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RACP Written Exam > ID > Flashcards

ID Flashcards

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1
Q

What causes neurocysticerosis?

A

Taenia solium
Ingested larvae from undercooked pork

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2
Q

Treatment for cysticercosis

A

Praziquantel

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3
Q

Treatment for neurocysticerosis

A

Albendazole

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4
Q

Cause of hydatid cysts in liver and lungs?
What occurs when they rupture

A

Echinococcus granulosus
If hydatid cysts rupture can cause anaphylaxis
Tx Albendazole

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5
Q

What does clononchis sinesis increase risk of?

A

Cholangiocarcinoma

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6
Q

Schistosomas can cause which type of inflammatory disease?

A

Granulomatous disease

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7
Q

Why in acute schistosomiasis do you have severe fever, uricaria, angiooedema, myalgias and arthralgias 3-8 weeks post infection

A

Period of egg production, increased Antigen production causing hypersensitivity

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8
Q

Chronic schistosomasis leads to increased risk of?

A

SCC of bladder
Pulmonary HTN

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9
Q

Treatment for schistosomaiasis

A

Praziquantel
Corticosteroids

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10
Q

Treatment of scabies

A

Permethrin cream
Oral ivermectin

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11
Q

What is genetic recombination

A

Viruses exchange genetic material

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12
Q

What are the ESCAPPM organisms?

A

Enterobacter
Serratia
Citrobacter
Aeromonas
Proteus
Providencia
Morganella

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13
Q

MoA of penicillin

A

D-ala-D-ala structural analogue that Binds penicillin binding proteins -> blocks cross linking of peptidoglycan wall

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14
Q

MRSA resistance mechanism

A

Altered penicillin binding proteins

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15
Q

What are penicillinase sensitive penicillins and what use do they have?

A

Amoxicillin and ampicillin
Extended spectrum penicillin HHEELPSS
H influenza h pylori e coli enterococci listeria proteus salmonella shigella

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16
Q

Penicillin toxcitities

A

Direct coombs positive haemolytic anaemia
Drug induced interstitial nephritis
C diff pseudomembranous colitis
Hypersensitivity

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17
Q

Moa of vancomycin

A

Inhibition of peptidoglycan formation by binding to d ala d ala

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18
Q

Aminoglycoside moa

A

Irreversible inhibition of ribosome initiation complex Binds 30s subunit, needs o2 so no anaerobic activity

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19
Q

Aminoglycoside mechanism of resistance

A

Bacterial transferase enzymes inactivate the drug via acetylation, phosphorylation or adenylation

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20
Q

Linezolid moa

A

Inhibits ribosome 50s unit and prevents initiation complex

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21
Q

Linezolid resistance

A

Point mutation of ribosome rna

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22
Q

What are the macrolides

A

Azithromycin, erythromycin, clarithromycin

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23
Q

Macrolide moa

A

Inhibit translocation in the ribosome so proteins cannot be produced, bacteriostatic

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24
Q

Macrolide uses

A

Atypical mycoplasma, chlamydia, legionella, Gram +ve cocci

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25
Macrolide resistance
Methylation of 23s rRNA binding site, drug can't bind
26
Macrolide side effects
MACRO gi motility, arrthymia (qt prolongation) cholestatic hepatitis, rash, eosinophilia
27
Linezolid also inhibits
MAO inhibitor, causes serotonin syndrome
28
Linezolid ADRs
Thrombocytopenia, peripheral neuropathy, serotonin syndrome, lactic acidosis
29
Tetracyclines and moa
Doxycycline Binds to 30s subunit, prevents trna attachement
30
Doxycycline resistance
Reduced uptake or increased removal from cell by Plasmid encoded transport pump
31
Type of bacteria doxycycline best against
Intracellular Rickettsia and chlamydia Use in atypicals
32
Clindamycin moa
Blocks tranlocation of peptides at 50s ribosome subunit
33
Clindomycin uses
Aneorobes above the diaphragm
34
Clindamycin adrs
C diff
35
Sulfonamides and their moa
Sulfamethoxazole Inhibit DHF synthesis, inhibits foliate synthesis, bacteriostatic
36
Sulfonamides adr
Hypersensitivity If g6pd def then haemolysis Tubulointerstitual nephritis SJS Displaces other drugs from alb (warfarin)
37
Sulfonamides resistance
Altered enzyme leads to decreased uptake or increases PABA synthesis
38
Dapsone moa
Inhibit DHF synthesis, inhibits foliate synthesis, bacteriostatic
39
Dapsone adrs
Methhaemoglobulinaemia, agranulocytosis, hameolysis if g6pd def
40
Trimethoprim moa
Inhibits bacterial dihydrofolate reductase, bacteriostatic
41
Trimethoprim adrs
HyperK, megaloblastic anaemia, leukopenia, granulocytopenia
42
Daptomycin moa
Creates transmembrane channels in Gram +ve cocci
43
What is dapsone used in
S aureus skin infections Can't use in lungs, inactivated by surfactant
44
Dapsone adrs
Myopathy, rhabdo
45
Metronidazole moa
Forms toxic free radical metabolites in bacteria which kills it Also kills protozoa
46
Metronidazole adrs
Red Man syndrome (disulfram like reaction, severe flushing, tachy, low bp) with alcohol, headache, metallic taste
47
Metronidazole used for
Get gap on the metro Giardia Entamoeba Trichmonas Garderella vaginalis Anaerobes
48
Fluroquinolones and moa
Ciprofloxacin, moxifloxacin Inhibits prokaryotic enzymes topoisomerase 2 and 4 (DNA gyrase inhibition)
49
Fluroquinolones adrs
GI, superinfections, rash, headache, dizziness, rarely myalgias, cramping, tendon rupture
50
Fluroquinolones resistance
Mutation in DNA gyrase Plasmid medicated resistance Efflux pumps
51
Rifampin moa
Inhibit bacterial rna polymerase -> reduced mrna synthesis
52
Rifampin adrs
Hepatotoxicity, cypP450 inducer Red-orange body fluids
53
Isoniazid moa
Inhibits mycolic acts synthesis and reduces cell wall synthesis Needs bacterial catalase peroxidase in order to convert to active form (encoded by KatG)
54
Isoniazid resistance
Needs bacterial catalase peroxidase in order to convert to active form (encoded by KatG) Mutations in katG
55
Insoniazid causes what deficiency
Vit B6 (pyridoxine)
56
Isoniazid adrs
B6 def, hepatotoxicity, cypP450 inhibition, drug induced lupus, overdose causes seizures
57
Pyrazinamide adrs
Hepatotoxicity, hyperuricaemia
58
Ethambutol moa
Inhibits arabinosyltransferase, reduces arabinogalactan synthesis and reduces cell wall synthesis
59
Ethambutol adrs
Optic neuropathy (red-green colour blindness and decreased visual acuity) Usually reversible
60
Treatment of TB leprosy
Dapsone and rifampin Add clofazimime for lepromatous form
61
Amphotericin B and nystatin MoA
Binds ergosterol and forms membrane pores which leak electrolytes
62
Treatment considerations when using amphotericin B
supplement K and Mg due to altered renal tubule permeability
63
Amphotericin B ADRs
nephrotoxicity, arrthymias, anaemia, phelbeitis, fever/chills, hypotension
64
MoA of Flucytosine
Antifungal Inhibts DNA and RNA synthesis by converting to 5FU through cytosine deaminase
65
ADR of Flucytosine
Myelosuppression
66
What are the azoles
clotrimazole, fluconazole, voriconazole, ketoconazole
67
MoA of Azoles
Inhibits fungal ergosterol synthesis by inhibiting CYP450 (usually converts lanosterol to ergosterol)
68
Azole ADRs
Testosterone synthesis inhibition (gynocomastia), liver dysfunction, QT prolongation
69
Terbinafine MoA
Inhibits fungal enzyme squaline epoxidase, stops lanosterol synthesis
70
What are the Echinocandins
Anidulafungin, caspofungin, micafungin
71
MoA echinocandins
inhibits Beta-glucan synthesis which inhibits cell wall synthesis
72
Griseofulvan MoA
interferes with microtubule function, accumulates in nails
73
Griseofulvin ADRs
teratogenic, carcinogenic, confusion, headaches, disulfram-like reaction, increased CYP450 and warfarin metabolism
74
What is a disulfiram-like reaction
adverse reaction to alcohol (N+V, headache, dizziness, hangover) caused by accumulation of acetaldehyde Cephalosporins, macrolides, sulfonureas
75
Oseltamivir MoA
Inhibits influenza neuramindase, reduces viral progeny release
76
Remdesivir MoA
prodrug of ATP analogue inihibts viral RNA-dependent RNA polymerase and evades viral proof-reading, reducing viral RNA production
77
Aciclovir, Famiciclovir, valaciclovir MoA
guanosine analogues phosphorylated by HSV/VZV viral thymidine kinase (not activated in uninfected cells and in CMV), inihibits viral RNA polymerase Valacyclovir is aciclovir prodrug, has beeter oral biovailability
78
Aciclovir, Famiciclovir, valaciclovir ADR
obstructive crystalline nephropathy and AKI if not hydrated enough
79
Aciclovir, Famiciclovir, valaciclovir resistance
mutated viral thymidine kinase
80
Ganciclovir MoA
Guanosine analoug phosphorylated by CMV viral kinase, inhibits DNA polymerase Valganciclovir is prodrug, has better bioavailability
81
Foscarnet MoA
Viral DNA/RNA prolymerase inhibitor and HIV reverse transcriptase inhibitor
82
Foscarnet ADRs
Nephrotoxicity Electrolyte disturbance
83
Cidofovir MoA and ADR
Inhibits viral DNA polymerase ADR: nephrotoxicity (use with probenicid and saline to reduce toxicity)
84
Common combo of HIV therapy
2 NRTIs and an integrase inhibitor
85
Therapy used for HIV PrEP
Tenofovir and emtricitabine
86
NRTIs MoA
abacavir, tenofovir inhibit nuceloside binding to reverse transcriptase to terminate DNA chain
87
NRTI ADRs
myelosuppression, nephrotoxicity
88
When is abacavir contraindicated?
HLAB5701 mutations, increases hypersensitivity
89
NNRTIs ADRs
rash, hepatoxocitity
90
Integrase inhibitor MoA
inhibiting integrase prevents HIV genome integration into host cell chromosome
91
Integrase inhibitors ADRs
raised CK, weight gain
92
Protease inhibitors all need to be prescribed with
ritonavir or cobicistat
93
Protease inhibitors MoA
protease usually cleaves RNA into functional parts, if inhibited prevents maturation of new virions
94
Protease inhibitor ADRs
hyperglycaemia, nausea and diarrhoea
95
MoA of enfuvirtide
binds gp41, inhibiting entry Fusion inhibitor
96
Maraviroc MoA
binds CCR5 and inhibits interaction with gp120
97
NS5A inhibitors MoA (hep C therapy)
end in pasvir is a viral phosphorylase which plays key role in RNA replication
98
NS5B inhibitors MoA
end in buvir RNA-dependent RNA polyermerase, prevents viral replication
99
NS3/4A inhibitors MoA
end in previr inhibit viral protease, prevents replication
100
Ribavirin MoA
inhibits guanine synthesis
101
Treatment for acyclovir resistant HSV
Foscarnet or Cidofovir
102
Extrahepatic manifestations of Hep C
DM Autoimmune hypothyroidism Membronous/membranoproliferative GN Lichen planus
103
Empiric treatment for sepsis in splenectomy
Ceftriaxone and vanc
104
mortality in sepsis and splenectomy
50%
105
Most common organisms causing sepsis in splenectomy pt
strep pneumoniae H influenza Neisseria meningiditis
106
empiric sepsis tx pre hospital
ceftriaxone
107
empiric tx community acquired
Gent and fluclox add vanc is MRSA add ceftriaxone if meningitis (cefazolin if allergic)
108
empiric tx of hospital sepsis
PipTaz
109
What is ecthyma gangrenosum and what caused by
rash with haemorrhagic vesicles, rim of erythema and central necrosis Caused by pseudomonas
110
What causes sepsis after ingesting raw shellfish (US) -> sudden malaise, fever, hypotension bullous haemorrhagic lesions occurs in liver disease, DM, renal insuff, cancer
vibrio vulnificus
111
Most common causitive organisms of nec fasc
group a strep clostridium perfringins
112
empriric treatment for nec fasc
meropenam or pip/taz plus vancomycin plus clindamycin if water associated wound add ciprofloxacin
113
Pneumovax dosing for adults
1 dose when non indigenous 70yo aborginal >50yo 3 doses pneumovax 23 better at preventing adult infections

RACP Written Exam (14 decks)

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