Term
B lactams
(Penicillins, Cephalosporins, Carbapenems) |
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Definition
-MOA: bind to PBP by mimic D-ala
-MOR: B lactamase, PBP mutation |
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Term
|
Definition
-Clavulonic Acid (+ amox)
-Sulbactam (+amp)
-Tazobactam (+piper) |
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Term
| B lactam hypersensitivity (toxicity) |
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Definition
-GI Upset: NVD
-C. difficile overgrowth --> coilitis
-oral/ vaginal candidiasis |
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Term
| Glycopeptide (Vancomycin) |
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Definition
MOA: bind directly to d-ala d-ala
MOR: d-ala --> d-lac |
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Term
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Definition
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Term
B lactam treats....
Penicillin
Cephalosporins
Carbapenems |
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Definition
Penicillin: gram (+), syphillis
Amoxicillin- strep
Nafcillin- staph
Cephalosporins: (+)/(-)
Carbapenems: everything (beta lactamase resistant) |
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Term
| Glycopeptide (vancomycin) toxicity.. |
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Definition
-Red Man Syndrome
-Nephrotoxicity |
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Term
| Vancomycin doesn't protect from.... |
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Definition
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Term
| Protein Synthesis (30s) Drugs... |
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Definition
-Tetracycline
Doxycycline (atridox, periostat)
-Aminoglycosides
Streptomycin |
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Term
Tetracycline treats...
Doxycycline treats... |
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Definition
Tetracycline= acne
Doxycycline= lyme, syphillis, chlamydia, risketta |
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Term
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Definition
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Term
|
Definition
-Teeth discoloration
-Photosensitivity
-Vestibularsensitivity
DO NOT USE FOR PREGOS + KIDS |
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Term
|
Definition
1) ≠ initiation
2)Mismatch tRNA
3) Terminate early |
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Term
|
Definition
1) Transferase enzyme
2)30s AT receptor deleted |
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Term
| Aminoglycoside targets and synergy use... |
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Definition
Aminoglycoside attacks:
Gram (-)
Gram (+) w/ B lactam (to create holes) |
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Term
| Aminoglycoside loves these conditions.. |
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Definition
-low pH
-aerobic conditions |
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Term
| Aminoglycoside toxicitiy.. |
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Definition
-Ototoxicity (irreversible)
-Nephrotoxicity (reversible) |
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Term
| Aminoglycoside post-antibiotic effect.. |
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Definition
| Effects still present after aminoglycoside removed. Thus, infrequent and large doses (lowering prolonged exposure that leads to toxicity) |
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Term
Bacterial Infxn and GI Tract:
H. Pylori (stomach)
IN VIVO : Vibrio cholera, ETEC (E. coli)
INVASIVE: Shigella, STEC (E. coli), Salmonella, C. jejuni
EX VIVO: Staph. auerus |
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Definition
H. Pylori= gastric ulcers/ cancer
Others= diarrhea |
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Term
|
Definition
-Vibrio cholera
- ETEC (E. coli) |
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Term
| In vivo toxins cause what kind of diarrhea, where... |
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Definition
(in small intestine...)
-Non-inflammatory
-H20
diarrhea |
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Term
| Vibrio cholera VF and it's MOA... |
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Definition
VF: Cholera toxin (AB)
MOA:
B binds to stomach
A into cell
Adenylate cyclase ACTIVATED
↑cAMP ↑ ion channels, allowing water
TX? Oral rehydration with Na+ and glucose |
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Term
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Definition
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Term
|
Definition
Labile toxin (plasmid encoded)
Stable toxin (chromosome encoded) |
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Term
|
Definition
Gram (-)
Oxidase (+)
Fermentation:
Glucose ✓
Lactose ✓ |
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Term
|
Definition
Shigella
STEC (E. coli)
Salmonella
--------------- Family Enterobacteriaceae
Gram/Oxidase (-)
Ferment: Glucose
~ Lactose
C. jejuni |
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Term
| Invasive cause what kind of diarrhea, where.... |
|
Definition
(in large intestine/ colon)
-Inflammatory
-Bloody.... WTFFFFF!
24 hrs |
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Term
| Shigella + STEC (E. coli) + Clinical Manifestations (CM) |
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Definition
Abdominal tenderness
↑WBC |
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Term
|
Definition
Shigella= human
STEC= zoonosis |
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Term
| Shigella + STEC Virulence Factor (VF) and it's MOA... |
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Definition
Shigella Toxin
MOA: Shigella toxin binds to kidney/ brain
↓
≠ protein synthesis
cytokine inflammation
c' |
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Term
| In terms of post-clinical manifestations, how can we tell Shigella and STEC apart? |
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Definition
STEC= Hemolytic Uremic Syndrome (permanently damaged
glomeruli) |
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Term
| Shigella + STEC Diagnostic Test (DT).... |
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Definition
Gram/ Oxidase: (-)
Shigella= ONLY Glucose
STEC= Glucose ✓
Lactose ✓ |
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Term
|
Definition
Gastroenteritis (rat shit)
Enteric fever |
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Term
| Salmonella Enterica VF... |
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Definition
| HA trick question. No one knows wtf. |
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Term
|
Definition
Gram/ oxidase: (-)
Glucose ✓ |
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Term
| Salmonella Enterica ssb typhi (paratyphi) CM... |
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Definition
TYPHOID
Early: delirium, rose spots
Late: psychosis, weight loss |
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Term
| Salmonella Enterica ssb typhi (paratyphi) VF |
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Definition
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Term
| Salmonella Enterica ssb typhi (paratyphi) cycle for carriers.... |
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Definition
Invades SI --> BM, Spleen, Liver --> re-seeds to spread microbe
"salmonella showers"
Carriers carry it in gallbladder reservoir |
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Term
| Campylobacter jejuni CM... |
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Definition
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Term
| Campylobacter jejuni VF... |
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Definition
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Term
| Campylobacter jejuni DT... |
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Definition
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Term
|
Definition
| Staphylococcal Exotoxins (SE) |
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Term
| Ex vivo toxins cause what kind of diarrhea... |
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Definition
-Non-inflammatory
-H20
<6hrs |
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Term
| Staphylococcal Exotoxins (SE), describe, where is it found between? |
|
Definition
≠infection
= intoxication --> NV, abdominal cramping ( w/ superantigen T cell
activation)
-GI mucosal interface |
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|
Term
Respiratory Tract: Upper........what causes and symptoms?
(normal flora) |
|
Definition
Origin: Virus/ Bacteria
Staph aureus
Strep pneumoniae
H. influenzae
C. diptheria
Conjunctivitus / nasal discharge
Otitis Media / 10-14+ days
Rhinosinusitus |
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Term
|
Definition
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Term
|
Definition
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Term
H. Influenzae DT
(hint: chocolate hazelnut) |
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Definition
Gram (-)
Oxidase (+)
Chocolate agar:
Hemin (x) ✓
NAD (v) ✓ |
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Term
| Corynebacterium diphtheriae CM ("CP3") |
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Definition
-pharyngitis (with fever)
-psuedomembranous tonsils
-cutaneous lesions |
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Term
| Corynebacterium diphtheriae VF |
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Definition
phage-encoded toxin
↓
tissue necrosis
acute inflammation |
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Term
| Corynebacterium diphtheriae Toxin CM |
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Definition
Toxin B= ♥, nerve tissue, kidney
Toxin A ≠ protein synthesis |
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Term
| Corynebacterium diphtheriae prevention? |
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Definition
| C. diphtheriae toxoid --> neutralizes antibody that attacks toxin B |
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Term
Respiratory Tract: Lower.......what causes and symptoms?
("sterile") |
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Definition
Acute bronchitis = wet cough
Bronchiolitis= wheezing
Pneumonia= inflammed lungs
due to...
-Bordetella Pertusis
CA Pneumonia:
70% Strep. pneumoniae (gram (+)
30% Atypicals:
Mycoplasm (≠ cell wall)
Chlamydia ( gram (-), ≠ see it)
Legionella (gram (-) |
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Term
|
Definition
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Term
|
Definition
Toxins (4):
1) ↓ciliary beating
2) ↑debris
3) Inflammation/necrosis
4) Cough reflux ("100 days cough") |
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Term
|
Definition
|
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Term
|
Definition
Invasive: meningitis
bacteremia
Local: otitis media
sinusitis |
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Term
|
Definition
1) capsule
2) teichoic acid
3) IgA |
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Term
|
Definition
| Mycoplasm= subacute, walking pneumonia |
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Term
|
Definition
Chlamydia= obligate intracellular
presents w/ laryngitis |
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Term
|
Definition
-H20 environment
-↑ fever, neurological/GI abnormalities
-Risk: old smoker, with diabetes and immunocompromised |
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Term
|
Definition
Nesseria meningitidis (-)
Strep. agalactiae "GBS" (+, cocci)
Listeria monocytogenes (+)
H. Influenzae (-)
Strep. penumonia (+) |
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Term
| Neisseria meningitidis (-) CM |
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Definition
-Meningitis
-Acute meningococcemia
-Bacteremia
-Access BBB --> CSF
-Disseminated Intravascular Coagulation (DIC) on extremities |
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Term
| Neisseria meningitidis VF |
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Definition
|
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Term
| Neisseria meningitidis DT |
|
Definition
Gram (-)
Glucose ✓
Maltose ✓
USE: Nucleic Acid Amplification Test |
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Term
| Neisseria meningitidis PX |
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Definition
|
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Term
| Strep. agalactiae (GBS) (+) CN |
|
Definition
Neonatal meningitis
Neonatal sepsis |
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Term
| Strep. agalactiae (GBS) (+) VF |
|
Definition
Capsule
Adhesin
Hemolysin
c' |
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Term
| Listeria Monocytogenes (+) CM |
|
Definition
Normal= asymptomatic
(20-30hr) fever, headache, diarrhea
Immunocompromised= Meningitis
(1-4 weeks) Bacteremiae
Encephalitis
PLACENTAL INFXN
MISCARRIAGE |
|
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Term
| Listeria Monocytogenes (+) DT |
|
Definition
Gram (+)
Beta hemolytics
△Temp (4-37 degrees-- wow) |
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Term
| Opportunistic nosocomial pathogens.... (2) |
|
Definition
-Enterococcus
-Pseudomonas aeruginosa |
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Term
|
Definition
Nosocomial
Intra-abdominal infxn
Endocarditis |
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Term
|
Definition
Gram (+)
Catalase (-): Non-hemolytic |
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|
Term
Pseudomonas aeruginosa
Think: hot tub |
|
Definition
-Tracts (GI, respiratory, Urinary
-CNS
-Otitis
-Osteomyelitis
-Skin/Soft tissue (folliculitis, burns) |
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Term
|
Definition
No enzymes to rid of oxygen radicals:
≠superoxidase mutase
≠ catalase
≠ peroxidase |
|
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Term
| Anaerobes characteristics: |
|
Definition
| -Foul-smelling, necrotic, gas |
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Term
| What do we use to treat anaerobes (eg. dental plaque fuscobacterium at gingival crevice)? |
|
Definition
Clindamycin
Metronidazole
Aminoglycoside (for the facultative) |
|
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Term
|
Definition
-Actinomyces israelii
- Bacteroides fragilis group
-Clostridium (tetanus, botulinum, difficile) |
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Term
|
Definition
-Trauma --> lumpy jaw (w/ sulfur granules)
-Endogenous opportunistic |
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Term
|
Definition
|
|
Term
| Bacteroides fragilis group CM |
|
Definition
chronic infxn
most common anerobe --> aspirating pneumonia |
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Term
| Bacteroides fragilis group |
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Definition
| Gram (-), non-inflammatory |
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Term
| Clostridium, DT/characteristics |
|
Definition
Gram (+)
Spore-forming
obligate anaerobes
exotoxin
tetanus
botulinum
-------------intoxication at neuromuscular jxn
difficile |
|
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Term
|
Definition
1)Enter: wound
2)Travel: alpha motor neuron --> CNS (retro)
3)BLOCK: glycine
↓
constant muscle contraction
(AKA lock jaw) |
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Term
|
Definition
BLOCKS acetyl-coA
↓
muscle relaxes
(AKA paralysis) |
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Term
|
Definition
pseudomemnrabous coilitis
(pre-disposing factor: prior antibiotic treatment) |
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Term
| Antibiotic use that leads to C. difficile overgrowth |
|
Definition
Clindamycin
Cephalophorins
Ciprofloxacin |
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Term
|
Definition
| 30s: Tetracycline + aminoglycoside |
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Term
|
Definition
Macrolide
Erythromycin
Clarithromycin
Azithromycin
Lincosamide
Clindamycin
Linezolid |
|
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Term
|
Definition
Bind 50s
≠chain elongation |
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Term
|
Definition
| GI upset (motilin receptors) |
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|
Term
| Macrolide drug-drug interactions: |
|
Definition
Erythromycin ≠ CYP450
Clarithromycin ≠ CYP450
(CYP450 is an enzyme used to metabolize and rid of shit)
*aizthromycin does NOT inhibit CYP450, so it's a star! |
|
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Term
|
Definition
-does NOT inhibit CYP450
- long AF half life: 68 hours --> infrequent, large doses |
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Term
| What do macrolides treat? |
|
Definition
|
|
Term
| Lincoasmide (Clindamycin) MOA |
|
Definition
Bind 50s
≠chain elongation |
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|
Term
| Lincoasmide (Clindamycin) Toxicity |
|
Definition
| c.difficile overgrowth --> pseudomembranous colitis |
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Term
| What does Lincoasmide (Clindamycin) treat? |
|
Definition
+/- anaerobes (abdomen, genitals, aspirating pneumonia)
+ aerobes
↓
Prophylaxis (as well as amoxicillin apparently)
Endocarditis
Allergic to penicillin |
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Term
| Cross-resistance: Macrolide + Lincoasmide (Clindamycin): |
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Definition
Macrolide + Clindamycin= methylation
Macrolid= esterase |
|
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Term
|
Definition
| ≠ initiation complex (f-met tRNA) aat 50s |
|
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Term
|
Definition
| ↓ Bone Marrow suppression |
|
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Term
|
Definition
Fluoroquinolone
Metrondiazole |
|
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Term
|
Definition
≠ bacterial DNA synthesis
≠ topoisomerase II + IV (cannot relax supercoiled DNA) |
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Term
|
Definition
-Enzyme binding mutation
-Cross-resistance b.w fluoroquinolone |
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Term
| Fluoroquinolone Drug-drug intrxn |
|
Definition
di/tri-valent cations ≠ oral absorption
≠ CYP450 |
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Term
| Fluoroquinolone Toxicity.. |
|
Definition
1) Joint/ connective tissue
2) ♥ (arrhythmia)
3) CNS (dizzy, headache, insomnia) |
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|
Term
| Fluoroquinolone is used to treat..... |
|
Definition
Gram (-)
Atypicals
UTIs (↑100x conc. in urine) |
|
|
Term
|
Definition
metrondiazole (prodrug) --[r] via ferredoxin--> anion radical
taken up to
destabilize DNA |
|
|
Term
|
Definition
-disulfirum rn w/ alcohol
-dark urine, dizzy, dry mouth
DO NOT TAKE IN 1ST TRIMESTER |
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Term
|
Definition
Sulfonamides (SMX)
Trimethoprim (TMP)
aka "Antifolates" |
|
|
Term
| DHFR inhibitors of the Folate cycle... |
|
Definition
Trimethoprim (TMP)
Pyrimethamine
Methotrexate |
|
|
Term
| PABA inhibitors of the Folate cycle... |
|
Definition
Sulfonamides (SMX)
Sulfadoxine |
|
|
Term
|
Definition
work at differnt spot of folate cycle,
bacteriostatic individually, but
bactericidal together |
|
|
Term
|
Definition
Gram (-)
SSTI (MRSA)
P. pneumonia |
|
|
Term
|
Definition
TMP= ↑ DHFR, or mutate DHFR
SMX= ↑PBP, or ↓dihydropteroate synthase |
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|
Term
|
Definition
Hypersensitivity (cross-reactivity)
hemolytic anemia
kernicterus (baby brain damage due to protein displacement) |
|
|
Term
| Infective Endocarditis caused by (2)... |
|
Definition
-Viridians group streptococci
-Staph. aureus
(plus enterococci
strep gallolyticus
fungi
HACEK: a mouth flora) |
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|
Term
| Why are Viridians streptococci group and staph aureus cause IE? |
|
Definition
| They have surface components that bind to host proteins |
|
|
Term
| High risk Endocarditis (3)... |
|
Definition
-Prosthetic valve
-Previous IE
-Congenital heart disease |
|
|
Term
| How does IE get into the body? |
|
Definition
-Skin (staph)
-Mucous membranes (tooth brushing, gum bleeding, etc) |
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|
Term
| Infective Endocarditis CM? |
|
Definition
-Fever
-Heart murmur
-Janeway lesions (non-tender lesion on hands/feet)
-Olser nodes (red, raised lesions on hands- ouch)
-Roth spots (retinal hemorrhages)
-Splinter hemorrhages (on nails) |
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|
Term
|
Definition
-Biopsies
-Suture removal
-Ortho bands |
|
|
Term
|
Definition
Anesthesia
X rays
Orto brackets
Baby teeth shedding
Trauma blood |
|
|
Term
|
Definition
|
|
Term
| Can't take oral prophylaxis? |
|
Definition
|
|
Term
| What prophylaxis to take if allergic to penicillin? |
|
Definition
Other B lactam: Cephalosporin
or Clindamycin
or a Macrolids (Azithromycin/ Clarithromycin) |
|
|
Term
| Now shit about pneumonia..... |
|
Definition
|
|
Term
| How do you treat bronchitis (inflammed airways)? |
|
Definition
|
|
Term
| How do you treat s. penumoniae? |
|
Definition
1. B lactam
2. macrolide, tetracycline, fluoroquinolone |
|
|
Term
| How do you treat Legionella (gram -, H20, old smokers etc)? |
|
Definition
| Fluoroquinolone or Macrolide |
|
|
Term
How do you treat H. Influenzae?
(gram -, meningitis, pneumonia, hazelnut chocolate) |
|
Definition
B lactam
Tetracycline
Macrolide
Fluoroquinolone |
|
|
Term
How do you treat mycoplasm?
(no cell wall, subactue, walking pneumonia) |
|
Definition
Tetracycline
Macrolid
Fluroquinolone
NO B LACTAM, LOSER ASS MYCOPLASM GETS NO Bs |
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