Term
| What's the difference between an enveloped icosahedral and enveloped helical virus? |
|
Definition
| icosahedral has a capsid; helical has a matrix or core protein and nucleocapsid proteins |
|
|
Term
| What viral genetic process causes worldwide influenza pandemics? |
|
Definition
|
|
Term
|
Definition
| exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology |
|
|
Term
|
Definition
| when viruses with segmented genomes exchange segments; high frequency recombination |
|
|
Term
|
Definition
| when one of two viruses that infects the cell has a mutation that results in a nonfunctional protein; nonmutated virus "complements" the mutated one by making a functional protein to serve both viruses |
|
|
Term
| What are the disadvantages to killed/inactivated vaccines? |
|
Definition
| induce only humoral immunity |
|
|
Term
| Name the live attenutated vaccines. |
|
Definition
| MMR, Sabin's polio, smallpox, yellow fever, chickenpox |
|
|
Term
| Name the killed viral vaccines. |
|
Definition
| rabies, influenza, salk polio and HAV |
|
|
Term
| Name the recominant vaccines? |
|
Definition
|
|
Term
| T/F You need a booster for live attenutaed vaccines. |
|
Definition
|
|
Term
| Name the viruses with circular DNA genomes. |
|
Definition
| papilloma, polyoma, and hepadnavirus |
|
|
Term
| Name the only dsRNA virus |
|
Definition
|
|
Term
| Name the positive single stranded RNA viruses. |
|
Definition
| retrovirus, togavirus, flavivirus, coronavirus, hepevirus, california, picornavirus |
|
|
Term
| Which viruses have genomes that can infect on their own? |
|
Definition
| purified nucleic acids of most dsDNA viruses (except poxvirus and HBV) and positive strand ssRNA viruses are infectious |
|
|
Term
| Name the only diploid virus. |
|
Definition
|
|
Term
| All DNA viruses replicated in teh nucleus except for... |
|
Definition
|
|
Term
| All RNA viruses replicate in the cytoplasm except for.. |
|
Definition
| influenza virus and retrovirus |
|
|
Term
|
Definition
| calicivirus, picorna virus, reovirus, parvovirus, adenovirus, papilloma, and polyoma |
|
|
Term
| What enveloped virus does not get its envelope from the plasma membrane? |
|
Definition
| herpesviruses because tehy acquire envelopes from nuclear membrane |
|
|
Term
| Which viruses have a circular, supercoiled dsDNA genome? |
|
Definition
|
|
Term
| What is the shape of DNA viruses capsules? |
|
Definition
| all are icosahedral except for poxvirus which is complex |
|
|
Term
| What allows poxvirus to replicate in the cytoplasm? |
|
Definition
| carries its own DNA dependent RNA polymerase |
|
|
Term
|
Definition
| hepadna, herpes, adeno, pox, parvo, papilloma, polyoma |
|
|
Term
|
Definition
| roseola (exanthem subitum) |
|
|
Term
| What diseases are caused by adenovirus? |
|
Definition
| febrile pharyngitis, acute hemorrhagic cystitis, pneumonia, conjuncitivitis |
|
|
Term
| Symptoms of parvovirus infection in adults= |
|
Definition
| pure RBC aplasia and rheumatoid arthritis-like sympotms |
|
|
Term
| Name the polyoma viruses? |
|
Definition
|
|
Term
| What is the largest DNA virus? |
|
Definition
|
|
Term
| What diseases can be caused by VZV? |
|
Definition
| chicken pox, shingles, encephalitis, pneumonia |
|
|
Term
| What is How can CMV be transmitted? |
|
Definition
| congenital, transfusion, sexual contact, saliva, urine, transplant |
|
|
Term
|
Definition
|
|
Term
| What are the symptoms of roseola/ |
|
Definition
| high fevers that can cause seizures, followed by a diffuse macular rash |
|
|
Term
|
Definition
| a smear of an opened skin vesicle to detect multinucleated giant cells; used to assay for HSV1 and 2 and VZV |
|
|
Term
| Name the medically important reoviruses? |
|
Definition
| coltivirus= colorado tick fever; rotavirus= MC cause of fatal diarrhea in children |
|
|
Term
|
Definition
| poliovirus, echovirus, rhinovirus, coxsackie virus, HAV |
|
|
Term
| What kind of disease is caused by echovirus? |
|
Definition
|
|
Term
| What kinds of disease are caused by Coxsackievirus? |
|
Definition
| aseptic meningitis, herpangina= febrile pharyngitis hand, foot, and mouth disease myocarditis |
|
|
Term
| Name a virus that is a calicivirus. |
|
Definition
|
|
Term
| Name the viruses that are flaviviruses. |
|
Definition
| HCV, yellow fever, dengue, St. louis encephalitis, west nile virus |
|
|
Term
| Name some of the togaviruses. |
|
Definition
| rubella, eastern equine encephalitis, western equine encephalitis |
|
|
Term
| Name are the retroviruses. |
|
Definition
|
|
Term
| What is the capsid symetry of the HIV virus? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Name the unenveloped RNA viruses. |
|
Definition
| reovirus, picornavirus, hepevirus, calicivirus |
|
|
Term
| How many segments does an orthomyxovirus have? |
|
Definition
|
|
Term
| Name some paramyxoviruses? |
|
Definition
| parainfluenza, RSV, rubeola (measles), mumps |
|
|
Term
| What is teh threatment for RSV bronchiolitis in babies? |
|
Definition
|
|
Term
| What disease is caused by parainfluenza? |
|
Definition
|
|
Term
| What type of virus is rabies virus? |
|
Definition
|
|
Term
|
Definition
| ebola/marburg hemorrhagic fever (often fatal) |
|
|
Term
|
Definition
| lymphocytic choriomeningitis virus and lassa fever encephalitis |
|
|
Term
| How is lassa fever encphealitis transmitted? |
|
Definition
|
|
Term
| How any segments are in arenaviruses? |
|
Definition
|
|
Term
| Name a nonsegmented RNA virus? |
|
Definition
|
|
Term
| How many segments do reoviruses have? |
|
Definition
|
|
Term
| How many segments do bunyaviruses have? |
|
Definition
|
|
Term
| What are some diseases caused by bunyaviruses? |
|
Definition
| california encephalitis, sandfly/rift valley fevers, crimean-congo hemorrhagic fever, hantavirus |
|
|
Term
| What kind of disease is caused by hantavirus? |
|
Definition
| hemorrhagic fever and pneumonia |
|
|
Term
| What type of virus is HDV? what is the genome? |
|
Definition
| deltavirus; SS (-) circular RNA with helical capsid |
|
|
Term
| Name the enveloped RNA viruses with an icosahedral capsid symmetry. |
|
Definition
| flavivirus, togavirus, retrovirus |
|
|
Term
| What are the negative stranded viruses RNA viruses? |
|
Definition
| arenaviruses, bunyaviruses, paramyxoviruses, orthomyxoviruses, filoviruses, and rhabdoviruses |
|
|
Term
| Name the segmented viruses. |
|
Definition
| bunyavirus, orthomyxovirus (influenza), arenavirus, and reovirus |
|
|
Term
|
Definition
| poliovirus, echovirus, rhinovirus, coxsackie virus, HAV |
|
|
Term
| All picornaviruses are enteroviruses, except for... |
|
Definition
| rhinovirus, a nonenveloped RNA virus; destroyed by stomach acid; therefore, does not infect the GI tract (unlike other picornaviruses) |
|
|
Term
| What is the reservoir and transmition of yellow fever? |
|
Definition
| transmitted by aedes mosquito; virus has a monkey or human reservoir |
|
|
Term
| What are the symptoms of yellow fever? |
|
Definition
| high fever, black vomitus and jaundice |
|
|
Term
| What is the bird flu serotype? |
|
Definition
|
|
Term
| What is the bird flu serotype? |
|
Definition
|
|
Term
| What are the symptoms of rubella? |
|
Definition
| fever, postauricular adenopathy, LAD, arthralgias, fine truncal rash that starts at head and moves down |
|
|
Term
| What a common feature of paramyxoviruses? |
|
Definition
| F (fusion) protein which causes respiratory epithelial cells to fuse and form multinucleated cells |
|
|
Term
| What can you give to premature infants to protect against pneumonia? |
|
Definition
| "palivizumab" monoclonal antibody against F protein found on paramyxoviruses like RSV |
|
|
Term
| What disease can cause subacute sclerosing panencephalitis? |
|
Definition
|
|
Term
| Besides rash, what are the symptoms of measles? |
|
Definition
| cough, coryza, conjunctivitis |
|
|
Term
| What are the possible complications of measles? |
|
Definition
| SSPE, encephalitis (1/2000) and giant cell pneumonia (rarely, in immunosuppressed) |
|
|
Term
| What's the difference between the rash of measles and rubella? |
|
Definition
| measles includes hands and feet; rubella is more truncal |
|
|
Term
| How does HBV and HCV increase your risk of HCC? |
|
Definition
| HCV from chronic inflammation; HBV has genes that can act as oncogenes |
|
|
Term
| What is the only serologic marker positive during window period of Hep B infection? |
|
Definition
|
|
Term
| How long does it take to become immune to hep B? |
|
Definition
| 7 weeks after infection; 5 weeks after symptoms |
|
|
Term
| What is the order of appearance of antigens/antibodies against hep C? |
|
Definition
| ag S, ag E, ab C, ab E, ab S |
|
|
Term
| What is the transmembrane glycoprotein of HIV? |
|
Definition
|
|
Term
| What are the capsid and matrix proteins of HIV? |
|
Definition
capsid protein= p24
matrix protein= p 17 |
|
|
Term
| ENvelope proteins of HIV are formed from the cleavage of... |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What mutations allow resistance to HIV? slower disease progression? |
|
Definition
| resistance= homozygous CCR5 mutation; immunity; heterozygous CCR5 mutation= slower course |
|
|
Term
| What cellular receptors does HIV use to gain entry into cells? |
|
Definition
| CXCR4 or CCR5 and CD4 on T cells; CCR5 and CD4 on macrophages |
|
|
Term
| How do you diagnose AIDS? |
|
Definition
| CD4 count less than 200; AIDS defining condition; or CD4;CD8 ratio of >1.5 |
|
|
Term
| At a CD4 count less than 50, AIDS pts start to get what infections? |
|
Definition
| CMV retinitis, MAC, and cryptococcus neoformans |
|
|
Term
| What's the difference on histology between kaposi's sarcoma and bartonella henselae? |
|
Definition
| neutrophilic infiltrate for bartonella henselae and lymphocytic infiltrate for kaposi's sarcoma |
|
|
Term
| Where does nonhodkin's lymphoma commonly present in AIDS patients? |
|
Definition
| oropharynx (Waldeyer's ring) |
|
|
Term
| What can cause respiratory infections in patients with AIDS? |
|
Definition
| interstitial pneumonia with CMV, invasive aspergillosis, pneumonia with PJP, tuberculosis or MAC |
|
|
Term
| If an HIV+ person has thrush it means that... |
|
Definition
| they're CD4 count is probably less than 400 |
|
|
Term
| What is Gerstmann-Straussler-Scheinker syndrome? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| At what CD4 count do you generally get PJP? |
|
Definition
|
|
Term
| What are the normal dominant flora of the colon? |
|
Definition
| bacteroides fragilis > e coli |
|
|
Term
| What bug causes food poisoning in contaminated seafood and wound infections? |
|
Definition
|
|
Term
| What kinds of food is staph aureus found in? |
|
Definition
| meats, mayonnaise, custard |
|
|
Term
|
Definition
|
|
Term
| What bacterial infections can mimic appendicitis? |
|
Definition
| campylobacter jejuni, non-typhoidal salmonella, yersinia entercolitica |
|
|
Term
| What causes gas gangrene or a watery diarrhea? |
|
Definition
|
|
Term
| What are the causes of pneumonia in neonates less than 4 weeks? |
|
Definition
|
|
Term
| What are the causes of pneumonia in children 4 weeks to 18 years? |
|
Definition
| viruses (RSV), mycoplasma, chlamydia trachomatis, strep pneumo |
|
|
Term
| What are the causes of pneumonia in adults 18 to 40 yoa? |
|
Definition
| mycoplasma, C. pneumonia, S. pneumoniae |
|
|
Term
| What are common causes of pneumonia in adults 40 to 65 yoa? |
|
Definition
| S. pneumo, H. flu, anaerobes, viruses, mycoplasma |
|
|
Term
| What are the causes of pneumonia in the elderly? |
|
Definition
| S. pneumo, influenza, anaerobes, H. flu, gram negative rods |
|
|
Term
| What are causes of nosocomial pneumoniae? |
|
Definition
| staphyloccoccus, enteric gram negative rods |
|
|
Term
| What are the causes of pneumonia in alcoholics/IVDUs? |
|
Definition
| S. pneumo, Klebsiella, and staphylococcus |
|
|
Term
| What are postviral causes of pneumonia? |
|
Definition
|
|
Term
| What are some causes of atypical pneumonia? |
|
Definition
| mycoplasma, legionella, chlamydia |
|
|
Term
| What is the empiric treatment for meningitis? |
|
Definition
| ceftriazone and vancomycin (add ampicillin if listeria is suspected) |
|
|
Term
| What are the causes of meningitis in newborns up to 6 months old? |
|
Definition
|
|
Term
| What are the common causes of meningitis in children 6 mos to 6 years? |
|
Definition
| Strep pneumo, N men, H flu type B, enteroviruses |
|
|
Term
| What are the causes of meningitis from age 6 to age 60? |
|
Definition
| S. pneumo, N men, enterovirus, HSV |
|
|
Term
| What are the most common causes of meningitis in adults over 60? |
|
Definition
| S. pneumoniae, gram negative rods, listeria |
|
|
Term
| osteomyelitis in diabetic or IVDU? |
|
Definition
|
|
Term
| osteomyelitis in prosthetic replacement? |
|
Definition
| S. aureus and S. epidermidis |
|
|
Term
| T/F Pregnancy predisposes you to UTI. |
|
Definition
|
|
Term
| Nitrate test positive on UA= |
|
Definition
| gram negative or S. saprophyticus |
|
|
Term
| What bacteria that cause UTI have urease? |
|
Definition
|
|
Term
|
Definition
| E coli, Staph saprophyticus, Klebsiella pnuemoniae, Serratia marcescens, enterobacter cloacae, proteas mirabilis, pseudomonas aeruginosa |
|
|
Term
|
Definition
|
|
Term
| Proteas mirabilis is asosciated with what kinds of stones... |
|
Definition
|
|
Term
| What are the symptoms of congenital toxo infection? |
|
Definition
| chorioretinitis, hydrocephalus and intracranial calcifications |
|
|
Term
| What are the maternal manifestations of rubella infection? |
|
Definition
|
|
Term
| What are the symptoms of congenital rubella? |
|
Definition
| PDA (pulmonary artery hypoplasia), cateracts and deafness +/- blueberry muffin rash d/t thrombocytopenia |
|
|
Term
| What are teh symptoms of congenital CMV infection? |
|
Definition
| hearing loss, seizures, petechial rash (blueberry muffin rash) |
|
|
Term
| What is the clinical presentation of scarlet fever? |
|
Definition
| erythematous, sandpaper-like rash with fever and sore throat |
|
|
Term
| What are the symptoms of hand-foot-mouth disease caused by coxsackie A? |
|
Definition
| vesicular rash on palm and soles (ulcers in oral mucosa) |
|
|
Term
| What STD can cause rectal strictures? |
|
Definition
| lymphogranuloma venereum (C. trachomatis L1-3) |
|
|
Term
| What are teh symptoms of haemophilus ducreyi infection? |
|
Definition
| chancroid= painful genital ulcer; inguinal adenopathy |
|
|
Term
| Feeding someone via IV or hyperalimentation, is a risk factor for infection with.. |
|
Definition
|
|
Term
| What is the MOA of metronidazole? |
|
Definition
|
|
Term
| What is the MOA of penicillins? |
|
Definition
| bind PBPs, block transpeptidase cross linking of peptidoglycan, activate autolytic enzymes |
|
|
Term
| Name the penicillinase resistant penicillins and their use. |
|
Definition
| methicillin, nafcillin, dicloxacillin (S. aureus except MRSA) |
|
|
Term
| Why don't we use methicillin anymore? |
|
Definition
|
|
Term
| Name the aminopenicillins and what they over. |
|
Definition
| ampicillin, amoxicillin= haemophilus influenzae, e coli, listeria monocytogenes, proteas mirabilis, salmonella, shigella, enterococci |
|
|
Term
| Name the carboxypenicillins and their spectrum. |
|
Definition
| ticarcillin, carbenicillin, piperacillin= pseudomonas, gram negative rods; susceptible to penicillinase so use with clavulanic acid |
|
|
Term
| What's the difference between a penicillin and a cephalosporin drug? |
|
Definition
| cephalosporins are beta lactams that inhibit cell wall synthesis but are less susceptible to penicillinases |
|
|
Term
| Name the first generation cephalosporins and their spectrum. |
|
Definition
| cefazolin and cephalexin= gram positive cocci, proteas mirabilis, e coli, klebsiella |
|
|
Term
| What are the second generation cephalosporins and what is their spectrum. |
|
Definition
| cefoxitin, cefaclor, cefuroxime= haemophilus influenzae, enterobacter aerogenes, neisseria, proteas mirabilis, e coli, klebsiella, serratia marcescens |
|
|
Term
| Ceftazidime is notably used to treat... |
|
Definition
|
|
Term
| What are the third generation cephalosporins and their spectrum. |
|
Definition
| ceftriazone, cefotaxime, ceftazidime= serious gram negative infections resistant to other beta lactams |
|
|
Term
| Name some fourth generation cephalosporins and their spectrum. |
|
Definition
| cefepime= increased activity against pseudomonas and gram positive organisms |
|
|
Term
| What are the side effects of cephalosporins? |
|
Definition
| hypersensitivity reactions, vitamin K deficiency, cross-hypersensitivity with penicillins in 5-10% of patients. Increased nephrotoxicity of aminoglycosides; disufiram like reactions with ethanol (in cephalosporins with a methylthiotetrazole group like cefamandole) |
|
|
Term
| What is the spectrum of aztreonam? |
|
Definition
| gram negative rods only; no activity against gram positive or anaerobes. for penicillin allergic patient sand those with renal insufficiency who cannot tolerate aminoglycosides (synergistic with aminoglycosides) |
|
|
Term
| What is the purpose of cilastatin? |
|
Definition
| given with imipenem; inhibits renal dehydropeptidase I to decrease inactivation of drug in renal tubules |
|
|
Term
| What is the spectrum of imipenem/cilastatin and meropenem? |
|
Definition
| wide spectrum but the significant side effects limit use to life-threatening infections, or after other drugs have failed (doesn't cover MRSA) |
|
|
Term
| What are the advantages to using meropenem over imipenem? |
|
Definition
| meropenem has reduced risk of seizures and is stable to dihydropeptidase I |
|
|
Term
| What are the SE of imipenem/cilastatin and meropenem? |
|
Definition
| GI distress, skin rash, and CNS toxicity (seizures) at high plasma levels |
|
|
Term
| What are the toxicities of vancomycin? |
|
Definition
| nephrotoxicity, ototoxicity, thrombophlebitis and red man syndrome |
|
|
Term
| Name the only bacteriocidal protein synthesis inhibitors? |
|
Definition
| aminoglycosides (maybe linezolid) |
|
|
Term
| What does linezolid treat? |
|
Definition
|
|
Term
| What antibiotic inhibits translocation of mRNA during peptide synthesis? |
|
Definition
| erythromycin (macrolides) |
|
|
Term
| What antibiotic is especially useful for bowel surgery? |
|
Definition
|
|
Term
| What antibiotic is synergistic with beta lactam antibiotics? |
|
Definition
|
|
Term
| What drug is synergistic with aminoglycosides for nephrotoxicity? |
|
Definition
|
|
Term
| What are the toxicities of aminoglycosides? |
|
Definition
| nephrotoxic (esp with cephalosporins), ototoxic (esp with loop diuretics), teratogenic |
|
|
Term
| How do bacteria become resistance to aminoglycosides? |
|
Definition
| transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation |
|
|
Term
| What are tetracyclines used to treat? |
|
Definition
| borrelia burgdorferi, M. pneumoniae, tularemia, ureaplasma, vibrio cholera; drugs ability to accumulate intracellularly make it effective against rickettsia and chlamydia |
|
|
Term
| How do bacteria become resistant to tetracycline? |
|
Definition
| decrease uptake into cells or increase efflux out of cell by plasmid encoded transport pumps |
|
|
Term
| What do macrolides treat? |
|
Definition
| atypical pneumoniaes (mycopalsma, chlamydia, legionella), URIs, STDs, gram positive cocci (strep infectiosn in patients allergic to penicillin), and neisseria |
|
|
Term
| What are teh toxicities of macrolides? |
|
Definition
| prolonged AT interval (esp erythromycin), GI discomfort, acute cholestatic hepatitis, eosinophilia, skin rashes, increases serum concentrations of theophyllines, oral anticoagulants |
|
|
Term
| How do bacteria become resistant to macrolides? |
|
Definition
| methylation of the 23 S rRNA binding site |
|
|
Term
| How is resistance to chloramphenicol conferred? |
|
Definition
| plasmid encoded acetyltransferase that inactivates drug |
|
|
Term
| What are the clinical uses of sulfonamides? |
|
Definition
| gram positive, gram negative, nocardia, chlamydia, tripple sulfas or SMX for simple UTI |
|
|
Term
| What is the toxicity of sulfonamdies? |
|
Definition
| hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity (tubulointerstitial nephritis), photoxensitivity, kernicterus in infants, displaces other drugs from albumin (e.g. warfarin) |
|
|
Term
| How does resistance to sulfonamides occur? |
|
Definition
| altered enzyme (bacterial dihydropteroate synthetase), decreased uptake, increased PABA synthesis |
|
|
Term
| What is teh MAO of pyrimethamine? |
|
Definition
| inhibits dihydrofolate reductase |
|
|
Term
| What is the spectrum of TMP SMX? |
|
Definition
| UTIs, shigella, salmonella, PJP |
|
|
Term
| What OTC should not be taken with flouroquinolones? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the clinical use of flouroquinolones? |
|
Definition
| gram negative rods of urinary and GI tracts (including pseudomonas), neisseria, some gram positive organisms |
|
|
Term
| What are the toxicities of flouroquinolones? |
|
Definition
| GI upset, superinfections, skin rashes, headaches, dizziness, contraindicated in pregnant women and in children because animal studies show damage to cartilage; tendonitis and tendon rupture in adults; leg cramp san dmyalgias in kids |
|
|
Term
| What is metronidazole used for? |
|
Definition
| giardia, entamoeba, trichomonas, gardnerella vaginallis, anaerobes (bacteroides, c diff), H. pylori |
|
|
Term
| What is the toxicity of metronidazole? |
|
Definition
| disulfiram-like reaction with alcohol; headache; metabolic taste |
|
|
Term
| What is the treatment for M TB? |
|
Definition
| rifampin, isoniazid, pyrazinamide, ehtambutol |
|
|
Term
| What is the prophylaxis for M TB? |
|
Definition
|
|
Term
| What is the prophylaxis for MAC? |
|
Definition
|
|
Term
| What is the treatment for MAC? |
|
Definition
| aziethromycin, rifampin, streptomycin, ethambutol |
|
|
Term
| What is the treatment for M. leprae? |
|
Definition
| dapsone, rifampin, clofazimine |
|
|
Term
| What converts INH to its active metabolite? |
|
Definition
| bacteria catalase peroxidase (KatG) needed to convert INH to active metabolite |
|
|
Term
| What is the half life of INH? |
|
Definition
| varies greatly whether the patient is a fast acetylator or a slow acetylator |
|
|
Term
| What is the toxicity of INH? |
|
Definition
| neurotoxicity, hepatotoxicity, lupus; pyridoxine can prevent neurotoxicity and lupus |
|
|
Term
| What is the MOA of pyrazinamide? |
|
Definition
| inhibits mycolic acid production by blocking mycobacterial fatty acid synthase I; effective in acidic pH of phagolysosomes, where TB engulfed by macrophages is found |
|
|
Term
| What is the toxicity of pyrazinamide? |
|
Definition
| hyperuricemia, hepatotoxicity |
|
|
Term
| What is the MOA of ethambutol? |
|
Definition
| decreased carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase |
|
|
Term
| What is the prophylaxis for meningococal infection? |
|
Definition
| cipro, rifampin, minocycline |
|
|
Term
| When do you start antibiotic prophylaxis in AIDS patients? |
|
Definition
| TMP SMX at <200 for PCP; TMP SMX at <100 for toxoplasmosis; azithromycin < 50 for MAC |
|
|
Term
|
Definition
| linezolid and streptogramins (quinupristin/dalfopristin) |
|
|
Term
| What is the empiric treatment for community-acquired pneumonia? |
|
Definition
outpatient setting= macrolides
inpatient setting= flouroquinolones
ICU setting= beta lactam + flouroquinolone or azithromycin |
|
|
Term
| Name a drug with the same MOA as terbinafine? |
|
Definition
|
|
Term
| What should be given with amphotericin B to decrease side effects? |
|
Definition
| K and Mg because of altered renal tubule permeability; hydration reduces nephrotoxicity; liposomal amphotericin reduces toxicity |
|
|
Term
| What is amphotericin B used for? |
|
Definition
| serious systemic mycoses= cryptococcus, coccidiodes, blastomyces, aspergillus, histoplasma |
|
|
Term
| What is the toxicity of amphotericin B? |
|
Definition
| fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis |
|
|
Term
| "swish and swallow" for oral candidiasis? |
|
Definition
|
|
Term
| What drug is esp good for aspergillosis? |
|
Definition
|
|
Term
| What is fluconazole esp good at treating? |
|
Definition
| cryptococcal meningitis in AIDS pts because it can cross teh blood brain barrier and candidal infections of all types |
|
|
Term
| What does ketoconazole treat? |
|
Definition
| blastomyces, coccidiodes, histoplasma, candida albicans, hypercortisolism |
|
|
Term
| What azoles are used mostly for topical fungal infections? |
|
Definition
| clotrimazole and miconazole |
|
|
Term
| What are the symptoms of azole tox? |
|
Definition
| hormone synthesis inhibition, liver dysfunction, fever, chills |
|
|
Term
| What is the MOA of flucytosine? |
|
Definition
| inhibits DNA synthesis by conversion to 5-flourouracil by cytosine deaminase |
|
|
Term
| What are caspofungins used for? |
|
Definition
| invasive aspergillosis and candida |
|
|
Term
| What is the toxicity of terbinafine? |
|
Definition
| abnormal LFTs visual disturbances |
|
|
Term
| What is the side effect of griseofulvin? |
|
Definition
| teratogenic, carcinogenic, confusion, headaches, increased p450 and warfarin metabolism |
|
|
Term
| What does pyrimethamine treat? |
|
Definition
| toxoplasmosis, or plasmodium falciparum |
|
|
Term
| What is the MOA of chloroquine? |
|
Definition
| blocks plasmodium heme polyerase |
|
|
Term
| What are the toxicities of chloroquine? |
|
Definition
| retinopathy, G6PD hemolysis |
|
|
Term
| What do you treat malaria with if it is resistant to chloroquine? |
|
Definition
| quinine for resistant species in combo with pyrimethamine/sulfonamide |
|
|
Term
| What is the toxicity of amantadine? |
|
Definition
| ataxia, dizzines, slurred speech (b/c of anticholinergic properties) |
|
|
Term
| What is the MOA of ribavirin? |
|
Definition
| inhibits synthesis of quanine nucleotides by competitively inhibiting IMP dehydrogenase |
|
|
Term
| What is the toxicity of ribavirin? |
|
Definition
| hemolytic anemia, severe teratogen |
|
|
Term
| What is the MOA of acyclovir? |
|
Definition
| monophosphorylated by HSV/VZV thymidine kinase; guanosine analog; triphosphate formed by cellular enzymes; preferentially inhibits viral DNA polymerase by chain termination |
|
|
Term
| What is the spectrum of acyclovir? |
|
Definition
|
|
Term
| What is used for herpes zoster? |
|
Definition
|
|
Term
| What is teh toxicity of ganciclovir? |
|
Definition
| leukopenia, neutropenia, thrombocytopenia, renal toxicity (more toxic to host enzymes than acylovir) |
|
|
Term
| What is the toxicity of foscarnet? |
|
Definition
|
|
Term
| What is the MOA of cidofovir? |
|
Definition
| preferentially inhibits viral DNA polymerase; does not require phophorylation by viral kinase |
|
|
Term
| What is the clinical use of cidofovir? |
|
Definition
| CMV retinitis in immunocompromised patients; acyclovir-resistant HSV; long half life |
|
|
Term
| What is the toxicity of cidofovir? |
|
Definition
| nephrotoxicity (coadminster with probenecid) |
|
|
Term
|
Definition
| when patient has AIDS defining illness; low CD4 cell count (<350 cells/mm3), or high viral load |
|
|
Term
| What are the three drugs of HAART therapy? |
|
Definition
| 2 NRTIs + 1 NNRTI or 1 protease inhibitor or 1 integrase inhibitor |
|
|
Term
| What protease inhibitor can "boost" other drug concentrations by inhibiting cytochrome P450? |
|
Definition
|
|
Term
| What are the side effects of protease inhibitors? |
|
Definition
| hyperglycemia, GI intolerance (N/D), lipodystrophy |
|
|
Term
| What NRTI can cause a lifethreatening hypersensitivity reaction? |
|
Definition
|
|
Term
| What is the MOA of NRTIs? |
|
Definition
| competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain (lack a 3'-OH group), must be phosphorylated by thymidine kinase to be active |
|
|
Term
| What anti-HIV drugs give you pancreatitis? |
|
Definition
| ritonavir, didanosine (ddI), zalcitabine, stavudine |
|
|
Term
| What NRTIs give you hepatic steatosis and peripheral neuropathy? |
|
Definition
|
|
Term
| What NRTI gives you megaloblastic anemia? |
|
Definition
|
|
Term
|
Definition
| nevirapine, efavirenz, delavirdine |
|
|
Term
| What's the difference between NRTIs and NNRTIs? |
|
Definition
| NNRTIs bind to reverse transcriptase at a different site and are noncompetetive; do not require phosphorylation to be active or compete with nucleotides |
|
|
Term
| Name the integrase inhibitor. |
|
Definition
|
|
Term
| What is the toxicity of raltegravir? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| chronic hep B and C and kaposi's sarcoma |
|
|
Term
| What is the toxicity of interferons? |
|
Definition
|
|
Term
| Name a teratogenic antiviral. |
|
Definition
|
|
Term
| What is the MOA of maraviroc? |
|
Definition
| binds to CCR5 to inhibit GP120 conformational change; most undergo tropism test before you give it |
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