind
73
Q
  • What is the mechanism of action of daptomycin?
A
  • Lipopeptide binds to cell membrane → depolarization of membrane → potassium efflux → rapid cell death
74
Q
  • What is the mechanism of action of fluoroquinolones?
A
  • Inhibits topoisomerase activity of prokaryotes
75
Q
  • What is a potential adverse effect of fluoroquinolones?
A
  • Tendon rupture
76
Q
  • What is the mechanism of action of metronidazole?
A
  • DNA Breakage: Absorption of drug allows the formation of a highly active radical that binds to the DNA, destabilizing the DNA.
77
Q
  • What is the mechanism of action of 50s subunit inhibitors?
A
  • They do not allow for the fMet-tRNA complex formation, therefore ceasing initiation.
78
Q
  • What are potential adverse effects of aminoglycosides?
A
  • Ototoxicity (vertigo or hearing loss)
  • Nephrotoxicity
79
Q
  • What is the mechanism of action of the tetracyclines?
A
  • Bind to 30s and prevent attachement of aminoacyl tRNA to the A site
80
Q
  • What are potential adverse effects of tetracyclines?
A
  • Chelates to bone (teeth staining)
  • Phototoxicity
81
Q
  • What three classes inhibit initiation in protein synthesis?
A
  • Tetracyclines
  • Aminoglycosides
  • Linezolid
82
Q
  • What two classes inhibit elongation in protein synthesis?
A
  • Macrolides (azithromycin, clarithromycin)
  • Clindamycin
83
Q
  • What is the mechanism of action of trimethoprim/sulfamethoxazole?
A
  • Folate synthesis
    • Bacteria must synthesize their own folate
84
Q

Gram: +

Bacilli

aerobic

A
  • Listeria
  • Bacillus
  • Corynebacterium
85
Q

Gram: +

Bacilli

anaerobe

A

Clostridium difficile/perfringens

86
Q

Gram: +

Cocci

aerobic

catalase: +
coagulase: +

87
Q

Gram: +

Cocci

aerobic

catalase: +
coagulase: -

A

S. epidermidis

88
Q

Gram: +

Cocci

aerobic

catalase: -
hemolysis: alpha

A

Strep peneumonia

89
Q

Gram: +

Cocci

aerobic

catalase: -
hemolysis: beta

A

Strep pyogenes

90
Q

Gram: +

Cocci

aerobic

catalase: -
hemolysis: gamma

A

enterococcus

91
Q

Gram: -

Cocci

aerobic

(5)

A
  • Neisseria gonorrhoeae (diplocooci)
  • Neisseria meningitidis (diplococci)
  • Haemophilus influenzae
  • Bordetella pertussis

-Moraxella catarrhalis

92
Q

Gram: -

Baccili

anaerobe

A

B. fragilis

93
Q

Gram: -

Baccili

aerobe

Lactase: +

A

EEK

  • Escherichia coli
  • Enterobacter
  • Klebsiella
94
Q

Gram: -

Baccili

aerobe

Lactase: -

A

P’s and S’s
(PSPSPSPS)
-Psuedoonas
-Proteus
-Providencia
-Salmonella
-Shigella
-Serratia

95
Q

Gram: indeterminate

Baccili

aerobe

Acid Fast: +

A

Mycobacterium tuberculosis

(bacillus)

96
Q

Spectrum:

  • Gram(+): Strep, Enterococcus, mouth flora
  • Gram(-): none
  • Other: Spirochetes (Syphilis)

Clinical:

  • Strep. Pyogenes (Group A)
  • Dental Infection
A

Natural Penicillin (IV or PO)

97
Q

Spectrum:

  • Gram(+): Strep, Enterococcus, mouth flora (methicillin-sensitive staph)
  • Gram(-): E.coli, Proteus, H. influenza, (B. fragilis)

Clinical:

  • Simple community acquired Gram (-)
A

Ampicillin/(sulbactam) [iv]

Amoxicillin/(clavulanate) [po]

98
Q

Spectrum:

  • Gram(+): Strep, Enterococcus, mouth flora (methicillin-sensitive staph)
  • Gram(-): Pseudomonas, Enterobacter, Acinetobacter, (B. fragilis)

Clinical:

  • Hospital acquired Gram (-)
  • Nosocomial aspiration pneumonia (caused by pseudomonas)
A

Piperacillin/(tazobactam) [iv]

99
Q

Spectrum:

  • Gram(+): staph, strep (MSSA)
  • Gram(-): none

Clinical:

  • Uncomplicated Cellulitis
A

Penicillinase – resistant penicillin (methicillin):

  • Nafcillin
  • Dicloxacillin
100
Q

Spectrum:

  • Gram(+): MSSA, beta strep, Strep pneumoniae
  • Gram(-): E. coli

Clinical:

  • Uncomplicated Cellulitis
  • Surgery prophylaxis (heart)
A

1st Generation

  • Cefazolin
  • Cephalexin
101
Q

Spectrum:

  • Gram(+):MSSA, beta strep, Strep pneumoniae
  • Gram(-): Neisseria meningitidis
  • Other: Borrelia burgforferi (Lyme)

Clinical:

  • Meningitis
  • Lyme Disease
A

3rd Generation (Cross BBB)

  • Ceftriaxone
  • Cefotaxime
102
Q

Spectrum:

  • Gram(+): Broad coverage
  • Gram(-): Broad including Pseudomonas

Clinical:

  • Nosocomial aspiration pneumonia (caused by pseudomonas)
A

4th Generation (Cross BBB)

  • Cefeprime
103
Q

Spectrum:

  • Gram(+): Broad coverage
  • Gram(-): Broad including Pseudomonas

Clinical:

  • Good for people w/ penicillin allergy
104
Q

Spectrum:

  • Gram(+): staph, streph, Enterococcus faecalis
  • Gram(-): Broad
  • Other: Anaerobes

Clinical:

  • (Broadest Antibiotic)
  • Doesn’t treat MRSA
105
Q

Spectrum:

  • Gram(+):Broad including MRSA, Enterococcus
  • Gram(-): none

Clinical:

  • MRSA
A

Vancomycin

106
Q

Spectrum:

  • Gram(+):Broad including MRSA and VRE
  • Gram(-): none

Clinical:

  • VRE
A

Daptomycin

107
Q

Spectrum:

  • Gram(+): none
  • Gram(-): Excellent!

Clinical:

  • Only oral drug for pseudomonas
  • Complex UTI
  • Too strong for most Gram (+)’s
A

Ciprofloxacin

108
Q

Spectrum:

  • Gram(+): strep, staph
  • Gram(-): Excellent!

Clinical:

  • Only oral drug for pseudomonas
  • High Risk Pneumonia
  • Complex UTI
  • Too strong for most Gram (+)’s
A

Levofloxacin

109
Q

Spectrum:

  • Gram(+): strep, staph
  • Gram(-): Excellent!
  • Other: Anerobes

Clinical:

  • Only oral drug for pseudomonas
  • High Risk Pneumonia
  • Complex UTI
  • Too strong for most Gram (+)’s
A

Moxifloxacin

110
Q

Spectrum:

  • Gram(+): none
  • Gram(-): none
  • Other: Mycobacteria

Clinical:

  • TB
  • In combo w/ other drugs b/c of development of rapid resistance
  • Accelerates P450 Enzymatic activity of other drugs
111
Q

Spectrum:

  • Gram(+): Anaerobes (C. diff)
  • Gram(-):Anaerobes
  • Other: Protozoa

Clinical:

A

Metronidazole

112
Q

Spectrum:

  • Gram(+): cocci
  • Gram(-): none

Clinical:

  • Reserved for VRE & MRSA
113
Q

Spectrum:

  • Gram(+): MSSA
  • Gram(-): H. flu, legionella, moraxella, chlamydia

Clinical:

  • Community acquired Resp. tract infection (atypical pneumonia)
  • Chlamydia
A

Azithromycin (Z-pack)

114
Q

Spectrum:

  • Gram(+): oral anaerobes, some MRSA
  • Gram(-): none

Clinical:

  • Oral infection if penicillin allergic
A

Clindamycin

115
Q

Spectrum:

  • Gram(+): none
  • Gram(-): broad including multi-drug resistance bacteria (Pseudomonas & Klebsiella)

Clinical:

  • LAST RESORT DRUG
  • Hearing loss & vertigo
A

Aminoglycosides

  • Gentamicin
  • Tobramycin
  • Amikacin
116
Q

Spectrum:

  • Gram(+): Staph (including MRSA)
  • Gram(-): Broad

Clinical:

  • THINK TICKS (Rickettsia, Lyme)
  • Staph Soft tissue infection
  • Chlamydia
A

Doxycycline

117
Q

Spectrum:

  • Gram(+): Staph (including MRSA)
  • Gram(-): E. coli

Clinical:

  • Pneumocystis jirovecii
  • UTIs
  • Staph Soft tissue infection
A

Trimethoprim/sulfamethoxazole

118
Q

Transmission: Food and water contaminated with cysts

Site of Infection: Colon, Metastatic Liver infection

Clinical Presentation: Amebic dysentery: fever, abdominal pain, cramps, bloody stools (RBCs engulfed)

Epidemology: N/A

A

Entamoeba histolytica

119
Q

Transmission: Food and water contaminated with cysts

Site of Infection: Small Intestine

Clinical Presentation: Chronic diarrhea, abdominal pain, bloating, foul smelling stool

Epidemology: Most common parasitic illness in USA, Transmission: person-person, daycare centers

A

Giardia lamblia,

  • duodenalis
  • intesitnalis
120
Q

Transmission: Food and water contaminated with cysts

Site of Infection: Small Intestine

Clinical Presentation: Chronic diarrhea, abdominal pain, bloating,

Epidemology: Uncommon in USA

A

Cyclospora cayetanensis

121
Q

Transmission: Food and water contaminated with cysts

Site of Infection: Small Intestine

Clinical Presentation: Chronic diarrhea, abdominal pain, bloating,

Epidemology: Transmission: daycare center

A

Cryptosporidium parvum

122
Q

Transmission: Sexual Intercourse

Site of Infection: Vagina, urethra

Clinical Presentation: Usually Asymptomatic, Dysuria from urethritis

Epidemology: Worldwide

A

Trichomonas vaginalis

123
Q

Transmission: Sexual Intercourse

Site of Infection: Vagina, urethra

Clinical Presentation: Usually Asymptomatic, Dysuria from urethritis

Epidemology: Worldwide

A

Trichomonas vaginalis

124
Q

Transmission: Triatomine bugs (kissing bugs)

Site of Infection: Intracellularly muscle and nerves

Clinical Presentation:

  • Organomegaly (i.e. cardiomyopathy, megacolon)
  • Romaña’s Sign: swelling of eyelid
  • Chagoma: ulcer at bite site

Epidemology: The Americas (south of the USA)

A

Trypanosomiasis cruzi (Americas) – Chagas

125
Q

Transmission: Tsetse flies

Site of Infection: Extracellular

Clinical Presentation:

  • Lymphadenopathy (Winterbottom’s sign)
  • Encephalopathy/ coma
  • Chancre: shallow ulcer
  • Sleeping sickness

Epidemology: Africa, Antigenic Variation of parasite

A

Trypanosomiasis brucei (African)

126
Q

Transmission: Sand flies

Site of Infection: Visceral and cutaneous tissues

Clinical Presentation:

  • Visceral/cutaneous disease of Kala-azar
  • Skin ulcers

Epidemology: Worldwide except for Australia/Antartica

A

Leishmania

127
Q

Transmission:

  • Foodborne (poorly cooked meat)
  • Handling of cat feces
  • Congenital Transmission
  • Organ Transplantation

Site of Infection: Tissue cysts in any tissue

Clinical Presentation:

  • Asymptomatic/limited flu sx in healthy people
  • Retinochoroiditis

Epidemology: HIV patients can have reactivation

A

Toxoplasma gondii

128
Q

Transmission: Ticks

Site of Infection: RBCs (tetrads form)

Clinical Presentation:

  • Asymptomatic/flu-like sx
  • Immunocompromised: anemia

Epidemology: Northeast/Midwest USA

129
Q

Transmission: Anopholes Mosquitoes

Site of Infection: Hepatocytes → RBCs → lysed RBCs → anemia

Clinical Presentation:

  • Malaria

Epidemology: Africa, South Asia, Tropical Regions

A

Plasmodium

130
Q

Transmission: Ingestion/penetration of skin

Site of Infection: Migratory

  • In small intestine
  • Travels to bile duct or pancreas

Clinical Presentation:

  • Intestinal obstruction
  • Pulmonary sx
A

Ascaris lumbricoides

131
Q

Transmission: penetration of skin

Site of Infection: Migratory

  • In small intestine

Clinical Presentation:

  • Ground itch
  • Anemia (attaches to epithelium and sucks blood)
  • Bloody stools
  • Transient pneumonitis​
A

Hookworm

  • Necator americanus
  • Ancylostoma
132
Q

Transmission: penetration of skin

Site of Infection: Migratory

  • In small intestine

Clinical Presentation:

  • Pruritic rash at site of penetration
  • Pulmonary sx
  • Autoinfection
A

Strongyloides

133
Q

Transmission: ingestion

Site of Infection: non-Migratory

  • colon/rectum

Clinical Presentation:

  • Perianal itch
  • Most common worm infection is USA
  • Insomnia
A

Enterobius (pinworm)

134
Q

Transmission: ingestion

Site of Infection: non-Migratory

  • colon/cecum

Clinical Presentation:

  • Painful passage of stool (blood, mucus)
  • Rectal prolapse
A

Trichuris (whipform)

135
Q

Transmission: Anopholes Mosquitos

Site of Infection: Lymphatic

Clinical Presentation:

  • Elephantitis
A

Filaria: wuchreria bancrofti

136
Q

Transmission: Flies (Simulium)

Site of Infection: Cornea

Clinical Presentation:

  • River blindness, dermatitis
A

Filaria: onchocerca volvulus

137
Q

Transmission: Flies

Site of Infection: Skin

Clinical Presentation:

  • swelling of skin
A

Filaria: Loiasis (Loa loa)

138
Q

Transmission: Midges and flies

Site of Infection: Skin

Clinical Presentation:

  • dermatitis
A

Filaria: Mansonellosis

139
Q

Transmission: Pork, wild animals

Site of Infection: Muscle Tissue

Clinical Presentation:

  • muscle inflammation
A

Trichinellosis

140
Q

Transmission: Insect bite, Swallowing crustaceans

Site of Infection: Blood and Tissue

Clinical Presentation:

  • Incubated for one year, then NVD
  • Blister formation
A

Dracunculiasis

141
Q

Transmission: Solium: Undercooked pork/beef

Site of Infection: Migratory tissue cysts from small intestines to bloodstream

Clinical Presentation:

  • Cysticercosis (formation of cysts)
142
Q

Transmission: Undercooked fish

Site of Infection: Small intestines

Clinical Presentation:

  • Prolonged infection → B12 deficiency (megoblastic anemia)
A

Diphyllobatrium latum

143
Q

Transmission: Sheep (Humans accidental)

Site of Infection: Lung and liver

Clinical Presentation:

  • Asymptomatic, nonspecific
  • Anaphylaxis
A

Echinococcus

144
Q

Transmission: Ingestion via anthropods

Site of Infection: GI

Clinical Presentation:

  • Nonspecific
  • Nasuea, weakness, abdominal pain, loss of appetite
A

Hymenolepis nana

145
Q

Transmission: Water exposure → penetration of skin

Site of Infection: Mesenteric/urogenital veins and super-migratory

Clinical Presentation:

  • inflammatory reaction
A

Schistosomes

  • hematobium: pelvic vein - hematuria
  • mansoni: liver/spleen enlargement, portal hypertension
146
Q

Transmission: Undercooked fish/watercrests (water plants)

Site of Infection: Small intestine → biliary system

Clinical Presentation:

  • GI problems
  • Biliary obstruction
  • RUQ pain
A

Liver Flukes

  • Clonorchis
  • Fasciola
147
Q

Transmission: Ingestion of undercooked crustaceans

Site of Infection: Migratory from GI to lungs

Clinical Presentation:

  • Egg in sputum sample
  • Acute infection
  • Mimics TB
A

Lung Flukes

  • paragohomus westermari
148
Q

Transmission: Ingestion of water plants

Site of Infection: Intestines

Clinical Presentation:

  • Asymptomatic
  • Can lead to infection
A

Intestinal Flukes

  • Fasciolopsis buski

SPM (17 decks)

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