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BT_Step1_NTK > ID_Final Exam NTK > Flashcards

ID_Final Exam NTK Flashcards

1
Q

What is the MOA of Amphotericin and Nystatin?

A

Bind to ergosterol to form holes in the CELL MEMBRANE. Leaky –> Death!

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2
Q

What are the main ADRs ~w/ Amphotericin?

A

CNS and seizures.

Hypotension and headaches

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3
Q

Intrathecal administration of what drug can be used to Tx funal CNS infections?

A

Amphotericin

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4
Q

Thromophlebitis, renal tubular acidosis type 1, HypoKalemia, and renal Mg+ wasting is ~w/ what anti-fungal drug?

A

Amphotericin

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5
Q

Anemia d/t decrease EPO production is ~w/ what anti-fungal drug?

A

Amphotericin

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6
Q

What is the MOA of Flucytosine?

A

fungal cytosine deaminase converts flucytosine (a fluorinated cytosine) into 5-FU (Flourouracil) ===> bacteriostatic

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7
Q

What infections are Tx with Nystatin?

A

very active vs. Candida

  • Topical: mucocutaneous candidiasis (vaginal candidiasis)
  • Oral rinse: oral candidiasis
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8
Q

________ class of anti-fungals block egrosterol synthesis.

A

Azoles.

Fucks with Linosterol –> ergosterol

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9
Q

Azoles are ________ of the CYP-450

A

Azoles are INHIBITORS of the CYP-450

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10
Q

Which Azoles is best used to Tx cryptococcal meningitis?

A

Fluconazole.

Can also Tx most/all Candida infections

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11
Q

What azole is used to Tx onchymycosis and dermatophytosis?

A

itraconazole! used to Tx Tinea

onchymycosis: Nail fungus is a common condition that begins as a white or yellow spot under the tip of your fingernail or toenail.
dermatophytosis: Ringworm of the body is a fungal infection that develops on the top layer of your skin.

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12
Q

Which Azole can Tx invasive Aspergillosis/oma?

A

Voriconizole

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13
Q

Visual issues, changes in color vision is the ADRS ~w/ what Azole?

A

Voriconizole

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14
Q

Which azole inhibits 17,20-desmolase, the first step of steroid synthesis from cholesterol, thereby inhibiting production of androgens and estrogens.

A

Ketoconazole

~/w GYNECOMASTIA!!!

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15
Q

Other than an Azole, what drugs can be used to Tx dermatophytosis?

A

Oral Griseofulvin

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16
Q

What anti-fungal is the first line drug for Tx of tinea corpis/capitis in Peds?

A

Oral Griseofulvin and Tarbanifine.

Also use this for dermatophytosis infection of the nails.

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17
Q

Griseofulvin _________ CYP450

A

Griseofulvin ACTIVATES CYP450

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18
Q

__________ inhibits fungal squalene epoxidase causing the accumulation of squalene.

A

Tarbanifine

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19
Q

What is the major ADR of Tarbanifine?

A

Hepatotoxicity

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20
Q

_____________ inhibits the beta,1-3 glucan of the CELL WALL?

A

Echinocandins.
Fucks with POLYSACCS not ergo!!!

Given IV for systemic Candida infections.

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21
Q

What is the MOA of Griseofulvin?

A

Bings fungal microtubules and blocks metaphase

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22
Q

Which INF is used to Tx Hepatitis B and C? HBV, HCV

A

Interferon Alpha

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23
Q

Which INF is used to Tx Multiple Sclerosis?

A

Interferon Beta

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24
Q

Interferon Gamma is used to Tx what diz?

A

GCD

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25
Q

Which INF is used to Tx Kaposi Sarcoma from HHV-8?

A

Interferon Alpha

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26
Q

What drug used in the Tx of Hepatitis (mainly C) is a guanosine nucleoside analog?

A

ribavirin;

Also used to Tx RSV infections.

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27
Q

___________ is a nucleoside analog that inhibits NS5B RNA polymerase?

A

Sofosabuvir

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28
Q

What is the MOA of of Simprevir?

A

NS3/4 protease inhibitor

CYP450 inhibitor!

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29
Q

What are the major ADRs ~w/ ribavirin?

A
  • Dose-Dep hemolytic anemia

- Teratogenic

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30
Q

Positive Serology of the following indicates what, w.r.t. HCV?

HCV antibodies ===> ???

HCV RNA (RT-PCR) ===> ???

A

(+) HCV antibodies ===> previous or ongoing infection

HCV RNA (RT-PCR) ===> Ongoing infection

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31
Q

Positive Serology of the following indicates what, w.r.t. HCV?

HBsAg ===> ???

Anti-HBsAg ===> ???

A

HBsAg ===> Infectious (ongoing infection)

Anti-HBsAg ===> past infection or vaccine (lifelong immunity)

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32
Q

What vaccine is used for HAV?

A

Passive (HBIG)

Active (Killed vaxx)

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33
Q

What vaccine is used for HBV?

A

Passive (HBIG) [Not recommended anymore.

Recombinant Subunit (HBsAg)

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34
Q

What vaccine is used for HDV?

A

HBV vaxx protects vs. HDV, b/c HDV needs HBV to co-infect!!!

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35
Q

What vaccine is used for HEV?

A

Not FDA approved in USA b/c of low prevalence. there is one in China

36
Q

What does HBeAg and Anti-HbeAg indicate?

A

HBeAg ==> High transmissibilty

Anti-HBeAg ===> Low transmissibility

37
Q

What are the AST and ALT patterns for viral hepatitis?

A

ALT > AST

38
Q

What are the AST and ALT patterns for viral hepatitis?

A

ALT > AST

39
Q
  • Meningitis ~
  • Latex agglutination test that detects CAPSULAR antigens ~
  • Stains with India Ink

Is all ~w/ what bug?

A

Crypococcus neoformans

40
Q
  • Mold with irreg. non-septate wide angle hyphae.
  • Causes black, facial lesions
  • DKA

Is all ~w/ what bug?

A

Mucor and Rhizopus spp.

41
Q

Is Aspergillus part of the normal human microbiome?

A

NO!!!

Candida is tho; mouth, vagina,

42
Q

Pt. was playing or exposed to fresh water. non-bloody diarrhea. What is the highest bug on teh ddX?

A

Cryptosporidum parvum

43
Q

Non-bloody diarrhea, fatty-smelly stools, bloated and gassy! recent travel/water exposure…THINK!?!?!

A

Giardia

44
Q

Bloody diarrhea, liver abcess, anchovy paste, RUQ pain. water exposure…THINK!?!?

A

Entamoeba Histolytica

45
Q

Severe watery diarrhea in AIDS pt.

Milder water diarrhea in normal pt.

THINK!?

A

Cryptosporidum parvum

46
Q

Cyclic fever, headache, anemia.

ACUTE, recent travel, east Africa–>THINK!?

A

Malaria.

P. falcip

47
Q

Cyclic fever, headache, anemia.

Sx show up LATER, Persistent!, liver issues, India travels –> THINK!?

A

Malaria

P. vivax- or-P. ovale

48
Q

Typanosoma cruzi = what diz?

A

Chagas’ disease.

~ dilated cardiomyopathy
~ megacolon
~ megaesophagus

49
Q

What is kala-azar?

A

Visceral leishmaniasis

d/t Leishmania donovani

50
Q

Which bug that causes African Sleeping Sleeping is human adapted and has a longer disease duration?

A

T. Brucei gambiense (West Africa)

51
Q

Which bug that causes African Sleeping Sleeping is CATTLE-adapted and has a SHORTER disease duration?

A

T. Brucei rhodiense (East Africa)

52
Q

Schistosomiasis:
• S. mansoni ~ ???
• S. haematobium ~ ???

A

Schistosomiasis:
• S. mansoni ~ fresh water
• S. haematobium ~ Asia- hematuria

53
Q

Phylogeny: ?

A

Phylogeny: evolutionary relationship between organisms

54
Q

Commensal: ?

A

Commensal: interaction between two species in which one benefits and one is unaffected

55
Q

Mutualist: ?

A

Mutualist: interaction between two species in which both species benefit

56
Q

Parasite: ?

A

Parasite: interaction between two species in which one benefits and one is harmed

57
Q

Immune homeostasis: ?

A

Immune homeostasis: balance between hyper-reactive/unresponsive immune system.

58
Q

Immune homeostasis: ?

A

Immune homeostasis: balance between hyper-reactive/unresponsive immune system.

59
Q

What are some beneficial function of the microbiome?

A

Beneficial function:

  • Pathogen exclusion
  • Nutrient, receptor competition
  • Antimicrobials: lactic acid, H2O2, pH, bacteriocins
60
Q

What are some structural function of the microbiome?

A

Structural functions:

  • Barrier functions
  • Immune system development (IgA induction)
  • Tight junctions
61
Q

What are some metabolic function of the microbiome?

A

Metabolic functions:

  • Ferment non-digestible polysaccharides and mucus
  • Synthesize vitamins (B3, B5, B6, B12, K, Biotin, Folate)
  • Sequester metals
62
Q

What are examples of Actinobacteria? (2)

A

mycobacterium tuberculosis, corynebacterium diphtheriae

63
Q

What is Dysbiosis and get two examples talked about in lecture?

A

Dysbiosis: abnormal composition of a microbiome

EX) IBS, antibiotic associated diarrhea, obesity, bacterial vaginosis, “non-bacterial” prostatitis, pouchitis, T1DM, Mother-to-child HIV transmission, MRSA colonization and infection

Bacterial vaginosis - caused by loss of protective species (lactobacilli) and gain of anaerobes (prevotella, gardnerella)

Crohn’s Disease: diminished levels of Clostridium and bacteroides species in the gut

64
Q

What is the difference between airborne and droplet precautions?

A

Airborne precautions:
- Isolation of patients with organisms spread via airborne droplet nuclei.
- Private room + negative pressure + > 6-12 air changes per hour.
- N-95 mask worn by all persons entering the room
Used for M. TB, measles, primary infection for VZV

Droplet precautions:

  • Isolation of patients infected with organisms that can be transmitted via droplets than can be generated by patient during coughing, sneezing, talking, or during procedures.
  • Private room + mask + hand hygiene
  • Influenza, RSV, Neisseria meningitidis
65
Q

What is the process of an outbreak investigation in a hospital/clinic setting?

A

1) Prepare for investigation
2) Confirm existence of outbreak
3) Establish DX/ Verify agent
4) Search for addition cases, collect critical data, develop line listing
5) Characterize disease
6) Immediate control measures
7) Formulate tentative hypothesis
8) Test hypothesis
9) additional studies/specimen collection
10) Implementation and evaluate infection prevention measures and initiate surveillance
11) Communicate findings

66
Q

What are the major causes of meningitis in Newborns (0-6 months)?

A

Newborn (0-6 months)
Group B strep
E. Coli
Listeria

67
Q

What are the major causes of meningitis in Children (6 months - 6 years)?

A

Children (6 months - 6 years)

Strep pneumoniae
Neisseria meningitidis
Haemophilus influenzae type B
Enteroviruses

68
Q

What are the major causes of meningitis in Adults (6-60 years)?

A

Adults (6-60 years):

N. Meningitidis
Enteroviruses
S. Pneumoniae
HSV

69
Q

What are the major causes of meningitis in Older Adults (60+ years)?

A

Older Adults (60+ years):

S. Pneumoniae
Gram negative rods
Listeria

70
Q

Why is it important to obtain a good travel history of patients when parasitic infections are suspected?

A

Because many parasites are endemic only in specific areas of the world. Also, as some parasites have long incubation periods, a detailed history extending back several years may be important. This organism may incubate for 10 days to many months.

71
Q

How are humans are infected with trypanosomes?

A

Humans are infected with trypanosomes through an intermediate host insect vector. In the case of Chagas’ disease, humans are infected by a triatomid (cone-nosed) bug, which takes a blood meal, defecates, and the victim scratches, rubbing T. cruzi from the feces into the bite site.

72
Q

What is Romaña’s sign?

A

Romaña’s sign (periorbital edema) occurs when the infection takes place in the ocular mucosa.

73
Q

Regarding E. histolytica intestinal infections, what other organ can be affected?

A

liver may become infected, resulting in amoebic abscesses.

74
Q

: Pear-shaped flagellate with an undulating membrane. Large nucleus and 3-5 flagella.

Most likely what organism?

A

Trichomonas vaginalis

BOTH the patient and her partner need to be treated with appropriate antibiotics for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis.

75
Q

Cysts are rounded up. Notice the fibrils and 2-4 nuclei. The trophozoites have a sucking disc and 2 nuclei that look like a little mask. Flagella and axoneme support structure down the middle.

Most likely what organism?

A

Giardia

76
Q

For Cryptosporidium, what animals play a major role in human infections?

A

Cryptosporidium, commonly associated with contaminated water supplies, generally was thought to be a commensal.

However, this organism has now been found to cause diarrhea and intestinal discomfort in immunocompromised patients, and in normal patients during large outbreaks (Milwaukee), and is now recognized as a human pathogen.

77
Q

What organism are typically crescent shaped trophozoites…note the nucleus..no kinetoplast and no flagella (distinguishing them from the crescent-shaped Trypanosomes).

A

Toxoplasma

78
Q

What is the definitive host for Toxoplasma?

A

Cats!

79
Q

Three common types of nematode larvae may pass through the lung:

A

Ascaris lumbricoides,

Hookworm (Necator americanus and Ancylostoma duodenale)

Strongyloides stercoralis.

80
Q

____________ is a tissue infection caused by the larval cysts of T. solium.

A

Cysticercosis;

when the nervous system is involved, the condition is termed neurocysticercosis.

It is the most common parasitic infection of the CNS. The cysts act as space-occupying lesions and can cause hydrocephalus and/or seizures. After many years these degenerate, evoking an inflammatory response that also can result in seizures or meningitis.

81
Q

Cysticercosis is found ONLY with an infection with what organism???

A

T. solium (Pigs)

When humans eat pork with cysticeri, the heads evaginate from the larvae and attach to the walls of the gut to grow into a “tapeworm”. Eggs from the “tapeworm” may then autoinfect to cause cysticercosis. Alternatively, non-pork eaters may still develop cysticercosis if feces containing T. solium eggs are ingested without having a “tapeworm”.

82
Q

Do the eggs of T. saginata cause autoinfections?

A

eggs of T. saginata do not cause autoinfections

83
Q

Can non-pork eaters develop csyticercosis?

A

YES!

non-pork eaters may still develop cysticercosis if feces containing T. solium eggs are ingested without having a “tapeworm”.

Oral-Fecal Route

84
Q

What is the arrangement of the hooklets of T. solium?

What is the arrangement of the hooklets of T. saginata?

A

T. solium has a double row of hooklets.

T. saginata does not have any hooks on its scolex.

85
Q

T. solium & T. saginata are differentiated by counting the numbers of lateral branches of the uterus in a gravid proglottid via India ink, to make the branches visible.

T. solium = how many branches?

T. saginata = how many branches?

A

T. solium: 13 or fewer branches.

T. saginata: 15 or more branches.

86
Q

The eggs of both Taenia saginata and T. solium have thick shells with radial striations. Inside there is a 6-hooked embryo. Taenia cannot be speciated using the ova, as ova from the two species are indistinguishable.

Eggs from T. solium are infectious or non-infectious???

T. saginata are infectious or non-infectious???

A

Eggs from T. solium are infectious.

T. saginata are NOT infectious. (from Cattle)

BT_Step1_NTK (28 decks)

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