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I&I - Antibiotics + Bugs
N/A
219
Medical
Professional
12/14/2013

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Cards

Term
What are the classes of antibiotics that target the cell wall
Definition
B-lactams -> prevent PG synth; penicillins, cephalosporins, carbapenems
Vancomycin -> prevent D-alanyl D-alanine cross links
Term
Which antibiotics target nucleic acid synth?
Definition
Quinolones (DNA)
Rifampin (RNA)
TMP-SMX (folic acid)
Term
What ENZ are targeted by B-lactams?
Definition
Transpeptidases (inhibit PG synthesis)
Term
Penicillinase Resistant Atb = ?
Definition
Cloxacillin
Term
What happens with increasing Cephalosporin generation?
Definition
Get MORE Gram NEGATIVE COVERAGE
LESS S. aureus coverage
Term
1st Gen Ceph?
Definition
Cefazolin
Cephalexin (orange, cat pee)
Term
2nd gen Ceph?
Definition
Cefuroxime
Term
3rd Gen Cephalosporins
Definition
Ceftazidime
Ceftriaxone
Ceflixime
Term
ALL cephalosporins have NO coverage against __________
Definition
ENTEROCOCCUS (intrinsic resistance)
Term
Cheapest vs most expensive carbapenem?
Definition
Cheapest = Imipenem
Expensive = Meropenem
Term
Seizure risk with carbapenems?
Definition
Imipenem - seizure risk when taking
Meropenem - no seizure risk
Term
What Atb's are the broadest spectrum of the B-lactams?
Definition
The CARBAPENEMS
Term
Cross-reactivity between penicillins & what other drug when it comes to allergy?
Definition
Cephalosporins (more common in older generations)
Term
What do the Aminoglycosides target?
Definition
30S ribosome (bactericidal)
Term
Which Atb has ototoxicity?
Definition
Gentamicin
Term
What are often used in synergism when treating Gram +'ve endocarditis?
Definition
B-lactams + aminoglycosides
Term
Examples of aminoglycosides?
Definition
Gentamicin, Tobramycin
Term
What are the differences in mode of action of aminoglycosides vs. tetracyclines?
Definition
AminoG - 30S ribosome; bactericidal

Tetracycline - 30S ribosome, reversible binding; bacteriostatic
Term
Examples of Tetracycline Atb's
Definition
Tetracycline, Doxycycline
Term
What drug is NOT chemically similar to the macrolides, but has a similar mode of action?
Definition
Clindamycin
Term
Macrolides mode of action...
Definition
Bind to 50S ribosome; bacteriostatic
Term
Examples of Macrolides:
Definition
Erythromycin
Clarithromycin (P450 drug interactions)
Azithromycin (fewer interactions)
Term
What is the mode of action of the quinolones?
Definition
Act on DNA gyrase + topoisomerase II - prevent DNA synthesis

Resistance via DNA gyrase mutations
Term
Older generation Quinolones?
Definition
Ciprofloxacin, Norfloxacin
Term
Newer generation Quinolones?
Definition
Levofloxacin, Moxifloxacin
Term
What happens to quinolone activity as you go from older to newer generations...
Definition
OPPOSITE of cephalosporin trend.

Older generation = better for Pseudomonas
Newer generation = better for S. aureus
Term
What is the mode of action of trimethoprim-sulfamethoxazole?
Definition
TMP-SMX - interfere with folic acid synthesis + DNA synthesis

Acts on DHF reductase
Term
What Atb can cause kernicterus in the newborn?
Definition
TMP-SMX
Term
What Atb should be avoided in those taking K+ retaining drugs (hyperkalemia)?
Definition
TMP-SMX
Term
What types of organisms is metronidazole effective against?
Definition
ANAEROBES (Clostridia, Peptostrepto, Bacteroides)

PARASITES
Term
Which drug can lead to an elevation in the INR?
Definition
Metronidazole - kills Vit K producing microbes in the gut
Term
Which drugs inhibit ergosterol synthesis + ENZ in fungal respiratory chain?
Definition
Triazoles - Fluconazole, Voriconazole
Term
Most commonly ordered anti-fungal to treat Candidiasis...
Definition
Fluconazole
Term
Aspergillus (fungal) can be treated with either (one of 2)...
Definition
Voriconazole

Caspofungin (echinocandin)
Term
What does PIRO stand for in relation to sepsis?
Definition
Predisposition
Insult/Inflammation
Response
Organ Dysfunction
Term
SIRS can be dx'd with 2 or more of...
Definition
Resp rate > 20
Tachycardia (HR > 100)
Temp above 38 or below 36
Leukocytosis or leukopenia
Term
Sepsis = _______ + _________
Definition
Insult/Inflammation + SIRS
Term
Severe Sepsis = Sepsis + __________
Definition
Acute organ dysfunction
Term
Is severe sepsis more commonly acquired in the community or the hospital?
Definition
Community
Term
C. diff classification
Definition
Gram Positive, Spore-Forming, Rod

Obligate anaerobe
Term
Clinical syndromes associated with C. diff infection
Definition
Toxic megacolon - rapid expansion of colon

Pseudomembranous colitis - C. diff overgrowth of colon
Term
Main virulence factors of C. diff
Definition
TcdA and B

Cause diarrhea and colonic epithelial cytotoxicity, respectively
Term
The virulence factors of C. diff are part of a family called _______...and are encoded on the__________
Definition
LCTs - large clostridial toxins

Encoded on Pathogenicity Locus (only present on pathogenic strains)
Term
How many domains do the large clostridial toxins have and what is their mechanism of action?
Definition
3 domains

catalytic domain inactivates GTPases to paralyze cytoskeleton
Term
Only way to effectively kill C. diff spores?
Definition
BLEACH
Term
Treatment for C. diff?
Definition
Either PO metronidazole (anti-fungal/anti-parasitic) OR PO vancomycin

*Vanco must be taken PO, can't be given IV to treat C. diff
Term
Gold standard test for C. diff vs. one thats most commonly used
Definition
Most common = EIA

Gold standard = CCCNA
Term
C. perfringens microbe classification
Definition
Gram positive, spore forming rod

Obligate anaerobe
Term
Treatment for C. perfringens infection
Definition
Penicillin + Clindamycin + Sx
Term
What is the major virulence factor of C. perfringens?
Definition
Alpha-Toxin - metalloproteinase that is NEEDED in order for C. perfringens to be infective; cause DAG release from phospholipids
Term
TeNT vs. BoNT neurotoxins (Tetanus vs. Botox)
Definition
TeNT - causes sustained contraction by blocking inhibitory neurons in CNS

BoNT - causes flaccid paralysis by preventing ACh release from presynaptic terminals
Term
Microbiological classification of ALL Clostridia species?
Definition
Gram positive, spore-forming rods
Obligate anaerobes
Term
Microbiological comparison of Clostridia vs. Bacteroides
Definition
Clostridia - Gram positive, rod, sporulating, obligate anaerobe

Bacteroides - Gram negative, rod, non-sporulating, obligate anaerobe
Term
Main virulence factor of Bacteroides fragilis?
Definition
Polysacch. capsule - promotes abscess formation

Also have HlyA,B; BFT enterotoxin
Term
In intra-abdominal sepsis, which phase of infection is B. fragilis usually present in?
Definition
Chronic phase (get E. coli in acute phase)
Term
Treatment of Bacteroides fragilis infection?
Definition
Metronidazole
Carbapenems
Clindamycin
Term
Microbio. classification of Peptostreptococcus?
Definition
Gram positive cocci
Term
Treatment of Peptostreptococcus magnus?
Definition
1st line - penicillins

Then - metronidazole, carbapenems
Term
Which Atb can be used to treat almost all anaerobic infections?
Definition
Metronidazole (most Clostridia, Bacteroides, Peptostrepto)
Term
Microbio classification of Streptococci?
Definition
Gram Positive, Cocci in Chains
Catalase Negative
Term
Hemolysis pattern of classification of bacteria...
Definition
Beta-hemolysis - GAS, GBS
Alpha-hemolysis - S. pneumoniae
Gamma-hemolysis - Enterococci
Term
Encapsulated microorganisms...
Definition
ESNKHCBP

E. coli
Streptococcus
Neisseria
Klebsiella
Haemophilus
Salmonella
Cryptococcus
Pseudomonas
Bacteroides
Term
What is the major virulence factor of S. pyogenes?
Definition
M-protein - adherence, prevent opsonization/phago
Term
Virulence factors of Strep.
Definition
#1 - M-protein
Streptolysin O - antigenic, B-hemolysis
Streptolysin S - non-antigenic, B-hemolysis
Exotoxins - superantigens
Capsule - hyaluronidase
Term
Rheumatic fever is a potential consequence of which infection?
Definition
S. pyogenes - because of similarity between M-protein of bacterium and heart valve proteins (cause of endocarditis)
Term
Rx of S. pyogenes infection?
Definition
1st line = Penicillin
2nd line = Erythromycin (Macrolide)

IF invasive - Vancomycin
Term
Difference in cultures of GAS (S. pyogenes) vs. GBS (S. agalactiae)
Definition
GAS - large zone B-hemolysis
GBS - pin-point colonies, small zone hemolysis; CAMP+
Term
What is the main virulence factor for GBS (S. agalactiae)
Definition
B-hemolysin - cytotoxic to pulmonary cells; can be killed off by surfactant
Term
What is the drug used for prophylaxis of GBS infection during pregnancy?
Definition
Pen G
Term
How do S. pneumoniae appear on a Gram stain? What is their pattern of hemolysis?
Definition
Gram Positive, Lancet-Shaped cocci

Alpha-Hemolysis
Term
Which bacterium is the #1 cause of pneumonia in adults?
Definition
Strep. pneumoniae
Term
What is the #1 cause of bacterial meningitis in adults?
Definition
Strep. pneumoniae
Term
Treatment for Strep. pneumoniae infection?
Definition
1st line = Pen G

If not = cephalosporins (3rd), erythromycin
Term
Vaccine recommendations for S. pneumoniae based on age?
Definition
2-5 yrs = conjugate vaccine
> 5 yrs = polysachhride vaccine
Term
What colour do the alpha-hemolytic colonies appear on blood agar?
Definition
Greenish - because of incomplete hemolysis
Term
Microbial classification of Enterococci?
Definition
Gram Positive Cocci in Pairs/Short Chains
Catalase Negative (like Strep, unlike Staph)
Term
Catalase tests for Strep vs. Enterococci vs. Staph
Definition
Strep, Enterococci = Catalase Neg

Staph = Catalase Positive
Term
What Atb's does Enterococcus have intrinsic resistance against?
Definition
Cephalosporins
Septra (TMP-SMX)
Term
What Atb's can Enterococcus develop acquired resistance to (not including intrinsically resistant ones)?
Definition
Cell wall agents - B-lactams, carbapenems; vancomycin
Term
Main virulence factors of enterococci?
Definition
Agg - agglutination, aggregation; intracell survival
Esp - extra cell protein; biofilm formation
MSCRAMMMs
Atb Resistance
Term
Most common infection with Enterococci?
Definition
UTIs - usually nosocomial
Term
How to treat vancomycin resistant vs. vancomycin sensitive Enterococci?
Definition
VRE - linezolid

VSE - Pen G/ampicillin + gentamicin

(Combo of B-lactam + aminoglycoside for bacterial endocarditis)
Term
Most common causes of bacterial endocarditis?
Definition
1. Strep. viridans
2. Staph. aureus
3. Enterococci
Term
Staph. aureus microbio classification?
Definition
Gram positive cocci in clusters (like clusters of grapes)
Catalase positive
Coagulase positive
Gold appearance on blood agar
Term
Coagulase testing of S. aureus vs. saprophyticus vs. epidermidis
Definition
S. aureus = coagulase positive

S. epiderm, saprophyt = coagulase negative
Term
How is Atb resistance conferred in S. aureus?
Definition
Secretion of penicillinases = penicillin resistance

PBP2' mutation = methicillin resistance
Term
Which diseases associated with S. aureus infection are caused by exotoxin release?
Definition
Scaled Skin Syndrome - by exofoliative exotoxin
Gastroenteritis - by heat toxic enterotoxin
Toxic Shock Syndrome - by TSST-1; superantigen
Term
Clinical syndromes associated with Staph. aureus?
Definition
SOFT PAINS
Skin infection
Osteomyelitis
Food poisoning
Toxic shock
Pneumonia
Acute endocarditis
Infective arthritis
Necrotizing fasc
Sepsis
Term
Rx for MSSA vs. MRSA:
Definition
MSSA - cloxacililn (1st line); cephazolin

MRSA - vancomycin; linezolid; TMP-SMX
Term
What is the 1st line treatment for MSSA?
Definition
Cloxacillin

2nd line = cefazolin (1st gen Ceph)
Term
Rx for S. epidermidis?
Definition
Vancomycin (usually is MDR)
Term
S. saprophyticus typically causes...
Definition
UTIs in sexually active young women
Term
Microbio classification of Chlamydia
Definition
Gram Negative, Obligate intracellular parasite (cannot make ATP)
Has NO PG layer (therefore, no B-lactams)
Term
What drug class can you not use on Chlamydias and why?
Definition
No B-lactams because no PG layer
Term
What are the 3 main species of Chlamydia
Definition
C. pneumoniae
C. psittaci
C. trachomatis
Term
What are the infective particles vs. active particles of Chlamydia called?
Definition
Elementary bodies = infective
Reticular bodies = active
Term
Main clinical syndrome caused by C. pneumoniae?
Definition
Atypical pneumonia in young adults
Term
What causes atypical pneumonia in pet workers?
Definition
Chlamydia psittacis
Term
Which species of Chlamydia can infect the greatest # of regions?
Definition
C. trachomatis - eyes, lungs, genitals
Term
Clinical syndromes associated with C. trachomatis infection?
Definition
Trachoma = chronic conjunctivitis
LGV = lymphogranuloma venereum

Infant conjunctivitis, pneumonia
Term
How is infant conjunctivitis with C. trachomatis treated?
Definition
Erythromycin eye-drops at birth
Term
Which serotypes of C. trachomatis cause which of its associated clinical syndromes?
Definition
Serotypes A-C = trachoma
Serotypes L1-L3 = LGV
Serotypes D-K = infant conjunctivitis; cervicitis, PID, non-gonoccal urethritis
Term
What are the genital manifestations of C. trachomatis infection?
Definition
Cervicitis, pelvic inflammatory disease
Lymphogranuloma venereum
Urethritis (non-gonoccal)
Term
Rx for trachoma from C. trachomatis?
Definition
Rx = azithromycin (macrolide)
Term
Rx for LGV from C. trachomatis infection?
Definition
3 weeks DOXYCYCLINE or ERYTHROMYCIN
Term
What are the age restrictions for doxycycline and quinolone use in treating C. trachomatis infections?
Definition
Doxycycline must be 7+ yrs of age (used to treat LGV)

Quinolones must be 18+ yrs of age (used to treat infant pneumonia)
Term
What is thought to be the most common UTI?
Definition
Non-gonococcal urethritis (caused by C. trachomatis)
Term
What are the microbiological characteristics of Neisseria gonorrhea?
Definition
Gram negative (like Chlamyd), diplococci
Intracellular (within neutrophils)
Coffee bean shaped
Term
What two general classes of drugs can be used to treat most Chlamydia infections?
Definition
Tetracyclines (Doxycycline)
Macrolides (Azithromycin, Erythromycin)

**Doxycyclines only given if 7+ yrs old
Term
What is the main virulence factor for Neisseria gonorrhea?
Definition
Type IV Pili - adherence, resist phagocytosis
Term
Diseases associated with N. gonorrhea infection?
Definition
Ophthalmia neonatorium (neonates; vertical transmission during birth)
Urethritis, cervicitis (PID), disseminated gonorrhea (bacteremia, arthritis)
Term
What glands are infected in urethritis in males leading to pus discharge when infected with N. gonorrhea?
Definition
Skene's glands
Term
Rx of N. gonorrhea?
Definition
3rd gen cephalosporin (ceftriaxone) + azithromycin

Prevent resistance; have highly resistant strains in Asia
Term
What is the smallest of all bacteria?
Definition
Mycoplasma
Term
Which two microbes have no PG and are therefore not able to be treated with any B-lactams?
Definition
Mycoplasma

Chlamydiae
Term
What are the 4 pathogenic species of Mycoplasma?
Definition
M. pneumoniae
M. genitalia
M. hominis
U. urealyticum
Term
What bacterial infection presents with "walking pneumonia"?
Definition
Mycoplasma pneumoniae - persistent cough, don't feel sick; atypical pneumonia; Stevens-Johnson syndrome w/ target shaped lesions
Term
Which Mycoplasma infection presents with target shaped lesions?
Definition
M. pneumoniae
Term
What is the Rx for pneumonia vs. NGU/cervicitis from Mycoplasma infection
Definition
Pneumonia = azithromycin, doxycycline, quinolones (same as C. pneumoniae)

NGU/cervicitis = azithromyc/doxycycline
Term
Which 2 drugs can treat most Mycoplasma infections?
Definition
Azithromycin
Doxycycline
Term
Characteristics of the Enterobacteriaceae family?
Definition
Gram negative rods; facultative anaerobes
Ferment glucose
Reduce nitrate to nitrite
Catalase +
Oxidase - (except for Plesiomonas)
Term
E. coli are lactose ______, indole ______, and catalase _______
Definition
POSITIVE
POSITIVE
POSITIVE
Term
Most common cause of UTIs?
Definition
E. coli (UPEC)
Term
Most common cause of neonatal meningitis?
Definition
Group B strep (Strep. agalactaciae)
Term
Virulence factors of E. coli
Definition
Siderophores
LPS (Lipid A Endotoxin)
Mucosal adherence
Heat-labile and stable toxin
Term
What colour do E. coli appear on MacConkey agar and why?
Definition
Appear PINK

Because they are lactose +'ve
Term
Where is the O antigen located on bacterium?
Definition
On the LPS (only on gram negatives)
Term
What colour are EHEC colonies on Sorbitol MacConkey Agar (SMAC)?
Definition
Colourless (clear colonies)
Term
What is the triad of symptoms in hemolytic uremic syndrome?
Definition
Hemolytic anemia, thrombocytopenia, acute renal injury
Term
Treatment of UPEC (uropathogenic E. coli)...
Definition
TMP-SMX

or

Quinolones (Ciprofloxacin, Norfloxacin)
Term
What treatments should NOT be given with EHEC dx?
Definition
NSAIDs (increased risk of renal insult)
Anti-motility, antibiotics (increased risk of HUS)
Term
What is the potent toxin of EHEC? Where is a similar toxin found?
Definition
Shiga toxin

Found in Shigella
Term
Which salmonella serovars can cause typhoid fever?
Definition
S. enterica serovar typhi, paratyphi (A-C)
Term
Symptoms of typhoid fever
Definition
Caused by S. enterica (serovars typhi and paratyphi)

Diarrhea, cramps, constipation, rose-spots on trunk (maculopapular)
Term
Struvite stones are seen in infection with...
Definition
Proteus (usually mirabilis, vulgaris)

Providencia (also urease +'ve)
Term
Characteristics of Proteus in Lab:
Definition
Urease +'ve
Lactose -'ve
Swarming Motility
Term
Two main virulence factors for Proteus?
Definition
Swarming Motility
Urease
Term
Which Proteus is indole positive?
Definition
Proteus vulgaris (is the encapsulated one bitch)
Term
What are the lab characteristics of Salmonella enterica?
Definition
Indole Negative
Hydrogen sulfide producing
Lactose Negative
Term
Which Enterobacteriaceae forms "mucoid colonies"?
Definition
Klebsiella
Term
Which Enterobacteriaceae are lactose positive?
Definition
E. coli

Klebsiella
Term
Which member of Enterobacteriacea is hydrogen sulfide producing?
Definition
Salmonella enterica
Term
Which Enterbacteriaceae are urease positive?
Definition
Proteus
Morganella
Providencia
Term
What can be used to treat the SPICE organisms?
Definition
All have inducible AmpC so are generally MDR

Use 4th generation cephalosporins or carbapenems
Term
Which Enterobacteriaceae are gelatinase positive? What is their main infection?
Definition
Serratia (UTI)
Term
What 3 factors does the efficacy of B-lactams depend on?
Definition
1) Amount of contact with target
2) Affinity for target
3) Production of B-lactamases
Term
Type of resistance conferred with porin mutations vs. efflux systems?
Definition
Porin = low level

Efflux = high level (usually in addition to porin mutations)
Term
What does LPS confer an INHERENT RESISTANCE to?
Definition
Pen G/V
Vancomycin
Macrolides
Term
In terms of their activity, ESBLs can be (3 different things)
Definition
Constitutive
Inducible
De-Repressed
Term
How do you test for ESBLs?
Definition
Need a B-lactamase inhibitor + 3rd gen cephalosporin

Compare growth w/ and w/o B-lactamase inhibitor (needs to be 8x or more larger w/ for it to be ESBL)
Term
Lab features/characteristics of Pseudomonas?
Definition
Gram Negative
Rod
Oxidase +'ve (unlike most Enterobacteriaceae)
Grape-like odour
Blue-green pigments on wound dressings
Term
Rx for Pseudomonas
Definition
PCCIA
Pip/Tazo
Ceftazidine
Ciprofloxacin
Imipenem
Aminoglycoside
Term
What is P. aeruginosa most commonly assocaited with in terms of respiratory infections?
Definition
Ventilator associated Pneumonia (common in CF patients)
Term
Ecthyma gangrenosum may result from infection by which microbe?
Definition
Pseudomonas aeruginosa
Term
Associated clinical syndromes with P. aeruginosa infection?
Definition
BE PSEUDO
Burns
Endocarditis
Pneumonia
Skin & soft tissue
External malignant otitis/eye infection
UTI
Diabetic osteomyelitis
Term
Drugs used for malaria prophylaxis
Definition
Chloroquine - widespread resistance
Doxycycline - photosensitivity; no kids
Primaquine - G6PD screening; causes dose dependent anemia
Mefloquine - good drug, bad rep
Term
Standard malaria treatment
Definition
Chloroquine + primaquine
Term
Where does Plasmodium undergo sexual vs. asexual replication
Definition
Sexual = in mosquito
Asexual = in RBCs and liver of us
Term
What are the infective Plasmodium cells called?
Definition
Sporozoites (swim from mosquito into our bloodstream)
Term
What are the inactive forms of P. vivax and ovale called that reside in the liver? How do we treat those?
Definition
Hypnozoites

Treat with primaquine
Term
What is the primary virulence factor of Giardia?
Definition
Its CYTOSKELETON
Term
Rx for Giardia
Definition
Usually not needed (self-limiting)
If needed - albendazole, metronidazole
Term
Difference between CYSTS and TROPHOZOITES for Giardia?
Definition
Cysts = infective form

Trophozoites = metabolically active form
Term
What are the only 3 diseases learned that spread through the air?
Definition
Varicella Zoster virus
Measles
Mycobacterium TB
Term
Characteristis of M. TB
Definition
Acid-fast staining (because of mycolic acids in cell wall)
Non-motile
Obligate Aerobe
Rod
Term
What are the special stains used for Mycobacterium TB staining called?
Definition
Ziehl Nielssen stain
Kinyoun stain
Can also use fluorescent staining
Term
What does Mycobacterium TB infection resolve in in the vast majority of cases
Definition
Ghon's complex - calcification of lymph nodes and caseous lesion
Term
1st line Rx for TB
Definition
RIPE
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
Term
What is the primary virulence factor of Haemophilus influenzae B?
Definition
The polyribitol phosphate capsule (6 types = A-F; B is most common)
Term
What was the #1 cause of meningitis in children until a vaccine was created in 1992?
Definition
Haemophilus influenzae B
Term
Lab characteristics of Haemophilus influenzae
Definition
Gram negative coccobacilli
Encapsulated
Term
Which gram negatives are coccobacilli?
Definition
Haemophilus
Bordetella pertussis
(Chlamydia)
Term
T. pallidum is classified as Gram _______
Definition
Negative
Term
Which Gram negatives are cocci?
Definition
Neisseria (meningitidis, gonorrheae)
Term
Rx for Haemophilus influenzae if infecting the brain?
Definition
3rd gen Cephalosporin - ceftriaxone
Term
Difference btwn typeable vs. non-typeable strains of H. influenzae
Definition
Non-typeable strains do not produce a capsule, are typically less virulent, mostly only seen in IV drug users
Term
Lab characteristics of Bordetella pertussis
Definition
Gram negative
Coccobacilli
Aerobic
Term
Gold standard for B. pertussis dx?
Definition
PCR
Term
Rx for B. pertussis?
Definition
Macrolides - erythromycin, azithromycin
Term
Candida treat with...
Definition
FLUCONAZOLE
Term
What anti-fungal can be used to treat all fungi except Cryptococcus?
Definition
Caspofungin
Term
MOST COMMON MOLD = ...
Definition
ASPERGILLUS
Term
MOST COMMON FUNGAL INFECTION = ...
Definition
CANDIDIASIS
Term
Treatment for cryptococcus?
Definition
Amphotericin, fluconazole
Term
What is the gold standard anti-fungal?
Definition
Ampho B
Term
Mechanism of action of azoles?
Definition
Inhibit ergosterol synthesis (fungistatic)
Term
Gram positive bacteria...
Definition
CLESSP
Clostridia
Listeria
Enterococci
Strep
Staph
Peptostrepto
Term
What are the only gram negative cocci?
Definition
Neisseria (meningitidis, gonorrheae)
Term
Gram negative rods...
Definition
PEB
Pseudomonas
Enterobacteriaceae
Bacteroides
Term
Gram negative spirochete...
Definition
T. pallidum
Term
What are the 3 gram neg coccobacili
Definition
Haemophilus influ.
Bordetella pertuss.
Chlamydia
Term
What are the 2 phases of B. pertussis infection?
Definition
Catarrhal - runny nose, start to cough; can intervene

Paroxysmal - cannot intervene; well established cough
Term
Rx for B. pertussis
Definition
MACROLIDES
Term
When is B. pertussis most contagious?
Definition
Catarrhal phase + 1st 2 weeks of coughing
Term
Can 3rd gen ceph cross the BBB
Definition
You bet they can!

Treat H. influenzae B meningitis with ceftriaxone
Term
What kind of viruses are the Herpes viruses?
Definition
Enveloped, dsDNA viruses
Term
Where does VZV hide in latent period?
Definition
DRG of the SC
Term
Which HSV cause oral and genital sores?
Definition
HSV-1 and 2
Term
Where do HSV-1 and 2 live in during their latent periods?
Definition
The pelvic ganglia (nerves)
Term
Where does HSV like to cause encephalitis?
Definition
Temporal lobe; causes seizures
Term
How do we treat neonatal herpes?
Definition
Acyclovir
Term
What is the 3rd most infectious disease known to man?
Definition
VZV (behind TB and Measles)
Term
Which herpes virus is considered to be the "strongest"?
Definition
VZV - dont need that big of a drop in immune function to re-activate
Term
What is the hallmark of almost every herpes virus?
Definition
BLISTER
Term
What is worse, peri-natal or congenital CMV?
Definition
CONGENITAL ; peri-natal is usually asymptomatic
Term
Therapy for CMV infection?
Definition
Ganciclovir (same family as acyclovir)
Term
When are the two peaks of EBV infection?
Definition
1-6 yrs; 14-20 yrs

**THIS IS IN DEVELOPED COUNTRIES

**In developing countries, 90% infected by age 2
Term
Where does the EBV hide during latency?
Definition
B-lymphocytes
Term
HHV-6 causes...
Definition
Roseola
Term
HHV-8 is associated with...
Definition
Kaposi's sarcoma (mainly in AIDS patients)
Term
What are the 3 subfamilies of herpes viruses
Definition
Alpha - HSV1, HSV2, VZV
Beta - CMV, HHV6, HHV7
Gamma - EBV, HHV8
Term
How did HIV get from non-human primates to us?
Definition
Started as Simian Immunodeficiency Viruses (SIV) rhesus macaques and sooty mangebays; to chimps; to us through eating chimps
Term
What happens to the normal CD4:8 ratio in HIV
Definition
It reverses

Normally CD4:8 > 1, but with CD4 infection of HIV, get decline and ratio reverses
Term
Highest probability of contracting AIDS?
Definition
Receptive anal intercourse (3 per 100)
Term
What is happening to HIV prevalence and incidence in Canada?
Definition
Prevalence - increasing (people are living longer)
Incidence - stable, no decline
Term
What is the only increasing HIV incidence population in Canada?
Definition
Aboriginals
Term
What does acute retroviral syndrome of AIDS mimic?
Definition
Acute Mono (2-3 weeks)
Term
What virus causes oral hairy leukoplakia?
Definition
EBV (is an HIV associated disease)
Term
HIV therapy is now recommended for whom?
Definition
ALL HIV infected people
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