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USMLE

New FA Micro 4

QuestionAnswer
which has greater oral availability - amoxicillin or ampicillin? amOxicillin
spectrum of ampicillin, amoxicillin "HELPS kill enterococci": h. flu, e. coli, listeria, proteus, salmonella, enterococci
cefazolin and cephalexin are what generation cephalosporins? first
coverage of cefazolin and cephalexin? "PEcK": proteus, e. coli, klebsiella (and gram positives)
cefoxitin, cefaclor, cefuroxamine are what generation? second
coverage of cefoxitin, cefaclor, cefuroxamine? "HEN PEcKS:" h. flu, enterobacter, neisseria, proteus, e. coli, klebsiella
ceftriaxone, cefotaxime, and ceftazidime are what generation? third
use of ceftriaxone, cefotaxime, and ceftazidime? serious gram-negative infections resistant to other beta lactams; meningitis; ex. ceftazidime for pseudomonas, ceftriaxone for gonorrhea
cefepime, cefpiramide belong to what generation? fourth
use of cefepime, cefpiramide? increased activity against pseudomonas and gram-positive organisms
serum-like sickness in infants and kids can be seen with what cephalosporin? ceflacor (2nd generation)
this is an inhibitor of renal dihydropeptidase I cilastin - decreases inactivation of imipenem in renal tubules
why are aminoglycosides ineffective against anaerobes? require O2 for uptake
drug used for bowel surgery? neomycin
this tetracycline is an ADH antagonist - acts as a diuretic in SIADH demeclocylcine
clinical use of tetracyclines? VACUUM THe BedRoom: vibrio cholerae, acne, chlamydia, ureaplasma urealyticum, mycoplasma, tularemia, h. pylori, borrelia burgdorferi, rickettsia
this drug treats anaerobes above the diaphragm clindamycin
these drugs can cause leg cramps and myalgias in kids fluoroquinolones
used for anaerobes below the diaphragm metronidazole
how does nystatin work? binds to ergosterol, disrupting fungal membranes (too toxic for systemic use)
mechanism of the -azoles? inhibit fungal steriod (ergosterol) synthesis
toxicities of -azoles? hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibition of P450), fever, chills
this antifungal inhibits DNA synthesis by conversion to fluorouracil, which competes with uracil flucytosine
toxicity of flucytosine nausea, vomiting, diarrhea, bone marrow suppression
mechanism of caspofungin? inhibits cell wall syntehsis
use of caspofungin? invasive aspergillosis
toxicity of caspofungin? GI upset, flushing
this antifungal inhibits the fungal enzyme squalene epoxidase terbinafine
use of terbinafene? used to treat dermatophytoses (especially onychomycosis)
mechanism of griseofulvin? interferes with microtubule function; disrupts mitosis; depostis in keratin-containing tissues (e.g. nails)
clinical use of griseofulvin? oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)
toxicity of griseofulvin? teratogenic, carcinogenic, confusion, headaches, increases warfarin metabolism
two diseases transmitted by inhalation fo asexual spores? coccidiomycosis and histoplasmosis
treatment for superficial candidal infection? for systemic? nystatin; amphotericin B
Southwestern US, valley fever coccidiomycosis
Mississippi and Ohio river valleys histoplasmosis
rural Latin America paracoccidiomycosis
bird or bat droppings; intracellular (tiny yeast inside macrophages) histoplasmosis
Captain's wheel appearance paracoccidiomycosis
states east of Mississippi River and Central America blastomycosis
big, broad-based budding blastomycosis
dimorphic fungi mold in soil; yeast in tissue
on what do you culture fungi? Sabouraud's agar
systemic mycoses can mimic what? TB (granuloma formation)
what is cocidiomycosis in tissue? spherule
treatments for mycoses? fluconazole or ketoconazole for local infection; ampho B for systemic infection
what causes tinea versicolor? malassezia furfur
hypopigmented skin lesions in hot, humid weather tinea versicolor
treatment for tinea versicolor? topical miconazole, selenium sulfide
what does cladosporium werneckii cause? tinea nigra
infection of keratinized layer of skin; appears as brownish spot tinea nigra
treatment for tinea nigra? salicylic acid
pruritic lesions with central clearing resembling a ring, caused by dermatophytes tinea pedis/cruris/corporis/capitis
mold hyphae in KOH prep, not dimorphic tinea pedis/cruris/corporis/capitis
mold with septate hyphae that branch at a V-shaped (45 degree) angle aspergillus
culture on Sabourauds' agar, stains with India ink? cryptococcus neoformans
heavily encapsulated yeast, not dimorphic, found in soil & pigeon droppings cryptococcus
fungus ball aspergillus
mold with irregular nonseptate hyphae branching at wide angles (>90 degrees) mucor and rhizopus
in what type of patients is mucormycosis typically seen? ketoacidotic diabetic and leukemic patients
fungi proliferate in walls of blood vessels and cause infarction of distal tissue; rhinocerebral, frontal lobe abscesses mucor and rhizopus
Created by: Asclepius