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648 Cards in this Set
- Front
- Back
teichoic acid is unique to what type of organisms?
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gram-positive
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endotoxin/LPS (outer membrane) is unique to what type of organisms?
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gram-negative
|
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what do teichoic acid and lipid A induce?
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TNF and IL-1
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space between the cytoplasmic membrane in gram-negative bacteria
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periplasm - contains many hydrolytic enzymes, including beta lactamases
|
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this mediates adherence to surfaces, especially foreign surfaces, e.g. indwelling catheters
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glycocalyx - made of polysaccharide
|
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this contains a variety of genes for antibiotic resistance, enzymes, and toxins
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plasmid - made of DNA
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what is the only gram-positive with endotoxin?
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listeria
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what is exotoxin made of?
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polypeptide
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what is endotoxin made of?
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lipopolysaccharide
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typical diseases with exotoxin?
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tetanus, botulism, diphtheria
|
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tpical diseases with endotoxin?
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meningococcemia, sepsis by gram-negative rods
|
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gram-negative cocci?
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neisseria
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these have a gram-negative cell wall but are too small to be seen with light microscope
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spirochetes - must be visualized with darkfield microscope
|
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no cell wall; neither gram-positive or gram-negative
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mycoplasma
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name the 6 classic gram-positives
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strep
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staph
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bacillus
|
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clostridium
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corynebacterium
|
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listeria
|
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lipopolysaccharide found in cell wall of gram-negative bacteria
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endotoxin - heat stable
|
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this bug inactivates elongation factor (EF-2), causes pharyngitis and pseudomembrane in throat
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corynebacterium diphtheriae
|
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ADP ribosylation of G protein stimulates adenylyl cyclase, increasing pumping of Cl- and H20 into gut
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cholera
|
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what does e. coli heat-labile toxin stimulate?
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adenylate cyclase
|
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what does e. coli heat-stable toxin stimulate?
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guanylate cyclase
|
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what does bordatella pertussis stimulate?
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adenylate cyclase; also inhibits chemokine receptor
|
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double zone of hemolysis on blood agar?
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C. perfringens
|
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what does C. tetani block the release of?
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inhibitory NT glycine
|
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what does C. botulinum block the release of?
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acetylcholine
|
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what does shiga toxin do?
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cleaves host cell rRNA; also enhances cytokine release, causing HUS
|
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what type of bugs are rickettsia and chlamydia?
|
intracellular parasites
|
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neisseria meningitidis ferments what?
|
maltose and glucose
|
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neisseria gonorrhea ferments what?
|
glucose
|
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what produces a blue-green pigment?
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pseudomonas
|
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what produces a red pigmetn?
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serratia maracescens
|
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IgA proteases allow what organisms to colonize mucosal surfaces?
|
strep pneumo, neisseria meningitidis, neisseria gonorrhoeae, h. flu
|
|
silver stain?
|
fungi, PCP, legionella
|
|
india ink?
|
cryptococcus neofromans
|
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Ziehl-Neelsen stain?
|
acid-fast baceria
|
|
PAS stain?
|
stains glycogen, mucopolysaccharides; used to diagnose Whipple's disease
|
|
Giemsa's stain?
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borrelia, Plasmodium, trypanosomes, chlamydia
|
|
congo red?
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amyloid; apple-green birefringence in polarized light (because of beta-pleated sheets)
|
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chocolate agar with factors V and X?
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H. influenzae
|
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Thayer-Martin (VCN) agar?
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N. gonorrhoeae
|
|
Bordet-Gengou (potato) agar?
|
B. pertussis
|
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tellurite plate, Loffler's medium, blood agar?
|
C. diphtheriae
|
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Lowenstein-Jensen agar?
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M. tuberculosis
|
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pink colonies on MacConkey's agar?
|
lactose-fermenting enterics - Klebsiella, e. coli, enterobacter (fast); citrobacer, serratia (slow)
|
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charcoal yeast agar buffered with increased iron and cysteine?
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Legionella
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Sabouraud's agar?
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fungi
|
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obligate aerobes (4)
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Nagging Pests Must Breathe
|
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nocardia, pseudomonas, mycobacterium TB, bacillus
|
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obligate anaerobes (3)
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clostridium, bacteriodes, actinomyces - lack catylase and/or superoxide dismutase, and thus are susceptible to oxidative damage; generally foul smelling, difficult to culture, and produce gas in tissue (CO2 and H2)
|
|
obligate intracellular bugs (2)
|
rickettsia, chlamydia (stay inside when it's Really Cold)
|
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facultative intracellular (8)
|
Some Nasty Bugs May Live FacultativeLY:
|
|
|
salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia
|
|
encapsulated bugs (4)
|
strep pneumo, H. flu, neisseria meningitidis, klebsiella - positive quellung reaction
|
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bacillus anthracis, c. perfringens, and c. tetani form what?
|
spores (gram positive soil bugs)
|
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alpha hemolytic bacteria?
|
strep pneumo (catalase negative and optochin sensitive)
|
|
|
viridans strep (catalase negative and optochin resistant)
|
|
beta hemolytic bacteria?
|
staph aureus (catalase, coagulase +)
|
|
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strep pyogenes (catalase -, bacitracin sensitive)
|
|
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strep agalactiae (catalase -, bacitracin resistant)
|
|
|
listeria
|
|
how do you differentiate strep pyogenes form strep agalactiae?
|
strep pyogenes - bacitracin sensitive
|
|
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strep agalactiae - bacitracin resistant
|
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obligate aerobes (4)
|
Nagging Pests Must Breathe
|
|
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nocardia, pseudomonas, mycobacterium TB, bacillus
|
|
obligate anaerobes (3)
|
clostridium, bacteriodes, actinomyces - lack catylase and/or superoxide dismutase, and thus are susceptible to oxidative damage; generally foul smelling, difficult to culture, and produce gas in tissue (CO2 and H2)
|
|
obligate intracellular bugs (2)
|
rickettsia, chlamydia (stay inside when it's Really Cold)
|
|
facultative intracellular (8)
|
Some Nasty Bugs May Live FacultativeLY:
|
|
|
salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia
|
|
encapsulated bugs (4)
|
strep pneumo, H. flu, neisseria meningitidis, klebsiella - positive quellung reaction
|
|
bacillus anthracis, c. perfringens, and c. tetani form what?
|
spores (gram positive soil bugs)
|
|
alpha hemolytic bacteria?
|
strep pneumo (catalase negative and optochin sensitive)
|
|
|
viridans strep (catalase negative and optochin resistant)
|
|
beta hemolytic bacteria?
|
staph aureus (catalas, coagulase +)
|
|
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strep pyogenes (catalase negative, bacitracin sensitive)
|
|
|
strep agalactiae (catalase -, bacitracin resistant)
|
|
|
listeria
|
|
how do you differentiate strep pyogenes form strep agalactiae?
|
strep pyogenes - bacitracin sensitive
|
|
|
strep agalactiae - bacitracin resistant
|
|
DNA transferred from 1 bacterium to another
|
conjugation
|
|
nature of DNA transferred in conjugation
|
chromosomal or plasmid
|
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DNA transferred by a virus from 1 cell to another
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transduction
|
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nature of DNA transferred in transduction
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any gene in generalized transduction; only certain genes in specialized transduction
|
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purified DNA taken up by a cell
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transformation (any DNA)
|
|
most capsules are made out of polysaccharide except bacillus anthracis, which contains what?
|
d-glutamate
|
|
chemical composition of spore?
|
keratin-like coat; dipicolinic acid - provides resistance to heat, dehydration, and chemicals
|
|
what is a pilus made out of?
|
glycoprotein
|
|
location of exotoxin genes?
|
plasmid or bacteriophage
|
|
location of endotoxin genes?
|
bacterial chromosome
|
|
which is antigenic - exotoxin or endotoxin?
|
exotoxin
|
|
both of these bugs activate EF-2
|
corynebacterium, pseudomonas (exotoxin A)
|
|
how do you distinguish staph epidermidis from staph saprophyticus
|
epidermidis - novobiocin sensitive
|
|
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saprophyticus - novobiocin resistant
|
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another name for group A beta hemolytic strep?
|
strep pyogenes
|
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another name for group B beta hemolytic strep?
|
strep agalactiae
|
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which is bile soluble - strep pneumo or strep viridans?
|
strep pneumo
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oxidase positive non-lactose fermenter?
|
pseudomonas
|
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oxidase-negative non-lactose fermenters?
|
shigella, salmonella, proteus
|
|
positive quellung reaction indicates what?
|
presence of a capsule (strep pneumo, h. flu, neisseria meningitidis, klebsiella)
|
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prokaryotes with axial filaments
|
spirochets - borrelia, leptospira, treponema
|
|
type of strep that can cause glomerulonephritis?
|
strep pyogenes - bacitracin sensitive
|
|
strep strains that cause scarlet fever contain what compared to strains that don't?
|
phage
|
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coagulase negative, non-hemolytic, novobiocin sensitive?
|
staph epidermidis
|
|
mechanism of amantadine?
|
blocks viral penetration/uncoating; may buffer pH of endosome. also causes the release of dopamine from intact nerve terminals
|
|
clinical use of amantadine?
|
prophylaxis and treatment for influenza A; Parkinson's disease
|
|
toxicity of amantadine?
|
ataxia, dizziness, slurred speech
|
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mehcanism of zanamivir, oseltamivir?
|
inhibit influenza neuraminidase
|
|
clinical use of zanamivir & oseltamivir?
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both influenza A & B
|
|
mechanism of ribavirin?
|
inhibits synthesis of gruanine nucleotides by competitively inhibiting IMP dehydrogenase
|
|
clinical use of ribavirin?
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RSV, chronic hepatitis C
|
|
toxicity of ribavirin?
|
hemolytic anemia, severe teratogen
|
|
mechanism of acyclovir?
|
preferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase; guanine analog
|
|
clinical use of acyclovir?
|
HSV, VZV, EBV; mucocutaneous and genital herpes lesions; prophylaxis in immunocompromised patients
|
|
toxicity of acyclovir?
|
delerium, tremor, nephrotoxicity
|
|
mechanism of ganciclovir?
|
phosphorylation by viral kinase; preferentially inhibits CMV DNA polymerase
|
|
clinical use of ganciclovir?
|
CMV, especially in immunocompromised patients
|
|
toxicity of ganciclovir?
|
leukopenia, neutropenia, thrombocytopenia, renal toxicity; more toxic to host enzymes then acyclovir
|
|
mechanism of foscarnet?
|
viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme; does not require action by viral kinase
|
|
clinical use of foscarnet?
|
CMV retinitis in immunocompromised patients when ganciclovir fails; acyclovir-resistant HSV
|
|
toxicity of foscarnet?
|
nephrotoxicity, hypoglycemia, hypomagnesia
|
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saquinavir, ritonavir, indinavir, nelfinavir, and amprenavir are what type of drugs?
|
protease inhibitors - used in HIV therapy
|
|
mechanism of protease inhibitors?
|
inhibit assembly of new virus by blocking protease enzyme
|
|
toxicity of protease inhibitors?
|
GI intolerance (nausea, diarrhea), hyperglycemia, lipid abnormalities
|
|
protease inhibitor that can cause thrombocytopenia?
|
indinavir
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zidovudine, didanosine, zalcitabine, stavudine, lamivudine, and abacavir are what type of drug?
|
nucleoside RT inhibitors
|
|
nevirapine, delaviridine, and efavirenz are what type of drug?
|
non-nucleoside RT inhibitors
|
|
mechanism of reverse transcriptase inhibitors?
|
preferentially inhibit RT of HIV; prevent incorporation of viral genome into host DNA
|
|
toxicity of RT inhibitors?
|
bone marrow suppression (neutropenia, anemia), peripheral neuropathy
|
|
what type of reverse transcriptase inhibitors can cause lactic acidosis?
|
nucleosides - zidovudine, didanosine, zalcitabine, stavudine, lamivudine, and abacavir
|
|
what type of RT inhibitors can cause rash?
|
non-nucleosides -nevirapine, delaviridine, and efavirenz
|
|
nucleoside RT inhibitor that can cause megaloblastic anemia?
|
AZT (zidovudine)
|
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what HIV drug is used during pregnancy to reduce the risk of fetal transmission?
|
AZT
|
|
interferon-alpha is used for what?
|
chronic hepatitis B andC, Kaposi's sarcoma
|
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interferon beta is used in what disease?
|
MS
|
|
interferon gamma is used in what disease?
|
NADPH oxidase deficiency
|
|
toxicity of interferons?
|
neutropenia
|
|
these are glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis
|
interferons
|
|
drug used for giardiasis, amebic dysentery, bacterial vaginitis, trichomonas?
|
metronidazole
|
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drug used for giant roundworm (asarcis), hookworm (necator/ancylostoma), and pinworm (enterobius)?
|
pyrantel pamoate
|
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drug used for trematode/fluke (schistosomes, paragnimus, clornorchis), and cysticercosis?
|
praziquantel
|
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drug used for cestode/tapeworm (e.g. diphyllobothrium latum, taenia species) infections except cysticercosis?
|
niclosamide
|
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drug used for onchocerciasis?
|
ivermectin (rIVER blindness)
|
|
drug used for nematode/roundworm (e.g. pinworm, whipworm) infections?
|
mebendazole/thiabendazole
|
|
block cell wall synthesis by inhibition of peptidoglycan cross-linking
|
penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
|
|
block peptidoglycan synthesis
|
bacitracin, vancomycin, cycloserine
|
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disrupt bacterial/fungal cell membranes
|
polymyxins
|
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disrupt fungal cell membranes
|
amphotericin B, nystatin, fluconazole/azoles
|
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block nucleotide synthesis
|
sulfonamides, trimethoprim
|
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block DNA topoisomerases
|
quinolones
|
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block mRNA synthesis
|
rifampin
|
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block protein synthesis at 50S ribosomal subunit
|
chloramphenicol, erythromycin/macrolides, lincomycin, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid
|
|
block protein synthesis at 30S ribosomal subunit
|
aminoglycosides, tetracyclines
|
|
bacteriacidal antibiotics (6)
|
penicilin, cephalosporins, vancomycin, aminoglycosides, fluoroquinolones, metronidazole
|
|
penicillin mechanism
|
bind PBPs, block transpeptidase cross-linking of cell wall; activate autolytic enzymes
|
|
penicillin toxicity
|
hypersensitivity reactions, hemolytic anemia
|
|
mechanism of methicillin, nafcillin, dicloxacillin
|
bind PBPs, block transpeptidase cross-linking of cell wall - penicillinase resistant because of bulkier R group
|
|
methicillin toxicity
|
interstitial nephritis
|
|
ampicillin, amoxicillin toxicity
|
hypersensitvity, ampicillin rash (esp. in pts. w/ mono), pseudomembranous colitis
|
|
ticarcillin, carbenicillin, piperacillin usage
|
pseudomonas (Takes Care of Pseudomonas)
|
|
mechanism of cephalosporins
|
beta-lactam drugs that inhibit cell wall synthesis - less susceptible to penicillinases
|
|
antibiotic for penicillin-allergic patients and patients w/ renal toxicity who can't tolerate aminoglycosides
|
aztreonam (synergistic w/ aminoglycosides)
|
|
drug of choice for enterobacter
|
imipenem/cilastin
|
|
antibiotic that can cause seizures at high plasma levels
|
imipenem/cilastin
|
|
mechanism of vancomycin
|
inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors
|
|
mechanism of resistance to vancomycin
|
amino acid change of D-ala D-ala to D-ala D-lac
|
|
vancomycin toxicity
|
well tolerated in general - does NOT have many problems: nephrotoxicity, ototoxicity, thrombophlebitis
|
|
aminoglycosides
|
streptomycin, gentamicin, tobramycin, amikacin - bacteriacidal
|
|
mechanism of action of aminoglycosides
|
inhibit 30S subunit - inhibit formation of initiation complex and cause misreading of mRNA
|
|
are aminoglycosides effective agains anaerobes?
|
no! require O2 or uptake
|
|
aminoglycosides cause nephrotoxicity especially when used in combination with _________
|
cephalosporins
|
|
aminoglycosides cause ototoxicity especially when used with_________
|
loop diuretics
|
|
are aminoglycosides safe to use in pregnancy?
|
no! teratogenic
|
|
which tetracycline can be used in patients with renal failure?
|
doxycycline because it is fecally eliminated
|
|
can you take tetracyclines with milk?
|
no! nor atacids or iron-containing preparations because divalent cations inhibit its absorption in the gut
|
|
tetracycline toxicity
|
discoloration of teeth and inhibition of bone growth in children, photosensitivity
|
|
mechanism of action of macrolides
|
inhibit protein synthesis by blocking translocation - bind to 23S rRNA of the 50S subunit
|
|
name 3 macrolides
|
erythromycin, azithromycin, clarithromycin
|
|
when can sulfonamides cause hemolysis?
|
G6PD deficiency
|
|
most common cause of noncompliance with macrolides
|
GI discomfort
|
|
macrolides increase the serum concentration of what drugs?
|
theophyllines, oral anticoagulants
|
|
acute cholestatic hepatitis & eosinophilia are toxicities of which class of antibiotics?
|
macrolides
|
|
clinical use of chloramphenicol
|
meningitis - H. flu, neisseria, strep pneumo
|
|
why does chloramphenicol cause gray baby syndrome?
|
because infants lack liver UDP-glucoronyl transferase
|
|
is the aplastic anemia seen with chloramphenicol dose dependent?
|
no! the anemia is, however
|
|
mechanism of action of chloramphenicol
|
inhibits 50S peptidyltransferase
|
|
what is the clinical use of clindamycin?
|
treatment of anaerobic infections - B. frag, C. perfringfens
|
|
clindamycin toxicity
|
pseudomembranous colitis - destroys normal GI flora
|
|
mechanism of action of sulfonamides (sulfamethoxazole, sulfisoxazole, triple sulfas, etc.)
|
PABA antimetabolites inhibit dihydropteroate synthase
|
|
what side effect can sulfonamides cause in infants?
|
kernicterus
|
|
mechanism of action of trimethoprim
|
inhibits bacterial dihydrofolate reductase
|
|
trimethoprim toxicity
|
megaloblastic anemia, leukopenia, granulocytopenia (may alleviate with supplemental folinic acid)
|
|
mechanism of action of fluoroquinolones
|
inhibit DNA gyrase (topoisomerase II)
|
|
what class of antibiotics can cause cartilage damage in kids?
|
fluoroquinolones
|
|
what drug is associated with a disulfiram-like reaction with alcohol and a metallic taste
|
metronidazole
|
|
what can prevent the neurotoxicity associated with INH?
|
pyridoxine (vitamin B6)
|
|
INH toxicity
|
hemolysis if G6PD deficient, neurotoxicity, hepatotoxicity, SLE-like syndrome
|
|
mechanism of action of rifampin
|
inhibits DNA-dependent RNA polymerase
|
|
what drug delays resistance to dapsone when used for leprosy?
|
rifampin
|
|
resistance mechanism for penicillins/cephalosporins
|
beta-lactamase cleavage of beta lactam ring
|
|
resistance mechanism for aminoglycosides
|
modification via acetylation, adenylation, or phosphorylation
|
|
resistance mechanism for chloramphenicol
|
modification via acetylation
|
|
resistance mechanism for macrolides
|
methylation of rRNA near erythromycin's ribosome binding site
|
|
resistance mechanism for tetracycline
|
decreased uptake or increased transport out of cell
|
|
resistance mechanism for sulfonamides
|
altered enzyme (bacterial dihydropteroate synthetase), decreased uptake, or increased PABA synthesis
|
|
mechanism of action of amphotericin B
|
binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes and disrupt homeostasis
|
|
drug of choice for systemic mycoses
|
amphotericin B
|
|
amphotericin B toxicity
|
fever/chills, hypotension, nephrotoxicity, arrhythmias, hypochromic normocytic anemia
|
|
do ketoconazole and ampho B act synergistically?
|
no - they antagonize each other's actions, so should never be used together
|
|
which has greater oral availability - amoxicillin or ampicillin?
|
amOxicillin
|
|
spectrum of ampicillin, amoxicillin
|
HELPS kill enterococci:
|
|
|
h. flu, e. coli, listeria, proteus, salmonella, enterococci
|
|
cefazolin and cephalexin are what generation cephalosporins?
|
first
|
|
coverage of cefazolin and cephalexin?
|
PEcK:
|
|
|
proteus, e. coli, klebsiella
|
|
|
(and gram-positives)
|
|
cefoxitin, cefaclor, cefuroxamine are what generation?
|
second
|
|
coverage of cefoxitin, cefaclor, cefuroxamine?
|
HEN PEcKS:
|
|
|
h. flu, enterobacter, neisseria, proteus, e. coli, klebsiella
|
|
ceftriaxone, cefotaxime, and ceftazidime are what generation?
|
third
|
|
use of ceftriaxone, cefotaxime, and ceftazidime?
|
serious gram-negative infections resistant to other beta lactams; meningitis; ex. ceftazidime for pseudomonas, ceftriaxone for gonorrhea
|
|
cefepime, cefpiramide belong to what generation?
|
fourth
|
|
use of cefepime, cefpiramide?
|
increased activity against pseudomonas and gram-positive organisms
|
|
serum-like sickness in infants and kids can be seen with what cephalosporin?
|
ceflacor (2nd generation)
|
|
this is an inhibitor of renal dihydropeptidase I
|
cilastin - decreases inactivation of imipenem in renal tubules
|
|
why are aminoglycosides ineffective against anaerobes?
|
require O2 for uptake
|
|
drug used for bowel surgery?
|
neomycin
|
|
this tetracycline is an ADH antagonist - acts as a diuretic in SIADH
|
demeclocylcine
|
|
clinical use of tetracyclines?
|
VACUUM THe BedRoom: vibrio cholerae, acne, chlamydia, ureaplasma urealyticum, mycoplasma, tularemia, h. pylori, borrelia burgdorferi, rickettsia
|
|
this drug treats anaerobes above the diaphragm
|
clindamycin
|
|
these drugs can cause leg cramps and myalgias in kids
|
fluoroquinolones
|
|
used for anaerobes below the diaphragm
|
metronidazole
|
|
how does nystatin work?
|
binds to ergosterol, disrupting fungal membranes (too toxic for systemic use)
|
|
mechanism of the -azoles?
|
inhibit fungal steriod (ergosterol) synthesis
|
|
toxicities of -azoles?
|
hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibition of P450), fever, chills
|
|
this antifungal inhibits DNA synthesis by conversion to fluorouracil, which competes with uracil
|
flucytosine
|
|
toxicity of flucytosine
|
nausea, vomiting, diarrhea, bone marrow suppression
|
|
mechanism of caspofungin?
|
inhibits cell wall syntehsis
|
|
use of caspofungin?
|
invasive aspergillosis
|
|
toxicity of caspofungin?
|
GI upset, flushing
|
|
this antifungal inhibits the fungal enzyme squalene epoxidase
|
terbinafine
|
|
use of terbinafene?
|
used to treat dermatophytoses (especially onychomycosis)
|
|
mechanism of griseofulvin?
|
interferes with microtubule function; disrupts mitosis; depostis in keratin-containing tissues (e.g. nails)
|
|
clinical use of griseofulvin?
|
oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)
|
|
toxicity of griseofulvin?
|
teratogenic, carcinogenic, confusion, headaches, increases warfarin metabolism
|
|
two diseases transmitted by inhalation fo asexual spores?
|
coccidiomycosis and histoplasmosis
|
|
treatment for superficial candidal infection? for systemic?
|
nystatin; amphotericin B
|
|
Southwestern US, valley fever
|
coccidiomycosis
|
|
Mississippi and Ohio river valleys
|
histoplasmosis
|
|
rural Latin America
|
paracoccidiomycosis
|
|
bird or bat droppings; intracellular (tiny yeast inside macrophages)
|
histoplasmosis
|
|
Captain's wheel appearance
|
paracoccidiomycosis
|
|
states east of Mississippi River and Central America
|
blastomycosis
|
|
big, broad-based budding
|
blastomycosis
|
|
dimorphic fungi
|
mold in soil; yeast in tissue
|
|
on what do you culture fungi?
|
Sabouraud's agar
|
|
systemic mycoses can mimic what?
|
TB (granuloma formation)
|
|
what is cocidiomycosis in tissue?
|
spherule
|
|
treatments for mycoses?
|
fluconazole or ketoconazole for local infection; ampho B for systemic infection
|
|
what causes tinea versicolor?
|
malassezia furfur
|
|
hypopigmented skin lesions in hot, humid weather
|
tinea versicolor
|
|
treatment for tinea versicolor?
|
topical miconazole, selenium sulfide
|
|
what does cladosporium werneckii cause?
|
tinea nigra
|
|
infection of keratinized layer of skin; appears as brownish spot
|
tinea nigra
|
|
treatment for tinea nigra?
|
salicylic acid
|
|
pruritic lesions with central clearing resembling a ring, caused by dermatophytes
|
tinea pedis/cruris/corporis/capitis
|
|
mold hyphae in KOH prep, not dimorphic
|
tinea pedis/cruris/corporis/capitis
|
|
mold with septate hyphae that branch at a V-shaped (45 degree) angle
|
aspergillus
|
|
culture on Sabourauds' agar, stains with India ink?
|
cryptococcus neoformans
|
|
heavily encapsulated yeast, not dimorphic, found in soil & pigeon droppings
|
cryptococcus
|
|
fungus ball
|
aspergillus
|
|
mold with irregular nonseptate hyphae branching at wide angles (>90 degrees)
|
mucor and rhizopus
|
|
in what type of patients is mucormycosis typically seen?
|
ketoacidotic diabetic and leukemic patients
|
|
fungi proliferate in walls of blood vessels and cause infarction of distal tissue; rhinocerebral, frontal lobe abscesses
|
mucor and rhizopus
|
|
yeast that causes diffuse interstitial pneumonia
|
pneumocystis cainii
|
|
how do you diagnose PCP?
|
lung biopsy or lavage
|
|
methenamine silver stain of lung tissue identifies what?
|
pneumocystis carinii
|
|
treatmetn for PCP?
|
TMP-SMX, pentamidine, dapsone
|
|
dimorphic fungus that lives on vegetation
|
sporothrix schenckii
|
|
cigar-shaped budding yeast visible in pus
|
sporothrix schenckii
|
|
treatment for sporothrix schenckii?
|
itraconazole or potassium iodide
|
|
bloody diarrhea, liver abscess, RUQ pain?
|
entamoeba histolytica
|
|
severe diarrhea in AIDS, mild disease (watery diarrhea) in non-HIV
|
cryptosporidium
|
|
brain abscess in HIV, brain defects (ring-enhancing lesions)
|
toxoplasma
|
|
foul smelling, greenish discharge; itching and burning
|
trichomonas vaginalis
|
|
dilated cardiomyopathy, megacolon, megaesophagus
|
trypanosoma cruzi (Chags' disease)
|
|
African sleepign sickness
|
trypanosoma gambinse, rhodesiense
|
|
visceral leishmaniasis (kala-azar)
|
leishmania donovani
|
|
rapidly fatal menigoencephalitis; swimming in freshwater lakes
|
naegleria
|
|
appears as maltese cross on blood smear
|
babesia
|
|
trophozoites on wet mount
|
trichomonas vaginalis
|
|
cysts on acid-fast stain
|
cryptosporidium
|
|
trophozoites or cysts in stool (2)
|
giardia, entamoeba
|
|
transmission of entamoeba, giradia, cryptosporidium?
|
cysts in water
|
|
transmission of toxoplasma?
|
cysts in meat or cat feces
|
|
transmission of babesia?
|
ixodes tick
|
|
transmission of leishmania?
|
sandfly
|
|
transmission of african sleeping sickness?
|
tsetse fly
|
|
undercooked pork tapeworm; larvae cause mass lesions in brain, cysticercosis
|
taenia solium (tapeworm/cestode)
|
|
eggs in dog feces when ingested can cause cysts in liver; causes anaphylaxis if antigens are released from cysts
|
echinococcus granulosus (cestode/tapeworm)
|
|
snails are host; cercariae penetrate skin of humans; causes granulomas, fibrosis, and inflammation of the spleen and liver
|
schistosoma (trematode/fluke)
|
|
undercooked fish; causes inflammation of the biliary tract
|
clonorchis sinensis (trematode/fluke)
|
|
undercooked crab meat; causes inflammation and secondary bacterial infection of the lung
|
paragonimus westermani (trematode/fluke)
|
|
larvae penetrate skin of feet; intestinal infection can cause anemia
|
ancylostoma duodenale (hookworm)
|
|
eggs are visible in feces; intestinal infection
|
asarcis lumbicoides (giant roundworm)
|
|
food contaminated with eggs; intestinal infection; causes anal pruritis
|
enterobius vermicularis (pinworm)
|
|
larvae in soil penetrate the skin; intestinal infection
|
strongyloides stercoralis
|
|
undercooked meat, usually pork; inflammation of muscle, periorbital edema
|
trichinella spiralis
|
|
in drinking water; skin inflammation and ulceration
|
dracunculus medinensis
|
|
transmitted by deer fly; causes swelling in skin (can see worm crawling in conjuctiva)
|
loa loa
|
|
transmitted by female blackflies; causes river blindness
|
onchocera volvulus
|
|
food contaminated with eggs; causes granulomas (if in retina leads to blindness) and visceral larva migrans
|
toxocara canis
|
|
female mosquito; causes blockage of lymphatic vessels (elephantiasis)
|
wuchereria bancrofti
|
|
parasite: brain cysts, seizures
|
taenia solium
|
|
parasite: liver cysts
|
echinococcus granulosus
|
|
parasite: B12 deficiency
|
diphyllobothrium latum
|
|
parasite: biliary tract disease
|
clonorchis sinensis
|
|
parasite: hemoptysis
|
paragonimus westermani
|
|
parasite: portal hypertension
|
schistosoma mansoni
|
|
parasite: hematuria, bladder cancer
|
schistosoma haematobium
|
|
parasite: microcytic anemia
|
ancylostoma, necator
|
|
parasite: perianal pruritis
|
enterobius
|
|
outbreaks after cleaning chicken coops or exploring caves
|
histoplasmosis
|
|
what type of fungus is cryptococcus?
|
yeast, not dimorphic
|
|
cauliflower skin lesions; broad based budding yeasts
|
blastomyces
|
|
how do you diagnose trichinella?
|
muscle biopsy
|
|
RMSF-type symptoms plus berry-like clusters (morulae) inside neutrophils?
|
anaplsma phagocytophilium
|
|
what causes human granulocytic erlichiosis?
|
anaplasma phagocytophilium
|
|
asarcis lumbricoides, clonorchis seinensis, and fascida hepatica can all cause what?
|
bacterial cholangitis
|
|
what types of milaria have dormant forms?
|
p. vivax and p. ovale
|
|
species of malaria that can cause severe (cerebral) disease?
|
p. falciparum
|
|
malaria drug to prevent relapse caused by p. vivax, p. ovale?
|
primaquine
|
|
all DNA viruses except what are dsDNA?
|
parvoviridae (part-of-a-virus)
|
|
all DNA viruses are linear except what?
|
papovaviruses (circular, supercoiled), hepadnaviruses (circular, incomplete)
|
|
name 3 naked RNA viruses?
|
calcivirus, picornavirus, reovirus (naked CPR)
|
|
this type of virus acquires envelopes from the nuclear membrane
|
herpesvirus
|
|
most enveloped viruses aquire their envelope from where?
|
from plasma membrane when they exit from cell
|
|
all viruses are haploid except what?
|
retroviruses, which have 2 identical ssRNA molecules (diploid)
|
|
all DNA viruses replicate where? what is the exception?
|
nucleus - except poxvirus
|
|
all RNA viruses replicate where? what are the exceptions?
|
cytoplasm - except influenza and retroviruses
|
|
name the DNA viruses
|
HHAPPPy viruses: hepadna, herpes, adeno, pox, parvo, papova
|
|
this DNA virus carries its own DNA-dependent RNA polymerase
|
poxvirus
|
|
all DNA viruses are icosahedral except what?
|
pox (complex)
|
|
naked DNA viruses (3)
|
PAP: parvo, adeno, papova
|
|
enveloped DNA viruses (3)
|
HPH: hepadna, pox, herpes
|
|
what is the largest DNA virus?
|
poxvirus
|
|
virus causing febrile pharyngitis, pneumonia, conjunctivitis
|
adenovirus
|
|
virus causing aplastic crises in sickle cell disease, fifth disease, hydrops fetalis?
|
parvovirus
|
|
what is the smallest DNA virus?
|
parvovirus (ss linear)
|
|
HBV is a member of what virus family?
|
hepadnavirus - DNA, partial circular
|
|
members of the picornavirus family?
|
PERCH:
|
|
|
poliovirus
|
|
|
echovirus
|
|
|
rhinovirus
|
|
|
coxsackievirus
|
|
|
HAV
|
|
HEV and Norwalk virus belong to what family?
|
calciviruses - RNA (ss, linear), icosahedral
|
|
virus causing roseola (exanthem subitum)
|
HHV-6
|
|
virus related to Kaposi's sarcoma?
|
HHV-8
|
|
what type of virus is JC - causes PML in HIV
|
papovavirus
|
|
type of virus causing Colorado tick fever?
|
reovirus
|
|
number one cause of fatal diarrhea in kids?
|
rotavirus
|
|
togaviruses (3)?
|
rubella, EEE, WEE
|
|
flaviviruses (5)?
|
HCV, yellow fever, dengue, St. Louis encephalitis, West Nile virus
|
|
to what family does influenza virus belong?
|
orthomyxovirus
|
|
paramyxoviruses (4)
|
PaRaMyxovirus:
|
|
|
parainfluenza - croup
|
|
|
RSV
|
|
|
measles
|
|
|
mumps
|
|
Rx for RSV bronchiolitis in kids?
|
ribavirin
|
|
what type of virus is rabies?
|
rhabdovirus
|
|
what type of virus is HDV?
|
deltavirus
|
|
MMR, Sabin polio, VZV, yellow fever, smallpox, and adenovirus have what type of vaccine?
|
live attenuated
|
|
rabies, infulenza, HAV, and Salk polio are what type of vaccine?
|
killed
|
|
egg-based vaccines?
|
FRY an egg:
|
|
|
Flu, MMR, Yellow fever
|
|
the vaccine for what is recombinant?
|
HBV- antigen is recombinant HBsAg
|
|
exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology
|
recombination
|
|
when viruses with segmented genomoes (e.g. influenza) exchange segments. high-frequency virus recombination; cause of worldwide pandemics
|
reassortment
|
|
when 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein; the nonmutated virus complemetns the mutated one by making a functional protein that serves both viruses
|
complementation
|
|
genome of virus A can be coated with the surface proteins of virus B; type B protein coat determines the infectivity of the phenotypically mixed virus; however, the progeny from this infection has a type A coat and is encoded by type A genetic material
|
phenotypic mixing
|
|
DNA enveloped viruses (3)
|
herpesvirus, HBV, smallpox
|
|
DNA nucleocapsid viruses (3)
|
adenovirus, papillomaviruses, parvovirus
|
|
influenza virus, parainfluenza, RSV, measles, mumps, rubella, rapies, HTLV, and HIV are what type of RNA viruses?
|
RNA enveloped viruses
|
|
enteroviruses (poliovirus, coxsackie virus, echovirus, HAV), rhinovirus, and reovirus are what type of RNA viruses?
|
RNA nucleocapsid
|
|
segmented viruses?
|
all are RNA viruses: BOAR
|
|
|
bunyaviruses, orhtomyxoviruses, arenaviruses, and reoviruses
|
|
all paramyxoviruses have 1 serotype except what?
|
parainfluenza virus - has 4
|
|
parainfluenza, mumps, measles, and RSV all belong to what family?
|
paramyxoviruses
|
|
parotitis, orchitis, and aseptic meningitis?
|
mumps
|
|
bluish-gray spots on buccal mucosa?
|
Koplik spots - diagnostic for measles
|
|
drugs for influenza A?
|
amantadine and rimantadine (especially prophylaxis)
|
|
drugs useful for both influenza A and B?
|
zanamivir and oseltamivir (neuraminidase inhibitors)
|
|
virus with a bullet-shaped capsid?
|
rabies
|
|
how does rabies travel to CNS?
|
migrates in a retrograde fashion up axons
|
|
variant of dengue fever in Southeast Asia?
|
hemorrhagic shock syndrome
|
|
caused by flavivirus, an arbovirus transmitted by Aedes mosquitos
|
yellow fever
|
|
high fever, black vomit, jaundice
|
yellow fever
|
|
councilman bodies (acidophilic inclusions) may be seen in liver with this virus
|
yellow fever
|
|
virus causing mono with negative monospot?
|
CMV
|
|
heterophil antibodies detected by agglutination of sheep RBCs?
|
monospot test
|
|
tzanck test
|
a smear of opened skin vesicle to detect multinucleated giant cells - used to assay for HSV-1, HSV-2, and VZV
|
|
hepatitis RNA picornavirus
|
HAV
|
|
hepatitis DNA hepadnavirus
|
HBV
|
|
hepatitis RNA flavivirus
|
HCV
|
|
hepatitis delta virus
|
HDV
|
|
hepatitis RNA calcivirus
|
HEV
|
|
how is HAV trasmitted?
|
fecal-oral
|
|
type of hepatitis that is transmitted enterically and causes water-borne epidemics
|
HEV
|
|
defective virus that requires HBsAg as its envelope
|
HDV
|
|
common cause of transfusion-mediated hepatitis
|
HCV
|
|
best test to detect active hepatitis A?
|
IgM HAVAb
|
|
continued presenc of what indicates carrier state of HBV?
|
HBSAg
|
|
provides immunity to HBV
|
HBsAb
|
|
positive during the window period of HBV
|
HBcAb
|
|
HBV vaccination - what serologic marker is seen?
|
HBsAb only
|
|
rectangular nucleocapsid protein of HIV?
|
p24
|
|
HIV envelope proteins?
|
gp41 and gp120
|
|
what crosses placenta in HIV infected mothers
|
anti-gp120
|
|
CXCR1 mutation
|
rapid progression to AIDS
|
|
CCR5 mutation
|
homozygous - immunity (1% U.S. caucasians)
|
|
|
heterozygous - slower course (20% U.S. caucasians)
|
|
infectious agents that don't contain DNA or RNA, just protein
|
prions
|
|
normal prions have what? pathologic prions are what?
|
normal - alpha helix
|
|
|
pathologic (like CJD) - beta pleated sheets
|
|
virus family of HPV?
|
papovavirus
|
|
aseptic meningitis, herpangina - febrile pharyngitis, hand, foot, and mouth disease, myocarditis
|
coxsackievirus - picornavirus
|
|
rotavirus belongs to what family?
|
reovirus - DS linear segmented RNA
|
|
hemorrhagic fever, pneumonia, RDS in NM, AZ, CO, UT
|
hantavirus - member of bunyavirus family (SS circular RNA; helical capsid)
|
|
ebola/marburg are what types of viruses?
|
filoviruses - SS linear RNA, helical capsid
|
|
triad of cutaneous hemorrhages, deafness, and periventricular CNS calcifications in a neonate
|
congenital CMV infection
|
|
virulence factor of staph aureus - binds Fc-IgG, inhibiting complement fixation and phagocytosis
|
protein A
|
|
superantigen that binds to MHC II and TCR, resulting in polyclonal T cell activation
|
TSST - (staph aureus)
|
|
what makes coagulase?
|
staph aureus
|
|
antibody to what enhances host defenses against strep pyogenes?
|
M protein
|
|
group A beta-hemolytic strep?
|
strep pyogenes
|
|
what detects recent strep pyogenes infections?
|
ASO titer
|
|
associated with rusty sputum, sepsis in sickle cell, and splenectomy?
|
strep pneumo
|
|
most common cause of meningitis, otitis, pneumonia, sinusitis?
|
strep pneumo
|
|
what gives immunity to strep pneumo?
|
IgG antibodies to surface acidic polysaccharide
|
|
causes pneumonia, meningitis, and sepsis mainly in babies
|
group B strep (agalactiae) - beta hemolytic, bacitracin resistant
|
|
what is Lancefield grouping based on?
|
differences in the C carbohydrate on the bacterial cell wall
|
|
what can grow in 6.5% NaCl
|
enterococci
|
|
enterococci can cause what?
|
UTI, subacute endocarditis, biliary tract infections
|
|
bacteria related to colon cancer?
|
strep bovis
|
|
type of strep viridans that can cause subacute bacterial endocarditis?
|
strep sanguis
|
|
what does C. perfringens produce?
|
alpha toxin
|
|
gram-positive rods with metachromatic granules?
|
corynebacterium diphtheriae
|
|
woolsorter's disease?
|
bacillus anthracis
|
|
inhalation of anthrax spores?
|
flulike symptoms that rapidly progress to fever, pulmonary hemorrhage, and shock
|
|
gram-positive anaerobe that causes oral/facial abscesses that may drain through sinus tracks in skin
|
actinomyces
|
|
gram positive, weakly-acid fast aerobe that causes pulmonary infection in immunocomprimised patients
|
nocardia asteroides
|
|
sulfur granules
|
actinomyces
|
|
gram-positive rods forming long branching filaments resembling fungi
|
actinomyces & nocardia
|
|
most invasive disease of H. flu is caused by what capsular type?
|
B
|
|
treatment for H. flu meningitis?
|
ceftriaxone
|
|
treatment for neisseria gonorrhea?
|
ceftriaxone - also z pack or doxycycline because 50% will also be infected with chlamydia
|
|
why don't you want to culture if pt. has epiglottitis?
|
manipulation cause laryngeal spasm
|
|
members of enterobacter family (7)
|
e. coli, salmonella, shigella, klebsiella, enterobacter, serratia, proteus
|
|
what antigen is related to the virulence of enterobacter?
|
K antigen
|
|
all of these ferment glucose and are oxidase negative
|
enterobacter
|
|
these bacteria grow pink colonies on MacConkey's agar
|
klebsiella, e. coli, enterobacter (KEE), citrobacter
|
|
salmonella or shigella: motile and can disseminate hematogenously?
|
salmonella
|
|
salmonella or shigella: which is more virulent?
|
shigella
|
|
salmonella or shigella: symptoms may be prolonged with antibiotic treatments
|
salmonella
|
|
salmonella or shigella: animal reservoir
|
salmonella
|
|
this is usually transmitted from pet feces, contaminated milk, or pork; outbreaks common in daycare centers
|
yersinia enterocolitica
|
|
this can mimic Crohn's or appendicitis & can disseminate to produce lymphadenitis
|
yersinia enterocolitica
|
|
arthritis can develop with yersinia infection in patients with what?
|
HLA-B27
|
|
vibrio parahaemolyticus and v. vulnificus
|
contaminated seafood
|
|
reheated rice
|
B. cereus
|
|
meats, mayonase, custard
|
s. aureus
|
|
reheated meat dishes
|
c. perfringens
|
|
undercooked meat
|
e. coli 0157:H7
|
|
poultry, meat, eggs
|
salmonella
|
|
bloody diarrhea; comma or S-shaped organisms
|
campylobacter
|
|
is campylobacter motile?
|
yes
|
|
e. coli producing shiga-like toxin; can cause HUS
|
enterohemorrhagic
|
|
day-care outbreaks, pseudoappendicitis
|
yersinia
|
|
protazoan causing bloody diarrhea
|
entamoeba histolytica
|
|
protaozoa causing watery diarrhea
|
giardia, cryptosporidium (in immunocompromised)
|
|
treatment for legionella?
|
erythromycin
|
|
UTI - urine with alkaline pH
|
proteus - very motile - able to break down urea
|
|
pneumonia in CF
|
pseudomonas
|
|
wound and burn infections
|
pseudomonas
|
|
treatment for pseudomonas?
|
amnoglycoside plus extended-spectrum penicillin (piperacillin, ticarcillin)
|
|
aerobic gram-negative rod; oxidase positive, non-lactose fermenting; pyocyanin pigment
|
pseudomonas
|
|
hot tub folliculitis
|
pseudomonas
|
|
pneumonia, sepsis, UTI, drug use and diabetic osteomyelitis
|
pseudomonas
|
|
cellulitis from animal bite, cats, dogs
|
pasteurella
|
|
dairy products, contact with animals
|
brucella
|
|
ghon complex
|
TB granulomas (Ghon focus) with lobar and perihilar LN involvement; reflects primary infection or exposure
|
|
mycobacterium scrofulaceum
|
cervical lymphadenitis in kids
|
|
mycobacterium kansasii
|
pulmonary TB-like symptoms
|
|
acid-fast bacillus that likes cold temperatures and cannot be grown in vitro
|
mycobacterium leprae
|
|
reservoir for m. leprae in U.S.?
|
armadillos
|
|
what does m. leprae infect?
|
skin and superficial nerves
|
|
treatment for leprosy?
|
long-term oral dapsone - toxicity is hemolysis and methemoglobinemia
|
|
which type of Hanson's diseaseiis worse?
|
lepromatous worse than tuberculoid
|
|
the chlamydial petidoglycan wall is unusual in that it lacks what?
|
muramic acid
|
|
treatment for chlamydia?
|
erythromycin or tetracycline
|
|
cytoplasmic inclusions seen on Giemsa or fluorescent antibody-stained smear
|
chlamydia
|
|
infection of liver capsule with RUQ pain; associated with chlamydial or gonococcal infection
|
Fitz-Hugh-Curtis syndrome
|
|
how do the reticulate bodies of chlamydia replicate?
|
binary fission
|
|
types A, B, and C of chlamydia
|
Africa/Blindness/Chronic infection
|
|
types D-K of chlamydia
|
urethritis/PID, ectopic pregnancy, neonatal pneumonia or conjunctivitis
|
|
types L1, L2, and L3 of chlamydia
|
lymphogranuloma venereum (acute lymphadenitis - positive Frei test)
|
|
treatment for neonate after passage through chlamydia-infected birth canal?
|
erythromycin eye drops
|
|
most common STD in U.S.?
|
chlamydia
|
|
only spirochete that can be visualized using analine dyes (Wright's or Giemsa stan) in light microscopy
|
borrelia
|
|
shepherd's crook-shaped spirochete
|
leptospira
|
|
Wal's disease
|
fatal from of leptospira infection - jaundice, bleeding, renal failure, skeletal muscle necrosis
|
|
treatment for Borrelia recurrentis?
|
doxycycline, erythromycin
|
|
treatment for Lyme disease?
|
doxycycline
|
|
what causes yaws?
|
tremonema pertenue - tropical infection that is not an STD, although VDRL test is positive
|
|
what are important reservoirs for ixodes? what is required for tick life cycle?
|
mice; deer
|
|
signs of tertiary syphilis?
|
broad-based ataxia; positive Romberg; Charcot joints; stroke without hypertension
|
|
congenital syphilis?
|
saber shins, saddle nose, deafness
|
|
primary syphilis?
|
painless chancre
|
|
secondary syphilis?
|
disseminated isease with constitutional symptoms, maculopapular rash (palms and soles), condylomata lata
|
|
VDRL positive, FTA positive?
|
active infection
|
|
VDRL positive, FTA negative?
|
probably false positive
|
|
VDRL negative, FTA positive?
|
successfully treated
|
|
VDRL false positives?
|
Viruses (mono, hepatitis)
|
|
|
Drugs
|
|
|
Rheumatic fever and rheumatic arthritis
|
|
|
Lupus and leprosy
|
|
Weil-Felix reaction?
|
classic test that uses cross-linking proteus antigens to confirm diagnosis of rickettsia
|
|
strep associated with pharyngitis, cellulitis, impetigo, scarlet fever, TSS, rheumatic fever, glomerulonephritis?
|
strep pyogenes (group A beta hemolytic)
|
|
characteristics of rheumatic fever?
|
subcutaneous nodules, erythema marginatum, chorea, carditis
|
|
tumbling motility, menigitis in newborns, unpasteurized milk
|
listeria monocytogenes
|
|
virulence factor of staph aureus?
|
protein A
|
|
what does c. difficile produce?
|
a cytotoxin, an exotoxin that kills enterocytes, causing pseudomembranous colitis
|
|
what encodes the exotoxin of corynebacterium diphtheriae?
|
beta-prophage
|
|
gram-positive rods with metachromatic granules?
|
corynebacterium diphtheriae
|
|
vesicular papules covered y black eschar
|
bacillus anthracis
|
|
what part of gram-negative bugs inhibits entry of penicillin and vancomycin?
|
the outer membrane layer
|
|
this vaccine contains type B capsular polysaccharide conjugated to diphtheria toxoid or other protein
|
h. flu
|
|
flagellar antigen of enterobacter?
|
H antigen
|
|
somatic antigen of enterobacter?
|
O antigen (polysaccharide of endotoxin)
|
|
viruses causing watery diarrhea?
|
rotavirus, adenovirus, norwalk virus
|
|
pertussis toxin permanently disables what?
|
Gi
|
|
cholera toxin permanently activates what?
|
Gs
|
|
how does pertussis toxin promote lymphocytosis?
|
by inhibiting chemokine receptors
|
|
treatment of choice for most rickettsial infections?
|
tetracycline
|
|
classic triad of rickettsiae?
|
headache, fever, rash (vasculitis)
|
|
rickettsiae are obligate intracellular parasites and need what?
|
CoA and NAD
|
|
all rickettsiae except what are transmitted by an arthropod vector and cause headache, fever, and rash?
|
coxiella
|
|
why is coxiella an atypical rickettsia?
|
because it is transmitted by aerosol and causes pneumonia
|
|
what causes rocky mountain spotted fever? to where is it endemic?
|
rickettsia rickettsii; endemic to east coast
|
|
vector for rocky mountain spotted fever?
|
tick; rickettsia rickettsii
|
|
vector for endemic typhus?
|
fleas; rickettsia typhi
|
|
vector for epidemic typhus?
|
human body louse; rickettsia prowazekii
|
|
what causes Q fever?
|
coxiella burnetii
|
|
rickettsial disease with no rash, no vector, negative Wiel-Felix, and casative organism can survive outside for a long time
|
coxiella burnetii
|
|
what does the Weil-Felix reaction assay for?
|
antirickettsial antibodies, which cross-react with proteus antigen
|
|
what is the only bacterial membrane containing cholesterol?
|
mycoplasma pneumoniae
|
|
growth on Eaton's agar?
|
mycoplasma pneumoniae
|
|
normal flora dominant in nose
|
staph aureus
|
|
normal flora dominant in skin
|
staph epidermidis
|
|
normal flora dominant in oropharynx
|
strep viridans
|
|
normal flora dominant in dental plaque
|
strep mutans
|
|
normal flora dominant in colon
|
bacteriodes fragilis > e. coli
|
|
normal flora dominant in vagina
|
lactobacillus, colonized by e. coli and group B strep
|
|
common causes of pneumonia in kids (6 wks. - 18 yrs)
|
viruses (RSV)
|
|
|
mycoplasma
|
|
|
chlamydia pneumoniae
|
|
|
strep pneumo
|
|
common causes of pneumonia in adults (18-40)
|
mycoplasma
|
|
|
c. pneumoniae
|
|
|
strep pneumo
|
|
common causes of pneumonia in adults (40-65)
|
strep pneumo
|
|
|
H flu
|
|
|
anaerobes
|
|
|
viruses
|
|
|
mycoplasma
|
|
common causes of pneumonia in elderly
|
strep pneumo
|
|
|
viruses anaerobes
|
|
|
H. flu
|
|
|
gram-negative rods
|
|
common causes of pneumonia in nosocomial
|
staph, gram-negative rods
|
|
common causes of pneumonia in immunocomprimised
|
staph, gram-negative rods, fungi, viruses, PCP (HIV)
|
|
common causes of pneumonia in aspiration
|
anaerobes
|
|
common causes of pneumonia in alcoholic/IV drug user
|
strep pneumo, klebsiella, staph
|
|
common causes of pneumonia in postviral
|
staph, h. flu
|
|
common causes of pneumonia in neonate
|
group B strep, e. coli
|
|
common causes of atypical pneumonia
|
mycoplasma, legionella, chlamydia
|
|
causes of meningitis in newborn (0-6 mos)
|
group B strep
|
|
|
e. coli
|
|
|
listeria
|
|
causes of meningitis in children (6 mos - 6 yrs)
|
strep pneumo
|
|
|
neisseria meningitidis
|
|
|
H. flu type B
|
|
|
enteroviruses
|
|
causes of meningitis in 6-60 year olds
|
n. meningitidis
|
|
|
enteroviruses
|
|
|
strep pneumo
|
|
|
HSV
|
|
causes of meningitis in elderly (over 60)
|
strep pneumo
|
|
|
gram negative rods
|
|
|
listeria
|
|
causes of meningitis in HIV
|
cryptococcus, CMV, toxoplasmosis (brain abscess), JC virus (PML)
|
|
CSF findings in bacterial meningitis
|
increased pressure
|
|
|
increased neutrophils
|
|
|
increased protein
|
|
|
decreased sugar
|
|
CSF findings in fungal/TB meningitis
|
increased pressure
|
|
|
increased lymphocytes
|
|
|
increased protein
|
|
|
decreased sugar
|
|
CSF findings in viral meningitis
|
normal/increased pressure
|
|
|
increased lymphocytes
|
|
|
normal protein
|
|
|
normal sugar
|
|
cause of osteomyelitis in most people
|
staph aureus
|
|
cause of osteomyelitis in sexually active
|
neisseria gonorrhoeae (rare), septic arthritis more common
|
|
cause of osteomyelitis in diabetics and drug addicts
|
pseudomonas
|
|
cause of osteomyelitis in sickle cell
|
salmonella
|
|
cause of osteomyelitis in prosthetic replacement
|
staph aureus and staph epidermidis
|
|
cause of vertebral osteomyelitis
|
TB (Pott's disease)
|
|
UTI in ambulatory patients
|
e. coli (50-80%), klebsiella (8-10%)
|
|
second most common cause of UTI in young ambulatory women
|
staph saprophyticus
|
|
cause of UTI in hospital?
|
e. coli, proteus, klebsiella, serratia, pseudomonas
|
|
UTI - colonies show metallic sheen on EMB agar
|
e. coli
|
|
UTI - large mucoid capsule and viscous colonies
|
klebsiella
|
|
UTI - swarming on agar (motility); produces urease
|
proteus
|
|
vaginitis, strawberry-colored mucosa
|
trichomonas vaginalis
|
|
noninflammatory, malodorous discharge; positive whiff test; clue cells
|
gardnerella vaginalis
|
|
risk factor: newborn nursery
|
CMV, RSV
|
|
risk factor: urinary catheterization
|
e. coli, proteus
|
|
risk factor: respiratory therapy equipment
|
pseudomonas aeruginosa
|
|
risk factor: work in renal dialysis unit
|
HBV
|
|
risk factor: hyperalimentation
|
candida albicans
|
|
risk factor: water aerosols
|
legionella
|
|
infections dangerous in pregnancy
|
ToRCHeS:
|
|
|
toxoplasma
|
|
|
rubella
|
|
|
CMV
|
|
|
HSV/HIV
|
|
|
syphilis
|
|
traumatic open wound
|
c. perfringens
|
|
surgical wound
|
staph aureus
|
|
sepsis/meningitis in newborn
|
group B strep
|
|
neutrophils in CSF?
|
bacterial meningitis
|
|
normal protein and sugar in meningitis?
|
viral
|