ID - Unit 3 Flashcards by Amanda Mahler

how is coccidioides transmitted?

inhalation of spores

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leishmaniasis amastigotes in macrophages in spleen

Middle East

sand fly

black fever, pancytopenia, HSM

stibogluconate, Ampho B

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trypanosoma cruzii (trypanosome in blood)

S/Central America

Reduviid bug / kissing bug

Romana’s sign (early sign, periorbital edema, usually unilateral), later signs = megacolon, megaesophagus, dilated cardiomyopathy

BENZnidazole, niFURtimax (cruisin’ in my BENZ in my FUR coat)

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entamoeba histolytica (cysts with up to 4 nuclei, ingested RBCs)

developing countries, men who have sex with men

fecal-oral (ingest eggs in contaminated water)

often asymptomatic, may have colonic ulcerations, flask-shaped lesions in colon, bloody diarrhea, liver cysts (usually R lobe, anchovy paste)

metronidazole, paramycin, iodoquinol (luminal agent)

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trichomonas vaginalis (motile trophozoite on wet mount)

STI (NO CYST FORM!!)

vaginitis/cervicitis STRAWBERRY CERVIX, yellow/green discharge

metronidazole (must treat partner as well)

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Giardia lambia

North America, camping

fecal-oral ingestion of eggs in contaminated water

steatorrhea, flatulence

metronidazole

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cryptosporidium (acid-fast stain)

Immunocompromised

fecal-oral, contaminated water

small intestine watery diarrhea, self-limiting except in I/C is severe

nitazoxamide, spiromycin

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toxoplamsa gondii (crescent-shaped trophozoites, no kinetoplast or flagella)

cat feces, uncooked meat

congenital: deafness, intracranial calcifications, chorioretinitis

HIV: encephalopathy (ring-enhancing lesions), nd brain biopsy to differentiate from primary CNS lymphoma)

sulfadiazine + pyramethazine

prophylaxis if CD4 <100 with TMP-SMX

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cyclospora (acid-fast oocysts like cryptosporidium but 2X BIGGER)

Central America, Peru

fecal-oral, contaminated produce

in patients with achlorhydria, “flu-like” symptoms (lethargy, muscle aches), severe GI –> chronic loss of appetite, nausea, loose stools

TMP-SMX

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p. vivax (only young RBCs infected)

stippling (Schuffner’s dots)

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p. falciparum (no merozoites in RBCs = schizonts seen in circulation, clogged in capillaries in periph)

multiple ring forms / RBC = greater infectivity

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schistosoma japonicum (egg with small spine)

Japan

snails

ascites, anemia, abd pain, HSM, eggs in stool

praziquantel

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schistosoma haemotobium (terminal spine)

Egypt

snails

hematuria, may cause bladder cancer, eggs in urine

praziquantel

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wuchereria bancrofti (microfilaria in peripheral blood)

culex mosquito

elephantiasis

diethylcarbamazine

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trichinella (cyst w/ worm on muscle biopsy)

larvae ingested from raw pork / bear meat

BILATERAL periorbital swelling (contrast w/ unilateral for Chagas/trypanosoma cruzii), muscle pain

benzimidazoles

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enterobius vermicularis (albuminous egg) / pinworm

US very common

eggs ingested

perianal itching

mebendazole, pyrantel pamoate

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ascaris lumbricoides (cysts in stool)

eggs ingested, fecal-oral, LUNG PHASE (also strongyloides, hookworm)

GI, obstruction

benzimidazoles, ivermectin

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strongyloides

larvae entry skin (through feet), LUNG PHASE (also ascaris, hookworm)

GI (severe in I/C, COPD, corticosteroids), purulent sputum, AUTOINFECTION

ivermectin

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taenia solium (eggs with thick shells w/ radial striations, can’t diff from saginata based on eggs, look at scolex, solium has hooks saginata no hooks)

central america

uncooked pork, ingestion of EGGS

SEIZURES

albendazole

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does histoplasma “hide” in macrophages?

YUP

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what fungus might be likely to infect cavities in the lungs (like, say, ones created from previous TB infection)?

aspergillus

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soap bubble lesions

cryptococcus neoformans

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what fungal infection is associated with DKA?

mucormycosis

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why can’t ampho B be used for pneumocystic pneumonia?

BECAUSE PNEUMOCYSTIS HAS NO ERGOSTEROL WOAH!

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what's that random treatment unique to sporothrix?

why is trypanosoma brucei such a bitch?

antigenic variation

why do you have to check for G6PD deficiency before giving someone anti-malarial drugs?

because they cause acute hemolysis you asshole

which trypanosoma brucei is worse?

rhodesiense (E) is worse than gambiense (W) because it has an animal reservoir and therefore can get more fucked up or something

does trichomonas have a cyst form?

NOPE

which nematodes have a lung phase?

ascaris, strongyloides, hookworms (necatur, ancylostoma)

what tapeworm causes B12 deficiency?

the fish one (diphyllobothrium)

which kinds of hepatitis can cause chronic infection?

B, C

what is the treatment for chronic HCV infection?

sofosbuvir (NS5B/polymerase inhibitor) + velpatasvir (NS5A/protein needed for replication inhibitor)

what is the treatment for chronic HBV infection?

tenofovir

which hepatitis viruses are common in the US?

A, B, C

what type of vaccine for Hep A?

killed whole virus (give active + passive for acute infection)

what type of vaccine for HBV?

surface Ag subunit vaccine

What type of vaccine for HCV?

THERE ISN'T ONE

What type of vaccine for hep d?

The hep B one protects against Hep D (surface Ag subunit vacc)

what type of vaccine for Hep E?

it's not FDA approved so who the fuck cares

what is the window period for HBV infection, and what do you look for on serology?

when HBsAg = anti-HBsAg and therefore neither shows up on serology, need to look for anti-HBcAg IgM

what is the significance of anti-HbeAg?

can tell the patient that they are on the road to recovery because it shows up before anti-HbsAg

do you treat acute HBV or HCV infection?

does strongyloides show eggs in the stool on O&P

NO! Only larvae

Is rhinovirus acid-stable?

contaminated shellfish

hep A

devil's grip?

coxsackie B

what drug treats aspergillus?

voriconazole

what is the mechanism of action of ampho B

binds ergosterol and creates pores in the cell membrane

what is the mechanism of action of flucytosine?

inhibits DNA and RNA synthesis

what is the mechanism of action of imidazoles and triazoles?

inhibit 14a-demethylase, enzyme that converts lanosterol to ergosterol

what is the mechanism of action of echinocandins?

inhibit B-D-glucan synthesis AT THE CELL WALL (only drug that acts at cell wall NOT cell membrane)

what is the mechanism of action of terbinafine?

inhibits squalene epoxidase

what is the mechanism of action of grisofulvin?

inhibits MTs, blocks metaphase (accumulates in keratin)

what are the adverse drug reactions for ampho B?

"shake & bake" fever renal tubular acidosis low Mg and K anemia

what are the adverse drug reactions for flucytosine?

bone marrow suppresion

what are the adverse drug reactions for imidazoles?

block steroid synthesis liver function long QT GI

what are the adverse drug reactions for triazoles?

teratogenic (fluconazole)

what are the adverse drug reactions for echinocandins?

minor GI histamine release facial flushing

what are the adverse drug reactions for terbinafine?

taste disturbance GI headache hepatotoxic

what are the adverse drug reactions for grisofulvin?

teratogenic antibuse reaction

which antifungals inhibit P450?

imidazoles (a lot) triazoles (a little)

which antifungals induce P450?

grisofulvin

what is the treatment for cryptococcal meningitis?

Ampho B + flucytosine followed by fluconazole

what is the treatment for tinea (capitus, corporalis, pedis, cruris)

clotrimazole, ketoconazole, miconazole

what is the treatment for candida infection in pregnancy?

clotrimazole, miconazole

what is the treatment for candida (not pregnant)

fluconazole or voriconazole | (nystatin for vaginitis or thrush)

what is the treatment for dimorphic fungi?

itraconazole

what is an IV treatment for systemic candida or aspergillus

echinocandins

what is the treatment for tinea capitus in kids?

terbinafine + grisofulvin

what is the treatment for onchynomycosis?

grisofulvin or terbinafine

what is a PO treatment for tinea?

grisofulvin

what treatments can be used for disseminated candidiasis?

fluconazole, voriconazole, echinocandins (capsofungin), ampho B

what is the only licensed treatment for mucormycosis

Ampho B

ID - Unit 3 Flashcards

(74 cards)