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Step 1 First Aid: Microbiology

Step 1 First Aid: Microbiology

by Nirbhau, Aug 2014

Subjects: Microbiology

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677 Cards in this Set

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	purpose of cell wall	support against osmotic pressure
	cell wall is made of ___	peptidoglycan
	cell wall component only present in G+	teichoic acid
	2 cell wall components only present in G-	periplasmic space outer membrane
	___ such as ___ are located in periplasmic space ___ is located in outer membrane	hydrolytic enzymes beta lactamase LPS
	3 parts of LPS ___ is the antigenic part ___ is the toxic part	O Ag core lipid A O Ag lipid A
	bacterial capsules are made of ___ except for ___'s, which is made of ___	polysaccharide B. anthracis poly-D-Glu
	pili and fimbriae are made of ___	glycoprotein
	coating of spores is made from ___	dipicolinic acid
	G- coccus	Nesseria
	4 G+ rods	Bacillus Clostridium Corynebacterium Listeria
	2 G+ branching filamentous bacteria	Actinomyces Nocardia
	2 pleomorphic bacteria	Rickettsiae Chlamydiae
	6 non-Gram-staining bugs	Treponema Rickettsiae Mycobacterium Mycoplasma Legionella Chlamydia (These Rascals May Microscopically Lack Color)
	culture for H. influenzae: ___ with ___ (2)	chocolate agar NAD+ hematin
	culture for N. gonorrhea: ___ with ___ (3)	Thayer-Martin vanco (against G+) polymyxin (against G-) nystatin (against fungi)
	culture for B. pertussis	Bordet-Gengou
	culture for C. diphtheriae (2)	Löffler's medium tellurite
	culture for M. tuberculosis	Löwenstein-Jensen agar
	culture for M. pneumoniae	Eaton's agar
	culture for lactose fermenters (2)	MacConkey eosin-methylene blue
	lactose fermenters do ___ to MacConkey agar E. coli does ___ to EMB agar	turn it pink turn it black with metallic sheen
	culture for Legionella: ___ buffered with ___	charcoal yeast extract Cys
	culture for fungi	Saburaud's agar
	4 obligate aerobes	Nocardia Pseudomonas Mycobacterium Bacillus "Nagging Pests Must Breathe"
	TB reactivations prefer ___ of lung because ___	apices highest V/Q ratio
	P. aeruginosa infection is typical for ___ (3)	burn wounds nosocomial pneumonia CF
	3 obligate anaerobes	Clostridium Bacteroides Actinomyces "Can't Breathe Air"
	2 enzymes missing in obligate anaerobes	catalase SOD (ROS susceptibility)
	because of ___, obligate anaerobes smell ___	SCFA bad
	obligate anaerobes commonly make ___ in tissue	gas (CO2, H2)
	anaerobes are normal if found in ___	GIT (nowhere else)
	___ antibiotics can't be used against anaerobes because ___	aminoglycoside they need O2 to enter cell
	2 obligate intracellular bugs these bugs are unable to ___	rickettsiae chlamydia make their own ATP
	7 facultative intracellular bugs	salmonella neisseria brucella mycobacterium listeria francisella legionella "Some Nasty Bugs May Live FacultativeLy"
	6 encapsulated bacteria	B. anthracis Klebsiella pneumoniae Salmonella S. pneumoniae Hib Neisseria meningitidis "B Kapsules Shield SHiN"
	3 bacteria which make IgA protease these 3 are also ___	S. pneumoniae Hib N. meningitidis competent for DNA uptake
	5 urease-positive bugs	Proteus Klebsiella H. pylori Ureaplasma Staph "Particular Kinds Have Urease"
	actinomyces makes ___ colored granules	yellow ("sulfur")
	pseudomonas aeruginosa makes ___ pigment	blue-green
	serratia marascens makes ___ pigment	red (red maraschino cherries)
	SA protein A does ___, which does ___	binds Ig Fc prevents opsonization
	S. pyogenes M protein does ___	prevents phagocytosis
	___ is a G+ bug which possesses an LPS-like substance	Listeria
	LD50 for exotoxin is ___ LD50 for endotoxin is ___	~1 ug 100s of ug
	endo/exotoxin is more toxic endo/exotoxin is more antigenic endo/exotoxins can have vaccines made against them endo/exotoxins are heat stabile at 60C	exo exo exo endo
	superantigen made by SA it causes ___	TSST toxic shock
	superantigen made by S. pyogenes it causes ___	scarlet fever-erythrogenic toxin toxic shock-like syndrome
	A part of AB toxin does ___ B part does ___	cytotoxic stuff (ADP ribosylation, rRNA cleavage) binding to cell receptor, causing endocytosis
	4 bugs with ADP-ribosylating AB toxins	B. pertussis V. cholera Corynebacterium diphteriae ETEC (BCDE)
	diphtheria AB toxin does ___	EF-2 inactivation
	cholera AB toxin does ___	activation of G_s
	G_s activation by cholera does ___ (2) this causes ___	increased Cl- pumping into lumen decreased Na+ absorption from lumen osmotic diarrhea
	2 toxins made by ETEC ___ is an AB toxin	heat labile heat stable heat labile
	ETEC heat labile toxin does ___ ETEC heat stable toxin does ___ both cause ___	G_s stimulation (like cholera) guanylyl cyclase stimulation watery diarrhea
	B. pertussis AB toxin does	G_i inhibition
	Clostridium perfringens ___ aka ___ causes gas gangrene ___ is a sign on blood agar	alpha toxin lecithinase double zone of hemolysis
	C. tetani toxin does ___ (2)	blocks GABA release blocks Gly release
	C. botulinum toxin does ___ it is heat labile/stable	blocks ACh release labile
	botulism pw	anticholinergic intoxication
	B. anthracis virulence factors are encoded on ___s called ___ (2)	plasmid pXO1 pXO2
	B. anthracis pXO1 encodes ___ pXO2 encodes ___	exotoxin enzymes for poly-Glu capsule
	3 parts of B. anthracis exotoxin	edema factor protective Ag lethal factor
	B. anthracis edema factor is ___	adenylyl cyclase
	B. anthracis lethal factor is ___ which does ___, causing ___	MMP inactivates protein kinase TNF and IL1 release
	Shigella produces a ___ toxin	AB
	shiga toxin is also present in ___ (2)	EHEC EIEC
	shiga toxin A unit does ___	cleaves 60s rRNA
	3 systems acted on by LPS	MQs complement coagulation
	3 LPS effects on MQs	IL-1 release TNFa release NO release
	LPS activates ___ complement pathway this causes release of ___ (2)	alternate C3a C5a
	C3a does ___ (2)	hypotension edema
	C5a does ___	neutrophil chemotaxis
	LPS activates coagulation via ___	hageman factor
	spore formation occurs during the ___ phase of bacterial growth	stationary
	generalized transduction happens when a bacterium is infected with a ___ phage it means ___	lytic random bacterial DNA inserted into viral capsule without phage genes
	specialized transduction happens when a bacterium is infected with a ___ phage it means ___	lysogenic the phage DNA incorporated into the host genome, then left with flanking bacterial DNA
	5 bugs with toxins encoded on lysogenic phage	shiga botulinum cholera diphtheria s. pyogenes erythrogenic toxin
	catalase test is used for ___, and distinguishes ___ from ___	G+ cocci Staph (+) Strep (-)
	coagulase test is used for ___s, and distinguishes ___ from ___ (2)	Staph SA (+) S. epidermidis S. saprophyticus
	novobiocin test is used for ___s, and distinguishes ___ from ___	coagulase -ve staph S. epidermidis (sensitive) S. saprophyticus (resistant)
	hemolysis test is for ___, and distinguishes ___ (3)	strep alpha hemolytic beta hemolytic gamma hemolytic
	2 alpha hemolytic strep distinguish these with ___ (3)	S. pneumoniae S. viridans quellung: S. pneum is + optochin: S. pneum is sensitive bile solubility: S. pneum is soluble (the opposite for S. viridans)
	2 beta hemolytic strep distinguish these with ___	S. pyogenes (GAS) S. agalactiae (GBS) bacitracin: S. pyogenes is sensitive
	3 gamma hemolytic strep distinguish these with ___	E. fecalis peptostrep S. bovis 6.5% NaCl: enterococci grow
	2 non-strep beta-hemolytic bugs	SA listeria
	S. viridans causes ___ (2)	caries (S. virdans mutans) subacute bacterial endocarditis (S. viridans sanguis)
	S. pneumoniae causes ___ (4)	meningitis otitis media pneumonia sinusitis
	7 S. pyogenes virulence factors	streptolysin o streptolysin s streptococcal pyogenic exotoxin streptokinase hyaluronidase streptodornase C5a peptidase
	of the S. pyogenes virulence factors, ___ activates plasminogen ___ is cardiotoxic ___ is a DNAse ___ is a superantigen	streptokinase streptolysin s streptodornase streptococcal pyogenic exotoxin
	enterococci cause ___ (2) unlike other group D bugs, they can grow in ___	SBE UTI 6.5% NaCl
	lancefield grouping is based on ___	C carbohydrate in cell wall
	enterococci are resistant to ___ but normally sensitive to ___	penicillin G vancomycin
	C. diphtheriae is ___ (stain/shape) with ___	G+ rod metachromatic (blue + red) granules
	tetanospasmin affects ___ cells in spinal cord these are ___s	Renshaw inhibitory interneurons
	2 clinical kinds of anthrax ___ is more common	cutaneous pulmonary cutaneous (95%)
	pulmonary anthrax pw (4)	fever pulmonary hemorrhage mediastinitis shock
	listeria infections occur via ___ (3)	unpasteurized dairy deli meat birth canal
	listeria spreads from cell to cell by ___ it has ___ motility	actin rockets tumbling
	actinomyces is normal in ___ but can cause ___ it is aerobic/anaerobic	mouth oral/facial abscess anaerobic
	nocardia is normal in ___ but can cause ___ in ___ it is aerobic/anaerobic	soil pulmonary infection immunocompromised aerobic
	ghon complex means ___ (2) it is a sign of ___	granuloma (usually lower lobe) ipsilateral hilar lympadenopathy 1' TB
	reservoir of M. leprae in US	armadillos
	leprosy is aka ___ 2 forms of leprosy	Hansen's disease tuberculoid lepromatous
	in tuberculoid leprosy, there are ___ lesions, which have/haven't hair, sensation is/isn't affected, bacilli are present/absent in scrapings, and lepromin test is +/-	1 haven't hypoesthetic absent +
	in lepromatous leprosy, there are ___ lesions, which have/haven't hair, sensation is/isn't affected, bacilli are present/absent in scrapings, and lepromin test is +/-	many have not affected present (innumerable) -
	3 drugs for leprosy	rifampin dapsone clofazimine
	2 dapsone SEs	hemolysis met-Hb-emia
	first step for G- diagnostic algortithm is separation by ___	shape
	3 shapes for G-	cocci (Neisseria) coccoid rods rods
	2 G- cocci both of these do ___ distinguish these with ___ test	N. meningitidis N. gonorrheae glucose fermentation maltose fermentation (N. meningitidis ferments)
	4 G- coccoid rods	H. influenzae B. pertussis Pasturella Brucella
	separate G- rods according to ___	lactose fermentation
	5 G- rod lactose fermenters	Klebsiella E. coli Enterobacter Citrobacter Serratia
	separate G- rod lactose fermenters according to ___	fast vs. slow fermenters
	3 G- rod fast lactose fermenters	Klebsiella E. coli Enterobacter
	4 G- rod non lactose fermenters	Shigella Salmonella Proteus Pseudomonas
	separate G- rod non lactose fermenters according to ___	oxidase (only Pseudomonas is +)
	because of ___, there is no vaccine for Neisseria ___	antigenic variation gonorrheae
	N. meningitidis is spread via ___ (2)	oral secretions respiratory droplets
	H. influenzae meningitis tx is ___ prophylaxis for close contacts is ___	ceftriaxone rifampin
	test for legionella	antigen in urine
	3 drug classes for txing legionella	macrolide tetracycline quinolone
	PSEUDOmonas stands for ___ (5) 3 other things it does	pneumonia (esp CF) sepsis external otitis UTI DM/Drug (IVDA) Osteomyelitis burn infection hot tub folliculitis malignant otitis externa in DM
	pseudomonas exotoxin A does ___	EF-2 inactivation
	pseudomonas tx (2)	anti-pseudomonal penicillin aminoglycoside
	3 antipseudomonal penicillins	piperacillin ticarcillin carbenicillin
	all enteric bacteria have ___ antigen, some have ___ Ag, but only ___ enterics have ___ Ag	O (LPS) K (capsule) motile H (flagella)
	Klebsiella is associated with ___ pneumonia in ___ (2) it can cause ___	aspiration alcoholics DM lung abscess
	both salmonella and shigella are ___ they may be distinguished by ___ (3)	enteroinvasive, non-lactose fermenting, oxidase -ve, G- rods flagella hematogenous spread H2S production (all 3 only present with Salmonella)
	Yersinia enterocolitica is commonly transmitted by ___ (3) outbreaks are common in ___	pet feces milk pork day care centers
	triple tx for HP is either ___ or ___	metro pepto-bismol tetracycline or amoxicllin metro omeprazole clarithromycin
	___ is the only spirochete visible with LM	borrelia
	leptospira is present in water contaminated with ___ it is most common in ___ (region)	animal urine tropics
	3 ocular sx of leptospirosis	jaundice photophobia conjunctivitis
	in severe form (called ___), leptospirosis causes ___ (2)	Weil's disease liver damage kidney damge
	Lyme disease is caused by ___ ___ is the vector disease has ___ stages tx is ___ (2)	borrelia burgdorferi Ixodes tick 3 doxycycline ceftriaxone
	stage 1 of lyme (2)	erythema chronicum migrans flulike sx
	stage 2 of lyme (2)	Bell's palsy AV block
	stage 3 of lyme (2)	chronic monoarthritis migratory polyarthritis
	yaws is caused by ___ it causes ___ (3) infection this causes ___ (2)	Treponema pertenue skin bone joints keloids limb deformities
	yaws is endemic to ___	tropics
	lesion in 1' syphilis it happens ___ after inoculation it lasts for ___, after which ___	painless chancre 3-6 weeks 4-6 weeks it resolves without scar
	2 lesions in 2' syphilis it occurs ___ after chancre heals it is present for ___, after which ___	condylomata lata maculopapular rash on hands, feet 6 weeks 6 weeks years long latency occurs (6 or more)
	4 manifestations of 3' syphilis ___% of latent stage syphilitics get 3' sx	gumma aortitis tabes dorsalis argyll robertson pupil 33
	gumma is a ___	granuloma
	T/F: VDRL remains positive after syphilis tx T/F: FTA remains positive after syphilis tx	false true
	4 causes of VDRL false positive	Viruses (mono, hepatitis) Drugs Rheumatic fever Lupus, Leprosy
	tx for syphilis	penicillin
	microscopic sign of gardnerella tx for gardnerella	clue cell metronidazole
	___ causes cat scratch fever	B. henselae
	B. henselae causes ___ in immunocompromised	bacillary angiomatosis
	___ causes undulant fever after exposure to ___ (2)	Brucella unpasteurized dairy animals
	___ causes cellulitis after animal bite	Pasteurella
	prairie dogs carry ___ which causes ___	Yersinia pestis plague
	rickettsiae are ___s they are transmitted by ___ except for ___ they typically pw ___ (3)	obligate intracellular G- arthropod coxiella HA fever rash
	coxiella is transmitted by ___ and causes ___	droplets Q fever
	chlamydia and rickettsiae depend on ___ (3) from host	ATP NAD+ CoA
	whereas chlamydia like to live in ___, rickettsiae prefer ___	columnar epithelium endothelium
	wherase chlamydia replicate in ___, rickettsiae do it in ___	endosomes cytoplasm
	rocky mountain spotted fever is caused by ___ and transmitted by ___	Rickettsiae ricketsii tick
	endemic typhus is caused by ___ and is transmitted by ___	R. typhi flea
	epidemic typhus is caused by ___ and is transmitted by ___	R. prowazekii body louse
	endemic/epidemic typhus has more severe presentation	epidemic
	rickettsial rash starts on ___ (2)	hands feet
	of the rickettsial rashes, only ___ involves the palms/soles	RMSF
	3 diseases with palm/sole rash	Coxsackie A RMSF Syphilis (CARS)
	serological test for rickettsial disease	Weil-Felix
	Weil-Felix test depends on cross rxn between rickettsiae and ___	Proteus
	rickettsial disease which has negative Weil-Felix	Coxiella
	tx for all rickettsial diseases (2)	chloramphenicol doxycycline/tetracycline
	chlamydial cell wall lacks ___	muramic acid
	chlamydia serotypes A, B, C cause ___ (2) they are endemic in ___	chronic infection blindness (trachoma) Africa
	chlamydia serotypes D--K cause ___ (3) in adults and ___ (2) in neonates	urethritis PID ectopic pregnancy pneumonia conjunctivitis
	chlamydia serotypes L1, L2, L3 cause ___	lymphogranuloma venereum
	chlamydia intracellular life cycle: ___ enters cell it becomes a ___ ___s replicate some ___s become ___s ___s are released	elementary body reticulate body reticluate body reticulate body elementary body elementary body
	trachoma causes blindness by ___ing (4 steps)	palpebral conjunctiva get scarred eyelid is pulled in so lashes are on cornea (entropion) lashes scratch cornea cornea gets scarred
	tx for trachoma	oral azithromycin
	conjunctivitis caused by types D--K is called ___	inclusion conjunctivitis
	tx for non-trachomatous chlamydia: ___ for infants/pregnant women ___ for adults	erythromycin doxycylcine
	tx for PID (2) ___ injection ___ for 14 days	ceftriaxone doxycycline
	tx for M. pneumoniae: ___ or ___	tetracycline erythromycin
	M. pneumoniae have no ___ they are the only bacterium with ___	cell wall cholesterol in cell membrane
	systemic mycosis from MI, OH river valleys	histoplasma
	histoplasma is found in ___ (2)	bird poop bat poop
	histoplasma spores are bigger/smaller than RBC	smaller
	systemic mycosis from states E of MI river or central america	blastomyces
	systemic mycosis from SW US	coccidioidomycosis
	coccidioidomycosis appears microscopically as ___	spherules with endospores
	systemic mycosis from latin america	paracoccidioidomycosis
	paracoccidioidomycosis appears microscopically as ___	captain's wheel formation
	systemic mycoses are ___s at room temp and ___s at 37C the exception is ___, which is a ___ at 37C	mold yeast coccidioidomycosis spherule
	tx for systemic mycosis: ___ for local infection ___ for systemic	fluconazole/ketoconazole ampho B
	systemic mycoses mimic ___ and cause ___s they cause a primary infection in ___, and then ___	TB granuloma lung spread hematogneously
	tinea versicolor is a ___ skin infection caused by ___ it causes ___ in skin it is common in ___ climate	superficial malassezia furfur hypopigmented patches warm, humid
	tx for malassezia furfur (2)	topical miconazole selenium sulfide
	dermatophytes cause infection of ___ (3) they make ___	skin hair nails keratinase
	3 main dermatophytes	microsporum trichophyton epidermophyton
	2 tests for dermatophytosis	KOH prep Wood's light
	lesions of tinea corporis are ___ shaped	ring
	tx for dermatophytoses	topical azole
	candida makes ___ at 20C, and ___ at 37C ___ form is pathognomonic	pseudohyphae germ tubes (true hyphae) germ tube
	tx for superficial candidiasis	nystatin
	tx for systemic candidiasis	ampho B
	aspergillus is mono/dimorphic	mono
	aspergillus mold branches at ___ angle hyphae are septate/aseptate	<45 degrees septate
	4 diseases caused by aspergillus	allergic bronchopulmonary aspegillosis aspergilloma invasive aspergillosis aflatoxin toxicity
	allergic bronchopulmonary aspergillosis pw ___ sx tx with ___	asthma CS
	aspergilloma pw ___ tx with ___	hemoptysis surgery
	invasive aspergillosis pw ___ tx with one of ___ (3)	necrotizing pneumonia voriconazole ampho B caspofungin
	aflatoxin damages ___	liver
	cryptococcus is present in ___ (2) it stains with ___ another test is ___ which detects its ___	pigeon poop soil india ink latex agglutination polysaccharide capsule
	cryptoccus pw ___ (3)	meningitis pneumonia skin lesions
	cryptococcus tx: ___ and ___ or ___	ampho B flucytosine fluconazole
	mucormycosis is caused by ___ (2) these molds have ___	mucor rhizopus broad branching angles
	tx for mucormycosis (2)	ampho B surgery
	tx for sporothrix schenkii (2)	itraconazole KI
	tx for giardiasis	metronidazole
	dx of giardiasis is by ___	cysts or trophozoites in stool
	entamoeba cysts have ___ nuclei	4
	entamoeba dx is by ___ (2)	serology stool
	entamoeba tx (2)	metronidazole iodoquinol
	cryptosporidium causes ___ in ___	severe diarrhea AIDS pts
	3 amoebas which cause encephalitis ___ is the most serious	naegleria acanthamoeba balamuthia naegleria
	naegleria causes ___ encephalitis in ___ hosts ___ are present in brain it is classically contracted from ___	acute normal (immunocompetent) amoeba swimming in fresh water
	acanthamoeba causes ___ encephalitis in ___ hosts ___ are present in brain	chronic immunocompromised amoeba + cysts
	in addition to encephalitis, acanthamoeba causes ___	keratitis (corneal infection)
	balamuthia causes ___ encephalitis in ___ hosts ___ are present in brain	chronic normal + immunosuppressed amoeba + cysts
	in addition to encephalitis, balamuthia causes ___	granulomatous skin lesions
	1 week mortality for naegleria	95%
	congenital toxoplasmosis pw	chorioretinitis hydrocephalus intracranial calcifications
	toxoplasmosis tx	sulfadiazine pyrimethamine
	dx of toxoplasmosis is by ___ (2)	serology biopsy
	3 pathogenic blood borne flagellates	Leishmania Trypanosoma brucei Trypanosoma cruzi
	Leishmania is spread by ___ it is endemic to ___ (3)	sandfly S. America Africa Middle East
	3 kinds of Leishmaniasis	cutaneous mucocutaneous visceral
	mucocutaneous Leishmaniasis damages ___ (3)	nasal septum soft palate lips
	visceral leishmaniasis is caused by ___ it pw ___ (3)	L. donovani fever hepatosplenomegaly pancytopenia
	tx for visceral leishmaniasis	stibugluconate
	dx of visceral leishmaniasis is via ___ (2)	serology MQs with amastigotes
	3 phases of african trypanosomiasis	painful skin ulcer recurring fever + lymphadenopathy CNS sx
	4 CNS sx of african trypanosomiasis	daytime drowsiness behavioral change ataxia coma
	T. brucei is transmitted by ___	tsetse fly
	african trypanosomiasis tx if no CNS sx	suramin
	african trypanosomiasis tx if CNS sx present	melarsoprol
	dx of african trypanosomiasis is via ___	blood smear
	T. cruzi is transmitted by ___ aka ___ it is endemic to ___	reduvid bug kissing bug Southern US + Central + S. America
	reduvid bug transmits T. cruzi in ___	its poop
	chronic Chagas disease causes ___ (3)	DCM megacolon mega-esophagus
	tx for Chagas' disease	nifurtimox
	malaria is caused by ___ (4)	Plasmodium vivax P. ovale P. malariae P. falciparum
	The most virulent malaria is caused by ___. The most widespread is caused by ___. The rarest is caused by ___.	P. falciparum P. vivax P. ovale
	The DH of plasmodium is ___. The IH is ___.	mosquito human
	3 parts of plasmodium life cycle	pre-erythrocytic erythrocytic mosquito
	4 steps of pre-erythrocytic phase	1. mosquito injects sporozoites when it bites IH 2. sporozoites home to hepatocytes 3. in liver, sporozoite matures into schizont 4. schizont matures into merozoites
	after ___, sporozoite changes from ___ shaped to ___ shaped, called ___	penetrating hepatocyte spindle round trophozoite
	a schizont is ___ cell(s) with ___ nuclei	1 1000s
	schizonts do ___ to become merozoites	create plasma membranes around nuclei
	4 steps of erythrocytic phase	1. merozoites infect RBCs 2. merozoites multiply inside RBCs and lyse them 3. merozoites become gametocytes 4. mosquito sucks RBCs with gametocytes
	4 steps of mosquito phase	1. gametocytes fuse in mosquito gut, making zygote 2. zygote matures into oocyst 3. oocyst outside mosquito gut ruptures, releasing sporozoites 4. sporozoites travel to salivary gland
	P. ovale and P. vivax have a ___ stage after ___ and before ___.	hypnozoid invasion of hepatocyte schizont
	merozoites inside RBCs can proliferate by becoming ___ which proliferate into ___	trophozoites erythrocytic schizonts
	clinical stages of malaria (4)	mild cold hot sweating
	cold stage symptoms (3)	fever chills shaking
	hot stage symptoms (4)	high fever nausea headache dizziness
	sweating stage sx (2)	sweating drop in temperature
	hemolysis occurs at ___ stage	cold
	people feel better after crises because ___	new RBCs are made with better O2 binding
	cerebral malaria is most commonly seen with ___. it is caused by ___ due to ___	P. falciparum ischemia emboli of infected and healthy RBCs blocking cerebral capillaries
	tertian cycle means fever every ___. quartan cycle means fever every ___. ___ (2) have tertian cycles, and __ has quartan.	48h 72h P. ovale P. vivax P. malariae
	___ may cause infections up to 30 years without treatment.	P. malariae
	plasmodium with continuous fever	falciparum
	plasmodium diagnosis is via (2)	PCR serology
	___ is required for invasion of P. vivax	Duffy Ag (many Africans don't express it)
	___ kills infected RBCs and ___ kills infected hepatocytes	cytokines CD8 cells
	___ (2) can inhibit invasion of liver	IFNg cytokines
	sickle cell trait helps by ___	lowering intracellular K+
	falciparum chloroquine sensitivity is present in ___ (2)	middle east mexico
	___ is recommended prophylactic in sensitive areas. ___ (4) is recommended in resistant areas.	chloroquine mefloquine doxycycline malarone primaquine
	___ can cause CNS symptoms	mefloquine
	for P. vivax/ovale you must add ___	primaquine
	___ is not available in Israel because ___. It works on the ___ stage of ___ (2).	primaquine G6PD function is required hypnozoid p. ovale p. vivax
	malarone is good but ___. it kills parasites in ___ and ___. it has (fewer/more) side effects than mefloquine. ___ (2) are resistant, though.	expensive blood liver fewer p. vivax p. ovale
	artemisin causes ___ by ___	denaturation of plasmodium proteins free radical release
	chloroquine works by ___ ___ is toxic to plasmodium, but not ___	inhibiting Hb aggregation to Hz Hb Hz
	plasmodium trophozoite looks like ___ inside RBC	ring
	babesiosis pw (2) it is transmitted by ___ it is endemic to ___	fever hemolytic anemia Ixodes tick northeast US
	babesiosis looks like ___ (2) inside RBC	ring maltese cross
	tx for babesiosis (2)	quinine clindamycin
	dx of babesiosis is from ___	blood smear
	trichomonas tx	metronidazole
	trichomonas dx is by ___	motile trophozoites visible on wet mount
	3 ways to get a nematode infection	eat them bug bite direct penetration
	5 nematodes you get by eating all of these may be treated with ___ (2), except for ___	Enterobius vermicularis Ascaris lumbricoides Trichinella spiralis Dracunculus medinensis Toxocara canis benzimidazole pyrantel pamoate Toxocara
	benzimidazole works on ___ it is metabolized by ___	microtubules CYP
	tx for Toxocara	diethylcarbamazine
	E. vermicularis is aka ___ it pw ___	pinworm anal pruritus
	a. lumbricoides life cycle (6)	females in human intestine release eggs eggs in feces are eaten in human intestine, juveniles hatch from eggs juveniles go through epithelium into bloodstream to lungs juveniles are coughed up and swallowed they mature into adults in intestine
	a. lumbricoides pw (4)	dyspnea abdominal pain abdominal distension anorexia
	trichinosis affects ___ (4)	GIT vasculature heart brain (in that order)
	GIT symptoms of T. spiralis (4)	nausea vomiting pain diarrhea
	systemic/vascular symptoms of T. sprialis (5)	edema periorbital conjunctivitis photophobia FCHM eosinophilia
	3 myocardial symptoms of T. spiralis	chest pain tachycardia thrombosis
	brain symptoms of T. spiralis (5)	headache vertigo deafness apathy coma
	T. spiralis life cycle (4)	1. females in intestine produce living juveniles 2. juveniles leave intestine and penetrate muscle tissue (& encyst) 3. humans eat muscle 4. muscle is digested and juveniles mature into adults in intestine
	toxocara does a life cycle identical to ___ in ___ humans are a ___ host	ascaris cats/dogs accidental
	2 sydromes causes by toxocara histopathology is ___	visceral larva migrans (VLM) ocular larva migrans (OLM) granulomas
	VLM affects ___ (4)	intestinal wall liver heart CNS
	OLM is from ___ (2)	retinal granuloma optic nerve damage
	3 nematodes transmitted by insect bite	onchocerca volvulus loa loa wuchereria bancrofti
	tx for nematodes transmitted by insect bite is ___ except for ___ which is txed with ___	diethylcarbamazine onchocerca ivermectin
	onchocerciasis is transmitted by ___ it is endemic to ___	black fly africa
	onchocerciasis pw ___ (2)	hyperpigmented skin river blindness
	loa loa is endemic to ___ worm goes to ___ (2)	africa skin conjunctiva
	worsening after treating nematode may be due to ___	release of LPS from Wolbachia (endosymbiont on worm)
	3 nematodes which directly penetrate skin the last 2 are called ___	strongyloides necator americanus ancylostoma duodenale hookworms
	strongyloides affects ___ (3)	GIT lungs skin
	3 strongyloides GIT sx	pain vomiting diarrhea
	strongyloides causes ___ in lungs	verminous pneumonia
	strongyloides life cycle is similar to ___	ascaris
	cestodes are aka ___s 3 cestodes	tapeworm taenia solium diphyllobothrium latum echinococcus granulosus
	___ is cestode associated with CNS infection ___ is cestode associated with anaphylaxis	t. solium (neurocysticercosis) echinococcus
	echinococcus cysts infest ___	liver
	tx for cestodes is ___ except for ___ (2), for which use ___	praziquantel neuroysticercosis echinococcus benzimidazole
	if you eat t. solium ____ you get tapeworm if you eat ___ you get cysticercosis	larvae (cyst) eggs
	trematodes are aka ___ they are all txed with ___	flukes praziquantel
	important trematode genera (3)	schistosoma clonorchis paragonimus
	major human schistosome parasites (3)	s. mansoni s. japonicum s. hematobium
	schistosomes have ___ as IH	snail
	s. mansoni homes to ___ s. hematobium homes to ___	portal vein bladder vasculature
	s. mansoni pw ___ this can cause ___ (4)	portal HTN pain ascites diarrhea bloody stool
	s. hematobium pw ___ (4) cause of symptoms	chronic cystitis urethritis hematuria bladder SCC granulomatous fibrosis
	schistosomes do passive molecular mimicry by ___ they do active molecular mimicry by ___	taking MHC and blood group antigens from RBCs and using them expressing their own versions of host proteins
	clonorchis sinensis is contracted from ___	undercooked fish
	clonorchis sinensis homes to ___	biliary tract
	clonorchis sinensis pw (2)	pigmented gallstones cholangiocarcinoma
	paragonimus westermani is endemic to ___ it is contracted from ___	china undercooked crab meat
	p. westermani affects ___ (2)	lung brain
	p. westermani lung sx (4)	dry cough pleurisy rusty-brown sputum 2' bacterial infection
	p. westermani brain sx	epilepsy
	2 kinds of viral capsid	icosahedral helical
	2 kinds of icosahedral capsid	enveloped non-enveloped (naked)
	only ___ viruses have helical capsid	RNA
	helical capsids are always ___	enveloped
	in general, you can't give ___ vaccines to immunocompromised or ___ ___ is an exception	live attenuated their contacts MMR
	advantage of live attenuated vaccine	no booster required
	6 viruses with live attenuated vaccine	smallpox chickenpox Sabin polio measles mumps rubella
	4 viruses with killed vaccine	rabies influenza salk polio HAV
	2 viruses with recombinant vaccine	HBV HPV
	all DNA viruses except ___ have ___ genome all except ___ (3) have ___ genome	parvovirus dsDNA papilloma polyoma hepadna linear
	all RNA viruses except ___ have ___ genome	reovirus ssRNA
	naked ____ (2) genomes are infectious	dsDNA + sense ssRNA
	2 non-infectious dsDNA genomes	poxvirus HBV
	___ are the only diploid viruses they have 2 ____ "chromosomes"	retrovirus + ssRNA
	all DNA viruses except ___ replicate in ___	poxvirus nucleus
	all RNA viruses except ___ (2) replicate in ___	influenza retrovirus cytoplasm
	3 naked RNA viruses	calici picorna reo
	4 naked DNA viruses	parvo adeno papilloma polyoma
	viral envelopes come from ___ one exception is ___, which comes from ___	budding through plasma membrane herpes nuclear membrane
	3 kinds of enveloped DNA virus	herpes HBV pox
	4 important families of enveloped RNA viruses	orthomyxo paramyxo rhabdo retro
	3 important orthomyxovirus genera	influenza A-C
	4 important paramyxovirus genera	parainfluenza (croup) RSV measles mumps
	1 important rhabdovirus genus	rabies
	2 important retrovirus genera	HIV HTLV
	___ is an important genus of picornavirus it includes ___ (5)	enterovirus polio echo rhino coxsackie HAV
	___ is an important reovirus	rota
	herpesviruses	HSV1 HSV2 VZV EBV CMV HHV6 HHV7 HHV8
	HSV1 causes ___ (4)	gingivostomatitis herpes labialis keratoconjunctivitis temporal lobe encephalitis
	HSV2 causes ___ (2)	genital herpes neonatal herpes
	VZV causes ___ (4) it is transmitted by ___	chicken pox shingles encephalitis pneumonia respiratory droplet
	EBV causes ___ (3) it is transmitted by ___ (2)	infectious mono Burkitt's Ly nasopharyngeal ca saliva respiratory droplet
	CMV causes ___ (3) in ___ it is transmitted by ___ (4)	infectious mono congenital CMV pneumonia immunosuppressed birth canal sex saliva blood
	HHV-6 causes ___	roseola
	roseola is aka ___ it pw ___ followed by ___	exanthem subitum high fever (+/- seizure) macular rash
	HHV7 causes ___	nothing
	HHV8 causes ___ it is transmitted by ___	Kaposi's sarcoma sex
	HSV dx is by ___	Tzanck test
	Tzanck test uses ___ and looks for ___	smear from skin vesicle multinucleated giant cell
	2 microscopic findings in HSV	multinucleated giant cell Cowdry A inclusion
	EBV infects ___ cells dx is by ___ test aka ___	B monospot heterophile antibodies
	abnormal lymphocytes in EBV	T
	3 clinical EBV signs	hepatosplenomegaly pharyngitis lymphadenopathy
	adenovirus causes ___ (3)	sore throat pneumonia conjunctivitis
	parvovirus B19 causes ___ (3)	erythema infectiosum hydrops fetalis aplastic crisis in sicke cell patients
	erythema infectiosum is aka ___ it pw ___	fifth disease slapped cheeks rash
	all the RNA viruses with icosahedral capsid symmetry are ___, except for ___, which is ___ 7 icosahedral RNA virus families	+ ssRNA reo dsRNA reo picorna hepe calici flavi toga retro
	2 important reoviruses	reo rota
	reovirus causes ___	colorado tick fever
	coxsackie virus is a ___ it causes ___ (5)	entero picornavirus aseptic meningitis herpangina febrile pharyngitis hand-foot-mouth disease myocarditis
	herpangina means ___	painful mouth blisters
	hepevirus is a ___ virus with ___ symmetry	+ ssRNA icosahedral
	important calicivirus	norovirus
	5 important flaviviruses	HCV yellow fever dengue fever St. Louis encephalitis West Nile
	3 important togaviruses	rubella eastern equine encephalitis western equine encephalitis
	corona is a ___ virus with ___ capsid symmetry it causes ___ (2)	enveloped + ssRNA helical common cold SARS
	filo is a ___ virus with ___ capsid symmetry it causes ___ (2)	enveloped - ssRNA helical Ebola Marburg
	arena is a ___ virus with ___ capsid symmetry 2 important arenaviruses	enveloped - ssRNA (circular) helical lymphocytic chriomeningitis virus (LCMV) lassa fever encephaltis
	lassa fever encephalitis is spread by ___	mice
	bunya is a ___ virus with ___ capsid symmetry 4 important bunyaviruses	enveloped - ssRNA (circular) helical california encephalitis sandfly/rift valley fever crimean-congo hemorrhagic fever hantavirus
	delta is a ___ virus with ___ capsid symmetry 1 important deltavirus	enveloped - ssRNA (circular) helical HDV
	the first enzyme transcribed by + ssRNA viruses	RNA-dependent RNA pol (RDRP)
	all - ssRNA viruses must be packaged with ___ to replicate	RDRP
	6 enveloped - ssRNA	Arena Bunya Paramyxo Orthomyxo Filo Rhabdo (Always Bring Polymerase Or Fail Repication)
	all segmented viruses are ___ 4 segmented viruses	RNA viruses bunya orthomyxo arena reo
	picornavirus RNA is translated into ___ polypeptides	1
	yellow fever is transmitted by ___ it pw ___ (3)	aedes mosquito fever black vomitus jaundice
	histopath finding in yellow fever	councilman bodies in liver
	rotavirus is major cause of ___ during ___, especially in ___	acute diarrhea winter day care centers
	histopath finding in rotavirus	villous destruction
	all paramyxoviruses express ___ this causes ___ in ___ it is neutralized by ___	surface F protein epithelial cell fusion RSV palivizumab
	measles is aka ___ german measles is aka ___	rubeola rubella
	3 complications of measles	SSPE encephalitis giant cell pneumonia
	measles rash spreads from ___ to ___	head toe
	mumps pw ___ (3)	parotitis orchitis aseptic enchephalitis
	histopath finding in rabies	negri bodies in neurons
	rabies has ___ shaped capsid	bullet
	T/F: in US, rabies is most commonly from dog	false
	serological marker for HAV	anti-HAV IgM
	2 serological markers for acute HBV	HBsAg anti-HBc IgM
	4 serological markers for chronic HBV	HBsAg HBeAg HBV DNA anti-HBc IgG
	2 serological markers for HCV	Anti-HCV HCV RNA
	2 serological markers for acute HDV	HBsAg anti-HDV
	serological marker for HEV	anti HEV
	in the HBV window phase, HBsAg is ___ anti-HBsAg is ___ anti-HBcAg is ___	- + +
	in HBV with complete recovery, HBsAg is ___ anti-HBsAg is ___ anti-HBcAg is ___	- + +
	in the HBV carrier state, HBsAg is ___ anti-HBsAg is ___ anti-HBcAg is ___	+ - +
	___ is a serological marker indicating high HBV infectivity ___ is a serological marker indicating low HBV infectivity	HBeAg anti-HBeAg
	HBeAg is part of ___ together with ___	HBV core HBcAg
	5 HIV virion layers from inside to out	+ ssRNA genome (diploid) nucleocapsid capsid matrix envelope
	___ is main capsid protein ___ is main matrix protein ___ is matrix protein which traverses envelope bilayer ___ attaches to the latter	p24 p17 gp41 gp120
	gp41 and gp 120 together make ___	gp160
	coding region of HIV genome is flanked by ___	long terminal repeats (LTRs)
	LTRs do ___ (2)	bind integrase for DNA insertion bind promoters for transcription
	3 genes common to all retroviruses	gag pol env
	3 HIV regulatory genes these are expressed via ___	tat rev nef alternative splicing
	gag codes for ___ (3)	nucleocapsid capsid matrix
	pol codes for ___ (3)	protease integrase reverse transcriptase (RT)
	env codes for ___	gp41 gp120
	___ (2) must be present on a leukocyte for HIV to penetrate	CD4 a co-receptor
	co-receptor for HIV on T cells is ___ co-receptor for HIV on MQs is ___	CXCR4 CCR5
	screening test for HIV confirmatory test for HIV	ELISA western blot
	use ___ to check current immune state use ___ to check rate of disease progresssion	CD4 count viral load
	___ regions in ___ make producing an HIV vaccine difficuilt	hypervariable env
	high mutation rate in RT causes ___	resistance to RTIs
	2 criteria for AIDS	HIV+ CD4 <200/uL or AIDS-defining lesion
	ELISA is usually falsely ___ during ___, and falsely ___ for ___	negative 1st 2 months of infection positive babies of HIV+ mothers
	4 infections which increase below 400 CD4/uL	oral thrush tinea pedis VZV reactivation TB reactivation
	5 infections which increase below 200 CD4/uL	HSV reactivation cryptospora isospora coccidioidomycosis PCP
	3 infections which increase below 100 CD4/uL	candida esophagitis toxoplasma histoplasma
	4 infections which increase below 50 CD4/uL	CMV retinitis CMV esophagitis MAI cryptoccal meningoencephalitis
	4 tumors associated with HIV	Kaposi's invasive cervical ca 1' CNS Ly NHL
	histopath of HIV encephalitis	microglial nodules with multinucleated giant cells
	HIV infects brain via ___	infected MQs
	prion conversion happens when protein adopts ___ conformation	beta pleated sheet
	___ is an inherited prion disease	Gerstmann-Sträussler-Scheinker syndrome
	2 bacteria which cause food poisoning from shellfish ___ causes wound infectious also	Vibrio parahemolyticus V. vulnificus V. vulnificus
	___ causes food poisoning from reheated rice	B. cereus
	2 main causes of pneumonia in neonate	GBS E. coli
	4 main causes of pneumonia in kids (<18)	RSV Mycoplasma Chlamydophila pneumoniae S. pneumoniae (Runts May Cough Sputum)
	3 main causes of pneumonia in adults (18-40)	Mycoplasma Chlamydophila pneumoniae S. pneumoniae
	5 main causes of pneumonia in adults (40-65)	S. pneumoniae H. influenzae Anaerobes Viruses Mycoplasma
	5 main causes of pneumonia in elderly	S. pneumoniae Viruses Anaerobes H. influenzae G- rods
	2 main causes of nosocomial pneumonia	Staph enteric G-
	3 main causes of pneumonia in alcoholic/IVDA	S. pneumoniae Klebsiella Staph
	2 main causes of postviral pneumonia	Staph H. influenzae
	3 main causes of meningitis in newborn (<6m)	GBS E. coli Listeria
	4 main causes of meningitis in children (<6 yrs)	S. pneum N. meningitidis Hib Enteroviruses
	4 main causes of meningitis (6-60 yrs)	N. meningitidis Enteroviruses S. pneumoniae HSV
	4 main causes of meningitis (>60 yrs)	S. pneumoniae G- rods Listeria
	cause of osteomyelitis in DM/IVDA	Pseudomonas
	cause of osteomyelitis in sickle cell	salmonella
	2 causes of osteomyelitis in patients with prosthetic joint	SA S. epidermidis
	cause of vertebral osteomyelitis	TB (Pott's disease)
	cause of osteomyelitis after cat/dog bite	Pasteurella multocida
	+ leukocyte esterase test means ___	bacterial UTI
	+ nitrite test means ___	G- bacterial UTI
	UTI cause which is frequently nosocomial, sometimes with red pigment	serratia marascens
	2nd MCC of UTI in sexually active women	Staph saprophyticus
	UTI cause with mucoid capsule + viscous colonies	Klebsiella pneumoniae
	motile UTI cause which swarms on agar	Proteus mirabilis
	P. mirabilis makes ___ stones	struvite
	UTI cause with blue pigment + fruity odor	P. aeruginosa
	neonatal rubella triad	PDA (or pulmonary a. hypoplasia) cataracts deafness +/- blueberry muffin rash
	neonatal CMV pw (2)	deafness seizures
	neonatal HIV pw (2)	recurrent infection chronic diarrhea
	neonatal HSV pw (2)	encephalitis herpetic lesions
	neonatal syphilis pw (4)	stillbirth hydrops fetalis abnormal facies saber shins
	3 facial abnormalities due to congenital syphilis	notched teeth saddle nose short maxilla
	3 rashes of childhood which start on head	measles rubella parvo B19
	T. vaginalis causes ___ colored mucosa with ___ discharge	strawberry greenish
	4 highest risk HPV serotypes for cervical ca	16 18 31 45
	2 HPV types which cause anogenital warts the latter are aka ___	6 11 condylomata acuminata
	___ is most common STD in US	C. trachomatis
	4 potential components of PID	salpingitis endometritis hydrosalpinx tubo-ovarian abscess
	complication of chronic PID	Fitz-Hugh-Curtis syndrome
	Fitz-Hugh-Curtis syndrome is ___	violin-string adhesions of parietal peritoneum to liver
	Trichomonas shows ___ on wet mount	corkscrew motility
	2 most common nosocomial infections	E. coli UTI SA wound infection
	working in dialysis unit is RF for ___ infection	HBV
	hyperalimentation is RF for ___ infection	candida
	exposure to water aerosols is RF for ___ infection	legionella
	in HIV patient presenting with: low-grade fever, cough, hepatosplenomegaly, suspect ___	Histoplasma
	histopath finding in histoplasmosis	oval yeasts inside MQs
	in HIV patient presenting with: superficial vascular proliferation suspect ___	Bartonella henselae (bacillary angiomatosis)
	lab finding in bacillary angiomatosis	neutrophilic inflammation in biopsy
	in HIV patient presenting with: neoplastic vascular proliferation suspect ___	HHV-8 (Kaposi's sarcoma)
	lab finding in Kaposi's sarcoma	lymphocytic inflammation of biopsy
	in HIV patient presenting with: chronic watery diarrhea suspect ___	cryptosporidium
	lab finding in cryptosporidium diarrhea	acid-fast cysts in stool
	in HIV patient presenting with: meningitis suspect ___	cryptococcus
	in HIV patient presenting with: encephalopathy suspect ___	JC polyomavirus (PML)
	in HIV patient presenting with: brain abscess suspect ___	toxoplasma
	in HIV patient presenting with: retinitis suspect ___	CMV
	fundoscopic finding in CMV retinitis	cotton-wool spots
	in HIV patient presenting with: hairy leukoplakia suspect ___	EBV
	in HIV patient presenting with: NHLy suspect ___	EBV
	in HIV patient presenting with: anal/cervical SCC suspect ___	HPV
	in HIV patient presenting with: interstitial pneumonia suspect ___	CMV
	in HIV patient presenting with: pleuritic pain, hemoptysis suspect ___	invasive aspergillosis
	in unimmunized child with meningitis, suspect ___ (2)	Hib poliovirus
	2 drugs which block peptidoglycan synthesis	vancomycin bacitracin
	drug which blocks RNA polymerase	rifampin
	6 bacteriocidal drugs	vanc fluoroquinolone penicillin aminoglycoside cephalosporin metronidazole (Very Finely Proficient At Cell Murder)
	3 penicillinase-resistant penicillins use these for ___ penicillinase resistance comes from ___	methicillin nafcillin dicloxacillin SA bulky R group
	SE from methicillin	interstitial nephritis
	penicillin is good against ___ (4)	G+ cocci G+ rods G- cocci spirochetes
	2 penicillin SEs	hypersensitivity rxn hemolytic anemia
	2 aminopenicillins	ampicillin amoxicillin
	in addition to normal penicillin spectrum, aminopenicillins cover ___ (5)	H. influenzae E. coli Listeria Proteus Salmonella enterococci
	3 aminopenicillin SEs	hypersensitivity rxn rash pseudomembranous colitis
	3 antipseudomonal penicillins	ticarcillin carbenicillin piperacillin
	antipseudomonal penicillins cover ___ they are resistant/susceptible to beta-lactamase	G- rods susceptible (need clavulanic acid)
	2 1st generation cephalosporins	cefazolin cephalexin
	use 1st generation cephalosporin for ___ (4)	G+ cocci Proteus E. coli Klebsiella (PEcK)
	3 2nd generation cephalosporins	cefoxitin cefaclor cefuroxime
	use 2nd generation cephalosporin for ___ (8)	G+ cocci H. influenzae Enterobacter aerogenes Neisseria Serratia Proteus E. coli Klebsiella (HENS PEcK)
	3 3rd generation cephalosporins	ceftriaxone cefotaxime ceftazidime
	use 3rd generation cephalosporin for ___	G- infection meningitis
	cephalosporin for Pseudomonas	ceftazidime
	cephalosporin for N. gonorrhea	ceftriaxone
	4th generation cephalosporin	cefepime
	use 4th generation cephalosporin for ___ (2)	Pseudomonas G+
	2 cephalosporin SEs	disulfiram-like rxn potentiate aminoglycoside nephrotoxicity
	___s are beta-lactam antibiotics with no ring fused to the lactam ___ is one	monobactam aztreonam
	aztreonam only works on ___ it is used for ___ (2)	aerobic G- penicillin-allergic pts renal failure (no aminoglycosides)
	aztreonam is resistant/susceptible to beta-lactamase	resistant
	2 carbapenems	imipenem meropenem
	the carbapenem ___ can be broken down by renal ___ for this reason it is always given with ___	imipenem dihydropeptidase I cilastatin (dihydropeptidase inhibitor)
	carbapenems are used for ___ (3)	G+ cocci G- rods anaerobes (DOC for Enterobacter)
	3 carbapenem SEs	GI distress rash seizures
	resistance to vanc is conferred by ___	D-ala-D-ala -> D-ala-D-lac
	vanc SEs	nephrotoxicity ototoxicity thrombophlebitis red man syndrome (flushing)
	vanc SEs are common/rare	rare
	prevent red man syndrome by ___ (2)	pre-administering anti-histamines slow infusion
	2 kinds of 30s ribosome drugs	aminoglycoside tetracycline (buy AT 30)
	5 aminoglycosides	genta neo tobra strepto amikacin
	aminolgycosides work by ___ing (2)	blocking formation of initiation complex causing mRNA misreading
	aminoglycosides only work on ___ because ___	aerobes O2 required for uptake
	3 aminoglycoside SEs	nephrotoxicity ototoxicity teratogenic
	aminoglycoside nephrotoxicity is worsened when ___	used with cephalosporins
	4 tetracyclines	tetracycline doxy demeclo mino
	___ is a tetracycline which blocks ADH	demeclo
	___ is a tetracycline which can be used in CRF because ___	doxy it's excreted fecally
	tetracyclines work by ___ing	blocking aa-tRNA attachment to 30s ribosome
	___ such as contained in ___ (3) can prevent GI absorption of tetracycline	divalent cations milk antacids Fe-containing preparations
	tetracycline is indicated for ___ (9)	V. cholerae Acne Chlamydia Ureaplasma Mycoplasma Tularemia HP Borrelia Rickettsia (VACUuM THe BedRoom)
	4 50s ribosome inhibitors	Chloramphenicol Erythromycin (macrolides) Lincomycin (lincosamides) Linezolid
	ribosomal steps blocked by drugs in physiological order	initiation complex transpeptidation translocation elongation
	2 drugs which block initiation complex	aminoglycoside (30s) linezolid
	1 drug which blocks transpeptidation	chloramphenicol
	2 drugs which block translocation	lincosamide macrolide
	1 drug which blocks elongation	tetracycline (30s)
	4 tetracycline SEs	GI distress teeth discoloration bone growth inhibition in children photosensitivity
	tetracycline is contraindicated for ___	pregnancy
	macrolides are indicated for ___ (5)	G+ cocci mycoplasma legionella chlamydia neisseria
	5 macrolide SEs	long QT GI discomfort cholestatic hepatitis eosinophilia rash
	macrolides increase levels of ___ (2)	warfarin theophyllines
	chloramphenicol is indicated for ___	bacterial meningitis
	3 chloramphenicol SEs	anemia (dose dependent) aplastic anemia (dose independent) gray baby syndrome
	gray baby syndrome is caused by ___	deficient hepatic UDPGT in baby
	lincosamides such as ___ (2) are indicated for ___	clindamycin lincomycin anaerobic infections
	3 lincosamide SEs	pseudomembranous colitis fever diarrhea
	sulfonamides inhibit ___, which makes ___ from ___	dihydropteroate synthetase dihydropteroate PABA
	TMP-SMX is indicated for ___ (4)	PCP recurrent UTI Shigella Salmonella
	3 TMP-SMX SEs	hematological rash diarrhea (in immunocompromised)
	3 hematological TMP-SMX SEs these may be alleviated by ___ing	megaloblastic anemia leukopenia thrombocytopenia giving folate!
	quinolones end in ___, or are named ___ (2)	floxacin enoxacin nalidixic acid
	quinolones are indicated for ___ (3)	G- rods from GIT G- rods from urinary tract some G+
	quinolone SEs: ___ (2) in adults ___ (2) in kids	tendonitis tendon rupture leg cramp myalgia
	metronidazole is indicated for ___ (6)	Giardia Entamoeba Trichomonas Gardnerella Anaerobes HP (part of triple tx)
	3 metronidazole SEs	disulfiram-like rxn headache metallic taste
	polymyxins are indicated for ___	resistant G- infection
	2 polymyxin SEs	neurotoxic acute RTN
	tx for TB	Rifampin INH Pyrazinamide Ethambutol
	TB prophylaxis	INH
	MAC tx (4)	rifampin ethambutol streptomycin azithromycin
	MAC prophylaxis	azithromycin
	M. leprae tx (3)	dapsone rifampin clofozamine
	2 INH SEs	neurotoxic hepatotoxic
	___ can prevent INH neurotoxicity	B6
	rifampin works by ___ing	inhibiting RNA pol II
	2 non-mycobacterial indications for rifampin	N. meningitidis prophylaxis Hib prophylaxis
	2 rifampin SEs	CYP inducer orange body fluids!?
	2 mechanisms for beta-lactam resistance	beta lactamase altered PBPs (e.g. MRSA)
	resistance to ___ (2) is via drug modification	aminoglycoside (acetylation, etc) chloramphenicol (acetylation)
	resistance to macrolide is via ___	rRNA methylation
	resistance to tetracycline is via ___ (2)	decreased uptake increased pumping out
	tx for MRSA	vanc
	2 tx for VRE (vanc resistant enterococci)	linezolid quinupristin/dalfopristin
	4 sites of action for antifungal	microtubules pyrimidine synthesis cell membrane cell wall
	___ disrupts fungal microtubules it is used for ___	griseofulvin superficial infections
	___ disrupts fungal pyrimidine synthesis ___ is a problem with this med for this reason, do ___	flucytosine widespread resistance use with ampho B
	anti-fungal cell membrane drugs target ___ 2 ways to do this are ___	ergosterol decrease synthesis bind it in the cell membrane
	2 drugs which decrease ergosterol synthesis	terbinafine triazole
	2 drugs which bind ergosterol in cell membrane this does ___	ampho B nystatin disrupts the membrane
	terbinafine decreases ergosterol synthesis by ___ing	inhibiting squalene epoxidase
	squalene epoxidase does ___	squalene -> lanosterol
	azoles inhibit ergosterol synthesis by ___ing	inhibiting (fungal) CYP
	fungal CYP demythelase does ___	lanosterol -> ergosterol
	ampho B is good for fungal meningitis because ___	doesn't cross BBB
	6 ampho B SEs	fever with rigor (chills) hypotension nephrotoxic arrythmia anemia IV phlebitis
	because of ___, nystatin is used ___ly (2)	toxicity topically orally
	non-fungal use of ketoconazole	hyper-cortisolism
	azole used for AIDS cryptococcal meningitis it does/doesn't cross BBB	fluconazole does
	2 topical azoles	clotrimazole miconazole
	4 azole SEs	endocrine dysfunction (gynecomastia) liver dysfunction fever chills
	1 anti-fungal cell wall drug	caspofungin
	caspofungin works by ___ing it is used for ___	inhibiting beta glucan synthesis invasive aspergillosis
	4 griseofulvin SEs	teratogenic carcinogenic confusion headache
	2 griseofulvin interactions	CYP induction induces warfarin metabolism
	5 blockable parts of virus life cycle	penetration uncoating nucleic acid synthesis packaging progeny release
	virus penetration can be blocked by ___	gamma globulins
	virus uncoating is blocked by ___ this drug acts on ___	amantadine viral M2 protein
	amantadine is used for ___ nonviral use is ___	influenza A DA secretagogue in PD
	problem with amantadine is ___ this is caused by ___	resistance mutated M2
	3 amantadine SEs	ataxia dizziness slurred speech
	3 enzymes targeted in viral nucleotide synthesis inhibition	IMP DH DNA pol RT
	___ is an IMP DH inhibitor it is a ___ analog it is indicated for ___ (2)	ribavirin purine RSV chronic HCV
	2 ribavirin SEs	hemolytic anemia teratogen
	4 antiviral DNA pol inhibitors	acyclovir ganciclovir cidofovir foscarnet
	2 antiviral DNA pol inhibitors which are guanosine analogs	acyclovir ganciclovir
	2 antiviral DNA pol inhibitors which require viral activation	aciclovir ganciclovir
	all antiviral DNA pol inhibitors have some degree of ___	nephrotoxicity
	aciclovir is indicated for ___ (3)	HSV VZV EBV
	2 aciclovir SEs	crystal nephropathy neurotoxic
	prevent aciclovir crystal nephropathy by ___ing	giving IVF
	T/F: aciclovir works on active and latent HSV/VZV infection	false: only active
	ganciclovir is indicated for ___	CMV
	2 kinds of ganciclovir SE	nephrotoxicity hematological
	3 hematological ganciclovir SEs	leukopenia neutropenia thrombocytopenia
	foscarnet is indicated for ___ (2)	CMV retinitis HSV (if aciclovir resistant)
	2 kinds of RTI all RTIs cause ___ (2)	nucleoside non-nucleoside bone marrow suppression peripheral neuropathy
	nucleoside RTIs end in ___, or are called ___ (3)	vudine didanosine zalcitabine abacavir
	all NRTIs cause ___	lactic acidosis
	zidovudine is aka ___ SE is ___	AZT megaloblastic anemia
	lamivudine is aka ___	3TC
	3 non-nucleoside RTIs	nevirapine efavirenz delavirdine
	all NNRTIs cause ___	rash
	CD4 threshold at which HAART is initiated	500/uL
	___ is RTI used for prophylaxis or ___	zidovudine preventing transplacental transmission
	HAART usually includes 2 ___s, 1 ___ and possibly 1 ___ or ___	NRTI NNRTI integrase inihbitor protease inhibitor
	protease inhibitors end in ___ they work by ___ing	navir preventing virion maturation
	4 protease inhibitor SEs	GI distress hyperglycemia lipodystrophy (e.g. hump) thrombocytopenia
	1 HIV fusion inhibitor	enfurvitide
	enfurvitide mechanism	binds gp41, blocking entry
	2 enfurvitide SEs	hypersensitivity rxn bacterial pneumonia
	enfurvitide is indicated for ___	patients who failed HAART
	viral packaging can be blocked by ___ it is used for ___	rifampin vaccinia
	viral progeny release is inhibited by targeting ___ this is used for ___	neuraminidase influenza A, B
	2 neuraminidase inhibitors	zanamivir oseltamivir
	4 oseltamivir SEs	nausea vomiting diarrhea headache
	IFNa is indicated for ___ (3)	chronic HBV chronic HCV Kaposi's sarcoma
	IFNb is indicated for ___	MS
	IFNg is indicated for ___	chronic granulomatous disease
	IFN SE	neutropenia
	9 antibiotics to avoid during pregnancy	Sulfonamide (kernicterus) Aminoglycoside (ototoxic) Fluoroquinolone (cartilage damage) Erythromycin (maternal cholestatic hepatitis) Metronidazole (mutagenic) Tetracycline (bone growth problems) Ribavirin (teratogen) Griseofulvin (teratogen) Chloramphenicol (grey baby)

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Step 1 First Aid: Microbiology

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677 Cards in this Set