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STEPH BPT 2021 > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

(75 cards)

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1
Q

A weekly drug used as chemoprophylaxis for malaria

Contraindications

A

Mefloquine

Neuropsychiatric disorders, conduction abnormalities, epilepsy

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2
Q

Severe malaria characterisitics

A

Reduced GCS, jaundice, oliguria, hypoglycaemia*, APO

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3
Q

Cancer associated with chronic typhoid infection

A

Gallbladder carcinoma

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4
Q

Gene conferring colistin resistance

A

MCR-1

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5
Q

EBV Oncogenic gene

Associated Cancers

A

LMP-1

Post-transplant lymphoproliferative disorders (small intestine, lung highest)
NP cancer 
Hodgkin's lymphoma 
Gastric Carcinoma 
Oral hairy leukopaenia
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6
Q

Drug associated with hypersensitivity reaction associated with HLAB5701

A

Abacavir (NRTI)

Abacavir binds to the ‘‘self-peptides’’ of the MHC1 of HLA5701, altering its structure -> triggers a cytotoxic T cell response

HLA-B*57.01 have more effective cytotoxic responses against HIV than people with other HLA types

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7
Q

Virulence factor of staph auerus associated with skin and soft tissue and nectrotising pneumonia

A

Panton-Valentine Leucocidin toxin

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8
Q

TB meningitis altered regimen

A

Moxifloxacin is better than ethambutol for CSF penetration
9-12 months therapy
Dexamethasone early to reduce risk of IRIS

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9
Q

Enterococci species sensitive to amoxicillin

A

E. Faecalis

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10
Q

AmpC gene

A

ESCAPPM beta lactamase gene

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11
Q

CRE treatment

A

Colostin
Tigecycline
High dose carbepenam
Aztreonam

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12
Q

Ceftazadime avibactam

A

KPC resistant organisms

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13
Q

NDM resistance drug

A

Colostin

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14
Q

Treatment of aspergillosis

A

Voriconazole

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15
Q

Benching filamentous fungi with branching hyphae

A

Aspergillis

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16
Q

Antibiotics that acts by binding to DD-transpeptidase, inhibiting its cross-linking activity and preventing new cell wall formation

A

Penicillin

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17
Q

Malaria species with hypnozites

A

Plasmodium ovale and Plasmodium vivax

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18
Q

Medication that treats malarial hypnozites

A

Primaquine

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19
Q

Cephalosporins with activity against pseudomonas

A

Ceftazidime

Cefepime

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20
Q

5th generation cephalosporin that has activity against MRSA

A

Ceftaroline

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21
Q

pharmacokinetic/pharmacodynamic mechanism best determines the clinical efficacy of penicillin based antibiotics

A

Time above MIC

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22
Q

What is the mechanism by which carbapenemase-producing gram negative organisms confer resistance to meropenem?

A

Inactivation by hydrolysing beta-lactamases

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23
Q

Action of integrase inhibitor

A

Prevent binding of preintegration complex (PIC) to host cell DNA preventing rna production

Raltegravir
Dolutegravir

SE: well tolertared
Weight gain

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24
Q

Action of protease inhibitors

A

Stop cleavage of gag-pol poly proteins resulting in immature virions

Darunavir
Atalazanavir

Metabolic SEs
Hepatotoxic

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25
Action NNRTIs
Prevent reverse transcriptase from adding néw nucleotides to the chain Efavirenz Etravirine Nevirapine
26
NRTIs action
Inhibits viral replication by competitively binding reverse transcriptase (false nucleotide) ``` Abacavir Tenofavir Lamivudine Emtricitabine Zidovudine ``` SE: mitochondrial toxicity (peripheral neuropathy, pancreatitis, lipoatrophy, hepatic steatosis abacavir- CV events
27
Parasitic cause of eisinophilic encephalitis
Angiostrongylus cantonensis
28
Culture negative infection with systemic features post cardiac surgery
Mycobacterium
29
New antibiotic treatment for C Diff
fidaxomicin
30
Screening test for syphilis
EIA
31
Confirmatory test for syphillis
TPHA/TPPA | VDRL/RPR test (can be used for monitorig disease activity)
32
Empiric therapy of bacterial meningitis
``` IV Dexamethason IV ceftriaxone or cefotaxime Add IV benpen for listeria if - Over 50 - immunocompromised - pregnant IV vanc if pneumococcal risk - otitis/sinusitis, mastoiditis ```
33
Treatment of Step Pneumo meningitis
IV ceftriaxone and vanc if MIC >1.5 | IV dexamethasone
34
Drugs that should not be used to treat brain abscesses
Aminoglycosides, erythromycin, tetracyclines, clindamycin, and first generation cephalosporins should not be used to treat brain abscess because these drugs do not cross the blood brain barrier at high concentrations
35
Strep involved in dental disease
strep viridans
36
Culutre negative endocarditis organisms
Coxiella burnetti Bortenella chlamydia Legionella Rx: ceftriaxone and gentamicin
37
IE empiric treatment
Flucloxacillin + Ben Pen+ Gentamicin or Vancomycin + Gentamicin
38
MAC treatment
clarithromycin or azithromycin PLUS rifampicin | rifabutin PLUS ethambutol.
39
Heart abnormalities/conditions for which preventative antibiotics are recommended
– A prosthetic heart valve – Valve repair with prosthetic material - Rheumatic valve – A prior history of infective endocarditis – Many congenital (from birth) heart abnormalities
40
Procedures for which high risk patients should have prophylactic antibiotics for
Dental procedures that involve manipulation of either gingival tissue or the periapical region of teeth or perforation of the oral mucosa; this includes routine dental cleaning. Tonsillectomy/adenoidectomy Surgery. atsite of an established infection
41
Treatment of malaria
P.vivax, ovale, malariae: – chloroquine/hydroxychloroquine (3 day course) P.vivax (chloroquine resistant) – Arthemether–lumafantrine (Riamet) first line in indonesia, timor,PNG, solomon island, vanuatu. 3 days – primaquine as anti relapse therapy for 14 days after chloroquine P.falciparum – Arthemether-lumafrantine (Riamet) for 3 days is first line – Atorvaquone-Proguanil (Malarone) is second line – Quinine and doxycycline for 7 days is third line. – IV artesunate for severe malaria(jaundice,reduced LOC,oliguria,anemia,pulmonary edema,hypoglycemia) – use quinine and clindamycin if pregnant.
42
Treatment of schistosomiasis
Praziquantel
43
Treatment of amaebic liver abscess
metronidazole /tinidazole and paromomycin.
44
High risk HPV
16, 18
45
Live vaccines
``` MMR Oral polio VZV/Zoster Yellow Oral typhoid BCG ```
46
Mechanism of MRSA resistance
mecA gene for penicillin-binding protein PBP-2a - Reduced affinity for beta-lactam drug binding Not enzymatic, can't be overcome by beta-lactamase inhibitor
47
Linezolid mechanism and side effects
Inhibits protein synthesis, binds to 50s ribosomal subunit Bacterostatic Good bioavailability and CNS/bone penetration SE: Reversible bone marrow suppression, irreversible neurotoxicity, optic neuropathy (rare) , serotinin syndrome
48
Daptomycin MOA and SE
Bacteriocidal antibiotic causes depolarisation of bacterial cell membrane SE: Myopathy, peripheral neuropathy, eosinophilic pneumonia
49
Tigecycline
Bacterostatic Binds to 30s subunit of ribosome, protein synthesis inhibitor high volume of distribution
50
Ceftaroline MOA and utility
5th gen cephalosporin with high affinity for PBP-2a
51
Mechanism of strep pneumoniae penicillin resistance
Alteration of PBP (transpeptidase enzyme) | Can be overcome by increasing dose (not in CNS infections)
52
Mechanism of strep pneumoniea macrolide resistance
mefA gene - efflux pump | ermB gene - alteration of binding site
53
Carbapenam resistant organisms
``` KPC (Kleb pneumonia carbapenemase) NDM-1 (New Delhi- metallo-beta-lactamase) OXA (oxacillin-type BL - Tur key) VIM IMP ```
54
ECHAPPM organisms
Gram negatives! Enterobacter Serratia marcescens Citrobacter freudii ``` Hafnia alvei Acinetobacter and aeromonas proteus vulgaris providencia morganella morganii ```
55
Mechanisms of ESCAPPM resistance
AmpC gene on chromosomes or plasmids encodes for beta-lactamases
56
Treatment of ESCAPPM
Carbapenems | Cefepime
57
Mechanism of ESBLs
Group of enzymes that hydrolzyse all penicillins, cephalosporins (including cefepime) and aztreonam Genes are carried on plasmids TEM1, TEM2, SHV1, CTX-M
58
Organisms that commonly carry ESBL
E.Coli | Klebsiella
59
Treatment of ESBL
Carbapenams
60
Treatment of CRE
Colistin High dose tigeycline Aminoglycasides High dose carbapenamse
61
Beta-lactamase inhibitors
Clauvulonic acid Tazobactam - Preferentially binds BL Avibatam - - inactivetes
62
Mechanism of Staph aureus resistance to vancomycin
VanA gene acquired from enterococci via conjugation - plasmid-mediated transfer encodes D-ala-D-ala -> D-ala-D-lac;substitution of a;anine for lactate
63
Treatment of Enterococcus faecium
Majority are resistant to penicillin/amoxi All Enterococci resistant to cephalosporins Treat with vancomycin or teicoplanin
64
Common cause or aeseptic meningitis
Enterovirus
65
When would dolutegravir + lamivudine not be used
VL >500,000, HBV coinfection, pregnant woman
66
Treatment of candidaemia
Caspofungin (Echinocandin)
67
Treatment of Cryptococcus
Amphotericin (polyene) + Flucytosine
68
Treatment of aspergillus (septate mould)
Voriconazole
69
Treatment of mucor(non-septate)/fusarium
Amphotericin
70
Highest risk of CMV in allogenic SCT patients
CMV D-/R+
71
Highest risk patient group in solid organ transplant
CMV D+/R-
72
Treatment of PJP
Trimethoprim-sulfamethoxazole (TMP-SMX) Steroids if pO2 <70mmHg/ hypoxia ART should commence 2 weeks post-therapy
73
mechanism by which strep pyogenes causes valvular disease in rheumatic fever
Molecular mimicry
74
PJP prophylaxis in HIV
cotrimoxazole
75
Asthma and CF associated condition with raised IgE
Allergic Bronchopulmonary Aspergillosis

STEPH BPT 2021 (17 decks)

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