Exam 1 Flashcards
(107 cards)
1
Q
What cells are typically. elevated in the presence of an infection?
A
Leukocytes
2
Q
What are the granulocytes?
A
Neutrophils, Eosinophils, Basophils
3
Q
What are the Agrangulocytes?
A
Lymphocytes, Monocytes
4
Q
What is the mnemonic for the proportions of different types of WBCs?
A
Never Let Monkeys Eat Bananas
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
5
Q
What is the most abundant WBC? What does it defend against?
A
Neutrophil-bacterial infections! Also active in fungal infections in physiological stress. First to arrive at site of an acute infection
6
Q
What is the primary defense cell for viral infections?
A
Lymphocytes. Most common WBC in the lymph
7
Q
What is the largest WBC? When are they elevated?
A
Monocytes. Elevation noted in late or chronic infection
8
Q
What WBC responds to allergic reactions or parasitic infections?
A
Eosinophils
9
Q
What WBCs defend in hypersensitivity reactions?
A
Basophils. they release inflammatory mediators
10
Q
What does a cloudy/Turbid Urinalysis significant of?
A
consistent with pyuria
11
Q
What is strong/fishy urinalysis odor consistent with?
A
infection
12
Q
When is a Wet prep/KOH prep indicated?
A
vaginal/cervical/urethral discharge
13
Q
What is a KOH prep best for visualizing?
A
fungal cells
14
Q
What are clue cells?
A
Epithelial cells of the vagina that get their distinctive stippled appearance by being covered with bacteria
15
Q
When is a lateral decubitus used?
A
When collecting fluid in which opening pressure is needed
16
Q
What is Xanthochromia indicative of?
A
bleeding in CSF
17
Q
How should CSF present?
A
Clear and colorless
18
Q
What does cloudy/turbid CSF indicative of?
A
infection
19
Q
How should CSF viscosity present?
A
same as water
20
Q
What is thick CSF viscosity indicative of?
A
infection
21
Q
What is the MC side effect after a lumbar puncture?
A
HA
22
Q
How does a pleural fluid analysis normally present?
A
light yellow and clear
23
Q
What is a milky appearance of pleural fluid analysis indicative of?
A
lymphatic system involvement
24
Q
Reddish fluid in the pleural fluid analysis is indicative of the what?
A
blood
25
What is a cloudy, thick pleural fluid indicative of in pleural fluid analysis.
microorganisms and/or WBC
26
What are some complications from a pericardiocentesis?
myocardial perforation, bleeding, pneumothorax, arrhythmia, acute pulmonary edema
27
How do CT scans work?
they utilize radiation to produce images
28
How do MRIs work?
they use powerful magnetic fields and radio frequency pulses to produce images
29
How would you order a stool culture?
Order a stool for "Ova and Parasites"
30
What is the most common bacteria found in a UTI?
E. Coli
31
Rust colored sputum indicates what?
Streptococcus pneumoniae
32
Yellowish/Green colored sputum indicates what?
Haemophilus influenzae
33
Green sputum indicates what?
Pseudomonas
34
Red, currant-jelly sputum is indicative of what?
Klebsiella
35
Bloody sputum is indicative of what?
TB
36
Foul smelling/bad tasting sputum is indicative of?
Anaerobes
37
Thin/scant sticky sputum is indicative of?
Atypicals-mycoplasma pneumoniae, chlamydia pneumoniae
38
Who should you avoid a strep test on?
Children <3 y/o
39
What is the MOA of Beta lactams?
inhibition of cell wall synthesis
40
What four antibiotics make up the Beta-Lactams?
Penicillinis, Cephalosporins, Carbapenems, Monobactams
41
What is the first line treatment for strep throat?
Natural Pencillin
42
What is the first line treatment for Syphilis?
Natural Penicllin
43
What is the first line treatment for Otitis media?
Aminopenicillins (amoxicillin, ampicillin)
44
What are the three bacterias that cause otitis media?
H. Flu
S. Pneumo
M. Cat
45
What is first line for sinusitis/ pneumonia/COPD exacerbations?
Augmentin and Unasyn
46
What has amazing pseudomonas coverage?
Piperacillin/tazobactam
47
What are the first generation cephalosporins?
cephalexin (keflex), cefazolin (ancef), cefadroxil
48
What are the 2nd gen cephalosporins?
Cefuroxime
Cefoxitin
Cefotetan
Cefaclor
Cefprozil
49
What are the 3rd generation cephalosporins?
Ceftriaxone (rocephin)
cefdinir (omnicef)
cefditoren (spectracef)
cefixime
cefpodoxime
ceftazidime
Ceftibuten
50
What is the first line treatment for Neisseria gonorrhoeae
Rocephin, meningitis, PID
51
What is the only beta-lactam with MRSA coverage
Ceftaroline
52
Which cephlasporin generation starts crossing the BBB
3rd generation
53
What drugs are a part of the carbapenems?
Imipenem
Imipenem/Cilastatin
Meropenem
Ertapenem
Doripenem
54
What is the MOA for carbapenems?
same as other beta-lactams
55
What is the MOA of vancomycin?
inhibits bacterial cell wall synthesis
binds to D-ala D-ala, a side chain in peptidoglycan, preventing the formation of peptidoglycan and phospholipids
this results in a weakening of the cell wall and inhibition of bacterial replication
56
What type of bacteria is Staph aureus?
Gram + Cocci
57
What type of bacteria is Clostridium?
Gram + Bacilli
58
What is the drug of choice for MRSA?
Vancomycin
59
What do you have to adjust for with vancomycin?
renal impairment
60
What are some adverse effects of Vancomycin?
Hyperemia (Red man syndrome)
Nephrotoxicity/Ototoxicity
61
What is a good alternative to vancomycin for VRE infections?
Daptomycin, Linezolid, Oritavancin
62
What drugs fall under aminoglycosides?
Gentamicin, Tobramycin, Amikacin, Streptomycin
63
What is the MOA for aminoglycosides?
Binds to the 30S subunit inhibiting bacterial protein synthesis
Post antibiotic suppression of bacterial growth
64
When are aminoglycosides indicated?
gram -
mycobacterium tuberculosis
65
What BBW come with aminoglycosides?
Ototoxicity
Nephrotoxicity
Neuromuscular paralysis
66
What pregnancy category are aminoglycosides?
Pregnancy category D
67
Do aminoglycosides have a narrow or wide therapeutic window?
Narrow--high risk of toxicity
Monitor peak and trough levels
Monitor BUN/Cr at baseline and periodically
Monitor audiometry-high doses, long term use or s/sx of hearing impairment
68
What drugs are tetracyclines?
Tetracycline
Doxycycline
Minocycline
69
What is the MOA for tetracyclines?
Binds to 30S ribosomal subunit
Blocks tRNA
70
What spectrum of activity do tetracyclines have?
Gram + and Gram -
MRSA coverage
Atypicals- mycoplasma, rickettsiae, chlamydiae, spirochetes
71
What is the first line treatment for lyme disease?
tetracycline
72
what is the first line treatment for rocky mountain spotted fever?
tetracyclines
73
what is the first line treatment for cholera?
tetracyclines
74
What is the first line treatment for acne?
Tetracyclines
75
Where are tetracyclines Contraindicated?
children <8-9 y/o because of the tooth discoloration during tooth development
relative CI-children <13 y/o
Pregnancy or nursing mothers
76
What are some adverse effects of tetracyclines?
GI distress, hepatotoxicity, photosensitivity, vestibular problems-specifically minocycline
Candida infections; C. diff
77
What are the macrolides?
Azithromycin
Erythromycin
Clarithromycin
78
What is the MOA for macrolides?
inhibits protein synthesis and translocation needed to replicate (50S subunit)
79
Do macrolides cross the BBB?
nope!!
80
When are macrolides uses as first line treatments?
Community acquired pneumonia
atypicals-mycoplasma, chlamydia
chlamydia
legionella
diptheria
COPD-acute exacerbations
81
Is azithromycin approved for the treatment of sinusitis?
NOPE
82
What are the adverse effects of macrolides?
GI-N/D (MC), c. diff
Hepatoxtocicity
Prolonged QT interval
Ototoxicity (transient)
83
What pregnancy category are macrolides?
Cat B
84
What does clindamycin cover?
Gram + (including some strains of MRSA)
Anaerobes
85
What is the BBW for clindamycin?
C. difficile colitis
86
What are the 3 quinolones?
Ciprofloxacin
Levofloxacin
Moxifloxacin
87
What is the MOA of quinolones?
inhibit bacterial DNA synthesis/DNA inhibitors
Inhibition of DNA gyrase and Topoisomerase IV
Rapid Bactericidal activity
88
What is the spectrum of activity for quinolones?
Gram - > Gram +
Gram +: Streptococcus and MSSA
Anaerobes: moxifloxacin
89
What are quinolones used as first line treatment for?
Pyelonephritis
Prostatisis
Traveller's diarrhea
Anthrax
URIs/Pneumonia with Comorbidities
90
Who are quinolones contraindicated for?
Prolonged QT/arrhythmias
Myasthenia Gravis
91
What pregnancy cateogry are Quinolones?
Cat C
92
What is the BBW for Quinolones?
Tendinitis/Tendon Rupture
93
What is the MOA for Trimethoprim?
Folate reductase inhibitor-inhibits bacterial amino acid synthesis
94
What is the MOA for sulfamethoxazole?
Folate synthesis inhibitor
95
What is Bactrim a DOC for?
Outpatient treatment for MRSA, UTI cystitis
96
What are the adverse effects of bactrim?
megaloblastic anemia
GI distress
Photosensitivity
Hepatotoxicity
97
What pregnancy cat is Bactrim?
Cat C
98
What is the MOA for Nitrofuratoin?
inhibits bacterial enzymes and damages DNA
99
What is Nitrofurantoin DOC for?
UTI
100
What is the MOA for Metronidazole and Tinidazole?
Disrupts microbial DNA
101
What is metronidazole the DOC for?
Trichomonas
Bacterial Vaginosis
C. Diff colitis
Amebiasis
Giardiasis
102
What should not be taken with alcohol?
Metronidazole!!
103
What are some adverse effects of metronidazole?
GI distress: N/V/D
Metallic taste
Disulfiram-like reaction
104
What is the BBW for metronidazole?
Carcinogenic in mice and rats
105
What is mupirocin most commonly indicated for?
Impetigo
106
What can you use for pseudomonas in the eye?
Polymyxin B
107
What is Bacitracin indicated for?
Gram + stuff
but it's limited to topical application only d/t nephrotoxicity
