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Flashcards in Micro Deck (266):
1

ampicillin/amoxicillin coverage

G(+) and HELPSS
Haemophilus
E. coli
Listeria
Proteus
Salmonella
Shigella

2

organisms not covered by cephalosporins

LAME
Listeria
atypicals (chlamydia, mycoplasma)
MRSA
Enterococci

3

first gen cephalosporins

cefazolin, cephalexin
PEcK and G(+)
Proteus, E. coli, Klebsiella

4

second gen cephalosporins

cefoxitin, cefaclor, cefuroxime
HENS PEcK
Haemophilus
Enterobacter
Neisseria (not gonorrhea)
Serratia
Proteus, E. coli, Klebsiella

5

third gen cephalosporins

ceftriaxone (excreted in bile), cefotazime, ceftazidime
G(-) bad guys
meningitis and gonorrhea
ceftazidime for pseudomonas

6

fourth gen cephalosporins

cefepime
good pseudomonas and broad G(+)

7

toxicity of cephalosporins

increased nephrotoxicity with aminoglycosides
disulfiram like reaction

8

given prior to surgery to prevent s. aureus infections

cefazolin (1st gen)

9

side effects of vancomycin

red man syndrome (mast cell degranulation)
NOT: nephrotoxicity, ototoxicity, thrombophlebitis

10

resistance to vancomycin

change of D-ala-D-ala to D-ala-D-lac

11

protein synthesis inhibitors

Buy AT 30, CELL at 50
30s: aminoglycosides, tetracyclines
50s: chloramphenicol, clindamycin, erythromycin (macrolides), linezolid

12

use for tetracyclines

VACUUM THe BedRoom
vibrio cholera
acne
chlamydia
ureaplasma urealyticum
mycoplasma pneumoniae
tularemia
H. pylori
Borrelia burgdorferi
Rickettsia

13

photosensitivity

SAT:
sulfonamides, amiodarone, tetracyclines

14

what to avoid with tetracyclines

milk, antacids, iron because they inhibit the absorption of tetracyclines

15

given for bowel surgery

neomycin

16

toxicity of aminoglycosides

nephrotoxicity, ototoxicity, teratogenic

17

clinical uses for macrolides

PUS
Pneumonia: mycoplasma, chlamydia, legionella
URI: strep pneumoniae, strep pyogenes
STD: chlamydia, gonorrhea

18

resistance to macrolides

mehtylation of 23S RNA subunit of 50S

19

clinical use for chloramphenicol and toxicity

use: meningitis (H. flu, N men, strep pneum)
tox: gray baby syndrome, aplastic anemia

20

clinical use of clindamycin and toxicity

use: MRSA abscess
tox: C. difficile

21

streptogramins

quinupristin and dalfopristin
bind 23s subunit of 50s
use: MRSA, VRE, staph and strep skin infections
SE: hepatotoxicity, pseudomembranous colitis, inhibits cP450 system

22

what causes:
gray baby
gray man
red man

baby: chloramphenicol
man: amiodarone
red man: vancomycin

23

prophylaxis for meningococcal infection

coprofloxacin
rifampin for children

24

prophylaxis for gonorrhea

ceftriaxone

25

prophylaxis for syphilis

benzathine penicillin G

26

prophylaxis for history of recurrent UTI

TMP-SMX, nitrofurantoin, amoxicillin

27

prophylaxis for pneumocystic jiroveci

TMP-SMX if CD4<200, dapsone if sulfa allergic

28

prophylaxis for endocarditis (surgery or dental procedure)

penicillins, aminopenicillins, cephalexin

29

prophylaxis for pregnant women with Group B strep

ampicillin during pregnancy

30

prophylaxis for strep pharyngitis in child with prior rheumatic fever

oral penicillin

31

prophylaxis for postsurgical infection of s. aureus

cefazolin

32

prophylaxis for gonococal or chlamydial conjunctivitis in newborn

erythromycin ointment

33

antibiotics to avoid in pregnancy

SAFe Children Take Really Good Care
Sulfonamides (kernicterus)
Aminoglycosides (ototoxicity)
Fluoroquinolones (cartilage damage)
Clarithromycin (embryotoxic)
Tetracylines (discolored teeth)
Ribavirn (teratogenic)
Griseofulvin (teratogenic)
Chlorammphenicol (Gray baby)
also metronidazole (mutagenesis 1st trimester)

34

antiplatelet antibodies

ITP: immunothrombocytopenia

35

newborn with chronic diarrhea, failure to thrice, and chronic Candida

SCID

36

child with eczema, coarse facial features, and cold abscesses

heyperimmunogloculinemia E syndrome (Job syndrome)

37

child with partial albinism, peripheral neuropathy, and recurrent infections

Chediak-Higashi

38

oropharynx colonized by

viridans streptococci

39

dental plaque

strep mutans

40

colon

Bacteroides fragilis>E. coli

41

vagina

lactobacillus; E. coli and group B strep sometimes

42

common cause of pneumonia in neonates

Group B strep
E. coli
Tx: ampicillin and gentamicin

43

common cause of pneumonia in children

RSV
Mycoplasma
Chlamydia
S pneumoniae
Tx: azithromycin or ceftriaxone

44

common cause of pneumonia in adults (<40)

Mycoplasma
C. pneumoniae
S. pneumoniae
Tx: azithromycin and ceftriaxone

45

common cause of pneumonia in adults (40-65)

S. pneumoniae
H influenzae
Tx: clarithromycin

46

common cause of pneumonia in elderly

S. pneumoniae
influenza virus
anaerobes
H. influenzae
Tx: cephapime or carbapenam

47

common cause of pneumonia in IV drug users

S. pneumoniae, Klebsiella, Staphylococcus

48

common cause of pneumonia cystic fibrosis

Pseudomonas, S. aureus, S pneumoniae

49

atypical pneumonia

Mycoplasma, Legionella, Chlamydia

50

postviral pneumonia

Staphylococcus, H flu, S pneumoniae

51

common cause of meningitis 0-6 months

Group B strep, E. coli, Listeria

52

common cause of meningitis <6

Strep pneumoniae, N. meningitidis, H flu, enterovirus (coxsackie A)

53

common cause of meningitis 6-60

S pneumoniae, n. meningitids, enterovirus, HSV

54

common cause of meningitis over 60

S. pneumoniae, G- rods, Listeria

55

common cause of meningitis in HIV

cryptococcus

56

osteomyelitis

S. aureus
sexually active: N. gonorrhea
Db and IV drugs: Pseudomonas, serratia
Sickle cell: salmonella
prosthetic replacement: S. aureus, S epidermidis
vertebral disease: TB
cat/dog bite: Pasteurella multocida

57

CSF findings in meningitis

bacterial: increased pressure, PMN, protein and decreased glucose
fungal: increased pressure, lymphocytes, protein and decreased glucose
viral: normal or increased pressure, increased lymphocytes and protein, normal glucose

58

most common etiology of bacterial meningitis

Group B strep

59

most common etiology of bacterial meningitis in kids

strep pneumoniae
n. meningitidis

60

most common bacterial meningitis in adults

S. pneumoniae

61

osteomyelitis in IV drug user

S. aureus or Pseudomonas

62

osteomyelitis in sickle cell

Salmonella

63

pt presents with vertigo, tinnitus, and hearing loss

Meneiere's disease

64

TORCHeS infections

Toxoplasma gondii
Other: parvovirus B19, meningitis
Rubella
CMV
Herpes 2/HIV
Syphilis

65

STD with clue cells

bacterial vaginosis

66

painless genital ulcer

syphilis

67

flagellated cells

trichomonas

68

strawberry cervix

trichomonas

69

most common reportable STD

Chlamydia

70

non-painful, indurated, ulcerated genital lesion

primary syphilis

71

painful, indurated, ulcerated genital lesion, with exudate

chancroid

72

stippled vaginal epithelial cells on a wet prep of vaginal discharge

bacterial vaginosis (clue cells)

73

common treatment for syphilis

penicillin G

74

common treatment for Trichomonas

metronidazole

75

common treatment for Chlamydia

doxycycline or azithromycin

76

common treatment for gonorrhea

ceftriaxone

77

toxoplasma gondii triad

chorioretinitis
hydrocephalus
intracranial calcifications

78

rubella triad

PDA
cataracts
deafness

79

CMV

hearing loss, seizures, blueberry muffin rash

80

vaginal discharge

young girl (puberty): physiological
cottage cheese: candidiasis
very itchy: trichomonas
fishy smell, clue cells: bacterial vaginosis

81

newborn nursery

CMV, RSV

82

urinary cath

E. coli, pseudomonas

83

respirator

Pseudomonas

84

renal dialysis

HBV

85

IV nutrition (hyperalimentation)

candida albicans

86

water aerosols

legionella

87

antibiotics safe during pregnancy

penicillins and aminopenicillins
piperacillin
cephalosporins
macrolides
metronidazole (after 1st trimester)
nitrofurantoin

88

RUQ pain and symptoms of PID

Fitz-Hugh-Curtis syndrome
follows PID episode and is sudden onset RUQ pain and may show violin string adhesions on laparoscopy

89

do not take Gram stain

Treponema
Rickettsia
Mycobacteria (high lipid content)
Mycoplasma (no cell wall)
Legionella pneuomophila
Chlamydia

90

Giemsa stain

Chlamydia, Borrelia, Rickettsiae, Trypanosomes, Pasmodium

91

PAS (peiodic acid-Schiff) stain

stains glycogen, mucopolysaccharides
Whipple's disease (Tropheryma whipplei)

92

Ziehl-Neelsen (carbol fuchsin)

acid fact organisms
Nocardia and Mycobacterium

93

India ink stain

Cryptococcus neoformans

94

Silver stain

fungi, legionella, H. pylori

95

encapsulated bacteria

Strep pneumoniae
Haemophilus influenzae
N. meningitidis
E. coli
Pseudomonas
Klebsiella
Salmonella typhi

96

organism in balanitis

candida albicans
balanitis is inflammation of glans penis

97

obligate aerobes

Nocardia, Pseudomonas, Mycobacterium tuberculosis, Bacillus

98

obligate anaerobes

Clostridium, Bacteroides, Actinomyces
lack superoxide dismutase

99

endotoxin

ENDOTOXIN
edema
nitric oxide
DIC/death
outer membrane
TNF-a
O-antigen
eXtremely heat stable
IL-1
Neutrophil chemotaxis

100

transformation

take up naked DNA

101

conjugation

plasmid passing

102

transposition

transfer genes from plasmid to chromosome and vice versa

103

transduction

packaging of DNA in phages

104

what 7 bacteria secrete enterotoxins (exotoxins in GI system)

vibrio cholera, E. coloi, s. aureus, shigella, yersinia, c. difficile, clostridium perfringens

105

skin pathogen that infects indwelling foreign devices

s. epidermidis

106

organisms most likely in subacute endocarditis

viridans strep, enterococci, s. bovis, coagulase neg. staph and HACEK
Haemophilus, actinobacillus, cardiobacterium, eikenella, kingella

107

streptococcus pyogenes disease

superficial/invasive: pharyngitis, impetigo, cellulitis, blood strema
toxin-mediated: toxic shock syndrome
immune-mediated: post-streptococcal glomerulonephritis, rheumatic fever

108

causes scalded skin syndrome

s. aureus

109

gray-white membrane in posterior pharynx of an unvaccinated child

corynebacterium diptheriae

110

pharyngitis resulting in glomerulonephritis

group A strep (s. pyogenes)

111

most common cause of meningitis in G+

strep pneumoniae

112

most common G+ cause of osteomyelitis

s. aureus

113

serious newborn infections

Group B strep, listeria, E. coli

114

infant with poor muscle tone

clostridium botulinum

115

diarrhea after using antibiotics

clostridium difficile

116

respiratory distress in a postal worker

B. anthracis

117

otitis media in children

S. pneumoniae

118

cellulitis

s. aureus and s. pyogenes

119

one hour after eating potato salad, entire family is vomitting

staph aureus

120

susceptible to Listeria monocytogenes

infants, elderly, immunocompromised, pregnant

121

spore forming bacteria

bacillus and clostridium species
also coxiella burnetti

122

branching, filamentous G+ rods with sulfur granules

actinomyces israeli

123

G- oxidase positive diplococci

N. gonorrhoeae or N. meningitidis

124

smoker has cough and sputum gram stain shows nothing. silver stain shows rods

legionella pneumophila

125

sepsis, DIC, adrenal hemorrhage and G-

N. meningitidis

126

5 year old with pharyngitis, drooling, and x-ray has thumb sign

H. influenzae

127

life threatening meningitis and purpura

N. meningitidis

128

septic arthritis in young, sexually active patients

n. gonoorhoae

129

antibiotics to treat c. difficile pseudomembranous colitis

metrinidazole and oral vancomycin

130

food poisoning as a result of mayonnaise sitting out too long

s. aureus

131

diarrhea caused by G- nonmotile organism that does not ferment lactose

shigella

132

diarrhea caused by an S-shaped organism

campylobacter jejuni

133

diarrhea transmitted from household pets

yersinia

134

food poisoning resulting from reheated rice

bacillus cereus

135

diarrhea caused by G- motile organism that doesn't ferment lactose

salmonella

136

most common cause of traveler's diarrhea

ETEC

137

food poisoning due to exotoxin

s aureus and bacillus cereus

138

osteomyelitis in sickle cell pt

salmonella

139

drugs cause Stevens-Johnson syndrome

penicillins, sulfas, allopurinol, seizure drugs (ethosuximide, lanotrigine, carbamazepine, phenobarbital, phenytoin)

140

most common cause of UTI

E. coli
staph saprophyticus
klebsiella
proteus mirabilis

141

most common medication used for UTI prophylaxis

TMP-SMX

142

most common bacteria in a patient with struvite kidney stones

proteus

143

standard treatment for T. pallidum

penicillin

144

cellulitis from a dog or cat bite

pasteurella multocida

145

non-painful, indurated, ulcerated genital lesion

chancre of 1 syphilis

146

moist, smooth, flat, white genital lesion

condylomata of late 2 syphilis

147

large bull's eye rash

erythema migrans of lyme disease

148

ghon complex

ghon focus (fibrosing nodule in lung) and hilar lymphadenopathy

149

negative PPD

never been exposed to TB
immunocompromised, steroids, sarcoidosis, malnourishment

150

"keeps lungs healthy but I have to take b vitamin to keep from hurting nerves"

isoniazid

151

calcified granulomas in the lung, plus hilar lymphadenopathy

ghon complex

152

back pain, fever, night sweats, and weight loss

pott's disease

153

standard treatment regimen for TB

RIPE
rifampin
isoniazid
pyrazinamide
ethambutol

154

rickettsial triad

headache, fever, rash

155

antibiotic of choice for
mycoplasma pneumoniae
Rocky mountain spotted fever
bacterial vaginosis

macrolide or tetracycline
doxycyline
metronidazole

156

live vaccines

smallpox, yellow fever, herpes zoster, chickenpox, Sabin's poli (oral), MMR, nasal influenza

157

where does herpesvirus get envelope

nuclear membrane

158

unenveloped viruses

adenovirus, calicivirus, papilloma, parvovirus, picornavirus, polyomavirus, reovirus, hepevirus

159

where do viruses replicate

DNA in nucleus except poxvirus
RNA in cytoplasm except influenza and retroviruses

160

virus ploidy

haploid except retroviruses are diploid

161

DNA viruses

normally double stranded, linear, icosahedral, and replicate in nucleus

162

treatment for herpes viruses

HSV-1, 2, zoster (VZV): acyclovir, valacyclovir, famciclovir
CMV: ganciclovir, foscarnet

163

latent herpes infection sites in body

HSV-1: trigeminal ganglia
HSV-2: sacral ganglia
VZV: dorsal root or trigeminal ganglia
EBV: B cells
CMV: mononuclear cells

164

dark purple nodules on the skin in an HIV patient

Kaposi sarcoma

165

temporal lobe encephalitis

HSV-1

166

Owl's eye inclusions in organ tissue

CMV

167

intranuclear eosinophilic droplets

Cowdry A inclusions
HSV, CMV

168

parvovirus B19

smallest DNA virus, ssDNA
aplastic crisis in sickle cell disease
"slapped cheek" rash in children (fifth disease)
hydrops fetalis and death in pregnancy

169

adenovirus

conjunctivitis: pink eye
can cause diarrhea

170

poxvirus

smallpox
vaccinia: cowpox
molluscum contagiousm: dome lesions with central dimples

171

JC virus

PML (progressive multifocal leukoencephalopathy) in HIV

172

hand, foot, and mouth disease

coxsackie

173

break bone fever

dengue

174

common cold

rhinovirus and coronavirus

175

fever, jaundice, black vomit

yellow fever

176

meningitis in summer months

echovirus or coxsackievirus

177

Tourniquet test helps diagnose hemorrhagic disease

dengue

178

infects motor neurons of the anterior horn

west nile and poliovirus

179

infantile gastroenteritis

rotavirus

180

antiplatelet antibodies

ITP (immune thrombocytopenia)

181

painful, raised lesions on finger pads + fever

Osler's nodes in infective endocarditis

182

prophylaxis for influenza A

zanamivir and oseltamivir

183

treatment of chronic hepatitis C

ribavirin and IFN-a

184

first line for herpes simplex viruses or varicella-zoster virus

acyclovir, vancyclovir, fanciclovir

185

characteristic barking seal cough

parainfluenza virus (croup)

186

asthma-sounding infection in infants (esp premies)

RSV (Respiratory syncytial virus)

187

bronchiolitis with cough and wheezing in babies

RSV

188

Downey cells

seen in EBV

189

aseptic meningitis

enteroviruses (echovirus, coxsackievirus) and mumps

190

fever, runny nose, cough, conjunctivitis, and diffuse rash

measles (rubeola)

191

small irregular blue-gray spots on the buccal mucosa, surrounded by a base of red

Koplik's spots in measles

192

HIV genes

env (gp120 and gp41)
gag (p24: capsid protein)
pol (reverse transcriptase)

193

envelope proteins in HIV

gp120: attachment to host CD4 T-cell
gp41: fusion and entry into cell

194

dark purple nodule on skin in an HIV patient

kaposi sarcoma

195

treatment for CMV

ganciclovir

196

most common opportunistic infection in HIV patients

Pneumocystis jirovecii pneumonia

197

drug used to prevent pneumocystis pneumonia

TMP-SMX

198

when to start HAART

Highly active antiretroviral therapy is started with:
AIDS defining illness
CD4<350
high HIV viral load

199

components of HAART

2 NRTIs and
1 NNRTI or 1 protease inhibitor or 1 integrase inhibitor

200

protease inhibitors

-navir
GI intolerance
inhibit cytochrome P450 (esp ritonavir)
hyperlipidemia/hypertriglyceridemia
lipodystrophy
pancreatitis: ritonavir
nephrolithiasis: indinavir and atazanavir
increased bilirubin: atazanavir

201

NRTI

zidovudine, didanosine, stavudine, abacavir
zidovudine: bone marrow suppression
didanosine pancreatitis and peripheral neuropathy
hepatic steatosis: didanosine and stavudine
hypersensitivity rxn: abacavir

202

NNRTI

efavirenz, delavirdine, nevirapine
Rash is all
neuropsychotic symp, false positive drug test, teratogenic are all efavirenz

203

HIV drug SE pancreatitis

didanosine, ritonavir

204

HIV drug SE anemia

zidovudine

205

HIV drugs that interact with envelope proteins

enfuvirtide: gp41 (inhibits fusion to T cell)
maraviroc: gp120 (CCR5 antagonist)

206

fungus causes diaper rash

candida albicans

207

opportunistic mold with septate hyphae that branch at a 45 angle

aspergillus

208

opportunistic mold with irregular nonseptate hyphea that branch at wide angles (>90)

mucor, rhizopus (mucormycosis)

209

causes thrush in immunocompromised patients and vulvovaginitis in women

candida

210

causes pneumonia in immunocompromised

pneumocystis jirovecii

211

treatment for oral candidiasis

nystatin, fluconazole

212

most common opportunistic infection in HIV

pneumocystis jirovecii

213

prophylaxis for cryptococcus in AIDS

fluconazole

214

treatment for systemic candidiasis

fluconazole, amphotericin B, echinocandin

215

appearance of KOH skin scraping of tinea versicolor

spaghetti and meatballs

216

the tinea species (other than versicolor) have what type of lesion

pruritic lesion with central clearing resembling a ring
KOH prep and are not dimorphic

217

organisms associated with birds

histoplasmosis
cryptococcus neoformans
chlamydophila psittaci
H5N1 influenza
west nile virus

218

found in rural Latin America

paracoccidioidomycosis

219

plant thorns and cutaneous injury

sporathrix schenckii

220

states east of Mississippi

blastomycosis

221

bird and bat droppings

histoplasmosis

222

mold form contains barrel-shaped arthroconidia

coccidioidomycosis

223

broad-based budding yeast

blastomycosis

224

multiple budding of yeast form

paracoccidioidomycosis

225

"swish and swallow" for oral candidiasis

nystatin

226

cell wall synthesis inhibitor used in invasive aspergillosis

caspofungin

227

most common treatment for onychomycosis

terbinafine, itraconazole, fluconazole

228

SE arrythmias and nephrotoxicity

amphotericin B

229

deposits in keratin-containing tissues

griseofulvin

230

drug of choice for sporotrichosis

itraconazole

231

severe diarrhea in AIDS

cryptosporidium

232

bloating flatulence, foul-smelling, fatty diarrhea

Giardia lamblia

233

bloody diarrhea with RUQ pain

entamoeba histolytica

234

cause of malaria

plasmodium

235

most common protozoal infection in US

trichomonas vaginalis

236

cause of chagas disease

trypanosoma cruzi

237

amoebic dysentery

entamoeba hystolytica

238

African sleeping sickness

trypanosoma brucei

239

transmitted in raw meat or infected cat feces

toxoplasma

240

transmitted by sandflies

Leishmania donovani

241

bloody diarrhea with cysts in stool

entamoeba hystolytica

242

diarrhea with RUQ pain and fever

entamoeba hystolytica

243

stages of malaria life cycle

injected form: sporozoite
replicating intracellularly: schizont
rupture of cells: merozoite

244

ring-enhancing brain lesion in an HIV patient

toxoplasma gondii

245

treatment for Trichomonas vaginalis

metronidazole

246

most common protozoal diarrhea

Giardia lamblia

247

most common helminthic infection in US

enterobius vermicularis (pinworms)

248

one-quarter of the world infected with

ascaris lumbricoides

249

second most common helminthic infection in US

ascaris lumbricoides

250

snail host, "swimmer's itch"

schistosoma species

251

most common predisposing factor for bladder cancer in third world countries

schistosoma haematobium

252

contracted by eating undercooked fish and causes an inflammation of the biliary tract

clonorhcis

253

soil -> enters through foot -> lungs -> swallowed after coughing

strongyloides
(ascaris is ingested initially)

254

hookworms

ancylostoma, necator

255

giant roundworm

ascaris lumbricoides

256

contracted by eating undercooked crabmeat and causes inflammation of the lung

Pargonimus westermaris

257

pork tapeworm

taenia solium

258

responsible for lympatic filariasis

elephantitis caused by
Wuchereria bancrofti

259

adult patient from Mexico with new onset seizures and brain calcifications

taenia solium

260

hematuria in patient from a developing country

schistosoma haematobium

261

med for most flukes and tapeworms

praziquantel

262

med for hookworms, pinworm, roundwom

benzimidazoles

263

med for chagas disease

benznidazole, nifurtimox

264

med for leishmaniasis

sodium stibogluconate or liposomal amphotericin B

265

treatment of pediculosis capitis and pubis

permethrin, pyrethrin

266

why is lindane not used for lice

neurotoxicity and resistance