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1
Q

which component of LPS induces TNF/IL1? which is the antigen?

A

Lipid A induces TNF and IL1

O polysaccharide is antigenic

2
Q

lipoteichoic acid is only in what kind of bacteria?

A

gram pos

3
Q

what organisms should be giemsa stained? (5)

A

chlamydia, borrelia, rickettsiae, trypanosomes, plasmodium

4
Q

PAS stain is used to dx which infectious dz?

A

Whipple’s dz (tropheryma whipplei)

5
Q

india ink used for

A

cryptococcus neoformans

6
Q

Ziehl-Neelsen stain good for

A

acid fast organisms (nocardia, mycobacteria)

7
Q

silver stain used for

A

fungi, legionella, h pylori

8
Q

tuberculosis agar

A

lowenstein jensen agar

9
Q

obligate aerobes

A

Nagging Pests Must Breathe

nocardia, pseudomonas, m tb, bacillus

10
Q

obligate anaerobes

A

Can’t Breathe Air

clostridium, bacteroides, actinomyces

11
Q

2 obligate intracellular bugs

A

chlamydia, rickettsia

12
Q

pts w/ CGD are vulnerable for what category of bugs?

A

catalase pos

13
Q

catalase pos bugs

A

pseudomonas, listeria, aspergillus, candida, e coli, staph aureus, serratia

14
Q

urease pos bugs

A

crytpo, h pylori, proteus, ureaplasma, nocardia, klebsiella, s epidermidis, s saprophyticus

15
Q

sulfur granules

A

actinomyces israelii

16
Q

protein A

A

binds Fc region of Ig to evade immune system. made by staph aureus

17
Q

IgA protease expressed by which bugs?

A

strep pneumo, h flu, neisseria

18
Q

M protein

A

helps prevent phagocytosis, expressed by strep pyogenes

19
Q

bacteria that make toxins that inhibit protein synth (4)

A

corynebacterium diphtheriae
pseudomonas
shigella
EHEC O157:H7

20
Q

bacteria that make toxins that inc fluid secretion (3)

A

ETEC (heat stabile and labile toxins)
bacillus anthracis
vibrio cholerae

21
Q

rice water diarrhea

A

cholera

22
Q

bacteria that make toxins that inhibit phagocytic activity (1)

A

bordetella pertussis

23
Q

bacteria that make toxins that inhibit NT release (2)

A

clostridium tetani

clostridium botulinum

24
Q

bacteria that make toxins that lyse cell membranes (2)

A
c perfringens (alpha toxin)
strep pyogenes (streptolysin O)
25
Q

bacteria that make toxins that are superantigens and cause shock (2)

A
staph aureus (toxic shock syndrome toxin)
strep pyogenes (exotoxin A)
26
Q

bacteria: transformation vs conjugation vs transduction

A

transformation - uptake of naked DNA from env
conjugation - bacteria sex
transduction - injecting DNA via virus

27
Q

phage encoded bacterial toxins (5)

A
ABCDE:
shigA-like toxin
Botulinum
Cholera
Diphtheria
Erythrogenic toxin of strep pyogenes
28
Q

alpha, beta, gamma hemolysis

A

alpha - partial, green. Strep pneumo and viridans

beta - complete, clear. Staph aureus, strep pyogenes, strep agalactiae, listeria

29
Q

staph epidermidis - what does it cause

A

infections of prosthetic devices / catheters. also common blood culture contaminant

30
Q

dental caries caused by

A

viridans strep (mutans)

31
Q

subacute bacterial endocarditis (abnormal valve)

A

viridans strep (sanguis)

32
Q

Jones criteria for rheumatic fever

A
Joints
Heart
Nodules
Erythema marginatum
Sydenham's chorea
33
Q

main concern w/ enterococcus

A

combining / transferring abx resistances (penicillin resistance, VREs)

34
Q

pseudomembranous pharyngitis

A

diphtheria

35
Q

2 groups of bacteria that form spores

A

bacillus

clostridium

36
Q

bacteria that blocks function of Renshaw neurons

A

c tetani

37
Q

tx of c diff

A

metronidazole or oral vanc

38
Q

reheated rice syndrome

A

bacillus cereus

39
Q

nocardia causes

A

pulm infxn in immunocompromised and cutaneous infxns after trauma in immunocompetent

40
Q

med condition that can make PPD negative

A

sarcoidosis

41
Q

Pott’s disease

A

extrapulm TB in vertebral bodies

42
Q

prophylactic tx for MAC

A

azithromycin

43
Q

reservoir for leprosy in US

A

armadillos

44
Q

lepromatous vs tuberculoid leprosy

A

lepromatous - diffusely over skin, leonine facies, due to low cell mediated immunity and a mostly humoral Th2 response

tuberculoid - hypoesthetic hairless skin plaques. high cell mediated immunity Th1 response

45
Q

lactose fermenting gram negs

A

Citrobacter, Klebsiella, E coli, Enterobacter, Serratia

46
Q

n. gonorrhoeae found inside what cells?

A

PMNs

47
Q

how do you tell meningococcus vs gonococcus

A

meningococcus ferments maltose

48
Q

which neisseria has a capsule

A

meningococcus

49
Q

Fitz Hugh Curtis syndrome is a complication of

A

gonorrhea / PID

50
Q

Waterhouse Friderichsen syndrome

A

complication of n. meningitidis infxn, causes bleeding of adrenals

51
Q

epiglottitis caused by

A

h flu type b

52
Q

hallmark lab finding in legionella infxn

A

hyponatremia

53
Q

legionnaires dz

A

severe pna, fever, GI and CNS sx

54
Q

pontiac fever

A

mild flu like syndrome caused by legionella

55
Q

common cause of diabetic osteomyelitis

A

pseudomonas

56
Q

two common manifestations of pseudomonas infxn in normal host

A

external otitis (swimmer’s ear), hot tub folliculitis

57
Q

tx of pseudomonas

A

aminoglycoside + extended spectrum pcn (ex piperacillin, ticarcillin)

58
Q

MCC traveler’s diarrhea

A

ETEC

59
Q

EPEC manifestation

A

diarrhea in kids

60
Q

triad of HUS

A

anemia, thrombocytopenia, renal failure

61
Q

red currant jelly sputum

A

klebsiella

62
Q

what organ does salmonella typhi hang out in in carriers?

A

gallbladder

63
Q

rose spots on abdomen

A

typhoid fever (s typhi)

64
Q

2 fairly common sequelae of campy

A

Guillian barre

reactive arthritis

65
Q

bacteria that can mimic Crohn’s or appendicitis

A

yersinia enterocolitica

66
Q

3 spirochetes

A

borrelia, leptospira, treponema

67
Q

leptospirosis sx

A

flu like sx, jaundice, photophobia w/ conjunctivitis

68
Q

Weil’s disease

A

severe for of leptospirosis w/ jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia

69
Q

reservoir and vector for borrelia burgdorferi

A

mouse > ixodes tick

70
Q

3 stages of lyme disease

A

stage 1 - erythema chronicum migrans, flu like sx
stage 2 - facial nerve palsy and AV nodal block
stage 3 - musculoskeletal (arthritis), encephalopathy and polyneuropathy, cutaneous manifestations

71
Q

bull’s eye erythema w/ central clearing

A

erythema migrans of lyme disease

72
Q

screening and confirmation tests for syphilis

A

screening - VDRL

confirmation - FTA-ABS / MHA - TP

73
Q

Argyll Robertson pupil

A

assoc w/ tertiary syphilis

pupil accomodates but does not react to light

74
Q

which congenital disease? saber shins, saddle nose, CNVIII deafness, Hutchinson’s teeth, mulberry molars

A

syphilis

75
Q

VDRL tests ab for ____. Who gets false pos?

A

cardiolipin

viral infxn, drugs, rheumatic fever, SLE, leprosy

76
Q

Jarisch Herxheimer reaction

A

flu like syndrome immediately after starting abx (seen in syphilis)

77
Q

gardnerella vaginalis

A

bacteria causing vaginosis (not STD, but assoc w/ sexual activity). causes gray vaginal d/c w/ fish odor, painless.

78
Q

classic triad of rickettsial diseases

A

HA, fever, rash

79
Q

cause of typhus (endemic vs epidemic)

A

endemic - rickettsia typhi

epidemic - rickesttsia prowazekii

80
Q

monocytes w/ morula (berry like inclusion) in cytoplasm
AND
granulocytes w/ same inclusion

A

ehrlichia in monocytes

anaplasma in granulocytes

81
Q

Chlamydia trachomatis serotypes A,B,C

A

Africa
Blindness
Chronic infection

other serotypes cause everything else

82
Q

atypical PNA w/ inc cold agglutinins (IgM)

A

mycoplasma pneumoniae

83
Q

histoplasma likes to hang out in (inside body)

A

macrophages

84
Q

broad based budding fungus

A

blastomycosis

85
Q

“captain’s wheel” formation

A

paracoccidiomycosis

86
Q

what causes all the tinea pedis / cruris / corporis / capitis?

A

Microsporum, Trichophyton, Epidermophyton

87
Q

Tinea versicolor

A

caused by Malassezia furfur
common in hot/humid weather
causes hypo/hyperpigmented patches

88
Q

specific disease that predsiposes to disseminated aspergillosis (not AIDS)

A

chronic granulomatous disease

89
Q

fungus that branches at acute angles

A

aspergillus

90
Q

“soap bubble” lesions in brain

A

cryptococcal meningitis

91
Q

who gets mucormycosis (2)

A

DKA pts

leukemic pts

92
Q

rose garderner’s disease

A

sporothrix schenckii

93
Q

parasite that causes severe diarrhea in AIDS but mild dz in normal pts

A

cryptosporidium

94
Q

classic triad of congenital toxo

A

chorioretinitis, hydrocephalus, intracranial calcifications

95
Q

causative organisms of african sleeping sickness

A

trypanosoma brucei, gambiense, rhodesiense

96
Q

sx of malaria

A

fever, HA, anemia, splenomegaly

97
Q

most severe causative agent of malaria

A

plasmodium falciparum

98
Q

babesiosis

A

fever and hemolytic anemia, predominantly in NE US (ixodes tick like lyme disease)

99
Q

causative agent of Chaga’s dz

A

trypanosoma cruzi

100
Q

sx of visceral leishmaniasis

A

spiking fevers, hepatosplenomegaly, pancytopenia

101
Q

sx of trichomonas vaginalis

A

foul smelling greenish d/c, itching and burning

102
Q

enterobius vermicularis infxn

A

pinworm, anal pruritis, dx w/ scotch tape test

103
Q

cause of visceral larva migrans

A

toxocara canis

104
Q

cause of cysticercosis

A

ingesting EGGS of taenia solium

105
Q

diphyllobothrium latum

A

tapeworm that causes vit b12 def > anemia

106
Q

echinococcus granulosus

A

tapeworm that causes cysts in liver > anaphylaxis if they burst

107
Q

schistosoma

A

from snails
liver and spleen granulomas
s. haematobium causes hemorrhagic cystitis and inc risk of SCC of bladder

108
Q

clonorchis sinensis

A

from undercooked fish

biliary tract inflammation > pigmented stones, inc risk of cholangioCA

109
Q

paragonimus westermani

A

from undercooked crab

lung inflammation, hemoptysis

110
Q

viral recombination vs reassortment

A
recombination = genetic drift
reassortment = shift
111
Q

live attenuated vaccines (6)

A
smallpox
chicken pox
yellow fever
Sabin's polio virus
MMR
influenza (intranasal)
112
Q

killed virus vaccines (4)

A

rabies
influenza (injection)
Salk polio
HAV

113
Q

only dsDNA virus

A

parvoviridae

114
Q

circular DNA viruses (3)

A

papilloma
polyoma
hepadna

115
Q

only dsRNA virus

A

reoviridae

116
Q

pos sense RNA viruses (7)

A
retro
toga
flavi
corona
hepe
calici
picorna
117
Q

which types of viruses (nucleic acid categories) are infectious as naked viral genomes?

A
most dsDNA (except pox and HBV)
pos sense ssRNA
118
Q

only diploid virus family

A

retroviruses

119
Q

nonenveloped viruses (8)

A

PAPP: papilloma, adeno, parvo, polyoma
CPR: calici, picorna, reo
hepeviridae

120
Q

DNA viruses

A

HHAPPPP

hepadna, herpes, adeno, pox, parvo, papilloma, polyoma

121
Q

HHV6 causes

A

roseola (exanthem subitum)

122
Q

HHV7 causes

A

less common cause of roseola

123
Q

hepadnavirus example

A

HBV

124
Q

adenoviruses can cause

A

febrile pharyngitis
hemorrhagic cystitis
PNA
conjunctivitis

125
Q

2 most important types of papillomavirus that cause cancer

A

16, 18

126
Q

2 polyomaviruses and what they cause

A

JC - PML in HIV

BK - in transplant pts, commonly targets kidney

127
Q

MCC sporadic encephalitis

A

HSV1

128
Q

what type of cells do EBV and CMV stay latent in, respectively?

A

EBV - B cells

CMV - monocytes

129
Q

Tzanck test

A

detects herpes from vesicular fluid

130
Q

2 reoviruses

A

coltivirus, rotavirus

131
Q

coltivirus causes

A

colorado tick fever

132
Q

MCC fatal diarrhea in children

A

rotavirus

133
Q

5 picornaviruses

A

polio, echo, rhino, coxsackie, HAV

PERCH

134
Q

a calicivirus

A

norovirus

135
Q

5 things caused by flaviviruses

A
HCV
yellow fever
dengue
st louis encephalitis
west nile
136
Q

2 things caused by togaviruses

A

rubella

W/E equine encephalitis

137
Q

influenza is part of what family

A

orthomyxoviridae

138
Q

4 viruses in paramyxoviridae

A

parainfluenza
RSV
measles virus
mumps virus

139
Q

filoviruses cause

A

hemorrhagic fever - ebola/Marburg

140
Q

arenaviruses cause (2)

A

LCMV (lymphocytic choriomeningitis virus)

Lassa fever encephalitis

141
Q

most notable bunyavirus

A

hantavirus (hemorrhagic fever, PNA)

142
Q

4 segmented viruses

A

bunya, orthomyxo, arena, reo

143
Q

viral infection causing black vomit

A

yellow fever

144
Q

fns of hemagglutinin and neuraminidase

A

hemagglutinin - helps w/ entry

neuraminidase - helps w/ new virus exiting cell

145
Q

palivizumab

A

monoclonal ab against F protein on paramyxoviruses - given to prevent PNA in premies

146
Q

Koplik spots

A

seen in measles

red spots w/ blue/white center on buccal mucosa

147
Q

3 c’s of measles

A

cough
coryza
conjunctivitis

148
Q

3 sx of mumps

A

parotitis, orchitis, aseptic meningitis

149
Q

negri bodies

A

rabies

150
Q

Hep E affects

A

pregnant women (high mortality)

151
Q

which hep B antibody indicated immunity?

A

anti-Hb surface

152
Q

Hep B E antigen

A

indicates acute viral replication > high transmissibility

153
Q

CD4 count for AIDS

A

<200

154
Q

presentation of histo in AIDs pt

A

low fever, cough, hepatosplenomegaly, tongue ulcer

155
Q

aids pt w/ superficial vascular proliferation, on biopsy shows neutrophilic inflammation

A

Bartonella henselae

156
Q

cotton wool spots on fundoscopic exam

A

CMV retinitis

157
Q

aids pt w/ superficial vascular proliferation, on biopsy shows lymphocytic inflammation

A

HHV8 (kaposi)

158
Q

cause of interstitial PNA in AIDs pt

A

CMV

159
Q

3 normal vaginal flora

A

lactobacillus
e coli
group b strep

160
Q

3 MCC meningitis in newborns

A

group B strep
E coli
listeria

161
Q

MCC of meningitis in non-newborns

A

strep pneumo

162
Q

in sickle cell pt w/ osteomyelitis, what is likely cause?

A

salmonella

163
Q

2nd MCC UTI in young sexually active women

A

staph saprophyticus

164
Q

“swarming” colonies

A

proteus

165
Q

classic presentation of congenital rubella

A

PDA (or pulm art hypoplasia), cataracts, deafness, +/- blueberry muffin rash

166
Q

which congenital infection (ToRCHeS) most often causes stillbirth?

A

syphilis

167
Q

rash of childhood that presents following high fevers (can cause febrile seizures)

A

roseola (HHV6)

168
Q

cause of chancroid

A

haemophilus ducreyi

169
Q

cause of condyloma acuminata

A

(genital warts) HPV 6 and 11

170
Q

MC bacterial STD in US

A

chlamydia

171
Q

Fitz Hugh Curtis syndrome

A

infxn of liver capsule and “violin string” adhesions of parietal peritoneum to liver

172
Q

what step of cell wall synth do beta lactams block?

A

peptidoglycan cross linking

173
Q

2 abx that block peptidoglycan synth

A

bacitracin, vanc

174
Q

mech of rifampin

A

block mRNA synth

175
Q

mech of metronidazole

A

damage DNA

176
Q

abx that block protein synth at 50S subunit

A

chloramphenicol, macrolides, clindamycin, streptogramins, linezolid

177
Q

abx that block protein synth at 30S subunit

A

aminoglycosides, tetracyclines

178
Q

PCN - bactericidal/static? for what types of bugs?

A

cidal for gram pos cocci and rods, gram neg coci, spirochetes

179
Q

oxacillin, nafcillin, dicloxacillin - mainly used for? important side effect?

A
staph aureus (non-MRSA)
interstitial nephritis
180
Q

2 wider spectrum penicilllins

A

ampicillin, amoxicillin

181
Q

beta lactamase inhibitors (3)

A

clavulanic acid, sulbactam, tazobactam

182
Q

what extra bugs do amoxicillin/ampicillin cover?

A

HELPSS - h flu, e coli, listeria, proteus, salmonella, shigella

183
Q

ticarcillin and piperacillin

A

penicillins active against pseudomonas

184
Q

which cephalosporin covers MRSA?

A

cephtaroline

185
Q

organisms typically not covered by cephalosporins

A

LAME - listeria, atypicals, MRSA, enterococci

186
Q

generations of cephalosporins - what do they cover

A

1st - gram pos cocci, proteus, e coli, klebsiella
2nd - 1st+ H flu, enterobacter, neisserias, serratia
3rd- serious gram neg infxns (meningitis, gonorrhea, pseudomonas)
4th- inc activity against pseudomonas and gram pos

187
Q

aztreonam

A

monobactam, works on gram neg rods only, good for pts w/ PCN allergy or renal insufficiency that can’t handle aminoglycosides

188
Q

what is imipenem always given w/ and why?

A

cilastatin - dec inactivation of drug in renal tubules

189
Q

when are -penems used?

A

life threatening infections or ones that have failed other options - must be worth risk of serious side effects

190
Q

main side effect to worry about for -penems

A

seizures

191
Q

vanc binds to

A

d-ala-d-ala portion of cell wall precursor

192
Q

vanc spectrum

A

gram pos only, but gets even the really resistant ones like MRSA, enterococci and C diff

193
Q

side effects of vanc

A

nephrotox, ototox, thrombophelbitis, diffuse flushing = red man syndrome
can mostly be prevented by giving antihistamines first and slow infusion rate
generally well tolerated

194
Q

batericidal/static for the protein synth inhibitors

A

aminoglycosides are cidal

rest are static

195
Q

which drugs are aminoglycosides

A

GNATS - gentamicin, neomycin, amikacin, tobramycin, streptomycin

196
Q

spectrum/uses of aminoglycosides

A

severe gram neg rod infxns

197
Q

aminoglycosides are synergistic w/

A

beta lactams

198
Q

side effects of aminoglycosides

A

nephrotoxicity, neuromuscular blockade, ototox, teratogen

199
Q

resistance to aminoglycosides

A

transferase enzymes inactivate drug

200
Q

demeclocycline non-abx use

A

used as diuretic in SIADH

201
Q

which tetracycline to use in pts w/ renal failure?

A

doxy

202
Q

why are tetracyclines avoided in kids?

A

inhibit bone growth

203
Q

resistance to tetracyclines

A

dec uptake or inc efflux from cells

204
Q

3 macrolides

A

azithromycin, clarithromycin, erythromycin

205
Q

what are macrolides good for

A

atypical PNA, STDs (chlamydia), gram pos cocci

206
Q

side effects of macrolides

A

MACRO - motility issues, arrhythmias (prolong QT), cholestatic hepatitis, rash, eOsinophilia

207
Q

resistance to macrolides

A

methylation of 23S rRNA binding site

208
Q

serious side effect of chloramphenicol

A

aplastic anemia (dose independent)

209
Q

clindamycin uses

A

anaerobic infxns above the diaphragm

210
Q

spectrum of SMX

A

gram pos, gram neg, nocardia, chlamydia - good for simple UTIs

211
Q

2 important side effects of SMX

A

hemolysis in G6PD def, nephrotox (tubulointerstitial nephritis)

212
Q

resistance to SMX

A

altered enzyme, dec uptake, or inc PABA synth

213
Q

enzyme blocked by TMP

A

dihydrofolate reductase

214
Q

what is TMP/SMX used for?

A

UTIs, shigella, salmonella, PCP

215
Q

side effects of TMP

A

megaloblastic anemia, leukopenia, granulocytosis

216
Q

which type of abx cant be taken w/ antacids?

A

fluoroquinolones

217
Q

spectrum of quinolones

A

gram neg rods of urinary and GI tracts, pseudomonas, neisseria, some gram pos

218
Q

unique side effect of quinolones

A

tendon rupture

219
Q

resistance to quinolones

A

altered DNA gyrase or efflux pumps

220
Q

what is metronidazole used for

A

giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes, part of triple therapy for h pylori

221
Q

2 sorta weird side effects of metronidazole

A

disulfiram like reaction to alcohol

metallic taste

222
Q

4 drugs used for active TB, 1 used for prophylaxis

A

rifampin, isoniazid, pyrazinamide, ethambutol

prophylaxis - isoniazid

223
Q

4 abx given for MAC

A

azithromycin, rifampin, ethambutol, streptomycin

224
Q

tx of m. leprae

A

dapsone + rifampin, add clofazimine for lepromatous form

225
Q

rifampin is used as prophylaxis for

A

contacts of children w/ h flu type B

226
Q

main side effect concern w/ rifampin

A

many drug interactions cuz inc P450 activity

227
Q

side effect of ethambutol

A

optic neuropathy causing red green colorblindness

228
Q

prophylaxis for endocarditis in surgical/dental procedures

A

penicillins

229
Q

prevention of gonococcal or chlamydial conjunctivitis in newborn

A

erythromycin ointment

230
Q

AIDS infxns prophylaxis schedule

A

CD4 <50 - add azithromycin for MAC

231
Q

what do you use for VREs?

A

linezolid and streptogramins (-pristin)

232
Q

-azoles mechanism

A

block ergosterol synth

233
Q

ampho B mechanism

A

binds ergosterol and forms leaky holes in fungal membrane

234
Q

side effects of ampho B

A

fever/chills “shake and bake”, hypotension, nephrotox (better w/ hydration), arrhythmias, anemia, IV phlebitis

235
Q

nystatin is

A

topical ampho B

236
Q

when to use the azoles - fluconazole? itraconazole? clotrimazole/miconazole?

A

flucon - chronic suppression of cyrptococcal meningitis, any candidal infection
itracon - blasto, cocci, histo (regional mycoses)
clotrim/micon - topical infxns

237
Q

side effects of azoles

A

gynecomastia (testosterone synth inhib), liver dysfunction

238
Q

when is 5FU used for fungal infxns?

A

systemic infxns alongside ampho B

239
Q

-fungins mech and use

A

mech - inhib cell wall synth by inhibiting synth of beta glucan
used for invasive aspergillosis and candida

240
Q

use of terbinafine

A

dermatophytoses

241
Q

griseofulvin used for

A

oral tx of superficial infxns (deposits in keratin rich tissues) - dermatophytes but has lots of side effects

242
Q

toxo tx

A

pyrimethamine

243
Q

trypansoma brucei tx

A

suramin and melarsoprol

244
Q

t. cruzi tx

A

nifurtimox

245
Q

leishmaniasis tx

A

sodium stibogluconate

246
Q

chloroquine used for

A

non-falciparum malaria (too much resistance in falciparum)

247
Q

drugs that tx plasmodium falciparum

A

artemether/lumifantrine, atovaquone/proguanil, quinidine for life threatening or artisunate

248
Q

drug for flukes

A

praziquantel

249
Q

zanamavir and oseltamivir - mech and use

A

inhib influenza neuraminidase > dec release of new virus

tx and prevention of influenza A and B

250
Q

ribavirin - mech, use, tox

A

mech - inhib IMP dehydrogenase to inhib synth of guanine nucleotides
use - RSV, chronic hep C
tox - hemolytic anemia, teratogen

251
Q

acyclovir and valacyclovir- mech, use, tox

A

guanosine analog - chain terminator
HSV and VZV (mucocutaneous and genital lesions, encephalitis)
no significant tox

252
Q

famciclovir used for

A

herpes zoster

253
Q

ganciclovir - mech, use, tox

A

guanosine analog - inhibits viral DNA polymerase
CMV
leukopenia, neutropenia, thrombocytopenia, renal tox

254
Q

foscarnet and cidofovir - mech, use, tox

A

viral DNA polymerase inhib (doesnt need to be activated)
CMV retinitis, acyclovir resistant HSV
nephrotox

255
Q

3 conditions for starting HAART

A

AIDS defining illness, CD4<500, or high viral load

256
Q

HAART regimen

A

2 NRTIs + (1 NNRTI OR 1 protease inhib OR 1 integrase inhib)

257
Q

suffix for protease inhibitors

A

-navir

258
Q

“booster” for protease inhibitors

A

ritonavir - inhibits cyt P450 to inc drug concentrations

259
Q

toxicity of protease inhibitors

A

hyperglycemia, GI intolerance, lipodystrophy

nephropathy and hematuria for just indinavir

260
Q

list NRTIs (4 drugs and 1 suffix)

A
DATE-
didanosine
abacavir
tenofovir
emtricitabine

-vudine

261
Q

which HIV drug is used during pregnancy to prevent vertical transmission?

A

ZDV - zidovudine

262
Q

tox of NRTIs and NNRTIs (same)

A
bone marrow suppression (fix w/ GCSF and EPO)
peripheral neuropathy
lactic acidosis
rash
anemia (ZDV)
263
Q

list NNRTIs (3)

A

NED -
nevirapine
efavirenz
delavirdine

264
Q

name integrase inhibitor

A

raltegravir

265
Q

tox of integrase inhibitors

A

hypercholesterolemia

266
Q

how do interferons work as antivirals?

A

block replication of both RNA and DNA viruses

267
Q

tox of IFNs

A

neutropenia, myopathy

268
Q

uses of IFN alpha, beta, and gamma respectively

A

alpha - chronic hep B/C, Kaposi’s sarcoma
beta - MS
gamma - NADPH oxidase def

269
Q

abx/virals/fungals/etc to avoid in pregnancy (8) and what they cause

A

SAFe Children Take Really Good Care

sulfonamides - kernicterus
aminoglycosides - ototox
fluoroquinolones - cartilage dmg
clarithromycin - embryotoxic
tetracyclines - discolored teeth, inhib bone growth
ribavirin - teratogenic
griseofulvin - teratogenic
chloramphenicol - "gray baby"