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253 Cards in this Set

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Alcoholic vomits gastric contents and develops foul-smelling sputum. What organisms are most likely?
Anaerobes
Middle-aged male presents with acute-onset monoarticular joint pain and bilateral Bell's palsy. What is the likely dz and how did he get it?
Lyme dz; bite from Ixodes tick
UA of a patient shows WBC casts. What is the diagnosis?
Pyelonephritis
Pt presents with "rose gardener's" scenario (thorn prick ulcers along lymphatic drainage). What is the infectious bug?
Sporothrix schenckii
25-year-old medical student has a burning feeling in his gut after meals. Biopsy of gastric mucosa shows gram (-)ive rods. What is the likely organism?
H. pylori
32-year-old male has "cauliflower" skin lesions. Tissue biopsy shows broad-based budding yeasts. What is the likely organism?
Blastomyces
Breast-feeding woman suddenly developes redness and swelling of her right breast. On exam it is found to be a fluctuant mass. What is the dx?
Mastitis caused by S. aureus
20-year-old college student presents with lymphadenopathy, fever, and hepatosplenomegally. His serum agglutinates sheep RBC's. What cell is infected?
B cells (EBV; infectious mononucleosis)
One hour after eating a custard at a picnic, a whole family began to vomit. After 10 hours they were better. What is the organism?
S. aureus (produced preformed endotoxin)
Infant becomes flaccid after eating honey. What organism is implicated, and what is the mechanism of action?
Clostridium botulinum; inhibited release of ACh
Man presents with squamous cell carcinoma of the penis. He had exposure to what virus?
HPV
Pt develops endocarditis 3 weeks after receiving a prosthetic heart valve. What organism is suspected?
S. epidermidis or S. aureus
55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows Gran (-) rods. What is the dx?
Legionella pneumonia
After making clindamycin, pt develops toxic megacolon and diarrhea. What is the mechanism of the diarrhea?
Clostridium difficile overgrowth
What is the chemical composition of the cell wall that is specific to gram (+) bacteria?
Teichoic acid
What is the function of teichoic acid?
Induces TNF and IL-1
What factor is unique to gram (-)ive bacterial outer membranes?
Endotoxin/LPS/LOS
What are the 4 phases of the bacterial growth curve?
Lag, Log, Stationary, Death
What causes the growth plateau of the stationary phase?
nutrient depletion slows growth
What bacteria causes toxic shock syndrome? What is the responsible exotoxin?
S. aureus; TSST-1
Which bacteria produce A-B toxins?
C. diptheriae; V. cholerae; E. coli; B. pertussis
What are the clinical sx of C. diptheriae?
pharygitis and pseudomembrane in the throat
What is the mechanism of action of V. cholera?
ADP ribosylation of G protein stimulates adenylyl cyclase; increases pumping of Cl- and H2O in the gut
What is the classic symptom of V. cholera?
rice water diarrhea
What is the difference between heat stabile and heat labile E. coli?
heat stabile: stimulates adenylate cyclase; heat labile: stimulates guanylate cyclase
What is the mechanism of action causing the sx in B. pertussis?
stimulation of adenylate cyclase (cough); inhibition of chemokine receptor (lymphocytosis)
What is an endotoxin?
a lipopolysaccharide found in the cell wall of gram (-) bacteria; it is heat stabile
What substances secreted by endotoxins activate macrophages?
IL1, TNF, NO
What is the result of the activation of Hageman factor from Gram (-) endotoxin?
stimulation of the coagulation cascade -> DIC
Neisseria meningitidis ferments which sugars?
Maltose and Glucose
Neisseria gonococci ferments which sugar?
glucose (Gonococci = Glucose)
S. aureus produces what color pigment?
yellow
Pseudomonas aeruginosa produces what color pigment?
blue-green
Serratia marcescens produces what color pigment?
red pigment
What media must be used to isolate H. influenza?
chocolate agar with factors V (NAD) and X (heme)
What media must be used to isolate N. gonorrhoeae?
Thayer-Martin media
What media must be used to isolate B. pertussis?
Bordet-Gengou (potato) agar
What media must be used to isolate C. diptheriae?
Tellurite plate, Loffler's medium, blood agar
What media must be used to isolate M. tuberculosis?
Lowenstein-Jensen agar
What media must be used to isolate Lactose-fermenting enterics?
Pink colonies on MacConkey's agar
What media must be used to isolate Legionella?
Charcoal yeast extract agar buffered with increased iron and cysteine
What media must be used to isolate fungi?
Sabouraud's agar
Congo red stains for what product?
Amyloid; apple-green birefringence in polarized light (because of beta-pleated sheets)
Giemsa's stain is used to id which organisms?
Borrelia, Plasmodium, trypanosomes, Chlamydia
PAS (periodic acid-Schiff) stains what rpoduct and is used to ID what disease?
stains glycogen, mucopolysaccharides; used to diagnose Whipple's dz
Ziehl-Neelsen stains for what organisms?
Acid-fast bacteria
India Ink is used to stain for what bacteria?
Cryptococcus neoformans
Silver stain is used to identify which organisms?
Fungi, PCP, Legionella
What genetic process is involved in bacterial conjugation? What type of DNA is transferred?
direct cell to cell DNA transfer; chromosomal or plasmid DNA
What genetic process is involved in bacterial transduction? What type of DNA is transferred?
any gene in generalized transduction; only certain genes in specialized transduction
What genetic process is involved in bacterial transformation? What type of DNA is transferred?
purified DNA is taken up by the cell; any DNA
What genetic process is involved in bacterialtransposition? What type of DNA is transferred?
DNA transfer to same of another chromosome or plasmid within a cell; DNA sequences "jumping genes"
Which bugs are obligate aerobes?
Nocardia, Pseudomonas aeruginosa, Mycobacterium tuberculosis and Bacillus (Nagging Pests Must Breathe)
Obligate anaerobes present with what signs?
foul smelling, difficult to culture, and produce gas in tissue
What is common to all obligate anaerobes?
lack catalase or superoxide dismutase making them susceptile to oxidative damage
Obligate intracellular bugs need what component from their host? Which bugs are obligate intracellular?
can't make own ATP; Rickettsia, Chlamydia
Which bugs are facultative intracellular?
Salmonella, Neisseria, brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia
What are the four main forms of encapsulated bacteria?
S. pneumoniae, H. influenza (esp. serotype B), N. meningitidis, Klebsiella pneumoniae
What type of reaction is diagnostic for detection of an encapsulated bacteria?
Postive quellung reaction; capsule swells in the presence of the anticapsular antisera
Which class of bacteria form spores when nutrients become limited?
Gram positive rods, "soil bugs" Bacillus anthracis, Clostridium perfringens, C. tetani
Which bacteria are a-hemolytic?
S. pneumoniae, Viridians strep (optochin resistant)
What are the 4 main b-hemolytic bacteria?
S. aureus, S. pyogenes (bactiracin sensitive), S. agalactiae, Listeria monocytogenes
What is the function of catalase?
Catalase degrades H2O2, an antimicrobial product
Which catalase positive bacteria are coagulase negative?
S. epidermidis and S. saprophyticus (S. aureus does make coagulase)
What is the virulence factor for S. aureus?
Protein A
What is the function of Protein A in S. aureus?
binds Fc-IgG, inhibiting complement and phagocytosis
What types of diseases are caused by S. aureus?
Inflammaotry diseases - skin infecitons, organ abcesses, pneumonia; toxin-mediated diseases - toxic shock syndrome, scalded skin syndrome, rapid-onset food poisoning
What is the classification of S. pyogenes?
group A, b-hemolytic strep
What are the immunologic sequelae from S. pyogenes?
ARF and PSGN
What is the main virulence factor in S. pyogenes?
M protein
S. pneumoniae is the most common cause of what four infections?
Meningitis, Otitis Media (kids), Pneumonia, Sinusitis
What are some characterisitcs of Group B strep?
Bacitracin resistant, B-hemolytic, most often in Babies - causes pneumonia, sepsis, meningitis
Lancefield grouping of bacteria is based on what factor?
C-carbohydrate on the bacterial cell wall
What are the main sites of infection for S. epidemidis?
prostheitc devices and catheters; component of normal skin flora
What is the classification of Viridans strep?
a-hemolytic; resistant to optochin
What are the two main illness caused by viridans strep? Which organisms?
dental caries (S. mutans), subacute bacterial endocarditis (S. sanguis)
What is the classification of Clostridia species?
Gram +, bacilli, spre forming, obligate anaerobes
For the following Clostridium genus, state the type of toxin and its MOA: C. tetani
exotoxin blocks glycine release from neurotransmitters causing tetanus
For the following Clostridium genus, state the type of toxin and its MOA: C. botulinum
heat-labile toxin that inhibits ACh release, causing botulism
For the following Clostridium genus, state the type of toxin and its MOA: C. perfringens
alpha toxin (lecithinase) that causes myonecrosis, gas gangrene or hemolysis
For the following Clostridium genus, state the type of toxin and its MOA: C. difficile
cytotoxin, an endotoxing that kills enterocytes causing pseudomembranous colitis; often 2' to antibiotic use
What is the MOA of the toxin produced by Crynebacterium diptheriae?
inibition of protein synthesis via ADP ribosylation of EF-2 (elongation factor)
What are the signs/sx of diptheria?
pseudomembraneous pharyngitis (grey-white membrane) with lymphadenopathy
What is the only bacterium with a protein capsule?
Bacillus anthracis (gram postiive, spore-forming rod)
What are the signs/sx of Actinomyces israelii?
oral/facial abcesses with "sulfur granules"; normal oral flora
Nocardia asteroides, a gram positive and weakly acid-fast aerobe in soil causes what symptoms in what patients?
pulmonary infections in immunocompromised patients
What drug is used to treat Nocardia asteroides?
Sulfa drugs
What drug is used to treat Actinomyces?
Penicillin
Which bugs are inherently resistant to Penicillin G?
Gram -ive bugs; outer membrane layer inhibits entry of Penicillin G and vanco
What is the classification of N. meningitidis?
gram -ive diplococci, coffee bean shaped
What are the characterisitcs of N.meningitidis?
polysaccharide capsule, maltose fermentor, vaccine, causes meningitis
What are the characterisitcs of N. gonorrhiae?
no polysaccharide capsule, no maltose fermentation, no vaccine, causes gonorrhea, septic arthritis, neonatal conjunctivitis, PID
What are the illnesses caused by H. influenza?
epiglottitis, meningitis, Otitis media, Pneumonia
What is the classification of H. influenza?
gram -ive coccobacilli
what is the mode of transmission for H. influenza?
aerosol
Which subtype of H. influenza causes the most invasive dz?
Type B
What product of H. influenza allows it to survive in its sight of colonization
IgA proteases
What factors are needed for growth of H. influenza on chocolate agar?
Factors V (NAD) and X (heme)
What do you use to treat meningitis from H. influenza?
ceftriaxone (3rd gen cephalosporin)
What do you use to prophylatically treat those in contact with a pt with meningitis?
rifampin
What are the distinguishing features of enterobacteriacea?
COFFEe: Capsular, O antigen, Flagellar antigen, ferment glucose, enterobacteriaceae
What are the 7 main bigs in the family enterobacteriacea?
E. coli, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus
What is the distinguishing feature between Shigella and Salmonella?
only Salmonella is motile and can invade further and disseminate hematogenously; Shigella is more virulent than Salmonella
Which bugs cause food poisoning?
Vibrio parahemolyticus/vulnificus, Bacillus cereus, S. aureus, C. perfringens, C. botulinum, E.coli O157:H7, Salmonella
Which bugs cause bloody diarrhea?
Campy, Salmonella, Shigella, EHEC, Enteroinvasive EC (O157:H7), Yersinia enterocolitica, C. diff, Entamoeba histolytica
Which bugs cause watery diarrhea?
ETEC, V. cholerae, C. perfringens, protozoa (giardia, crypto), viruses (rota, adeno, norwalk)
Which four bugs induce cAMP?
V. cholerae, pertussis, E. coli, Bacillus anthracis
For the following bug describe how the toxin induces cAMP: Vibrio cholerae
permanently activates Gs - rice water diarrhea
For the following bug describe how the toxin induces cAMP: Pertussis
permanently disables Gi - whooping cough
For the following bug describe how the toxin induces cAMP: E.coli
ADP ribosylation that permanently activates adenylate cyclase -> increases cAMP
For the following bug describe how the toxin induces cAMP: Bacillus anthracis
edema factor, a bacterial adenylate cyclase increased cAMP
All DNA viruses are dsDNA except…
Parvoviridae (part of a virus)
All DNA viruses are linear except (2)….
papovaviruses and hepadnavirus (circular)
All RNA viruses are ssRNA except…
Reoviridae (dsRNA)
Which RNA viruses are naked?
Calicivirus, Picornavirus and Reovirus (Naked CPR)
How do enveloped viruses acquire their envelope? What is the one exception?
acquire it from the plasma membrane when they exit the cell; herpes acquires it from nuclear membrane
Where does replication of DNA viruses occur?
Nucleus (except poxvirus)
Where does replication of RNA viruses occur?
Cytoplasm (except influenza and retroviruses)
What are the characteristics of most DNA viruses? (exceptions in parens)
double stranded (parvo), linear (papova, hepadna), icosahedral (pox), replicate in the nucleus (pox)
Which viruses are DNA viruses?
HHAPPPy: Herpes, Hepadna, Adeno, Pox, Parvo, Papova
Hepadnavirus causes what dz?
HBV
What are the 7 viruses caused by herpesvirus?
HSV1, HSV2, CMV, EBV, VZV, HHV6, HHV8 (Kaposi's)
What are the 5 genera of viruses in the family Picornavirus?
PERCH: Polio, Echo, Rhino, Coxsackie, HAV
What is the #1 cause of fatal diarrhea in children?
Rotavirus
What are the 4 genera of viruses in the family Paramyxovirus?
Parainfluenza (croup), RSV, Measles, Mumps
Influenza virus is a genus of what viral family?
Othromyxovirus
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): hepadnavirus
enveloped, partial circular DNA, HBV
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Herpesvirus
enveloped; linear DS DNA; HSV1, HSV2, VZV, EBV, CMV, HHV6, HHV8
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Adenovirus
naked; linear DS DNA; febrile pharyngitis, pneumonia, conjunctivitis "pink eye"
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Parvovirus
naked; linear SS DNA (smallest DNA virus); B19 virus - aplastic crisis in sickle cell disease
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Papovavirus
naked; circular DS DNA; HPV, CIN, Cervical cancer, progressive multifocal leukoencephalopathy in HIV pts
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Poxvirus
enveloped; linear DS DNA (largest DNA virus); smallpox, molluscum contagiosum
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Picornaviruses
naked; linear SS + RNA; icosohedral; Polio, echo, coxsackie, HAV (PERCH)
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Caliciviruses
naked; linear SS + RNA; icosohedral; HEV Norwalk virus (gastroenteritis)
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Reovirus
naked; linear segments DS RNA; double icosahedral; reovirus and rotavirus
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Flaviviruses
enveloped; linear SS + RNA; Icosahedral; HCV, Yellow fever, Dengue, St. Louis encephalitis, WNV
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Togavirus
enveloped; linear SS+ RNA; Icosahedral; rubella, eatern equine encephalitis, western equine encephalitis
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Retroviruses
enveloped; linear SS+ RNA; icosahedral; have reverse transcriptase, HIV/AIDS, HTLV/T cell leukemia
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Orthomyxoviruses
Enveloped, SS - linear segmented RNA; helical; influenza viruses
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Coronaviruses
Enveloped; SS + linear RNA; helical; "common cold" and SARS
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Paramyxoviruses
enveloped; SS - nonsegmented RNA; helical; Parainfluenza, RSV, Measles, Mumps
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Rhabdoviruses
enveloped; SS - linear; helical; rabies
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Filoviruses
enveloped; SS - linear; helical;Ebola/Marburg hemorrhagic fever - often fatal
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Arenaviruses
enveloped; SS - circular; helical; LCV - lymphocytic choriomeningitis, meningitis
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Bunyaviruses
enveloped; SS - circular; helical; hanta virus, California encephalitis
For the following virus state its envelope status, DNA/RNA structure, capsid symmetry and important illness(es): Delta virus
enveloped, SS - circular; helical; HDV
What is the route of transmission for Legionella pneumophila?
aerosol transmission from a water source; no human to human transmission
What is the tx for Legionella pneumophila?
erythromycin
What comorbidities are most often associated with Pseudomonas aeruginosa?
burn infections and wounds
What dzs does Pseudomonas aeruginosa cause?
PSEUDO: Pneumonia, Sepsis, External otitis, UTI, Drug use and Diabetic Osteomyelitis
What are the virulence factors of Pseudomonas aeruginosa?
Endotoxin (fever, shock) and Exotoxin A (inactivates EF-2)
What is the tx for P. aeruginosa?
aminoglycoside + extended spectrum penicillin (pipercillin, ticarcillin)
What is the tx for H. pylori?
Triple therapy: bismuth, metronidazole and tetracycline or amoxicillin
For the following zoonotic bacteria state the dz it causes and the transmission/source: Borrelia burgdorferi
Lyme dz; bite from Ixodes tick
For the following zoonotic bacteria state the dz it causes and the transmission/source: Brucella spp.
Brucellosis/Undulant fever; Unpasteurized dairy products, contact with animals
For the following zoonotic bacteria state the dz it causes and the transmission/source: Francisella tularensis
Tularemia; tick bite; rabbits, deer
For the following zoonotic bacteria state the dz it causes and the transmission/source: Yersinia pestis
Plague; flea bite; rodents, esp prarie dogs
For the following zoonotic bacteria state the dz it causes and the transmission/source: Pasteurella multocida
Cellulitis; animal bite; cats, dogs
What factors would lead to a positive PPD test?
current infection, past exposure, BCG vaccinated
What factors would lead to a negative PPD test?
no infection, anergy (steroids, immunocompromised, malnutrition)
What is a Ghon complex?
TB granulomas with lobar and perihilar lymph node involvement; reflective of 1' TB exposure/infection
What is the hallmark of mycobacterium?
acid-fast organisms
What are the sx of TB?
fever, night sweats, weight loss and hemoptysis
What are the notable forms of mycobacteria?
TB, kansasii, avium-intracellulare, leprae
What are the two forms of leprosy (Hansen's Dz)? Which is worse?
Tuberculoid, leptromatous; lepromatous is worse
What is the reservoir for Leprosy in the US?
armadillos
What are the signs of leprosy?
rash, loss of eyebrows, nasal collapse,lumpy earlobe, enlarged cheeks, loss of sensation
Why does leprosy infect the skin and superficial nerves?
Likes cooler temperatures
What is the tx for leprosy?
long-term oral dapsone
What is the classic triad of Rickettsiae sx?
headache, fever, rash
What is the route of transmission for Rickettsia?
arthropods
What is the tx of choice for most rickettsial infections?
Tetracycline (doxy)
What bug causes Rocky Mountain Spotted Fever?
Rickettsia rickettsii
What bug causes Endemic typhus (from fleas)?
Rickettsia typhi
What bug causes Epidemic tyhpus (human body louse)?
R. prowazekii
What bug causes Q fever (inhaled aerosols)?
Coxiella burnetti
What is the difference in rash between thypus and spotted fever?
typhus = thorax outward spotted fever = wrist and ankles inward to thorax
Where is Rocky Mountain Spotted Fever endemic in the US?
East coast
A Weil-Felix reaction is positive/negative for which Rickettsial dzs?
+ for typhus and spotted fever; - for Q fever (+ for both of the rash-causing infections)
Which is the only bacterial membrane containing cholesterol?
Mycoplasma pneumoniae
What is the classic cause of atypical pneumonia?
Mycoplasma pneumoniae
What are the sx of atypical pneumonia?
insidious onset, headache, nonproductive cough, diffuse interstitial infiltrate
What is the tx for Mycoplasma pneumoniae?
tetracycline or erythromicin (no penicillin since they do not have cell walls)
Which form of Chlamydial bacteria enters the cell via endocytosis?
Elementary body
Which form of Chlamydial bacteria replicates in the cell by fission?
Reticular body
What are the sequellae of a C. trachomatis infection?
arthritis, conjunctivitis, and nongonococcal urethritis
What type of stain is necessary for to see chlamydia?
Geisma stain
Which organisms are spirochetes?
Borrelia, Leptospira, and Treponema
What organism causes Lyme dz?
Borrelia burgdorferi (spirochete)
What is the classic sx of Lyme dz?
erythema chronicum migrans = "bulls eye" rash
What are the three stages of Lyme dz?
1: erythema chronicum migrans and flu sx, 2: neurologic and cardiac manifestations, 3: autoimmune migratory polyarthritis
What is the Tx for Lyme dz?
tetracycline
What other dz, aside from Treponema pallidum, tests positive with VDRL?
T. pertenue (Yaws)
What are the sx of the 3 stages of syphilis?
1': painless chancre, 2': disseminated dz with maculopapular rash, 3': gummas, aortitis, neuro
Between VDRL and FTA-ABS which is the better test for treponemes?
FTA-ABS are most specific, earliest positive, and remains positive the longest
Which viruses are negative stranded viruses (need to go from neg to positive)?
Arena-, Buny-, Paramyxo-, Orthomyxo-, Filo-, Rhabdo- (Always Bring Polymerase or Fail Replication)
Which viruses are segmented?
All RNA viruses: Buny-, Orthomyxo-, Arena-, and Reo (BOAR)
Which genum are in the family Picornovirus?
Plio-, Echo-, Rhino-, Coxsackie-, HAV (RNA viruses; PERCH)
What are the dz caused by paramyxoviruses?
Parainfluenza (croup), RSV, Measles, Mumps
What are the sx of mumps virus?
1 serotype causing Parotitis, Orchitis and aseptic meningitis
Between genetic shift and genetic drift, which genomic modification causes pandemics?
Genetic shift: reassortment of viral genome (human virus recombines with animal)
What is the target of flu vaccines amantadine and rimantadine?
M2 protein for Type A only
What is the target of flu vaccines zanamavir and oseltamavir?
neuraminidase inhibitors (Types A and B)
What is the name for the characteristic cytoplasmic inclusions in neurons infected by rabies virus?
Negri bodies
How does rabies vaccine get to the CNS?
Retrograde migration up the axons
What is the route of transmission of Arboviruses?
arthropods (mosquitos and ticks)
What are classic examples of arboviruses?
Dengue fever and yellow fever (Flavivirus, Togavirus, Bunyvirus)
What virus causes yellow fever?
Flavivirus
What are the sx of yellow fever?
fever, black vomitus, jaundice
Which antimicrobial drugs block cell wall synthesis via inhibition of peptidoglycan cross-linking?
Penicillins and Cephalosporins
Which antimicrobial drugs block peptidoglycan synthesis?
Vanco, Bacitracin, cycloserine
Which antimicrobial drugs disrupt bacterial/fungal cell membranes?
Polymyxins
Which antimicrobial drugs disrupt fungal cell membranes?
Amphotericin B, Nystatin, fluconazole/azoles
Which antimicrobial drugs block nucleotide synthesis?
sulfonamides, trimethoprim
Which antimicrobial drugs block DNA topoisomerases?
Quinolones
Which antimicrobial drugs block mRNA synthesis?
Rifampin
Which antimicrobial drugs block protein synthesis at the 50S ribosomal subunit?
macrolides, clindamycin, linezolid, chloramphenicol
Which antimicrobial drugs block protein synthesis at the 30S ribosomal subunit?
Aminoglycosides, tetracyclines
Which antimicrobial drugs are bactericidal?
Penicillin, cephalosporin, vanco, aminoglycosides, fluoroquinalones, metronidazole
What are penicillins used for?
gram + cocci/rods; gram - cocci, spirochetes
What are the adverse reactions to penicillin?
hypersensitivity, hemolytic anemia
Penicllinase-resistant penicillins are used for what bug?
non-MRSA S. aureus
What drug should be combined with ampicillin or amoxycillin to enhance spectrum?
clavulonic acid (penicillinase inhibitor)
Ampicillin or amoxycillin are used to treat what bugs?
Gram +/-
Ticarcillin, Carbenicillin, piperacillin are used to treat what bug?
Pseudomonas (TCP: takes care of Pseudomonas)
What is the difference between 3rd generation cephalosporins and generations 1 and 2?
3rd gen gets to CSF
4th generation cephalosporin is used for what bug?
Pseudomonas
Azetronam is used to treat what bugs?
GNRs (Kleb, Pseudo, Serratia)
Vancomycin inhibits cell wall mucopeptide formation by binding to what portion of the cell wall?
D-ala, D-ala
What are the adverse reactions to vancomycin?
Nephrotoxicity, ototoxicity, thrombophlebitis (NOT many problems)
Aminoglycosides are used for what bugs?
severe gram - rod; use with B-lactam antibiotics
Vancomycin is used to treat what bugs?
S. aureus and C. difficile
Which tetracycline can be used in patients with renal failure?
Doxycyline (fecally eliminated)
Tetracyclines should not be taken with what other substances?
milk, antacids or iron-containing preparations (inhibit absorption in gut)
Demeclocycline is an antagonist against what hormone?
ADH (use as a diuretic in SIADH)
What is the major adverse reaction of clindamycin?
Pseudomembranous colitis (C. difficile overgrowth)
Sulfonamides (PABA antimetabolites) work by inhibiting what enzyme?
dihydropteroate synthase
What are the adverse reactions associated with sulfonamides?
hypersensitivity, hemolytic anemia in G6PD deficient, kernicterus in infants; displace warfarin from albumin
What is the adverse reaction to trimethoprim?
megaloblastic anemia, leukopenia, granulocytopenia (TMP:Treats marrow poorly)
What are the adverse reactions to fluoroquinalones?
damage to cartilage (
What is the mechanism of Rifampin?
inhibits DNA-dependent RNA polymerase
Other than TB, what may Rifampin be used for?
Prophylaxis of meningococcal infection and for contacts of children with H. influ, Type B
What are the 4 R's of Rifampin?
1. RNA Pol inhibitor, 2. Revs up P450, 3. Red/orange body fluids, 4. rapid resistance if used alone
Which antimicrobial is used for prophylaxis of meningococcal infection?
Rifampin
Which antimicrobial is used for prophylaxis of Gonorrhea?
ceftriaxone
Which antimicrobial is used for prophylaxis of Syphilis?
Pen G
Which antimicrobial is used for prophylaxis of hx of recurrent UTIs?
TMP-SMX
Which antimicrobial is used for prophylaxis of PCP?
TMP-SMX
Which antimicrobial is used for prophylaxis of endocarditis with surgical or dental procedures?
penicillins
What is the MOA of amphotericin B?
binds ergosterol and forms membrane pores that allow leakage and disrupt homeostasis
What is the main difference between Amp B and Nystatin?
Nystatin is too toxic for systemic use; topical only
What is the MOA of the azoles?
inhibits the synthesis of ergosterol
For what bugs are the azoles used?
systemic mycoses