Antimicrobials, Fungals, Virals, Etc

Question 1

What do penicillins and cephalosporin irreversibly bind to and what is one form of that?

Answer 1

Penicillin binding proteins, transpeptidases

Question 2

How do bacteria become resistant to penicillins and cephalosporins

Answer 2

Change in structural proteins and producing beta lactamases( drug can’t bind at all)

Question 3

A severe side effects of ganciclovir, esp when combined with zidovudine is _______

Answer 3

neutropenia

Question 4

Primaquine attacks the ______ which prevents ______ _______

Answer 4

hyponozoites, disease relapse

Question 5

IV acyclovir can cause crystalline _______ if adequate hydration is not also provided

Answer 5

nephropathy

Question 6

______ prevent beta lactamase from inhibiting penicillin drugs, which extends their spectrum

Answer 6

beta lactamase inhibitors: clavulanic acid, tazobactam, sulbactam

Question 7

Ratelgravir is an ______ inhibitor that prevents

Answer 7

integrase, production of viral messenger RNA

Question 8

Immunization of diphtheria leads to which immunoglobulin production

Answer 8

IgG

Question 9

Bordet Gengou is used to culture what bacteria

Answer 9

Bordatella pertussis

Question 10

Loffelers medium and cysteine telluride culture what bacteria

Answer 10

Diphtheria

Question 11

What cells are important to prevent hematogenous spread of Candida vs superficial infection

Answer 11

T cells are important to prevent superficial infections

Neutrophils are important to prevent hematogenous spread

Question 12

Pneumococoal conjugate vaccine is better because allows for both __ and ___ recruitment

Answer 12

B and T cell

Question 13

Isoniazid is metabolized by what process?

Answer 13

acetylation (fast or slow can lead to a bimodal distribution of metabolism)
-slow acetylators are at inc risk of adverse effects

Question 14

If varicella virus is lacking phosphorylating enzymes: use instead

Answer 14

cidofovir(needs cellular kinases for activation) or foscarnet (viral DNA polymerase inhibitor)

Question 15

________ does NOT require intracellular activation by viral or cellular kinases

Answer 15

foscarnet

Question 16

Which anti fungal binds ergosterol in the cell membrane and leads to pore formation and cell lysis

Answer 16

amphotericin B, nystatin

Question 17

Which antifungal block beta glucan synthesis (polysaccharide in cell wall)

Answer 17

capsofungin= echinocandin

Question 18

Which anti fungal binds microtubules inhibiting mitosis

Answer 18

Griseofulivn

Question 19

_______ hypersensitivity reaction occurs with the HLAB*57:01 allele

Answer 19

abacavir

Question 20

Gardanella can be treated with what two things

Answer 20

metronidazole, clindamycin

Question 21

_____ are a common cause of sudden disorientation and confusion in the elderly

Answer 21

UTIs

Question 22

How to prevent Group B strep in Mom

Answer 22

intrapartum Penicillin or ampicillin

Question 23

Which anti fungal inhibits erogosterol synthesis

Answer 23

conazoles

Question 24

Which antigun gal inhibits squalene oxidase

Answer 24

terbinafine

Question 25

Where should we stick a needle for lumbar puncture and why?

Answer 25

Between L4-L5 (level of iliac crest) because the spinal cord ends at L2 but subarachnoid space and caudal equina continue until S2 so between L4-5 you can get subarachnoid space without hitting the cord

Question 26

Order of things you pierce with Lumbar puncture

Answer 26

skin->ligaments->epidural space->dura->arachnoid, BUT NOT PIERCE THE PIA

Question 27

Antibiotic modifying enzymes (adding acetyl groups, phosphate groups) are a major way to resist which class of drugs

Answer 27

aminoglycosides

Question 28

Patients with lepromin skin test will be positive in patients with tuberculoid leprosy as they exhibit a strong _________ T cell mediated response

Answer 28

CD4, Th1

Question 29

Patients with lepromatous leprosy will test _____ due to their weak ______ T cell mediated response

Answer 29

negative, Th1 | -so will see accumulation of acid fast bacilli within macrophages and Th2 response

Question 30

penicillins have a what AA sequence structure

Answer 30

D-ala, D-ala

Question 31

mixing a patient's serum with cardiolipin, cholesterol-lecithin- antigen is for what test

Answer 31

VRDL in syphillis for anticardiolipin antibodies

Question 32

Ganciclovir inhibits _______

Answer 32

DNA chain elongation (interfere with DNA replication)

Question 33

Compare polio vaccines: inactivated vs oral

Answer 33

- inactivated polio vaccine contains killed virus and can't revert to a virulent form. - oral (Active) polio vaccine can revert to an active virulent form and gives mucosal IgA immunity

Question 34

why is imipenem partnered with cilastatin

Answer 34

cilastatian functions to prevent proximal renal tubular brush border hydrolysis of imipenem---> prolonging imipenems antimicrobial effects in the urine

Question 35

why give probenecid with penicillin

Answer 35

probenecid blocks organic ion transporters on renal tubular cells to inhibit tubular secretion of certain antibiotics