Drugs and bugs DNT1U4 Flashcards
(230 cards)
1
Q
This gene is responsible for a lower binding affinity of the transpeptidase or penicillin binding protein. Responsible for MRSA and non-beta lactamase resistance to penicillins and cephalosporins by strep pneumonia.
A
MecA gene
2
Q
Beta lactamase resistant penicillins
A
Nafcillin, oxacillin, dicloxacillin
3
Q
Beta lactamase scavenger (inhibitor) along with clavulanate)
A
sulbactam (also tazobactam)
4
Q
penicillin that has some billiary excretion
A
nafcillin
5
Q
this drug can be used to block the renal excretion of penicillin
A
probenecid (also used for gout)
6
Q
Two species of bacteria that cephalosporins do not work against
A
enterococci, L monocytogenes
7
Q
Third generation cephalosporins that are first line for bacterial meningitis (2)
A
Ceftriaxime, cefotaxime
8
Q
Monobactam drug (1)
A
Aztreonam
9
Q
Vancomycin mechanism of action
A
binds firmly to the d-ala-d-ala terminus of a nascent peptidoglycan pentapeptide, preventing elongation and cross-linking
10
Q
Sons of anarchy story
A
Vancomycin has 0% oral bioavailability
11
Q
The only use for PO dosing of vancomycin
A
Third line therapy for C. Dificile colitis
12
Q
“when vancomycin won’t work, try this drug”
A
Daptomycin
13
Q
Use: Bacitracin
A
Part of decolonization protocol for people with recurrent MRSA skin infections
14
Q
Receptor for SARS-COV
A
ACE2 receptor in lungs
15
Q
Finding in the mouth that is pathognomonic for Measles
A
Koplik spots
16
Q
Bordetella (alternative names)
A
Pertussis, or whooping cough
17
Q
Pertussis / Whooping cough causative bacteria
A
Bordetella
18
Q
Major target for Bordetella vaccine, is the main cause of adhesion to cells
A
Fimbrial Hemagglutinin
Pertussis toxin
19
Q
Pertussis toxin: action
A
Inhibits monocytes and neutrophils by increasing cAMP
20
Q
Vaccine recommended in the 20th week of pregnancy
A
Tdap
21
Q
Which week of pregnancy is the Tdap vaccine recommended?
A
20th
22
Q
Organisms that cause otitis media
A
Haemophilus, moraxella, strep pneumonia
23
Q
Chocolate agar is used to culture
A
Haemophilus influenzae
Neisseiria meningities
Neisseiria gonorrhoeae
24
Q
H. influenzae major virulence factor
A
Capsule (6 serotypes)
25
Streptococcus pnuemoniae major virulence factor
Capsule (8o serotypes)
26
Bacteria "twins"
Moraxella and unencapsulated Haemophilus influenzae
27
Otitis Media treatment
Amoxicillin, Augmentin, or Cephalosporin
28
Necrotizing Fasciitis causative agents
Group A streptococcus, Psuedomonas
29
Psuedomonas extended family
Stenotrophomonas maltophilia, Burkholderia cepacia
30
Psuedomonas distant extended family
Acinetobacter baumanii, Aeromonas hydrophila
31
Test useful for distinguishing between Psuedomonas and other GNRods like E Coli
Oxidase test (blue means Pseudomonas)
32
What does Haemophilus require to grow
Factor X and Factor V
33
Atypical pneumonia definition
1) Negative growth on blood and chocolate agar
2) Negative gram stain of sputum
3) no response to penicillin or other B-lactams
34
Legionella treatment
Azythromycin (or other macrolides)
35
Tetracycline MOA
Inhibits 30s ribosomal subunit
36
Macrolides MOA
Inhibit 50s ribosomal subunit
37
Macrolide drugs
-mycin
Erythromycin
azithromycin
Clarithromycin
38
Cephalosporins Drugs
5 generations or classes
Cephalexin
Cephazol
Cefuroxime
Cefoxitine
Cefotetan
Cefdinir
Cefotaxime
Ceftriaxone
Cefepime
39
Chloramphenicol side effects
Anemia
| Gray baby disease
40
Chloramphenicol side effects
Anemia
| Gray baby syndrome (deficiency in glucuronic acid)
41
Drugs used to treat MRSA (3)
Vancomycin
Daptomycin
Linezolid
42
Amino glycoside drugs (5)
```
Neomycin
Streptomycin
Gentamicin
Tobramycin
Amikacin
```
43
Two most important adverse effects of aminoglycosides
Ototoxicity and nephrotoxicity
44
Test used to distinguish Streptococcus pneumonia from other streptococcus
Optochin
45
Most common cause of community acquired pneumonia
Strep pneumonieae
46
First line tx in Rocky Mountain Spotted Fever (Rickettsia)
Doxycycline (tetracycline class)
47
Bacteria that grow inside macrophages (3)
Mycobacterium
Legionella
Nocardia
48
Fungi that grow inside macrophages (2)
Histoplasmosis
| Blastomyces
49
Symtom constellation: cough or pneumonia, erythema nodosum, hepatosplenomegaly
Histomycosis/ Blastomycosis
50
Catalase positive fungi (2)
Aspergillus and candida
51
Diagnostic test for Aspergillus
Galactomannan Serum Antigen
52
Gaalctomannan Serum Antigen test: organism?
Aspergillus
53
Test that can help differentiate cryptococcus from other fungi
Urease
54
Distinctive drug in treatment of cryptococcus
Flucytosine [flute player]
55
Distinctive drug used to treat pneumocystis pneumonia
Pentamidine [pentagon shaped ping pong paddle]
56
What is the Strep Pyogenes capsule made of?
Hyaluronic acid [Hot Apple pie]
57
Scarlet fever symptom contellation (3)
Pharyngitis
Strawberry tongue
Rash that spares the face
58
Strep pyogenes toxin type that causes necrotizing fasciitis
SpeB [burnt ginger bread cookie]
59
Strep Pyogenes virulence factor and cause of rhuematic fever
M protein
60
JONES CRITERIA: N
subQ Nodules
61
JONES CRITERIA: E
Erythema marginatum
62
JONES CRITERIA: S
Sydenham's chorea: shaking of hands and twitching of face
63
Strep pyogenes: Tx
Penicillin
64
Test for differentiation between Group A and Group B strep
Group A is bacitracin sensitive
| Group B is not
65
Strep viridans and strep pneumoniae are:
Alpha hemolytic
66
Group B strep species name
S. agalactiae
67
Four findings that point to Strep throat as opposed to viral pharyngitis
1) lack of cough
2) fever
3) cervical lymphadenopathy
4) tonsillar exudate
68
Test that differentiates Group B strep from all other streps
CAMP test: when GBS is plated with Staph aureus, it has a greater zone of hemolysis
69
#1 cause of meningitis in neonates
Group B strep
70
Tests for group B strep
1) Hippurate (+)
2) CAMP (+)
3) Bacitracin resistant
71
Mycoplasma bacteria has:
NO cell wall!
72
Bacteria that cannot appear on gram stain
Mysoplasma
73
Special media for mycoplasma
Eaton's agar
74
Diptheria exotoxin subunit A MOA
Rybosylation of Elongation factor 2 (EF2) causes cell death
75
Special agar for Corynebacteria culture (2)
Telluride
Loeffler's
[Child laughing at the tele vision]
76
"Fried egg" colonies
Mycoplasma (can remember because their cell membranes have cholesterol)
77
Bacterium with terminal organelle
Mycoplasm
78
Types of antibiotic that cause QT prolongation (2)
| Anti-fungal (1)
Macrolides
Fluoroquinolones
VORACONAZOLE
79
Drugs that are bound by divalent cations and should not be taken with milk, iron, etc. (2)
Tetracyclines
| Fluoroquinolones
80
Mupirocin MOA
Inactivates staphylococcal isoleucyl tRNA synthetase
81
Nitrofurantoin side effects (2)
Major: cumulative pulmonary fibrosis
| Hemolytic anemia in G6PD deficiency
82
Type of antibiotic used for COPD exacerbation
Macrolide
83
Friends of pseudomonas
```
Aeromonas
Acinetobacer
Elizabethkingella
Burkholderia
4
```
84
Special virulence factor for Pseudomonas aeruginosa
Alginate polysaccharide capsule
85
MOA: amphotericin B
Binds to ergosterol in the cell membrane causing membrane damage
86
Major toxicity of Ampho B (#1)
infusion reaction
87
Major toxicity of Amphotericin B (#2)
Nephrotoxicity
Hypokalemia
Hypomagnesia
NAGMA/RTA
88
Combo therapy drug for Ampho B in invasive fungal infection
Flucytosine
89
MOA: Flucytosine
Acts like 5-FU in cancer cells- inhibits thimydilate synthase, inhibiting DNA synthesis
90
Anti-fungal med that is teratogenic and contraception must be used concurrently
Voriconazole
91
QT prolonging drugs
Macrolides
Fluoroquinolones
Voriconazole
92
Endocandin- Drug name and MOA
Caspofungin
| Inhbits production of glucan which is only contained in fungi cell walls
93
Caspofungin interacrion
tacrolimus
94
Nystatin MOA
Nings to ergosterol and causes membrane damage, but IS NOT absorbed through any mucous membrane
95
Pseudomonas Tx (4)
1) Zosyn (pipericillin/tazobactam)
2) Cefepime (4g cef.)
3) Ceftazidime (3g cef.)
4) Carbapenems
5) Colistin (polymixin) (for MDR strains)
96
Black box warning for montelukast
Depression/ suicidal thoughts
97
Ziluteon MOA
5-lipoxygenase inhibitor (inhibits production of all leukotrienes
98
When is Levalbuterol indicated?
When the patient has a documented arrhythmia caused by albuterol
99
Major receptor for rhinovirus A and B
ICAM-1
100
Most common cause of secondary pneumonia
Staph Aureus
101
Pott disease
When reactivated TB spreads to the bones, specifically the lumbar vertebrae
102
Sarcoidosis is classically seen in
African american females
103
Classic findings in sarcoidosis (2)
Increased serum ACE
| Hypercalcemia
104
Type of cell that produces surfactant
Type II pneumocyte
105
Unique site of metastasis for lung carcinoma
Adrenal gland
106
New blood test for pneumocystis jirovecii
1-3 beta d glucan
107
Treatment for Pneumocystis jirovecii
Bactrim, maybe glucocorticoids
108
Diptheria causes
myocarditis
109
Nocardia tx
Bactrim
110
Gram positive filamentous rods (2)
Nocardia and Actinomycetes
111
Common cause of pneumonia in alcoholics
Klebsiella
112
Mycobacterium tuberculi lives inside
Alveolar macrophages
113
Virulence factor for M tuberculi that prevents fusion of phagosome with lysosome
cord factor
114
Most common cause of ventilator associated pneumonia
Pseudomonas aeruginosa
115
Virus diagnosed in infants with ELISA
RSV
116
How is RSV induced bronchiolitis diagnosed in infants
ELISA assay
117
Aztreonam is effective against
Gram negative rods (like Klebsiella)
118
Special agar for Klebsiella
MacConkey agar
119
Bacterium grown on MacConkey agar
Klebsiella
120
These antibiotics show concentration dependent killing
Quinolones and aminoglycosides
121
Types of drugs that work at the cell membrane (2)
Polymyxin
Daptomycin
(amphotericin and nystatin too)
122
Treatment for syphillis
Penicillin
123
Anti staphylococcal penicillins (2)
Nafcillin
| Oxacillin
124
Penicillin with biliary excretion
Nafcillin
125
Tx for enterococci and Listeria monocytogenes
Ampicillin (because they are resistant to cephalosporins)
126
Risk of cross reactivity of cefalosporing in patient with TRUE PCN allergy (%)
First gen 1-10%
127
Cef Gen: Cefazolin
1st
128
Cef Gen: Cefalexin
1st
129
Cef Gen: Cefachlor
2nd
130
Cef Gen: Cefoxitin
2nd
131
Cef Gen: Cefuroxime
2nd
132
Cef Gen: Cefotetan
2nd
133
3rd gen Cefalozporins
TTTDF
134
Aztreonam spectrum of action
Gram negative aerobic rods
135
Vancomycin is
Not absorbed at all in the gut
136
Whem vancomycin won't work for VRE, try this drug
Daptomycin
137
Bacitracin MOA
disrupts the lipid cycling that transports peptidoglycan building blocks to the cell wall
138
Pertussis toxin MOA
Inactivates Gi, increaseing cAMP
139
Diptheria toxin causes
myocarditis
140
"Fried egg colonies"
mycoplasm
141
Special agar for mycoplasma pneumonia
Eaton's agar
142
Major player in acellular vaccine for Bordetella pertussis
```
Fimbrial hemagglutinin
(also pertussis toxin todoid)
```
143
Diagnostic feature of pertussis
Lymphocytosis
144
Common findings with pertussis infection (2)
Seizures
| Lymphocytosis
145
Special media for Bordetella pertussis (2)
Bordet-Gengou
| Regan-Lowe
146
Pertussis diagnosis
PCR
147
Pertussis tx
Macrolide
148
Signet ring sign
When the bronchiole is larger in diameter than the corresponding blood vessel, indicating bronchiectasis
149
Treatment for uncomplicated strep pneumoniea
Macrolide
150
Bacteria with virulence factor IgA protease (2)
Strep Pneumo
| Haemophilus influenza
151
Major virulence factor for Haemophilus influenza
Capsule (like S pneumoniae)
152
Special agar for H Influenza
Chocolate agar with factor X and factor V
153
H influenza and Moraxella cat treatment
3rd gen cefalosporin
154
Hydroxizine (vistaril) use:
Itching
155
Second generation antihistamines: (3)
Claritin, Zyrtec, Allegra
156
Important side effect of intranasal corticosteroids
Can cause open angle glaucoma. suggested routine eye exams
157
Nebulized mucolytic used in special inpatient circumstances
Acetylcysteine
158
Benzonatate MOA
Suppressant, local anesthetic on respiratory stretch receptors
159
Most common adverse effects of amphotericin B (2)
Nephrotoxicity and electrolyte imbalances
160
Caspofungin MOA
Inhibits synthesis of the glucan component of fungal cell wall
161
Small cell carcinoma paraneoplastic effects
Cushing syndrome and SIADH
162
Squamous cell carcinoma paraneoplastic effects
Hypercalcemia secondary to parathyroid hormone related peptide
163
Beta-2 agonist that can be used in premature labor to slow contractions
Terbutaline
164
Contraindication for Singulair
Liver disease
165
Main MOA of Theophylline
Release of epinephrine from adrenal glands
166
Roflumilast MOA
Phosphodiesterase 4 inhibitor- decrease inflammation only
167
Roflumilast monitoring
LFT's
168
At risk for spontaneous pneumothorax
Paraseptal bullae emphysema
169
Location of Antitrypsin gene
Chromosome 14
170
Cystic Fibrosis gene abnormality
Deletion on chromosome 7
171
Rifampin MOA
Inhibits RNA pol
172
Isoniazid MOA
Inhibits mycolic acid synthesis
173
Pyrazinamide MOA
Inhibits cell membrane formation
174
Ethambutol MOA
Inhibits Cell wall formation
175
Gene for isoniazid resistance
KatG
176
Ethambutol MOA enzyme
Inhibits ATIII arabinosyl transferase
177
Problem with rx of ethambutol
Requires frequent dosing
178
PyrAZamide
activated by acidic conditions
179
Pyrazimade special info
The concentration of this drug is highly concentrated at site of action compared to serum
180
Dapsone MOA
PABA analogue, acting analogous to sulfa drugs but only in bacteria
181
Dapsone warning
G6PD deficiency
182
G6PS deficiency caution (drug)
Dapsone
183
Differentiating factor between Hypersensitivity pneumonitis and sarcoidosis
No hilar adenopathy in HP
184
Honey combing and fibroblastic focus
Idiopathic Pulmonary Fibrosis
185
NSIP vs UIP
Collagen vascular disease (homogenous lymphocytic infiltrate) vs IPF (heterogenous)
186
Silicosis x ray finding
Upper lobe predominant
187
Eosinophil Pneumonia CT finding
Reverse pulmonary edema sign (edema on periphery of lungs)
188
Finding with drug induced Interstitial lung disease
Eosinophilia
189
Caplan's syndrome
Co-existence of pneumoconiosis with rheumatoid arthiritis
190
Stain for asbestos fibers
Prussian blue
191
Bleomycin causes
Pulmonary fibrosis
192
Important testing to confirm Group A strep infection
Serology anti-streptolysin O
193
Age group for Group A strep throat
5-15 years
194
Pneumocystis jiroveci is (habitat)
normal flora in lungs
195
Opportunistic bacteria for post flu infection (2)
Pseudomonas
| Staph aureus
196
Cell type precursor to small cell carcinoma
Kulchitzky or apud
197
Cell Type precursor to adenocarcinoma
Clara cell
198
Ampho B same MOA as
Nystatin
199
Nystatin same MOA as
Amphotericin B
200
Major toxicity with Ampho B
Nephrotoxicity (with NAGMA)
201
Caspofungin MOA
prevent synthesis of fungal cell wall material glucan
202
Griseofulvin acts like
taxanes. binds and prevents formation of microtubules
203
Macrolides MOA
Bind 50s subunit and block the exit tunnel
204
Clindamycin MOA
Bind 50s subunit and block the exit tunnel
205
Chloramphenicol MOA
Prevent peptide bond formation (50s)
206
Linezolid MOA
Binds to the 50s subunit and prevents the 50s/30s complex formation
207
Tetracyclines MOA
Bind to 30s and prevent binding of tRNA
208
Aminoglycosides MOA
Bind to 30s subunit and cause misreading of codon
209
"Mycin" = bye-cin
Macrolides and clyndamycin block the exit tunnel and elongation of peptides
210
Rickettsia Rickettsiae Rocky mountain spotted fever treatment **
Doxycycline
211
Doxycycline drug interactions
PCCP Phenytpoin, carbemazepine, chronic alcohol, phenobarbitol
212
Tetracycline used to treat SIADH
Demeclocycline
213
Erythromycin side effect
induces gut motility (diahrrea)
214
Drug used for pertussis prophylaxis
Erythromycin
215
Linezolid side effects
Hematologic
Optic neuropathy
Lactic acidosis
216
Aminoglycosides spectrum and use
Limited to serious gram negative IV use
217
Resistance to aminoglycosides
acidic environment
218
Aminoclycoside adverse effect
Nephrotoxicity (like amphotericin)
219
Amino glycoside must be used synergistically with
Cell wall agent
220
Drugs actively transported into the cell
Fosfomycin, aminoglycosides
221
Metronidazole MOA
converted intracellular to active drug, then oxidative damage
222
Drugs for anaerobes: (2)
Clindamycin and metronidazole
223
Drugs with Disulfiram reaction (vomiting when taken with alcohol) (2)
Metronidazole and Cefotetan
224
Metronidazole toxicity
Seizures and peripheral neuropathy
225
Metronidazole interactions (3)
Warfarin increae
Phenytoin
Phenobarbitol
226
Mupirocin (topical) MOA
Inhibits isoleucyl tRNA synthase
227
Polymixin spectrum
gram negative only
228
G6PD drugs: (3)
Sulfonamides (bactrim)
Dapsone
Nitrofurantoin
229
Amino glycosides cannot be used to treat
anaerobic infections
230
Muscle pain is a side effect of this antibiotic
Daptomycin (monitor creatinine levels)
