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808 Cards in this Set
- Front
- Back
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what bacterial structure protects against osmotic pressure
|
peptidoglycan
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what antigens on g+, g- induce tnf, il1, and il6
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teichoic acid on g+, lipid a (LPS) on g-
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what is the outermost structure in g+ vs g-
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both may have capsule on the outside. But g+ has peptidoglycan. G- has the outer membrane
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what ribosomal subunits are present in bacteria
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50,30
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what area contains beta lactamases in g-
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periplasm
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function of capsule
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prevent phagocytosis
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what is the composition of capsules
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polysaccharide
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what does the outer membrane consist of in g-
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LPS/endotox
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what is the function of the pilus/fambria
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adherence (i.e. colonization) and sex
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where are you likely to see dipicolonic acid
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spore
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function of glycocalyx
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aderence to surfaces
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which bacterial structures contain polysaccharide
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outer membrane of of g-, capsule, glycocalyx
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what type of bacteria is listeria
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GPR
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what type of bacteria is legionalla
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GNR
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what type of bacteria is francisella
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GNR
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what type of bacteria is pasteurella
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GNR
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what type of bacteria is bartonella
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GNR
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what type of bacteria is borrelia
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spirochete
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which bacteria contain sterols
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mycoplasma
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which bacteria do not have cell wall
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mycoplasma
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which bacteria have the highest lipid content in cell membrane
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mycobacterium
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which bacteria lacks muramic acid in cell wall
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chlamydia
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which bacteria will stain well with giemsa
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borrelia, plasmodium, trypanosome, chlamydia
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which bacteria will stain well with pas
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whipples
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what bacterial will stain well with a stain that contains carbolfuschin
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ziehl neelsen
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which bacteria will stain well with ziehl neelsen
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acid fast
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which organisms will stain well with india ink
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cryptococcus
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which organism will stain with mucicarmine, what color
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cryptococcus, red
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which organism will stain with silver
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fungi, legionella, pcp
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which organism requires chocolate agar with v (nad),x (hematin) to grow
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hi
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which organism benefits w/ coculture with sa? What does sa provide?
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hi (cuz staph makes hematin)
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which organism helps staph to perform hemolysis
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group b strep
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what reagents does thayer martin contain
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vanc, polymixin, nystatin
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which organism grows on thayer martin
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gonnococcus
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which organism grows on bordet gengou
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b pertussis
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which organism grows on tellurite plate
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diphtheria
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which organism is assoc/ w/ loffler's media
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diphtheria
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how to grow tb
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lowenstein jensen
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what color colonies are formed on macconkey w/ lactose fermenting enterics
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pink
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what grows blue black colonies w/ metalic sheen on eosin-methylene blue
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e coli
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how to grow legionella
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charcoal yest w/ cysteine
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how to grow fungi
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sabourand
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name some obligate aerobes
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nocardia, pseudomonas, mycobacterium, bacillus
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how to grow m pneumoniae
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eaton
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name some obligate anaerobes
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clostridium, bacteroides, actinomyces
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why are anaerobes foul smelling
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they contain short chain fatty acids
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what bacteria tend to produce gas
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obligate anaerobes like co2 and h2
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would aminoglycosides be useful against actinomyces
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no, cuz it's an obligate anaerobe
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which bacteria are facultative intracellulars
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salmon/shiga, neisseria, brucella, mycobacterium, listeria, legionella, francicella
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which bacteria are encapsulated
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strep pneumo, klebs, hib, neisseria MENGITIS NOT GONO, salmon/shiga, group b strep
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why are some polysaccharides attached to proteins for vaccination
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to increase t cell response and promote class switching
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name some urease positive bugs
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proteus, klebs, h pylori, ureaplasma
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which bacteria produces yellow sulfer granules
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actinomyces
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which bacteria produces yellow pigment
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s aureus
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which bacteria produces blue green pigmetn
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pseudomans
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which bacteria produces red pigment
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serratia
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which bacteria has protein A, function
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saureus, binds Fc of Ig
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which bacteria have iga protease
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pneumococcus, hi, neisseria
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which bacteria demonstrate type III secretion
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y pestis, salmonella/shigella, chlamydia, pseudomonas
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which bacteria cause pathogenesis by endotoxin
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meningococcus, salmonella, e coli
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which bacteria cause pathogenesis by fimbraie
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gonococcus, meningococcus, e coli
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which bacteria cause pathogenesis by hyaluronidase
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staph, group a strep, c difficile
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capsule is important for PATHOGENSIS in
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hib, e coli
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how do superantigens work? What cytokines involved
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crossliniking of tcr and mhc2 which causes release of ifngamma and il2
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name 4 toxins secreted by s aureus
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tsst, enterotoxin, exfoliatin, alpha toxin (hemolysis)
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what toxin can cause scarlet fever
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erythrogenic toxin of scarlet fever
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which bugs can cause superantigen
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s aureus, s pyogenes
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how does an AB toxin work
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b binds receptor causing endocytosis, a adp ribosylates protein
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name bacteria that secrete ab toxin
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diptheria, cholera, e coli, pertussis, b cereus
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what bacteria inactivate ef2
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diptheria, pseudomonas
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Which is more heat stable: endotoxin or exotoxin
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endotoxin
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which bacterial toxins act on g proteins
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cholera, e coli, pertussis
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b cereus - which toxin is long acting and which one is short acting
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heat labile = long acting = diarrheal syndrome.
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action of cholera toxin
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simulation of g protein increases camp, which causes insertion of cftr
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heat labile vs heat stable toxin of e coli
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heat labile = adenylate cyclase. Heat stable = guanylate cyclase. "labile like the air, stable like the ground"
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what AB toxin inhibits chemokine receptors
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pertussis, causes lymphocytosis
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which bacteria increase camp
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cholera, pertussis, e coli, bacillus anthracis, b cereus
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which bacteria increase cgmp
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e coli, y enterocolitica
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which bacterial toxin causes spastic paralysis
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c tetani
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which bacterial toxin causes flaccid paralysis
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botulinum
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which bacteria have alpha toxin
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s aureus and c perfringens (mechanism is different)
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action of alpha toxin in c perfringens. Pattern of hemolysis
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lecithinase, eats cell membrane. Results in double zone of hemolysis in agar
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which neurotransmitters are decreased with tetanus toxin
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gaba and glycine
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which nerutransmitters are decreased with botulinbum
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ach
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what bacteria produce shiga toxin (strain specific)
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shigella, e coli 0157h7
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mechanism of shiga toxin action
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cleaves rrna (inactivates 60s), causes cytokine releaese (cause hus)
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pathogenesis of HUS
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toxin causes endothelial damage, and can also inactivate the ADAMTS13 (same deficiency in TTP), cytokine release stimulates inflammation
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normal function of streptolysin o
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hemolysis
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what is edema factor
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protein on anthrax which is an adenylate cyclase
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name 3 inflammatory pathways activated by endotoxin
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macrophages (which make il1, tnf, no), alternative complement (c3a and c5a), and hageman factor
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what is lag phase of bacterial growth
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period of non-division where bacteria are getting used to new media, not dividing yet
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during what phase of growth does spore formation occur
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stationary phase
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which bacteria have increased ability to take up dna from the environment
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shin
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which form of conjugation involves transfer of choromosmal materal + plasmid
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hfr x f-
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which form of conjugation involves transfer of only plasmid material
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f+ x f-
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generalized vs specialized transduction
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both involve phage. Generalized = parts of bacterial dna get CARRIED by LYTIC phage. Specialized = parts of bacterial dna get EXCISED w/ phage dna and become part of LYSOGENIC phage
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5 toxins encoded for by lysogenic phage
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shiga/ecoli, botulinum, cholera, diphtheria, erthryogenic toxin (pyogenes)
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gram positive diplococci
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s pneumonia
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gram positive clusters
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staph
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gram positive chains
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strep
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novobiocin can be used to distinguish what bacteria
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s epidermis (sensitive) and s saphrophyticus
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optochin can be used to distinguish what bateria
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viridans (resist) vs pneumonia
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bacitracin can be used to distinguish what bacteria
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group b (resist) vs group a
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alpha vs beta hemolysis
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beta = forms clear area, apha = green ring
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saline can be used to distinguish what bacteria
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enterobacter and peptostreptococcus (grows) vs s bovis
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which organisms are beta hemolytic
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s aureus, group a and b strep, listeria
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|
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function of coagulase
|
converting fibrinogen to fibrin to trap neutrophils and provide scaffold for bacteria to grow
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what type of staph can make biofilms
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epidermis
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what is a common contaminant in blood cultures
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s epidermis
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what is pneumococcus the most common cause of
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meningitis, otitis (in children), pneumonia, sinusitis
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what is common cause of dental caries
|
strep mutans
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common cause of subacute ie
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strep sanguis
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antibodies to m protein can enhance host defenses against group a strep
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yes
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complications of strep pyogenes skin infection vs pharyngitis
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both can cause kidney, but only pharyngitis can cause rf
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can ab prevent rheumatic fever? Glomerulonephritis?
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only rheumatic fever
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where is group b strep normally found
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vagina
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what can group b strep cause
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pneumonia, meningitis, and sepsis IN BABIES
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management of group b strep positive pregnants
|
intrapartum penicillin
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when do you screen pregnant women for strep b
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35-37w
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relationship of enterococci to streptoccus
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enterococcus = type of group d strep
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drug resistance of enterococci
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pen g resistant, often vanc resistant too
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lancefield grouping
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differences in C carbohydrates on cell wall
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what can cause bacteremia and ie in crc pts
|
s bovis
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what can cause ie in pts w/ GU procedures
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enterococcus
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what type of granules are seen in diptheria? How can you visualize?
|
metachromatic (blue, red). Visualize w/ methylene blue
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what bacteria form spores
|
clostridium, bacillus, coxiella burnetti
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how can you kill spores
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autoclave (steam at 121c for 15m)
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which bacteria acts on alpha unit of Gi? What does it do
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pertussis toxin, inactivates it
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why is it bad to scrape pseudomembranous pharyngitis
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can spread it
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where does tetanus toxin act at
|
renshaw cell s of spinal cord
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what toxin might cause risus cardonicus
|
tetanus
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onset of diarrhea of c perfringes compared to b cerues
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lote onseet
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what toxins does c difficile produce
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toxin a & b
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what does toxin a (difficile) do
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binds to brush border,
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what does toxin b( difficle ) do
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destroys enterocyte cytoskeleton -> pseudomembrane
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how is c diff dx
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toxin in stool
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|
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only bacteria with a d-glutamate capsule
|
antrax
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lesions present in antrhax
|
black eschar surrounded by edematous ring
|
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manifestations of antrax
|
cutaneous that can progress to bacterimia, pulmonary anthrax, dysentary
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where is listeria found
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unpasteurized milk/cheese
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actin rockets
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listeria
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tumbling motility
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listeria, t vaginalis
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what is granulomatosis infantiseptica, what causes it
|
listeria, pyogenic granulomas over whole body
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what is the only gram + to make endotoxin
|
listeria
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how does listeria live intracellular
|
survives inside acidified phagolysosome
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how to treat nocardia
|
sulfa
|
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how to treat actinomyces
|
pen
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complication of actinomyces
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oral/facial abscesses that drain through sinus tracts in skin
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where is actinomyces found
|
colon, vagina
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what disease does nocardia cause
|
pulmonary infection in IC
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when can primary tuberculosis cause progressive lung dz
|
hiv, malnutrition
|
|
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ghon complex vs ghon focus
|
ghon complex = granulomas in lower lobes (focus) + hilar node involvement
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decrease in what cytokines can decrease response against mycobacterium
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il12, th1, tnfalpha
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is ghon focus seen with primary or secondary infection
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primary
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when is M kansasii oft seen
|
COPD pts
|
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what is cord factor, what bacteria has it
|
cord factor inhibits neutrophils (blocks macrophage), and causes tb to form cords. Mycobacteria have it
|
|
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what bacteria is associated with water infections
|
legionella, mycobacterium marinum, pseudomonas
|
|
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prophylaxis for mai
|
azithromycin
|
|
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what bacteria prefers lower temperature areas of the body
|
mycobacterium leprae
|
|
|
toxicity of dapsone
|
hemolysis and methemoglobinemia. G6pd tox
|
|
|
2 forms of leprosy
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lepromatous and tuberculoud. Lepromatous is worse
|
|
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what predisoposes to lepromatous leprosy
|
weak t cell response
|
|
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tx for leprosy
|
dapsone. Alternative is rifampin + clofazimine/dapsone
|
|
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what tissues oft injured in leprosy
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skin, superficial nerves, leonine facies
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what nerve is oft injured in leprosy
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ulnar
|
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|
emetic syndrome vs diarrheal syndrome in b cereus
|
emetic = heat stable. Diarrheal = heat labile (camp)
|
|
|
tennnis racquet shaped terminal spore
|
c tetani
|
|
|
what can oxidase distinguish b/w
|
pseudomonas (ox pos) vs shigella/salmon/proteus
|
|
|
what can maltose fermentation distinguish b/w
|
meningococcus = ferments, gonococcus doesn't
|
|
|
how to tell between vibrio cholera and campylobacter
|
campylobacter grows in 42*, cholera grows in alkaline media (cuz it's from distal gut)
|
|
|
what type of bacteria is moraxella catarhallis
|
gnc
|
|
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what bacteria will grow pink colones on macconkeys
|
klebsiella, e coli, enterobacteria, citrobacter, serratia
|
|
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why doesn't macconkeys agar grow gm+
|
crystal violet and bile salts prevent growth of gm+
|
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gram negative outer membrane prevents entry of what abs
|
vanc, pen g
|
|
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why is there no vaccine for gonoccus
|
rapid antigenic variation of pilus
|
|
|
most common cause of septic arthritis in young
|
gonoccus
|
|
|
what is fitz hugh curtis syndrome
|
gonococcal infection that has ascended to liver
|
|
|
which occurs first: gonococcal neonatal conjunctuvitis or chlamydia
|
gonococcal
|
|
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what is endotox of neisseria
|
lipooligosaccharide (causes all of sx) NOT LPS
|
|
|
how to tx meningitis from hib or neisseria
|
ceftriaxone
|
|
|
why might legionella infection cause hyponatremia
|
destruction of jg cells
|
|
|
is legionella contageous
|
no (no person to person spread)
|
|
|
tx for legionella
|
erythromycin
|
|
|
dx of legionella
|
ag in urine
|
|
|
how is legionella spread
|
water source (aerosol)
|
|
|
stain for legionella
|
silver
|
|
|
pertussis - does it have a capsule
|
yes
|
|
|
pertussis - is it motile
|
yes
|
|
|
how does pertussis attach to mucosa
|
fha
|
|
|
what can cause ecthyma gangrenosum
|
pseudomonas - round lesion w/ erythematous halo & necrotic center
|
|
|
what can pseudomonas cause
|
pneumonia (cf), sepsis, external otits, uti, diabetic osteomyelitis, hot tub folliculitis
|
|
|
odor of pseudomonas
|
grapelike
|
|
|
what type of exotoxin does pseudomonas produce
|
exotoxin A - inhibits ef2, like diptheria
|
|
|
tx for pseudomonas
|
AG + extended spectrum pen
|
|
|
k capsule is found on what, what does it do
|
e coli, causes pneumonia and NEONATAL meningitis "kough capsule"
|
|
|
e coli fimbriae causes what
|
cystitis, pyelo
|
|
|
how to distinguish ehec from other e coli
|
ehec can't ferment sorbitol
|
|
|
red currant jelly sputum
|
klebsiella
|
|
|
4 strains of e coli
|
eiec, etec, ehec, epec
|
|
|
dysentary of eiec vs ehec
|
dysentary of eiec is due to both invasion and toxin which causes necrosis and inflammation. Ehec is just toxin
|
|
|
which e coli strain causes malabsorptive diarrhea
|
epec
|
|
|
which bacteria has mucoid appearance on culture
|
klebsiella
|
|
|
common cause of pneumonia in alcoholic or diabetes
|
klebsiella
|
|
|
which bacteria have human to human transmission
|
pertussis, hi, n meningitis, chlamydia
|
|
|
characteristics of enterobacteriacae
|
1. all have "O" antigen - polysaccharide endotoxin, 2. all ferment glucose, 3. non have oxidase, 4.all are GNR
|
|
|
mcc of gm- sepsis
|
e coli, klebsiella
|
|
|
most common organism in large bowel
|
bacteroides fragilis
|
|
|
common cause of peritonitis when gut perforated
|
bacteroides fragilis
|
|
|
salmonella vs shigella: which has flagella
|
salmonella
|
|
|
which bacteria can remain in gallbladder chronically
|
salmonella typhi
|
|
|
fever, diarrhea, and spots on abdomen
|
salmonella typhi
|
|
|
salmonella vs shigella: which is more virulent
|
shigella
|
|
|
salmonella vs shigella: which makes h2s
|
salmonella
|
|
|
common bacterial cause of guillain barre
|
campylobacteria
|
|
|
salmonella vs shigella: which can disseminate
|
salmonella
|
|
|
which bacteria is assoc/ w/ reiter's
|
shigella flexari, chlamydia
|
|
|
what cells does shigella infect
|
m cells in peyers patches
|
|
|
transmitted from pet feces
|
yersinia enterocolitica
|
|
|
transmitted from poultry
|
campylobacteria
|
|
|
where is campylobacer found
|
poultry, meat, unpasteurized
|
|
|
what bacteria that causes bloody diarrhea likes hot temperatures (42*)
|
campylobacter (campfire)
|
|
|
diarrhea in day care center
|
yersinia enterocolitica
|
|
|
causes mesenteric adenitis that mimics appendicitis or crohns
|
yersinia enterocolitica
|
|
|
permanently activates Gs, increasing camp. Oxidase positive
|
vibrio cholera
|
|
|
triple therapy for pylori
|
1. metro, bismuth, tetracycline/amox
2. metro, PPI, clarithromycin 3. PPI, clarithromycin, amox/metro (common drugs: bismuth/PPI, clarith, amox, metro, tetra) |
|
|
where does h yplori live
|
antrum of stomach
|
|
|
name 3 spirochetes
|
borrelia, treponema, leptospira
|
|
|
spirochete that can be seen with aniline dyes in LM
|
borrelia
|
|
|
founnd in water contaminated with animal urine, often in surfers and tropics
|
leptospira
|
|
|
jaundice and photophobia and fever
|
leptospira
|
|
|
weils dz
|
leptospirosis w/ jaundice and azotemia, can get hemorrhage and aniema
|
|
|
erythema chronicum migrans
|
lyme dz. Bull's eye red rash w/ central clearing
|
|
|
sx for lyme's dz
|
erythema chronicum migrans, bells and heart block, arthritis
|
|
|
tx for lyme dz
|
doxy, ceftriaxone
|
|
|
how to confirm syphilis
|
fta-abs
|
|
|
what bacteria can cause alopecia
|
syphilis
|
|
|
what congenital infection can cause blood tinged nasal secretions
|
snuffles from syphilis
|
|
|
what does vdrl detect
|
ab's that react w/ beef cardiolipin
|
|
|
what can give false positive vdrl
|
mono, hep, drugs, rheumatic fever, lupus, leprosy
|
|
|
red/purple nodules and papules after cat scratch
|
bartonella henselae
|
|
|
cycles of fever that occur after lice bite
|
borrelia recurrentis
|
|
|
cycles of fever w/ muscle pain that occur after milk drink
|
brucella
|
|
|
fever and enlarged lymph nodes that ulcerate after tick bite
|
tularemia (p154)
|
|
|
fever and chills w/ enlarged lymph nodes that ulcerate after flea bite? Where did flea get dz from
|
yersinia pestis. Prarie dog
|
|
|
red, hot, tender patch on leg w/ dermal inflammation after dog bite
|
pasteurella
|
|
|
gray vaginal discharge
|
gardnerella
|
|
|
mobiluncus
|
one of the components of bacterial vaginosis. (anaerobe)
|
|
|
pathogensis of bacterial vaginosis
|
bacterial overgrowth
|
|
|
what 2 components do rickettsiae need from host cell
|
need coa and nad
|
|
|
how are most rickettsiae spread? What is exception?
|
arthropod, coxiella (aerosol)
|
|
|
headache, fever, and rash after mosquito bite
|
rickettsial infection
|
|
|
what rickettsial organism can cause pneumonia
|
ccoxiella
|
|
|
which rickettsia lives in an acidified phagolysosome
|
coxiella
|
|
|
ricketsia typhi vs r prowazekii
|
typhi causes endemic typhus, prawazekii is epidemic
|
|
|
what is brill zinsser dz
|
reactivation of r prawazekii
|
|
|
what is typhus
|
sudden fever , chills, and headache w/ potential rash
|
|
|
rash of typhus vs rocky mountain spotted fever
|
typhus rash is trunk, rickettsial is hands and feet
|
|
|
does erlichia have a rash
|
no
|
|
|
what disease will have a berry cluster of organisms in granulocytes
|
erlichosis
|
|
|
how is coxiella spread
|
spores that are inhaled from tick and cow feces
|
|
|
weil felix rxn
|
proteus O antigens are agglutinate serum of pt with ricketsial infection (does not occur for xociella)
|
|
|
where is rocky mountain spotted fever endemic
|
east cost
|
|
|
what dzz can have peeling of palms and soles
|
mercury poisoning and kawasaki
|
|
|
elementary body vs reticulate body
|
reticulate replicates
|
|
|
how does elementary body survive in tissue
|
avoids fusion w/ lysosome
|
|
|
what bacteria have no peptidoglycan in their cell walls
|
ureaplasma and chlamydia
|
|
|
reticulate or elementary: which one seen on tissue culture
|
reticulate
|
|
|
will fitz hugh curtis syndrome produce altered lfts
|
no
|
|
|
types abc chlam trach can cause
|
chronic infection, blindness, oft in africa
|
|
|
types d-k chlam trach cause
|
urethritis/pid/ectopic, neonatal pneumonia, neonatal conjunctuvitis (appears later than gonnococcal opththalmia)
|
|
|
stacatto cough
|
neonatal pneumonia from chlamydia trachomatis
|
|
|
type l chlam trychomatatis cause
|
lymphogranulua veneram
|
|
|
high titer of igm antibodies
|
mycoplasma
|
|
|
only bacteria with cholesterol in membrane
|
mycoplasma
|
|
|
what can hib cause
|
epiglottis, meningitis, otitis, penumonia
|
|
|
what protein produced by yersinia pestis inhibits phagocytosis
|
f1
|
|
|
is ab's a good tx for salmon
|
no, prolongs infection
|
|
|
what organism is often assoc/ w/ salmonella enteritis
|
turtles
|
|
|
how can pseudomonas kill cell membrane
|
phospholipase c
|
|
|
which bacteria helps to make vitamin k
|
bacteroides fragilis
|
|
|
which gram - organism lacks endotoxin
|
bacteroides fragilis
|
|
|
how to tx mycosis
|
flu/ketoconazole for local, amphotericin for systemic
|
|
|
similarity and diff b/w systemic mycoses and tb
|
both have granuloma formation, systemic mycoses has no person to person transmission
|
|
|
where is histo found
|
mississipi and ohio river valleys. Bat droppings, caves
|
|
|
where is blasto found
|
east of mississippi and central america
|
|
|
where will you see histo yeast
|
phagosome inside macropahge
|
|
|
lung infections that disseminate to mucosa and cause ulcerative granulomas
|
paracoccidioidomycosis
|
|
|
when are dimorphic fungi yeast
|
mold = cold. Yeast = warm EXCEPT FOR CANDIDA
|
|
|
why can m furfur cause hypo/hyperpig
|
degrade lipids, release acids, dmg melanocytes
|
|
|
tinea versicolor assoc/ w/ what type of weather
|
hot humid
|
|
|
tx for tinea versiculor
|
topical azole or selenium sulfide
|
|
|
which fungi are dimorphic
|
all the systemic mycosis (except coccidio), candida, and sporothrix
|
|
|
which fungi are just yeast
|
cryptococcus and pneumocystis
|
|
|
mcc of tinea capitis
|
trichophyton contrans
|
|
|
mcc of tinea other than capitis
|
trichophyton rubor
|
|
|
which tinea can be detected with uv light
|
microsporum
|
|
|
reservoir for microsporum
|
pets
|
|
|
what fungus can cause ie
|
candida
|
|
|
pH of vaginal discharge: candida vs bacteria vs parasite
|
pH doesn't change in candida. Bacteria & parasite: ph > 4.5
|
|
|
which fungus is catalase +
|
aspergillus
|
|
|
tx for superficial candida
|
nystatin
|
|
|
histology of aspergillus
|
mold w/ septate hypahe that branch at acute angles
|
|
|
where is cryptococcus often found
|
soil and pigeon droppings
|
|
|
dx of cryptococcus
|
latex agglutination detects polysaccaride capsule
|
|
|
presentation of cryptococcus in brain
|
soap bubble lesions
|
|
|
how are people infected with cryptoccosu
|
lungs
|
|
|
where is aspergillus flavus found
|
rice, peanuts
|
|
|
what does aspergillus flavus produce? What does it do?
|
aflatoxin, which mutates p53
|
|
|
histology of mucormycoses
|
mold w/ irregular nonseptate hypahe at wide angles
|
|
|
what part of body is mucormycoses seen
|
blood vessel walls where there is excess sugars. Penetrate cribiform plate and enter brain and form abscess
|
|
|
who gets mucormycoeses
|
diabetic, leukemic (i.e. IC)
|
|
|
black necrotic eschar on face
|
anthrax, mucormycoses,
|
|
|
tx for chlam - neonatal dz
|
azithromycin
|
|
|
dx for mucormycoses
|
mucosal biopsy
|
|
|
complication of mucormycoses
|
invasion of blood vessel lead to infarct
|
|
|
how is pneumocystis acquired
|
inhalation
|
|
|
dx of pneumocystis
|
lung biopsy or lavage, methenamine silver stain
|
|
|
tx of pneumocystis
|
tmp smx, pentamidine, dapsone
|
|
|
when do you start prophylax for pneumocystis in hiv
|
cd4 < 200
|
|
|
nodular ascending lymphangitis
|
sporotrichosis
|
|
|
histological appearance of pneumocystis
|
saucer shaped yeast
|
|
|
histological appearance of sporothrix
|
cigar shaped yeast w/ unequal budding
|
|
|
tx for sporothrix
|
itraconazole, potassium iodide
|
|
|
what 2 forms can entamoeba exist in
|
cyst, trophozoite (need 2 types of tx)
|
|
|
why use iodoquinol for entamoeba
|
to clean out cysts in gi
|
|
|
bloody diarrhea, protozoa infection, cysts w/ 4 nuclei. Hepatic findings
|
entameoba. Anchovy paste lesions in liver w/ jaundice
|
|
|
what might cytoplasm of entamoeba contain
|
rbcs
|
|
|
cysts, watery diarrhea in protozoal infection. How to stain
|
cryptosporidium. See cysts on acid fast stain
|
|
|
what is triad of congenital toxo
|
chorioretinits + hydrocephalus + intracranial calcifications
|
|
|
what protozoa can cross the placenta
|
toxo
|
|
|
tx for toxo
|
sulfadiazine, pyrimethamine
|
|
|
sx of toxoplasmosis
|
flu/swollen lymph. IC: pneumonitis, myocarditis, necrotizing encephalitis, skeletal mm infection
|
|
|
rapidly fatal meningoencephalitis
|
naeglaeri fowleri
|
|
|
how does naeglaria get into body
|
cribiform plate
|
|
|
dx of naeglaria
|
ameba in csf
|
|
|
sx of trypanosoma brucei
|
sleeping sickness: swollen lymph, recurring fever, somnolence, coma
|
|
|
what bug transmits trypanosoma brucei
|
tsetse fly
|
|
|
bit of reduviid bug vs tsetse fly
|
tsetse = painful
|
|
|
what transmits t cruzi
|
reduviid bug
|
|
|
what transmits leishmania
|
sandfly
|
|
|
macrophages that contain protozoa that have lost flagella
|
leishmania (amastigote)
|
|
|
tx for t cruzi
|
nifortimox
|
|
|
tx for t brucei
|
suramin for blood borne, melarsoprol for cns
|
|
|
sx of leishmania
|
spiking fevers, hsm, and pancytopenia
|
|
|
tx of leishmania
|
sodium stibogluconate
|
|
|
lifecycle of malaria
|
anopheles transmits sporozoite to blood -> infection of liver -> merozoite -> propagation in rbc -> formation of gametocytes that gets taken up by mosquito
|
|
|
sx of p malaria
|
72 hr fever, headache, anemia, splenomegaly
|
|
|
what transmits malaria
|
anopheles
|
|
|
cycle of p vivax/ovale
|
cycles every other day
|
|
|
cycle of p falciparum
|
daily cycles (quotidian)
|
|
|
which plasmodium can occlude capillaries in brain kidney and lung
|
p falciparum
|
|
|
which plasmodium infects old rbcs. New rbcs. Both
|
malaria, vivax/ovale, falciparum
|
|
|
which plasmodium demonstrates small trophozoite ring? Large? Band?
|
falciparum, vivax/ovale, malaria
|
|
|
which plasmodium can remain dormant in liver? How to tx
|
vivax/ovale. Add primaquine
|
|
|
how to tx malaria if chloroquine resist
|
mefloquine
|
|
|
maltese cross in rbc
|
babesia
|
|
|
fever and hemolytic anemia in NE us
|
babesia
|
|
|
how is t vaginals diff from gardenella
|
gardenerella is 1.not std 2. no pain 3. bacteria 4. gray discarge, trich is green
|
|
|
strawberry cervix
|
trichimonas
|
|
|
1 nucleus, 5 flagella
|
trichimonas
|
|
|
2 nuclei, 4 flagella
|
giardia
|
|
|
muscle pain and periorbital edema after eating prok
|
trichinella
|
|
|
lung pneumonitis w/ eosinophilic infiltrate after eating contaminated food
|
loffler's syndrome (ASCARIS, but also strong, hookworm, trichinella)
|
|
|
what are hookworms
|
ancyclostoma, necator
|
|
|
niridazole used to tx
|
dracunculus
|
|
|
which worms can cause intestinal infection
|
pinworm, ascaris, trichinella, strongyloides, hookworms
|
|
|
which helminths get in through skin
|
SANS (strong, hookworms, schistosoma)
|
|
|
what is pinworm
|
enterobius
|
|
|
transmitted by female blackflies
|
onchocerca
|
|
|
hyperpigmented skin after bite
|
onchocerca
|
|
|
sx of onchocerca
|
river blindness, black skin
|
|
|
how is loa loa transmitted
|
deer fly, horse fly, mango fly
|
|
|
worm crawling in conjunctiva
|
loa loa
|
|
|
worm transmitted by female moaquito
|
wucheria
|
|
|
viseral larva migrans
|
toxocara
|
|
|
allergic reaction to microfilaria
|
onchocerca
|
|
|
granulomas in eyes can cause blindness (worm)
|
toxocara
|
|
|
swiss cheese brain
|
t solium
|
|
|
anaphylaxis during gall bladder surgery
|
echinococcus
|
|
|
what are nematodes
|
roundworm
|
|
|
what are cestodes
|
tapeowrm
|
|
|
worm that can cause b12 deficiency
|
d latum
|
|
|
how to tx d latum
|
praziquantel
|
|
|
how to tx echinococcus
|
bendazole
|
|
|
smallest cestode
|
echinococcus
|
|
|
what are trematodes
|
fluke
|
|
|
carried by snails (helminth)
|
schistosoma
|
|
|
inflammation of liver and spleen and portal hypertension
|
shistosoma mansoni
|
|
|
scc of bladder
|
s hematobium
|
|
|
swimmer's itch (helminth)
|
schistosoma
|
|
|
how to treat fluke infection
|
praziquantel
|
|
|
helminth assoc w pigmented gallstone
|
clonorchis sinensis
|
|
|
cholangiocarcinoma
|
clonorchis sinensis
|
|
|
helminth found in undercooked fish
|
d latum, clonorchis sinensis
|
|
|
eggs in dog feces
|
echinococcus
|
|
|
undercooked crab meat
|
paragonimus westermani
|
|
|
hemoptysis and inflammation of lung after eating crabs
|
paragonimus westermani
|
|
|
intestinal infection that leads to anemia because parasite feeds off of blood
|
hookworms
|
|
|
compare trematodes vs nematode in terms of body structure
|
nematodes have compete digestive tube, trematode don't. both are nonsegmented unlike tapeowrms
|
|
|
which parasies have flagella
|
giardia, trichimonas, leishmania, trypansoma
|
|
|
pedunculosis capitis vs pubis. Tx?
|
lice vs crabs. Tx w/ primethrin
|
|
|
what are the live vaccines
|
small, yellow fever, chickenpox, mmr, polio (sabin)
|
|
|
what is the only live vaccine that can be given to hiv+
|
mmr
|
|
|
what are the killed vaccines
|
rabies, influenca, polio (salk), hav
|
|
|
what are the recombinant viruses
|
hbv, hpv (6,11,16, 18)
|
|
|
which vaccines have component of egg in them
|
flu, yellow fever
|
|
|
what are the positive stranded rna viruses
|
I went to a retro toga party and drank flavored corona and ate hippy california pickles
|
|
|
which viruses are diploid
|
retrovirus
|
|
|
which dna virsus replicate in the cytoplasm
|
poxvirus
|
|
|
which rna viruses replicate in the nucleus
|
influencza, retrovirus
|
|
|
what are the naked viruses
|
cpr (calici, picorna, reo) and papp (parvo, polyoma, adeno, papilloma). Also HEV
|
|
|
where do enveloped virsues acquire their envelopes?
|
plasma membrane EXCEPT HERPESVIRUS
|
|
|
what viruses are more resistant o harsh environment: naked or enveloped
|
naked
|
|
|
how are most naked viruses transmitted
|
feco oral
|
|
|
what are the helical RNA viruses
|
BARF COPD (bunya, arena, rhabdo, filo, corona, orthomyxo, paramyxo, delta)
|
|
|
what group of viruses must carry protease
|
+ sense, linear, nonsegmented ssRNA virus
|
|
|
what type of virus will invoke humoral response? Cell mediatedD?
|
naked = humoral
enveloped = both |
|
|
which DNA viruses are icosahedral
|
all except pox
|
|
|
which DNA viruses are linear
|
all except papilloma and polyoma (circular, supercoiled) and hepadna (circular incomplete)
|
|
|
sx of adenovirus
|
sore throat, hemorrhagic cystisis, pneumonia, conjunctuvitis, gastroenteritis
|
|
|
dz caused by b19 parvovirus
|
1. aplastic crisis in sickle cell 2. erythema infectiosum 3. hydrops fetalis 4. rbc aplasia and RA-like dz in adults
|
|
|
contrast rash caused by erythema infectiosum vs roseola
|
erythema infectiosum is rash on face that can spread to trunk. Roseola only on face. Also roseola rash appears only after fever, whereas b19 is concurernt
|
|
|
what type of virus is jc virus
|
polyoma
|
|
|
contrast smallpox lesions w/ chicken pox
|
lesions are same age, are deeper, more on face and palms
|
|
|
flesh colored dome lesion w/ central dimple
|
molluscum contangiosum
|
|
|
MCC of sporadic encephalitis
|
hsv
|
|
|
cowdry type A inclusions seen in
|
hsv1&2
|
|
|
route of transmission of hsv1
|
resporatory, saliva
|
|
|
dzz caused by hsv1
|
gingivostomatitis, keratoconjunctuvitis, temporal lobe encephalitis, esophagitis, bell's
|
|
|
complications of vzv
|
pneumonia, encephalitis, varicella zoster
|
|
|
what cells do cmv remain latent inside
|
mononuclear cells
|
|
|
what cells and what gland does ebv latent
|
b cells, salivary
|
|
|
relationship of cmv to mhc
|
blocks mhc I expression
|
|
|
owl's eye inclusion in viral infection
|
cmv
|
|
|
transcriptional changes in kaposi's sarcoma
|
increased vegf, decreased rb
|
|
|
what cells are affected by hhv8
|
endothelial cells
|
|
|
mcc of infantile febrile seizures
|
hhv6
|
|
|
high fevers followed by rash in children
|
hhv6
|
|
|
what corresponds to the following: hhv1-8
|
hsv1, hsv2, vzv, ebv, cmv, roseola, 7 = nothing, kaposis
|
|
|
peak incidence of mononucleosis
|
15-20
|
|
|
"downy cells"
|
atypical lymphocytes
|
|
|
what cancers does ebv predispose to
|
hairy leukoplakia, hodgekins, burkitts, nasopharyngeal carcinoma, 1* cns lymphoma, nonhodgekins lymphoma
|
|
|
what things can produce atypical lymphocytosis
|
ebv, cmv, toxoplasma, listeria, bartonella, hhv6, phenytoin
|
|
|
appearance of hairy leukoplakia
|
white patches in lateral aspect of tongue
|
|
|
fever, hsm and lymphadenopathy develops rash after tx w ampicillin
|
ampicillin rash assoc/ w/ ebv
|
|
|
of the following, which are arbovirus: colorado tick fever, norwalk, yellow fever, dengue, st lous enceph, west nile, eastern equine, western equine, ebola, marburg, lassa fever, california encph, sandfly fevere, rift valley fever, crimean congo fever, hantavirus
|
most proper names and locations. Except colorado tick, norwalk, ebola, marburg, lassa fever, and hantavirus
|
|
|
dzz caused by cox a
|
herpangina, hand foot mouth, meningitis
|
|
|
contrast herpangina vs hsv
|
both have vesicles in mouth. Herpangina is more internal (palate), hsv is more external
|
|
|
dzz caused by cox b
|
myocarditis, pericarditis, meningitis
|
|
|
mcc of adult gastroenteritis
|
norwalk
|
|
|
jaundice, fever, black vomit
|
yellow fever
|
|
|
fever+severe arthralgia+myalgia+rash
|
dengue
|
|
|
2nd most common cause of viral encephalitis
|
st louis
|
|
|
seasonal characteristic of arbovirus
|
tends to occur in summer
|
|
|
complication of sars
|
ards
|
|
|
what type of virus is htlv
|
retrovirus
|
|
|
classify the following viruses: rotavirus, cox, hev, hav, norwalk, rhino, echo, hanta, crimean congo
|
reo, picorna, hepe, picorna, calici, picorna, picorna, bunya, bunya
|
|
|
classify the following viruses: yellow fever, eastern equine, rubella, influenza, st louis, west nile, parainfluenza, hcv
|
flavi, toga, toga, orthomyxo, flavi, flavi, paramyxo, flavi
|
|
|
classify the following viruses: dengue, western equine, rsv, ebola, mumps, marburg, lassa fever, sandfly, crimean, hdv, california encephalitis, lcmv
|
flavi, toga, paramyxo, filo, paramyxo, filo, arena, bunya, bunya, delta, bunya, arena
|
|
|
what rna virus is spread by mice
|
lassa fever
|
|
|
what are the negative strand viruses
|
always bring polymerase or fail replication (arena, bunya, paramyxo, orthomyxo, filo, rhabdo) also delta
|
|
|
what are the segmented viruses
|
boar (bunya, orthomyxo, arena , reo)
|
|
|
which picornavirus can cause meningitis
|
all except rhino and hav
|
|
|
which picornavirus are enterovirus (feco oral )
|
all except rhino
|
|
|
why cant rhinovirus infect gi tract
|
acid labile
|
|
|
what transmits yellow fever
|
aedes mosquito
|
|
|
acute diarrhea in day care centers in winter
|
rotavirus
|
|
|
green diarrhea
|
rotavirus
|
|
|
descripbe the role of hemagluttin and neuroaminidase
|
promotes viral entry, promotes release
|
|
|
genetic shift vs drift
|
drift = epidemic & reassortment, shift=pandemic, random mutation
|
|
|
why do people die of influenza
|
secondary infection
|
|
|
fever, postauricular tenderness and rash in children
|
rubella. MEASLES DOES NOT CAUSE POSTAURICULAR TENDERNESS
|
|
|
where would you be most likely to see lymphadenopathy in rubella
|
suboccipital
|
|
|
characteriscs of rubella rash
|
starts on face and goes down, but face clears often by the time it is seen
|
|
|
mcc of croup
|
parainflunza
|
|
|
what other virus have na and hg besides influenza
|
paramyxo (except rsv)
|
|
|
what protein is common to paramyxo and what does it cause
|
f protein, causes fusion and syncytia (multinucleated cells)
|
|
|
what is palivizumab used for
|
rsv infection, neutralizes f protein
|
|
|
pathology of rotavirus
|
villous destruction with atrophy (decreased absorption of sodium and water)
|
|
|
sx of measles
|
cough, coryza, conjunctuvitis, koplik spots followed by head to toe maculopapular rash
|
|
|
3 complications of measles
|
sspe, encephalitis, giant cell pneumonia
|
|
|
tx of measles
|
vitamin a
|
|
|
sx of mumps
|
POMP (parotitis, orchitis, meningitis, pancreatitis)
|
|
|
what cells are eventually targeted by rabies
|
purkinje cels of cerebellum
|
|
|
what does rabies bind to to enter neuron
|
nAChR
|
|
|
management of rabies
|
immediate vaccination on exposure, also immunoglobluin
|
|
|
progression of rabies
|
fever -> agitaiton, photo and hydrophobia -> paralysis, coma
|
|
|
common animals to have rabies
|
bat, raccoon, skunk, cayote
|
|
|
what type of viruses are hav, hbv, hcv, hdv, hev
|
picornavirus, hepadnavirus, flavivirus, deltavirus, hepevirus
|
|
|
incubation time of hav vs hbv vs hcv vs hev
|
hev and hav are short (3w), others are long (3m)
|
|
|
which hepatits has highest mortality in preg
|
hev
|
|
|
which hepatitis predispose to chronic hep, cirrhosis, and hcc
|
hbv and hcv
|
|
|
which hepatitis is enteric transmission
|
hav, hev
|
|
|
which hepatitis is associated with water borne epidemics
|
hev
|
|
|
common cause of posttransfusion hepatitis
|
hcv
|
|
|
what protein is required by hdv
|
hbv surface ag
|
|
|
which hepatitis is associated with cryoglobulinemia
|
hcv
|
|
|
which hepatitis is associated with pan
|
hbv
|
|
|
which hepatitis is associated with mpgn1
|
hbv
|
|
|
most common needle stick infection
|
hbv
|
|
|
histological diff b/w hbv and hcv
|
hcv will have a lymphocytic infiltrate and focal microvascular steatosis
|
|
|
know antigen vs time of hepatitis
|
p172
|
|
|
what does hiv bind on t cells
|
cxcr4, cd4
|
|
|
what does hiv bind on macrophage
|
ccr5, cd4
|
|
|
what is p24
|
capsid protein that is a serologic marker in hiv infection
|
|
|
what is gp41
|
env protein that is responsible for fusion and entry in hiv
|
|
|
what is gp120
|
env protein that mediates attachment in hiv
|
|
|
what is reservoir for hiv in infection
|
follicular dendritic cells
|
|
|
when is aids dx made
|
<200 cd4, or If hiv+ w/ aids defining infection or if cd4/cd8 < 1.5
|
|
|
elisa vs western blot in hiv
|
elisa is good screening test (sensitive), western blot is speific
|
|
|
why are babies born to hiv+ moms likely to have false positive
|
anti gp120 can cross placenta
|
|
|
why are there less cd4 cells in hiv
|
1. cell lysis 2. ctl mediated killing 3. multinucleated giant cell formation
|
|
|
review the time course of hiv infection
|
p174
|
|
|
what is the most common aids related malignancy
|
kaposis sarcoma
|
|
|
what is the most common cause of blindness in aids
|
cmv retinits
|
|
|
when is threshold for opportunistic infections in aids
|
<400 cd4
|
|
|
management of aids at <200, <100, <50 cd4
|
start tmpsmx/dapsone (pcp), azithromycin, fluconazole
|
|
|
review opportunistic infections
|
p174
|
|
|
what is gerstmann starussler schienker syndrome
|
inherited prion dz
|
|
|
what is creutzfeldt jakob dz
|
sporadic prion dz
|
|
|
what is normal flora on: skin, nose, oropharynx, dental, colon, vagina
|
p175
|
|
|
neonates delivered by cesarean section: flora compared to vaginal
|
less
|
|
|
vibrio parahaemolytics and vulnificus: what dz and when
|
contaminated seafood causes food poison, vulnivicus can cause wound infection
|
|
|
which organisms have rapid onset and rapid ending of food poison
|
s aureus, b cereus
|
|
|
what food is most likely to cause food poison from c perfringens
|
reheated meat
|
|
|
which bacteria secrete proteases that cleave cellular proteins
|
botulinum and tetanus kills synaptobrevin, lethal factor kills MAP; exfoliating toxin kills desmoglein; speB in pyogenes kills nonspecific protein
|
|
|
which bacteria are associated with the following animal things: cat scratch, dog/cat bite, cat feces, animal urine, dog feces
|
bartonella, pasturella, toxo, leptospirosis, yersinia
|
|
|
review diarrhea table
|
p176
|
|
|
csf finding in meningitis (pressure, cell types, protein, sugar)
|
p177
|
|
|
mcc of osteomyletis: normal, sex, diabetes, sickle, prosthetic, vertebral, cat or dog bite
|
p177
|
|
|
where does osteomyelitis uisally occur
|
metaphysis
|
|
|
what bacteria tend to occur w/ prosthetic replacement
|
s epidermidis
|
|
|
sx of uti
|
dysuria, frequency, urgency, suprapubic pain
|
|
|
risk factors for male uti
|
infant w/ defect, vesicoureteral reflux
|
|
|
risk factors for elderly uti
|
enlarged prostate
|
|
|
sx of pyelo
|
fever, chills, cva tenderness, hematuria, wbc cast
|
|
|
risk factors for uti
|
obstruction, kidne surgery, cath, gu malformation, dm, preg
|
|
|
positive nitrite test in ua indicative of
|
gn bacterial uti
|
|
|
3 mcc of uti
|
e coli, staph saphro, klebs
|
|
|
review uti table
|
p178
|
|
|
swarming on agar
|
cuz of motility. Proteus
|
|
|
most common cause of sepsis
|
e coli sepsis from uti
|
|
|
sx of congenital rubella
|
pda + cataracts + deafness + blueberry muffin rash
|
|
|
sx of congenital cmv
|
deafness + seizures + petechial rash + microceph/mr
|
|
|
sx of congenital syphilis
|
oft hydrops fetalis; notch teeth, saddle nose, short maxilla, saber shin, DEAF, etc
|
|
|
causes (infection) of deafness in child
|
rubella, cmv, syphilis
|
|
|
congenital vzv infection can result in what sensory deficit
|
eye
|
|
|
does mumps have rash
|
no
|
|
|
where do vzv rashes begin
|
trunk
|
|
|
causes of fever in postop
|
by time elapsed: wind (atelectasis), water (uti), wound (infection), walking (dvt), wane (=vein, thrombophebitis), wonder drugs (usually antibiotic)
|
|
|
another name for Calymmatobacterium granulomatis
|
klebsiella granulomatis
|
|
|
which std can cause rectal stricture
|
lymphogranulum venerum
|
|
|
which stds can have lymphadenopathy
|
syphilis, chancroid, lymphogranulum venerum (NOT GRANULOMA INGUINALE)
|
|
|
chandelier sign
|
severe cervical motion tenderness assoc/ w/ pid
|
|
|
presentation of chlamydia vs neisseria
|
neisseria is usually acute w/ fever, chlamydia is oft asymptomatic
|
|
|
2 most common nosocomial infections
|
e coli UTI and s aureus
|
|
|
most common nosocomial newborn nursery infections
|
CMV, RSV
|
|
|
most common foley cath nosocomial infection
|
e coli, proteus
|
|
|
most common infection to be transmitted by dialyssi
|
hbv
|
|
|
most common infection from giving too much IV nutrient
|
candida
|
|
|
oval yeast in macrophages
|
histoplasma
|
|
|
biopsy reveals neutrophilic inflammation of vessels in hiv+
|
bartonella henselae
|
|
|
biopsy reveals lymphocytic inflammation of vessels in hiv+
|
hhv8
|
|
|
brain abscess in hiv+
|
toxoplasma
|
|
|
cotton wool spots in eye in hiv+
|
cmv
|
|
|
enlargement of waldeyer's ring in hiv+
|
ebv (nhl)
|
|
|
severely enlarged neck in child with fever and pain
|
diphtheria
|
|
|
which ab's are bacteriostatic
|
ECSTaTiC - erythromycin, clindamycin, SMX, TMP, tetracycline, chloramphenicol
|
|
|
which ab's are bacteriocidal
|
Very Finely Proficient At Cell Murder - vanc, fluoro, pen, aminoglycoside, cephalo, metronidazole
|
|
|
penicillin is structural analog of what
|
d-ala-d-ala
|
|
|
what form of pen is IV? Oral?
|
G, V
|
|
|
3 mechanisms of penicillin
|
1. bind pbp's 2. block transpeptidase cross linking 3. activate autolysis
|
|
|
spectrum of pen G
|
gp (incl actinomyces) and syphilis
|
|
|
which penicillin drug can cause intersititial nephritis
|
methicillin
|
|
|
what is the additional spectrum added by aminopenicillins
|
HELPS kill enterococci = Hi, Ecoli,Listeria, Proteus, Salmonella, enterococci
|
|
|
which ab cause most of pseudomembranous colitis (c diff)
|
clindamycin, aminopen
|
|
|
name some penicillins used to tx pseudomonas
|
ticarcillin, carbenecillin, pipericillin (TCP - takes care of pseudomonas)
|
|
|
name some b lactamase inhib
|
clavulanic acid, sulbactam, tazobactam
|
|
|
mechanisms of resistance to penicillin
|
beta lactamase, alternation in pbp
|
|
|
spectrum 1g ceph
|
PEcK - proteus, e coli, klebsiella + gram pos
|
|
|
classify the following ceph: ceftraixone, cefaclor, cephalexin, cefoxitin, cefazolin, cefepime, cefotaxime, cefuroxime, ceftazidime
|
3, 2, 1, 2, 1, 4, 3, 2, 3
|
|
|
spectrum of 2g ceph
|
gram pos + HEN PEcKS - hi, enterobacter, neisseria proteus, ecoli, klebs, serratia
|
|
|
spectrum of 3g ceph
|
gn. Ceftriaxone good vs meningitis. Ceftazidime good vs pseudomonas
|
|
|
spectrum of 4g ceph
|
gram pos + pseud
|
|
|
is there cross hs with pen for ceph
|
5-10%
|
|
|
what antibiotic can increase nephrotox of aminoglycosides
|
ceph
|
|
|
what antibiotic can cause nausea and ill feeling with alcohol use
|
ceph, esp cefamandole AND METRONIDAZOLE
|
|
|
resistance to ceph
|
modification of prtoein, beta lactamase. These are same as pen
|
|
|
spectrum of aztreonam
|
gnr
|
|
|
pt infected w/ e coli uti and has azotemia -- what to give: aztreonam or aminoglycoside
|
aztrenam
|
|
|
does aztreonam has cross hs w/ ceph or pen
|
no
|
|
|
what drug is imipenam always given w/
|
cilastatin, inhibits dhp1 in kidney and reduce inactivation
|
|
|
spectrum of carbapenams
|
wide -- gram pos cocci, gnr, anaerobes
|
|
|
which carbapenam has greatest risk of seizures
|
imipenam
|
|
|
what is the drug of choice for enterobacter
|
meropenam
|
|
|
mechanism of vanc
|
binds d-ala-d-ala and prevents cell wall formation
|
|
|
spectrum of vanc
|
gram pos ONLY
|
|
|
tox of vanc
|
nephro, oto, thrombophlebitis, red man
|
|
|
which antibiotic can cause a widespread flushing reaction
|
vanc
|
|
|
how to prevent red man reaction w/ vance
|
give antihistamine
|
|
|
which antibiotics inhibit 30s
|
aminoglycoside, tetracycline
|
|
|
which ABs inhibit 50s
|
chloramphenicol, clinda, macrolide, lincomycin, linezolid, streptogramin
|
|
|
mechanism of linezolid
|
binds 23s and prevention of inhibiation comples
|
|
|
mechanism of aminoglycoside
|
inhibits initiation complex, causes mrna misreading
|
|
|
which Abs block translocation
|
erythromycin
|
|
|
which abs block binding of trna to the A site
|
tetracycline
|
|
|
which abs block peptidyltransferase activity
|
chloramphenicol, lincosamides
|
|
|
resistance to aminoglycoside
|
inactivation of drug (acetylization, phosphorylation, adenylation)
|
|
|
which tetracycline can be used in renal patients
|
doxy (fecal elim)
|
|
|
which abs should not be taken with milk, antacids, or iron containing foods
|
divalent cations inhibit absorption of tetracyclines
|
|
|
spectrum of tetracycline
|
VACUUM THe BedRoom - vibrio, acne, cholera, ureaplasma, urolytica, mycoplasma, tuleramia, hpylori, borellia, ricketssia
|
|
|
resistance to tetracycline
|
decreased uptake, increased efflux
|
|
|
binds to 23s
|
macrolide, linezolid, lincosamides, chloramphenicol. Pretty much all the 50s inhibitors
|
|
|
spectrum of macorlide
|
PUS - atypical pneumonia, URI, STD + neisseria
|
|
|
toxicity of macrolides
|
prolonged QT, inhibition of CYP leads to GI discomfort & cholestatic hepatitis
|
|
|
what antibiotic could cause decreased frequency of urination
|
demeclocycline
|
|
|
which ab can cause eosinophilia
|
macrolides
|
|
|
resistance to macrolides
|
methylation of 23s
|
|
|
resistance to chloramphenicol
|
inactivation of drug (acetylizatin)
|
|
|
use for chlormapnenicl
|
meningitis
|
|
|
use for clindamycin
|
anaerobic infections above diaphragm
|
|
|
mechanism of smx
|
inhibition of dihydropterate synthase
|
|
|
spectrum of tmpsmx
|
uti, shigella, salmonella, pcp
|
|
|
what antibiotics can cause intersitial nephritis
|
sulfonamides, methicillin
|
|
|
what drug can displace other drugs from their binding site
|
sulfonamides
|
|
|
resistance to smx (3)
|
altered dihydropteroate synthase, decreased uptake, increased PABA
|
|
|
why can smx cause kernicterus
|
cyp inhib
|
|
|
name all the sulfa drugs
|
sulfonamide, sulfasalazine, sulfonylurea, thiazide, acetazolamide, fursemide, celcoxib, prebenecid
|
|
|
whats nalidixic acid
|
quinolone antibiotic (i.e. like fluoroquinolone)
|
|
|
whats enoxacin
|
fluoroquinolone
|
|
|
fluroquinolone cannt be taken with what
|
antacid
|
|
|
spectrum of fluoroquinolone
|
gnr incl pseudomonas and neisseria
|
|
|
antipseudomonal fluoroquinoles
|
cipro, levo
|
|
|
uti fluroquinolone
|
norfloccacin
|
|
|
respiratory fluoroquinolone
|
moxi, levo
|
|
|
CI for fluoroquinolone
|
pregnant, infant (cartilage dmg)
|
|
|
ab that causes leg cramps and myalgia in children
|
fluoroquinolone
|
|
|
resistance to fluoroquinolone
|
mutation in dna gyrase
|
|
|
mechanism of metronidazole
|
ros
|
|
|
spectrum of metronidazole
|
GET GAP (giardia, entamoba, trich, garnerella, anarobe, pylore). Anaerobe infections below the diaphragm
|
|
|
which antibiotic has a metallilc taste
|
metronidazole
|
|
|
spectrum of polymixin
|
gnr, only used topically
|
|
|
what is colistimethate
|
polymixin e
|
|
|
mechanism of polymimxin
|
basic proteins that act like detergents to poke holes in membrane
|
|
|
toxicity of polymixin
|
neuro, ATN
|
|
|
prophylax for tb
|
inh
|
|
|
tx for mai
|
azithromycin, rifampin, ethambutol, streptomycin
|
|
|
mechanism of ethambutol
|
blocks carboyhydrate polymerization of cell wall, blocks arabinosyltransferase
|
|
|
why is pyrazinamide effective in tx tb
|
active in acidic ph where tb is
|
|
|
2nd line therapy for tb
|
cycloserine
|
|
|
side effects of ethambutol
|
red green color blindness
|
|
|
main toxicity of tb drugs
|
hepatotox
|
|
|
mechanism of inh
|
decreases synthesis of mycolic acids
|
|
|
resistance to inh
|
inh is converted by bacteria to active form by CATALASE-PEROXIDASE (so mod)
|
|
|
tox of inh
|
INH Injures Neurons and Hepatocytes. Lupus.
|
|
|
is there a difference in genetic ability to process inh
|
fast v slow acetyl
|
|
|
tx for leprosy
|
dapsone, rifampin (delays resistance for dapsone), clofazimine
|
|
|
mechanism of rifampin
|
beta subunit of rna pol inhibit
|
|
|
usage of rifampin (4)
|
tb, delays resist to dapsone for leprosy, meningocox prophylax and hib prophylax
|
|
|
which drug can produce orange body fluids
|
rifampin
|
|
|
tx for tb
|
RIPE - rifampin, INH, pyrazinamide, ethambutol
|
|
|
how to prophylax: meningocox, gonorrhea, syphilis, uti, pcp, endocardis w/ dental, mai
|
1. rifampin/mino 2. ceftraixone 3. pen g (benzathine) 4. tmpsmx 5. tmpsmx, pentamidine,dapsone 6. pen 7. azithromycin
|
|
|
how to treat vre
|
linezolid + streptogramin
|
|
|
mechanism of amphotericin
|
binds ergosterol and forms pores (2)
|
|
|
tox of amphoterrible
|
nephro (most notorious),hepatotox, arrythmia, anemia, phlebitis, hypotension, fever chills
|
|
|
what can reduce toxicity for amphotericin
|
hydration can reduce nephrotox, usage of liposomal amptericin
|
|
|
use for nystatin
|
topical candidasis
|
|
|
mechanism of azoles
|
inhibits p450 (acts on normal cels too), which helps to make ergosterol
|
|
|
which antifungal can cross bbb
|
fluconazole
|
|
|
which azoles are used only topiccaly
|
colotrimazole, micronazaole
|
|
|
mechanism of flucytosine
|
inhibits dna synthesis cuz gets converted to 5fu
|
|
|
tox of flucytosine
|
bm suppression, nvd
|
|
|
what is caspofungin used for
|
invasive aspergillosis
|
|
|
mechanism of caspofungin
|
inhibits synthesis of beta glucan (cell wall component that is NOT ergosterolO)
|
|
|
mechnaism of terbinafine
|
inhibits squalene epoxidease (first step in ergosterol synthesis)
|
|
|
use of terbinafine
|
dermatophytes, esp onchomyucosis
|
|
|
mechanism of griseofulvin
|
interferes w/ MTs and mitoses
|
|
|
only antifungal to have mental side effects
|
griseofulvin
|
|
|
mechanism of pyrimethamine
|
inhibits DHFR selective to plasmodium. Good for toxo
|
|
|
mechanism of suramin
|
inhibits energy metabolism. No cns
|
|
|
mechanism of melarsoprol
|
inhibits sulfhydryl groups in parasite enzymes. Can go into cns
|
|
|
mechanism of nifurtomix
|
ros
|
|
|
mechanism of sodium stibogluconate
|
inhibits PFK of leishmania
|
|
|
mechanism of chloroquine
|
blocks plasmodial heme synthesis
|
|
|
mechanism of mefloquine
|
??????
|
|
|
mechanism of pyrantel pamoate
|
stimulates nAChR and causes tetanic paralysis. Doesn't work on tapeworms or flukes
|
|
|
mechansim of praziquantel
|
increases calcium permeability in TAPEWORMS AND FLUKES
|
|
|
mechanism of ivermectin
|
stimulates GABA and causes immobilization; doesn't cross bbb and that's why it doesn't cause effects on humans
|
|
|
mechanism of amantadine
|
blocks viral uncoating (m2 protein)
|
|
|
mechanism of amantadine in parkinsons
|
increases dopamine release
|
|
|
what types of influnza can amatadine tx
|
influenza a only
|
|
|
toxicity of amantadine
|
ataxia, dizzy, slurred speech
|
|
|
mechanism of resitance to amatadine
|
mutated m2 prot
|
|
|
amantadine vs rimantidine
|
rimantadine doesn't cross bbb, so fewer side effectssss
|
|
|
mechanism of zanamivir
|
blocks neuroaminidase (blocks progeny release)
|
|
|
mechanism of oseltamivir
|
blocks neuroaminidase (blocks progeny release)
|
|
|
what can griseofulvin be applied toically for
|
trick question -- taken orally so that it can deposit in keratin containing tissues where superficial fungal infections are
|
|
|
what types of influnza can zanamivir and oseltamivir tx
|
both a and b
|
|
|
use of ribavirin
|
chronic hep c
|
|
|
mechanism of ribavirin
|
inhibits imp dehydrogenase
|
|
|
toxicity of ribavirin
|
hemolysis. Is a teratogen
|
|
|
mechanism of acyclovir and gancyclovir
|
these are guanosine analogs that have no phosphate groups. Gancyclovir is specific for cmv viral kinase. They get phosphate group attached by viral kinase and then host cell attaches more to make nucleotides. Inhibits viral DNA polymerase by chain termination
|
|
|
mechanism of resistance to acyclovir and gancyclovir
|
lack of viral kinase. Or for CMV can have mutated cmv dna polymerase
|
|
|
why is cidofovir good for resistant viruses
|
this is a monophosphate form, so doesn't need viral kinase
|
|
|
tox of acyclovir vs ganciclovyr
|
gancyclovir is more toxic. Involves depression of blood cells and renal tox
|
|
|
mechanism of foscarnet
|
pyrophosphate analog that blocks dna polymerase by binding to pyrophospate site
|
|
|
use of foscarnet
|
resistant cmv or hsv
|
|
|
why does foscarnet cause seizures
|
renal toxicity causes loss of ca and mg
|
|
|
what is haart
|
2 x nrti + pi or nnrti
|
|
|
which hiv drugs can cause lipodystrophy
|
amprenavir, saquinavir, indinavir, RALTEGRAVIR
|
|
|
which hiv drugs can cause pancreatitis
|
ritonavir, zalcitabine, stavudine, didanosine
|
|
|
which hiv drugs can cause peripheral neuropathy
|
didanosine, zalcitobine, stavudine
|
|
|
which hiv drugs can cause inhibition of cyp
|
pi
|
|
|
which hiv drugs can cause nephrolithiasis
|
indinavir
|
|
|
which hiv drugs can cause gi intolerance
|
pi, zidovudine
|
|
|
which hiv drugs can cause hepatic steatosis
|
didanosine, stavudine
|
|
|
which hiv drugs can cause lactic acidosis
|
nrti
|
|
|
which hiv drugs can cause megaloblastic anemia
|
zidovudine
|
|
|
which hiv drug can cause hypersensitivyt rxn
|
abacavir, enfuvertide
|
|
|
which hiv drug can cause rash
|
nnrti
|
|
|
which hiv drug can cause fp on cannabis test
|
efavirinz
|
|
|
which hiv drug can cause confusion
|
zidovudine
|
|
|
what hiv drug used in preg to prevent transmission
|
zidovudine
|
|
|
what does maraviroc bind
|
ccr5 (fusion inhibitor)
|
|
|
use of interferons
|
alpha - hbv, hcv, kaposi. Beta - ms. Gamma - nadph oxidase deficiency
|
|
|
tox of interferon
|
neutropenia
|
|
|
what could occur if this drug was given during preg: sulfonamide
|
kernicterus
|
|
|
what could occur if this drug was given during preg: erythromycin
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acute cholestatic hepatitis
|
|
|
which antimicrobials are teratogens
|
ribavirin, metronidazole (in 1st trim), griseofulvin, aminoglycoside
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|
|
which are safe abs to use in preg
|
pen, macrolide, metronidazole after first trim, nitrofurantoin
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|
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bad abs for preg
|
SAFE Moms Take Really Good Care - sulfonamide, aminoglycoside, fluoroquinolone, erythromycin, metronidazole, tetracycline, ribavirin, griseofulvin, chloramphenicol
|
|
|
which antibiotics can kill gnrs
|
aminopen, monobactam, polymixin, some ceph, aminoglycosides, pipercillin, fluoroquinolone
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|
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what antibiotic good for killing listeria
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ampicillin, linezolid
|
|
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what is reservoir for west nile
|
birds
|
|
|
flulike sx in summer
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arbovirus like west nile
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|
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cxr finding in parainfluenza
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steeple sign
|
|
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low pitch cough vs high pitch cough
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croup vs broncheolitis
|
|
|
mcc of viral mental retard
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cmv
|
|
|
which virus can cause PML
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jc virus (polyoma)
|
|
|
papillomavirus: lytic vs lysogenic cycle
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lysogenic involves e6, e7. lytic involves killing of keratinized epithelim
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|
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transmission of adenovirus
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aerosol, contact, fo
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|
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what type of HS is involved in dermatophyte infection
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hs4
|
|
|
what fungi can lead to infarction
|
mucormycoses, aspergillosis
|
|
|
small opacities in lung on xray after inhalation of bat droppings
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histoplasma calcifications
|
|
|
most common helminth infection
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ascaris
|
|
|
migration of toxocara vs ascaris
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toxocara is visceral larval migrans, can go to many places. Ascaris just goes to respiratory system
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|
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most common parasitic cause of myocarditis
|
trichenilla spirals
|
|
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how do you acrquire dracunculus
|
water with eggs
|
|
|
which nematodes are ingested
|
enterobius, ascaris, trichenella, toxocara
|
|
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how are cestodes acquired
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ingestion
|
|
|
which helminths have hook on scolex? Which one don’t
|
solium. Saginata
|
|
|
which helminths can migrate to lung
|
ascaris, toxocara, hookworms, strongyloides
|
|
|
which cells would be increased in leprematous infection
|
th2
|
|
|
how is borrelia recurrentis spread
|
lice
|
|
|
reservoir for leishmania
|
dogs rodent
|
|
|
what is kala azar
|
"kalo" = black - balck skin lesions
|
|
|
why does leishmania cause hsm and pancytopenia
|
invasion of macrophages (remember amastigotes) leads to spread to RES
|
|
|
where are merozoites likely to be released from
|
liver
|
|
|
what antifungal can cause anemia
|
amphotericin
|
|
|
how does ebola stop immune response
|
glycosylated coat
|
|
|
MCC of cold
|
rhino, then corona, then adeno
|
|
|
which virus binds to icam1
|
rhinovirus
|
|
|
how can rhinovirus cause otitis
|
inflammation of passage leads to blockage and then bacterial infection
|
|
|
which virus has higher mortality: eastern or western equine
|
eastern
|
|
|
does pertussis have a capsule
|
yes
|
|
|
effects of pertussis toxin
|
lymphocytosis
|
|
|
what toxin from pertussis can inhibit phagocytosis
|
adenylate cyclase toxin
|
|
|
what toxin can increase insulin and histamine sensitivity
|
pertussis
|
|
|
what type of host defense is needed to kill intracellular bacteria like listeria
|
good macrophage and cell mediated immunity to activate macrophage killing response
|
|
|
what ab's are inactivated by acetylization
|
aminoglycoside, chlormphenicol
|
|
|
round lesions w/ erythematous halo w/ necrotic center
|
ecthyma gangrenosum from pseudomonas
|
|
|
mcc of pneumonia in neonates
|
strep B, e coli
|
|
|
mcc of pneumonia in children
|
RSV, mycoplasma, chlamydia, pneomococcus
|
|
|
mcc of pneumonia in adults 18-40
|
mycoplasma, chlamydia, pneumococcus
|
|
|
mcc of pneumonia in adults 40-65
|
pneumococcus, hi, anaerobe, virus, mycoplasma
|
|
|
resistance to ab by inactivating drug
|
penicillin, cephalosporin, aminoglycoside, chloramphinicol
|
|
|
mcc of pneumonia in elderly
|
pneumococcus, influenza, anaerobe, hi, gnr
|
|
|
what is sulfisoxazole
|
sulfonamide
|
|
|
mcc of nosocomial pneumonia
|
staph, enteric gnr
|
|
|
mcc of IC pneumonia
|
staph, enteric gnr, fungi, virus, PCJ (HIV)
|
|
|
mcc of alcoholic pneumonia
|
anaerobe, klebs
|
|
|
what drug can cause kernicterus in infants
|
sulfonamides
|
|
|
mcc of CF pneumonia
|
pseudomonas
|
|
|
mcc of postviral pneumonia
|
pneumococcus, staph, hi
|
|
|
what is sulfadiazine
|
sulfonamide
|
|
|
mcc fungal pneumonia
|
histoplasma
|
|
|
how to tell between hcv and hbv on histology
|
hcv has lymphocytes and focal microvesicular steatosis
|
|
|
mcc meningitis in 0-6mo
|
group b strep, e coli, listeria
|
|
|
mcc meningitis in 6mo-6y
|
pneumococcus, meningococcus, hib, enterovirus
|
|
|
resistance to ab by not taking in drug or pumping out drug
|
tetracycline, sulfonamide
|
|
|
mcc meningits in 6-60yo
|
meningococcus, enterovirus, pneumococcus, hsv
|
|
|
mcc meningitis in 60+ yo
|
pneumnococcus, gnr, listeria
|
|
|
what is kernigs sx
|
lifting up thigh then extending leg produces pain if meningitis
|
|
|
what is brudzinsky's sx
|
involuntary lifting of leg when lifting neck
|
|
|
resistance to ab by modifying target of drug
|
penicillin, macrolide, sulfonamide, fluoroquinolone, cephalosporin
|
|
|
viral causes of meningitis
|
enterovirus, herpesvirus (hsv, vzv), hiv, west nile (and other arbovirus), mumps
|
|
|
name 3 non lactose fermenting oxidase - bacteria
|
salmonella, shigella, proteus
|
|
|
likelihood of reactivation vzv vs reactivation hsv in hiv pt
|
vzv reactivates at <400. hsv reactivates at <200
|
|
|
when does tb reactivate in hiv
|
<400
|
|
|
when do you start to see superficial fungal infections in hiv pt
|
<400
|
|
|
when do you start to see disseminated fungal infections in hiv
|
<200
|
|
|
when do you start to see disseminated mai in hiv
|
<50
|
|
|
when do you see cryptococcal meningoencephalitis in hiv
|
<50
|
|
|
another name for lipid A
|
endotoxin on outer membrane of gram negative
|
|
|
live vs killed vaccines -- what type of immunity invoked
|
killed = only humoral immunity. live = both humoral and cell mediated.
|
|
|
ring enhancing brain lesion in aids pt after eating pork
|
toxoplasma
|
|
|
what protein produced by pseudomonas contributes to ecthyma gangrenosum
|
elastase
|
|
|
sx of CMV colitis
|
nonspecific GI sx, erosions and ulcerations on colonscopy
|
