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129 Cards in this Set

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What is sterilization?
Process that eliminates all viable microorganisms
What is disinfection?
Process used to destroy vegetative pathogens but not endospores; reduce infectious dose present
What is disinfectant used on?
Inanimate objects
What is antiseptic used on?
Animate objects
What does bacteriostatic mean?
Prevents the growth of bacteria on tissues or on objects in the environment
What does bacteriocidal mean?
Destroys bacteria
What are the factors affecting microbial control/death?
Nature of the microorganism, number of microorganisms at the start, and concentration of antimicrobial agent
What are the targets of antibacterial agents?
Inhibition of cell wall synthesis, disruption of plasma membrance, inhibition of protein synthesis, inhibition of nucleic acid synthesis, antimetabolites, and targeting regulatory molecules
What are the methods of antibiotic resistance used by bacteria?
Target tissue alteration, active efflux, inactivation or degradation of antimicrobial agent, decreased uptake, or production of decoy molecules
What is selective toxicity?
Able to kill the pathogen instead of or before killing the host
What is a drug with high selective toxicity?
Penicillin
Do antibacterial agents have a broad, narrow, or both spectrum of activity?
Both
Can antibacterial agents cause adverse host reactions?
Yes. Vancomycin destroys cell wall but has high nephrotoxicity rates
What is the minimum inhibitory concentration (MIC)?
The lowest concentration of a drug that prevents growth
What is the therapeutic index?
The ratio of drugs toxic dose to its minimum therapeutic dose
What is synergism?
The effect of two antibiotics is greater than the effect of one.
What is antagonism?
One agent is not as effective when added with another agent......D is not as effective when added to C
What are the major classes of drugs that inhibit cell wall synthesis?
Beta-lactams, Glycopeptides, Bacitracin
What are special antimicrobials that affect Acid Fast cell walls?
Isoniazid and Ethambutol
What do Beta-Lactmas do?
Bind to and block the action of penicillin binding proteins
What do Glycopeptides do?
Bind to and block tetrapeptide linkage?
What does Bacitracin do?
Interferes with recycling of transport proteins, and interferes with cytoplasmic membrane integrity
What does Isoniazid do?
Blocks synthesis of mycolic acid
What does Ethambutol do?
Blocks synthesis of arabinogalactan
What makes an effective cell wall inhibitor?
Bind/associate with bacteria, penetrate through the outer membrane and periplasmic space in gram -, interact with penicillin binding proteins, activate an autolysin that degrades the cell wall
What are two ways resistance to cell wall inhibitors are created?
Production of enzymes that break down the drug, and alteration of the target within the bacteria
What are the major classes of inhibitors of protein synthesis?
Amnioglycosides, Tetracyclines, Macrolides, and Oxazolidones
What do aminoglycosides do?
Interferes with binding of f-met tRNA; bactericidal
What do Tetracyclines do?
Inhibits tRNA entry into acceptor sites (elongation); bacteriostatic
What do Macrolides do?
Block translocation
What do Oxazolidones do?
Block assembly of ribosomes (bind to 50s)
What are the resistance mechanisms used against proten synthesis inhibitors?
Mutation of the ribosomal binding site, enzymatic modification of the antibiotic, decreased uptake of the drug, active efflux, and production of proteins that mimic elongation factors
What are the major classes of inhibitors of nucleic acid synthesis?
Quinolones, Rifampin, Rifamycin, and Metronidazole
What do Quinolones do?
Inhibits DNA gyrase in gram positives; inhibits topoisomerase IV in gram negatives; bacteriacidal
What does Rifampin and Rifamycin do?
Inhibits DNA dependent RNA polymerase
What does Metronidazole do?
Blocks H2 production, binds DNA, reduced nitro group cytotoxic free radical; active against anaerobic organisms & parasites
What are two major resistance mechanisms used against nucleic acid inhibitors?
Changes in DNA gyrase subunit structure to lower affinity for the drug; and changes in the cell wall permeability leading to decreased uptake
What are the major classes of Antimetabolites?
Sulfonamides and Trimethoprim
What do Sulfonamides do?
Compete with PABA as a substrate for folic acid synthesis
What does Trimethoprim do?
Inhibits dihydrofolate reductase; combined with sulfamethoxazole to treat a broad range of organisms
What are the major resistance mechanisms used against antimetabolites?
Permeability barriers, alteration in target enzyme (dihydrofolate redcutase), exogenous source of folic acid, intrinsic resistance in organisms which use exogenous thymidine
What are the major classes of inhibitors of cytoplasmic membrane function?
Polymyxins, Lipopeptides, and Bacitracin
What do Polymyxins do?
Increases cell permeability
What do Lipopeptides do?
Triggers rapid depolarization; loss of membrane potential leading to inhibition of protein DNA and RNA synthesis
What does Bacitracin do?
Inhibits cell wall synthesis; damage bacterial cytoplasmic membranes
What are the major resistance mechanisms used against cytoplasmic membrane function?
Mutation of the binding site, enzymatic modification of the antibiotic, decreased transport of the anitibiotic
What are targets for antiviral agents?
Attachment, Uncoating, Nucleic Acid Synthesis, Protein Synthesis, Assembly, and Release
What drugs target attachment?
Enfuviritide (fusion inhibitors)
What drugs target uncoating?
Amantadine and Rimantatine
What kind of agents inhibit uncoating?
Neutralizing agents
What drugs target nucleic acid synthesis?
AZT, Ribavirin, Acyclovir, Ganciclovir, and Nevirapine
What drug is a base analog?
AZT
What drug inhibits nucleotide biosynthesis?
Ribavirin
What drugs inhibits DNA polymerase?
Acyclovir and Ganciclovir
What drug inhibits reverse transcriptase?
Nevirapine
What drug targets protein synthesis?
Interferon
What drug targets assembly?
Protease inhibitors (Ritonavir)
What drugs target release?
Zanamivir
What does Zanamivir do?
Inhibits Neuraminidase or Hemagglutinin
What are the major resistance mechanisms used against antiviral agents?
Mutation of the binding site, enzymatic modification of the antibiotic, and decreased uptake of the antibiotic into host cell
What are the major classes of Antifungal drugs?
Polyenes, Imidazoles, Echinocandins, and Base analogs
What do polyenes do?
Inserts in fungal membrane next to ergosterol causing pore formation and ion leakage
What are examples of polyenes?
Amphotericin B and Nystatin
What do imidazoles do?
Targets cytochrome P450; demethylase necessary for ergosterol synthesis
What are examples of imidazoles?
Ketoconazole and Fluconazole
What do Echinocandins do?
Inhibits synthesis of glucan components
What are examples of echinocandins?
Caspofungin
What do base analogs do?
Inhibits RNA function and/or DNA synthesis; narrow spectrum of activity
What is an example of a base analog?
Flucytosine
What are the major mechanisms of resistance against antifungal agents?
Decreased permeability, active efflux, and decreased production of the target enzyme
What are the limitations of antiparasitic drugs?
Low selective toxicity, prolonged administration due to cuticles, and complex life cycles with multiple developmental stages (may require more than one antiparasitic drug)
What are the targets for antiparasitic drugs?
Folic acid biosynthesis, DNA replication, protein synthesis inhibition, interference with neuromediators, and interaction with transport
What are the drug classes involved in DNA replication?
Animoquinoline analogues, Diamidines, and Nitroimidazoles
What do animoquinoline analogues do?
Interfere with DNA replication; hemoglobin digestion
What is an example of animoquinoline analogues?
Chloroquine
What do diamidines do?
Bind DNA
What is an example of diamidines?
Pentamidine
What do nitroimidazoles do?
Inhibits DNA synthesis
What is an example of nitroimidazoles?
Metronidazole
What class of antiparasitic drug is involved in folic acid biosynthesis?
Pyrimethamine
What does Pyrimethamine do?
Inhibition of biosynthetic pathways
What class of antiparasitic drugs is involved in inhibition of protein synthesis?
Paramomycin
What does paramomycin do?
Binds to the ribosome
What class of antiparasitic drugs is involved in transport disruption?
Benzimidazole
What do benzimidazoles do?
Inhibit glucose transport and fumurate reductase; disrupts microtubules
What is an example of benzimidazoles?
Mebendazole
What class of antiparasitc drugs are involoved in inhibition of neuromuscular action?
Tetrahydropyrimidine, Piperazines, Avermectins, and Pyrazinoisoquinoline
What do tetrahydropyrimidines do?
Blocks neruomuscular action, fumurate reductase
What is an example of tetrahydropyrimidines?
Pyrantel pamoate
What do piperazines do?
GABA antagonists; stimulate phagocytic cells
What do Avermectins do?
Block neuromuscular action; GABA antagonists
What is an example of an avermectin?
Ivermectin
What do pyrazinoisoquinolines do?
calcium antagonist (neuromuscular); tegumental disruption
What is an example of a pyrazinoisoquinolines?
Praziquantel
What are the major resistance mechanisms against antiparasitic agents?
Efflux mechanisms, mutations in target, alternative pathways, and life cycle alteration
What is sensitivity?
Measures how often a test is positive when we know people have the disease
What is specificity?
Measures how often a test turns out negative when we know that people do not have the disease
What is the incubation period?
Time between exposure and development of symptoms
What is the prodromal period?
Not feeling well----malaise, anorexia, fever, sore throat, etc.
What is clinical disease?
Full expression of signs and symptoms
What is the recovery period?
Remission of signs and symptoms
What are "signs" of disease?
Things that are measurable
What are "symptoms" of disease?
Things that are subjective---what the patient tells you
What is the primary case?
The individual who brings the disease into a population (index case)
What is the secondary case?
The people infected by the primary case
What is the tertiary case?
Those people infected by the secondary case
What is a point source outbreak?
All exposed at one time; cases occur suddenly after minimum incubation time; often assoicated with food poisoning
What are propagated outbreaks?
Person to person outbreaks; secondary cases appear after a period of first wave; often associated with respiratory disease
What is primary prevention?
Prevent the occurrence of the disease (the best prevention strategy)
What is secondary prevention?
Cure, block transmission, slow the progress
What is tertiary prevention?
To limit disability and to provide rehabilitation--food poisioning--can't cure but can lessen the severity
What are some examples of diseases that need to be reported immediately to local health departments?
Anthrax, Botulism, Pertussis, Polio
What are some examples of diseases that need to be reported within one working day?
Brucellosis, HAV, TB
What are some diseases that need to be reported on a weekly basis?
AIDS, chickenpox, Hantavirs, Mumps
What is pharyngitis?
Inflammation of the pharynx
What are most cases caused by?
Viruses
What is the most common bacterial throat infection causing pharyngitis?
Group A beta-hemolytic streptococcus (GAS or GABHS); streptococcus pyongenes
What is the primary symtpom of pharyngitis?
Sore throat
What are other signs and symptoms of pharyngitis?
Pain when swallowing, fever, enlarged lymph nodes, runny nose, postnasal drip, ha
What are the sources of actue viral pharyngitis?
Adenovirus, rhinovirus, parainfluenza virus, coxsackievirus, HSV
What are the sources of acute bacterial pharyngitis?
Streptococcus pyogenes, Corynebacterium diphtheriae, haemophilus influenzae, moraxella catarrhalis
What are some complications of streptococcus pyogenes (strep throat)?
Scarlet fever; bacteremia and streptococcal toxic shock syndrome
What are the sequelae of strep throat?
Rheumatic fever and glomerulonephritis
Is streptococcus pyogenes gram postive or gram negative?
Gram positive
What is the shape of streptococcus pyogenes?
Cocci
Is streptococcus pyogenes extracellular or intracellular?
Extracellular
Where is streptococcus pyogenes normal habitat?
Upper respiratory tract
Is streptococcus pyogenes a facultative aerobe or anaerobe?
Facultative anaerobe
How is pharyngitis spread?
Respiratory droplets