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Microbiology

FA complete review

Question	Answer
What is the function of flagellum?	Motility
What is the function of Pilus/fimbriae?	Mediate adherence of bacteria to cell surface; sex pilus forms during conjugation
What is the chemical composition of a spore?	Keratin-like coat; dipicolinic acid; peptidoglycan , DNA
Which type of bacteria have spores?	Gram (+) only
What is the main function or purpose of a spore?	Survival: resists dehydration, heat, and chemicals
What is the composition of a CAPSULE?	Organized, discrete polysaccharide layer
What it the function of a capsule?	Protects against phagocytosis
What cellular structure is in charge of protecting against phagocytosis?	Capsule
Composed of loose network of polysaccharides?	Glycocalyx
What is the function of Glycocalyx?	Mediates adherence to surface, especially foreign surfaces
What is the the exception of Capsule?	Poly-D-glutamate on B anthracis
What are the 3 main components of the Outer membrane?	1. Outer leaflet 2. Embedded proteins 3. Inner leaflets
What is the composition of outer leaflets of the outer membrane?	Endotoxin (LPS/LOS)
Phospholipids is the main component of which part of the outer membrane?	Inner leaflet
What kind of bacteria is the only one with outer membrane?	Gram negative only
What are the role of porins in the outer membrane?	Transport across the membrane
What is the role of Lipid A?	Induces TNF and IL-1
What is the space between cytoplasmic membrane and outer membrane in gram (-) bactria?	Periplasm
What is in the middle of the Periplasm?	Peptidoglycan
What is the function of the periplasm?	Accumulates components exiting gram (-) cells, including hydrolytic enzymes
What is the composition of the Cell wall?	Peptidoglycan is a sugar backbone with peptide side chains cross-linked by transpeptidase
What is the main function of the cell wall?	Net-like structure gives rigid dsupport, protects against osmotic pressure damage
What are the two roles of the Cytoplasmic membrane?	1. Site of oxidative and transport enzymes; PBPs involved in cell wall synthesis 2. Lipoteichoic acids induce TNF-alpha and IL-1.
What are the main components of the cytoplasmic membrane?	- Phospholipid bilayer sac with embedded proteins and other enzymes - Lipoteichoic acids (gram (+) only) extend from membrane to exterior
What cell envelope structures are exclusive of gram (-) bacteria?	Outer membrane (Endotoxin/LPS, porin), and Periplasmic space
Lipoteichoic acid is unique to gram _________ bacteria.	Positive
What is another way to refer to spherical morphology?	Coccus
Coccus gram negative bacteria:	1. Moraxella catarrhalis 2. Neisseria
What are common pleomorphic (no cell wall) gram negative bacteria?	Anaplasma, Ehrlichia, Chlamydiae, Rickettsiae, Mycoplasma, and Ureaplasma
Which bacteria is identified with Giemsa stain?	Rickettsia, Chlamydia, Trypanosomes, Plasmodium, Borrelia
A bacteria with a thick peptidoglycan layer will stain what color?	Violet
Thin peptidoglycan wall bacterial stains __________________, in color.	Pink or red
Which bacteria do not stain well do to lack of peptidoglycan wall due to decreased muramic acid?	Legionella, Rickettsia, Chlamydia, Bartonella, Anaplasma, and Ehrlichia
What is similar in Mycoplasma and Ureaplasma?	NO cell wall
Cell wall too thin to be visualised is seen in:	Treponema and Leptospira
Mycobacteria does not stain well because:	Cell wall has high lipid content
What condition is diagnosed with Periodic acid-Schiff stain?	Whipple disease
What is primarily stained with Periodic acid-Schiff stain?	Glycogen and mucopolysaccharides
Acid-fast bacteria most commonly include:	Mycobacteria and Nocardia
Ziehl-Neelsen stain is also known as:	Carbol fuchsin
What substance is stained with Ziehl-Neelsen stain?	Mycolic acid in cell wall
What bacteria or organism are stained with Ziehl-Neelsen stain?	Acid-fast bacteria and Protozoa
Identification of Cryptosporidium oocysts with stain is done with:	Ziehl-Neelsen stain
What stain is used in Cryptococcus neoformans identification?	India ink stain
What stain is used in fungi?	Silver stain
For what is Silver stain used?	Fungi, Legionella, and H. pylori
What is the main function of Selective media?	Favors the growth of particular organisms while preventing growth of other organisms
What is a common example of a Selective media?	Thayer-Martin agar
What is Indicator (differential) media function?	Yields color change in response to the metabolism of certain organisms
MacConkey agar is an example of ___________________media.	Indicator (diffencital)
How is the color change indicated by a differential media?	Due to changes in pH
What is the media used in H. influenzae?	Chocolate agar
What are components of Chocolate agar?	Factors V (NAD+) and X ( hematin)
Media made of Factor V (NAD+) and X (hematin).	Chocolate agar
What type of media is used for Neisseria species?	Thayer-Martin agar
In Thayer-Martin media, the growth of gram positive organism is done with _______________.	Vancomycin
What antibiotics are included in Thayer Martin agar to inhibit growth of gram negative bacteria, except Neisseria?	Trimethoprim and Colistin
Nystatin is used to inhibit __________ growth in Thayer Martin agar.	Fungi
Media used for B. pertussis	Bordet-Gengou agar
What is the component of Bordet-Gengou agar?	Potato extract
What is the components of Regan-Lowe medium?	Charcoal, blood, and antibiotic
What organism uses Regan-Lowe medium?	B. pertussis
Tellurite agar + Loffer medium are used for _________________ growth.	C. diphtheriae
Agar used to M. tuberculosis?	Lowenstein-Jensen agar
M. pneumoniae uses ___________ agar and requires _____________.	Eaton agar; Cholesterol
What media is used by Lactose-fermenting enterics?	MacConkey agar
Fermentation caused in a MacConkey agar culture, turns colonies __________ (color)	Pink
What media is often used by E. coli growth?	Eosin-methylene blue (EMB)
What is the color of E. coli colonies been cultured with EMB?	Green metallic sheen
What characteristic media is used by Legionella?	Charcoal yeast extract agar buffered with cysteine and iron
Sabouraud agar is used to grow cultures of __________.	Fungi
What are common examples of Anaerobes?	Clostridium, Bacteroides, Fusobacterium, and Actinomyces israelii.
What are enzymes are lacking in Anaerobic?	Catalase and/or superoxide dismutase
What are some key features used to describe and identify anaerobes?	1. Foul-smelling (short-chain FAs) 2. Difficult to culture 3. Produce gas in tissue
Where in the body are anaerobes usually part of the normal flora?	GI tract
Which class of antibiotics are ineffective to anaerobes?	Aminoglycosides
What is the characteristic definition of Facultative anaerobes?	May use O2 as a terminal electron acceptor to generate ATP, bu can also use fermentation and other O2-independent pathways
Which class of bacteria are a mixed of anaerobes and anaerobes?	Facultative anaerobes
What are some common Facultative anaerobes?	Streptococci, staphylococci, and enteric gram (-) bacteria
What are the two classes of INTRACELLULAR bugs?	Obligate and Facultative
What organisms are Obligate intracellular?	RIckettsia, Chlamydia, Coxiella
Which class of organism rely on host ATP?	Obligate intracellular
List of Facultative intracellular bacteria:	1. Salmonella 2. Neisseria 3. Burcella 4. Mycobacterium 5. Listeria 6. Francisella 7. Legionella 8. Yersinia pestis
Salmonella, Mycobacterium, Listeria, Legionella, and Yersinia pestis are examples of _______________________ bacteria	Facultative intracellular
What are the most common Encapsulated bacteria?	Streptococcus pneumoniae, H. Influenzae type b, Neisseria meningitidis, E. coli, Salmonella, Klebsiella pneumoniae, and group B Strep
What is the role of the capsules of "Encapsulated" bacteria?	Serve as antiphagocytic virulence factor
Capsular polysaccharide + protein conjugate =	Antigen in vaccines
What mnemonic is used for Encapsulated bacteria?	Please SHINE my SKiS
how are encapsulated bacteria cleared from body?	Opsonized and cleared by the spleen
Which type of patients are at higher risk of encapsulated bacterial infections?	Asplenics
Available vaccines for Encapsulated bacteria (3):	1. N. meningitidis 2. S. pneumoniae 3. H. influenzae type b
What is the purpose of Encapsulated bacteria vaccines composition?	Polysaccharide capsule is conjugated to carrier protein, in order to enhance immunogenicity by promoting T-cell activation and subsequent class switching
Mnemonic used for Urease- positive organisms:	Pee CHUNKSS
Pee CHUNKS stands for:	Proteus, Cryptococcus, H. pylori, Ureaplasma Nocardia Klebsiella S. epidermidis S. saprophyticus
Urease positive organism predispose to which type of kidney stone?	Struvite
Which urease (+) organism most commonly predisposes to Struvite formation?	Proteus
What is the function of Urease?	Hydrolyses urea to release ammonia and CO2 ---> increase in pH
What is the function of Catalase?	Degrades H2O2 into H2O and bubbles of O2 before it can be converted to microbicidal products by the enzyme myeloperoxidase
What immunodeficiency is often have higher risk of catalase (+) organism infections?	Chronic granulomatous disease
Examples of Catalase (+) organisms:	Nocardia, Pseudomonas, Listeria, Aspergillus, Candida, E. coli, Staphylococcus, Serratia, B cepacia, and H pylori
Nocardia, Pseudomonas, E. coli, H. pylori, Serratia, and H. pylori are all ___________ positive organisms	Catalase
C cepacia is __________ positive	Catalase
Yellow "sulfur" granules seen with:	Actinomyces israelii
What color pigment is seen with S. aureus?	Yellow
Blue-green pigment is associated with:	P. aeruginosa
Color pigment associated with Serratia?	Red
What infections are associated with S. epidermidis biofilm production?	Catheter and prosthetic device infections
What are some biofilm-producing bacteria?	S. epidermidis, Viridans streptococci, P. aeruginosa, and nontypeable H. influenzae.
Dental plaques, infective endocarditis ar due to biofilms produced by ______________________.	Viridans streptococci
What conditions are associated with P. aeruginosa biofilm production?	1. Ventilator-associated pneumonia 2. Contact lens-associated keratitis 3. Respiratory tree colonization in CF patients
What is the purpose of Bacterial virulence factors?	Promote evasion of host immune response
What organism has Protein A virulence factor?	S. aureus
IgA protease is a virulence factor seen with:	S. pneumoniae, H. influenzae type b, and Neisseria
Which virulence factor binds to Fc region of IgG?	Protein A
After binding, what actions are prevented by Protein A?	Opsonization and phagocytosis
What is the function virulence factor IgA protease?	Enzyme that cleaves IgA, allowing bacteria to adhere to and colonize mucous membranes
M protein helps prevent _____________.	Phagocytosis
What kind of bacteria expresses M protein virulence factor?	Group A streptococci
What is a possible underlying reason for the autoimmune response seen in acute rheumatic fever?	M protein
Shares similar epitopes to human cellular proteins (molecular mimicry)	M protein
What is another name for Type III secretion system?	Injectisome
What is an injectisome?	Needle-like protein appendage facilitating direct delivery of toxins from certain gram (-) bacteria to eukaryotic host cell
What is the process of bacterial Transformation?	Competent bacteria can bind and import short pieces of environmental naked bacterial chromosomal DNA
Besides IgA protease virulence factor, the SHiN bacteria, undergo ______________________ readily.	Transformation
What can prevent transformation?	Adding deoxyribonuclease degrades naked DNA
What are the two types of conjugation?	1. F+ x F- 2. Hfr x F-
Which plasmid contains genes for sex pilus and conjugation?	F+
What is transferred via the sex pilus?	Single strand of plasmid DNA
What is a plasmid?	Small, extrachromosomal DNA molecule within a cell
What kind of DNA is NOT transferred in Conjugation?	Chromosomal DNA
What is Hfr?	Plasmid that has incorporated the F+ plasmid
How is conjugation of chromosomal DNA possible?	Using Hfr only
What are the two modes of Transduction?	Generalized and Specialized
What mode of Transduction is referred as a packing "error"?	Generalized
What is generalized transduction?	Lytic phage infects bacterium, leading to clava of bacterial DNA.
Which transduction mode is referred as an "excision" event?	Specialized
What kind of phage is used in Specialized transduction?	Lysogenic
Transduction mode in which host and phage DNA break into little pieces?	Generalized
Newly formed phage capsids in Generalized transduction contain bacterial DNA , which then:	Infects other bacteria and creates then a recombinant DNA
In Specialized Transduction, instead of cleavage of bacterial DNA, it:	Viral DNA from the lysogenic phage incorporates in bacterial DNA
What is the difference in newly created phage capsids between Generalized and Specialized transduction?	In specialized, all the new phage capsids contain recombinant bacterial and viral DNA, which creates genes different from donor and recipient
Which are the 5 bacterial toxins aht are encoded in a lysogenic phage?	Group A strep erythrogenic toxin Botulinum toxin Cholera toxin Diphtheria toxin Shiga toxin
What is Transposition?	Segment of DNA that can "jump" from one location to another, can transfer genes form plasmid to chromosome and vice versa
What is the most common way to transfer plasmid with multiple antibiotic resistance among species?	Transposition
What are some key features of Spores?	1. Lack metabolic activity 2. Highly resistant to heat and chemicals 3. Core contains dipicolinic acid
What temperature of an autoclave should be in other to kill spores?	121 C for 15 minutes
Where are the endotoxins most likely located?	Outer cell membrane of most gram (-) bacteria
What is the main component of Endotoxins?	Lipid A component of LPS
Where are the genes located in a Endotoxin?	Bacterial chromosome
What are the most common clinical effects of an endotoxin?	Fever, shock (hypotension), and DIC
What is the MOA of endotoxins?	Induce TNF, IL-1, and IL-6
What are the most typical diseases produced by Endotoxins?	Meningococcemia; Sepsis by gram (-) rods
Which are more toxic, Exotoxins or Endotoxins?	Exotoxins
Do exotoxins or endotoxins, produce antitoxins?	Exotoxins
Which can resist higher temperatures, exotoxins or endotoxins?	Endotoxins
How are exotoxins used in vaccines?	Toxoids produced are used as vaccines
What are the most typical exotoxin produced diseases?	Tetanus, botulism, and diphtheria
Which exotoxin producing organism inhibit protein synthesis?	Corynebacterium diphtheriae, Pseudomonas aeruginosa, Shigella spp., and Enterohemorrhagic E. coli.
Which bacteria's exotoxins inactivate elongation factor 2 (EF-2)?	Corynebacterium diphtheriae and Pseudomonas aeruginosa
What is C. diphtheriae clinical manifestation?	Pharyngitis with pseudomembranes in throat and severe lymphadenopathy (bull neck), myocarditis
What is P. aeruginosa exotoxin?	Exotoxin A
What is the clinical manifestation of Endotoxin A?	Host cell death
What is the mechanism of action of EHEC and Shigella spp toxins?	Inactivate 60S ribosome by removing adenine form rRNA
Which organisms' toxin inhibit protein synthesis by inactivating the 60S ribosome?	Shigella spp and EHEC
Which organism has Shiga-like toxin?	EHEC
What is the clinical manifestation of Shiga toxin?	1. GI mucosal damage --> dysentery 2. Enhance cytokine release, causing HUS
What is a clinical difference of how Shigella and EHEC toxins act?	EHEC does not invade host cells
HUS is caused by which two organisms?	Shigella spp and EHEC
Which endotoxin containing organisms act by increase in fluid secretion?	ETEC, Bacillus anthracis, and Vibrio cholerae
What are the two exotoxins found in Enterotoxigenic E. coli?	1. Healt-LABILE 2. Heat- STABLE
MOA of Heat-Labile ETEC exotoxin?	Over activates adenylate cyclase (increase cAMP --> increase Cl- secretion in gut and water efflux
Overactivates guanylate cyclase (increase cGMP) --> decrease resorption of NaCl and water n gut.	Heat-stable toxin of ETEC
What is the mode of action of Anthrax toxin?	Mimics adenylate cyclase
Which toxin is know to permanent activating Gs?	Cholera toxin
What organism is responsible for edematous border of black eschar in cutaneous anthrax?	Bacillus anthracis
Voluminous "rice-water" diarrhea	Vibrio cholerae infection
What organism causes Whooping cough?	Bordetella pertussis
What is the mode of action of Pertussis toxin?	Inactivates the inhibitory Gi --> activation of adenylate cyclase and increase of cAMP.
What is the analogue condition of Whooping cough in adults, called?	"100-day cough"
Pertussis toxin inhibits the _______________ ability.	Phagocytic
Which exotoxin interferes with optimal phagocytic activity?	Pertussis toxin
Which two common exotoxins inhibit the release of neurotransmitters?	Tetanospasmin and Botulinum toxin
What is the MOA of C. tetani and C. botulinum neurotoxins?	Proteases that cleave SNARE, a set of protein required for NT release via vesicular fusion
What NT release is inhibited by Tetanospasmin?	Inhibitory (GABA and glycine) NTs form Renshaw cells in spinal cord
GABA and glycine release is inhibited by _________________.	Tetanospasmin
What are the classic signs of Tetanus?	Spastic paralysis, risus sardonicus, and trismus (lockjaw)
What NT release is inhibited by Botulinum toxin?	Stimulatory ACh signal at Neuromuscular junction
What are the clinical findings of Botulism?	Flaccid paralysis
Which organisms' toxins lyse cell membranes?	Clostridium perfringens and Streptococcus pyogenes
What are the two associated exotoxins with Strep pyogenes?	1. Streptolysin O 2. Erythrogenic exotoxin A
What is the MOA of alpha toxin in C. perfringens?	Phospholipase that debrades tissue and cell membranes
What is the name of the enzyme used in Alpha toxin?	Lecithinase
What organism causes "gas gangrene"?	Clostridium perfringens
What are the most common clinical manifestations of Clostridium perfringens?	1. Degradation of phospholipids --> myonecrosis ("gas gangrene") 2. Hemolysis ("double zone")
What are antibodies against Streptolysin O?	ASO
What titer levels are used to Dx rheumatic fever caused by S. pyogenes?	ASO titers
Streptococcus pyogenes ANTIBODIES cause ________________.	Rheumatic fever
Streptococcus pyogenes immune complexes cause _______________________.	Poststreptococcal glomerulonephritis
What organisms have supertantiges causing shock exotoxins?	S. aureus and S. pyogenes
What is the mode of action of TSST-1 and Erythrogenic exotoxin A?	Cross-links B region of TCR to MHC class II on APCs outside ot the antigen binding site
What is the result of the cross link process of TCR and MHC II in superantigens?	Overwhelming release of IL-1, IL-2, IFN-gamma, and TNF-alpha ----> shock
What are the clinical manifestation of S. aureus Toxic shock syndrome?	Fever, rash and shock
Exfoliative toxin of S. aureus causes --->	Scalded Skin Syndrome
What is characteristic manifestation of S. pyogenes Toxic Shock syndrome?	Fever, rash, shock, and Scarlet fever
What is the composition of LPS?	O antigen + core polysaccharide + lipid A
What is the toxic component of LPS composition?	Lipid A
What are the 3 main effects of LPS?	1. Macrophage activation (TLR4/CD14), 2. Complement activation 3. Tissue factor activation
ENDOTOXINS is a menemoconc to remember what characteristic of endotoxins?	E- edema N- nitric oxide D- DIC/Death O- outer membrane T- TNF-alpha O- O antigen + core polysaccharide + lipid A X - eXtremely heat stable I- IL-1 and IL-6 N- neutrophil chemotaxis S- Shock
Scarlet Fever is caused by which bacteria exotoxin?	S. pyogenes
Gram positive Aerobic Bacilli:	LIsteria, Bacilus, and Corynebacterium
Clostridium is an important represent of:	Anaerobic Gram positive bacili
Nocardia is:	Aerobic gram positive branching filamentous bacteria
Which is the most common Gram (+) branching filament anaerobic bacteria?	Actinomyces
Which bacteria have NOVOBIOCIN sensitivity testing?	S. saprophyticus and S. epidermidis
Which specie of Staphylococcus is Novobiocin positive?	S. epidermidis
Group A strepto:	S. pyogenes
What is the MC representant of Group B strep bacteria?	S. agalactiae
Which are the 2 most common representations of Viridans streptococci?	S. mutans and S. mitis
Viridans streptococci has no_____________.	Capsule
Which streptococci categorie has Optochin testing?	Partial hemolytic streptococcus
S. pneumonia is Opsonin ____ or positive.	Sensitive
What type of sensitivity is used in Group A and Group B streptococci?	Bacitracin sensitivity
Partial reduction of hemoglobin causes greenish or brownish color without clearing around growth on blood agar.	Alpha-hemolytic anemia
Which bacterial is included in Alpha-hemolytic bacteria?	1. Streptococcus pneumoniae 2. Viridans streptococci
Which a-hemolytic bacteria is Optochin resistant?	Viridans streptococci
Complete lysis of RBCs --> clear area surrounding colony on blood agar.	Beta-hemolytic bacteria
What are the 3 most common bacterial denomited Beta-hemolytic?	1. Staphylococcus aureus 2. Streptococcus pyogenes 3. Streptococcus agalactiae
Catalase (-), bacitracin sensitive, gram +	Strept pyogenes
Which beta-hemolytic bacteria is bacitracin resistant?	Streptococcus agalatiae
Group A streptococcus =	Strep pyogenes
Complete bacterial description of S. aureus	Gram (+), B-hemolytic, catalase (+), coagulase (_) cocci in clusters
What virulence factor is seen in S. Aureus?	Protein A
Where are the common locations for S. aureus colonization?	Nares, ears, axilla, and groin
What are common complications of an S. aureus infection?	1. Inflammatory disease 2. Toxin-mediated disease 3. MRSA
What is the clinical manifestation of description of S. aureus - induced inflammatory disease?	Skin infections, organ abscesses, pneumonia, endocarditis, septic arthritis, and osteomyelitis
What are Toxin-mediated diseases by S. aureus?	TSST-1, scalded skin syndrome, rapid-onset food poisoning
What is MRSA?	Methicillin-resistant S. aureus
What are common complications of MRSA infection?	Serious nosocomial and community-acquired infects
Why is MRSA resistant to methicillin and nafcillin?	Altered penicillin-binding protein
Where does the TSST-1 superantigen bind to?	MHC II and T cell receptors --> polyclonal T cell activation
Main signs and symptoms of Staphylococcal toxic shock syndrome (TSS)?	Fever, vomiting, rash, desquamation, shock, and endo-organ failure
What are common causative association of Staphylococcus TSS?	Prolonged use of vaginal tampons or nasal packaging
Streptococcus TSS is associated with an __________________, unlike Staphylococcal TSS.	Painful skin infection
Staph epidermidis description	Gram (+), catalase (+), coagulase (-), urease (+) cocci in clusters
S. epidermidis is Novobiocin ______________________ and it does not ferment ______________.	Sensitive; Mannitol
Which staph specie ferments Mannitol?	Aureus
What is commonly infected by S. epidermidis?	Prosthetic devices (hip implant, heart valve), and IV catheters by proeicudn adherent biofilms
What aids in the infections of S. epidermidis?	Biofilm production
Novobiocin resistant.	Staph saprophyticus
Which staphylococcal specie is found in normal flora of female genital tract and perineum?	Staph saprophyticus
S. saprophyticus is:	The 2nd MCC of uncomplicated UTI in young women
Gram (_), lancet-shaped diplococci	Streptococcus pneumoniae
S. pneumoniae is ____________________ and ______________________.	Encapsulated and Optochin sensitive
What mnemonic is often used to summarize some clinical manifestations of S. pneumoniae?	MOPS
What does MOPS stand for?	M. meningitis O. Otitis media (in children) P. Pneumonia S. Sinusitis
Pneumococcus is associated with _____________ sputum.	"rusty"
What kind of patients have increased risk of sepsis by S. pneumoniae?	Sickle cell disease patients and those asplenic patients
A S. pneumoniae losses it capsule. It means?	NO virulence
Which alpha-hemolytic gram (+) bacteria is Optochin resistant?	Viridans group streptococci
Which species of Viridans cause dental caries?	S. mutans and S. mitis
What viridian streptococci specifically creates dextrans?	S. sanguinis
S. sanguinis creation of Dextrans causes:	Dextrans to bind to fibrin-platelet aggregates on damaged heart valves causing Subacute bacterial endocarditis
What type of endocarditis is associated with S. sanguinis?	Subacute Bacterial endocarditis
A Group A strep infection causes:	1. Pyogenic manifestations 2. Toxigenic conditions 3. Immunologic diseases
What are the clinical manifestation of Pyogenic Group A infection?	Pharyngitis, cellulitis, impetigo ("honey-crusted" lesion), and erysipelas
Scarlet fever, toxic shock-like syndrome, and necrotizing fasciitis, are:	S. pyogenes toxigenic manifestations
What thow Immunologic conditions are associated with S. pyogenes infection?	Rheumatic fever and PSGN
S. pyogene-induced pharyngitis can cause __________________ if left untreated.	Rheumatic fever
Rheumatic fever is often preceded by:	Pyogenic Pharyngitis
What is the most common preceding S. pyogenes manifestation leading to PSGN?	Impetigo
What is Scarlet Fever?	Blanching, sandpaper-like body rash, strawberry tongue, and circumoral pallor i the setting of group A streptococcal pharyngitis (erythrogenic toxin (+).
Gram (+) cocci, bacitracin resistant, B-hemolytic, colonizes vagina.	Streptococcus agalactiae (group B streptococci)
What are the possible results of a S. agalactiae infection in a baby?	Pneumonia, Meningitis, and sepsis
Which factor is produced by Group B streptococcus?	CAMP
What is the role of CAMP?	Enlarges the area of hemolysis form by S. aureus
Hippurate test (+). PYR (-)	Streptococcus agalactiae (group B streptococci)
Woman intrapartum, (+) S. agalactiae should be given?	Intrapartum penicillin prophylaxis
Which weeks are usual times for screening pregnant mother for S. agalactiae infection?	35-37 weeks
S. gallolyticus is a subspecies of:	Streptococcus bovis
What conditions or diseases are associated to S. gallolyticus?	Bacteremia and Subacute endocarditis
What cancer type is associated with S. gallolyticus?	Colon cancer
What area is colonized by Strep bovis?	Gut
What are the 2 most common species of Enterococci?	E. faecalis and E. faecium
What are some features of Enterococci?	- Resistant to penicillin G - Cause: UTI, biliary tract infections, and subacute endocarditis
Catalase (-), PYR (+), and variable hemolysis.	Enterococci
What does VRE stand for?	Vancomycin-resistant enterococci
VRE are a imporntac cause of:	Nosocomial infections
Entero =	intestine
Which are more resilient, Streptococci or Enterococci?	Enterococci
Strepto =	Twisted (chains)
What organism is gram (+), spore-forming rod that produces anthrax toxin?	Bacillus anthracis
What is caracheirstic of B. anthracis' capsule?	Only one with a polypeptide capouse that contains D-glutamate
The description of colonies as "Medusa head" refers to:	Bacillus anthracis
What are the tow types of B. anthracis?	1. Cutaneous anthrax 2. Pulmonary anthrax
What is th clinical presentation of Cutaneous anthrax?	Painless papules surrounded by vesicles --> ulcer with black eschar --> not common to progress to bacteria and death
What is another name given to Pulmonary anthrax?	Woolsorter's disease
CXR may show a widened mediastinum. Dx?	Pulmonary anthrax
Pathogenesis of Pulmonary anthrax:	Inhalation of spores --> flu-like symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis, and shock
Common gram positive rod that causes food poisoning?	Bacillus cereus
Spores of which organism are often seen in Cooking rice?	Bacillus cereus
What causes reheated rice syndrome?	Spore infection by B. cereus
What is the preformed toxin of B. cereus?	Cereulide
What is the clinical presentation of the B. cereus infection of diarrheal type?	Waterry, nonbloody diarrhea and GI pain within 8-18 hr
Clostridia (all) are:	Gram (+), spore-forming, obligate anaerobic rods
Where is GABA and glycine secreted from?	Renshaw cell in Spinal cord
What is trismus?	Lockjaw
What is sardonicus?	Raised eyebrows and open grin
What is Opisthotonos?	Spasms of spinal extensors
What condition is seen with Trismus, Sardonicus, and Opisthotonos?	Tetanus
Heat-labile toxin that inhibits ACh release at the NMJ causing botulism. Organism?	C. botulinum
What is the a common mode of ingestion of Botulinum toxin in babies?	Ingestion of spores in honey
What are the 4 D's of Botulism?	Diplopia, Dysarthria Dysphagia Dyspnea
What specific symptoms of Botulism are treated with local botox injections?	Dystonia, achalasia, and muscle spasms.
What is a better description of the alpha toxin produced by C. perfringens?	Lecithinase, a phospholipase
What are the clinical manifestations of C. perfringens?	1. Myonecrosis (gas gangrene) which presents with tissue crepitus and hemolysis
How many toxins are produced by C. difficile?	2 toxins
What is Toxin A of C. difficile?	An enterotoxin, which binds to brush border of gut and alters fluid secretion.
What is the action of Toxin B of C. difficile?	Cytotoxin, which disrupts cytoskeleton via actin depolymerization
How does Toxin B of C. difficile causes disruption of the cytoskeleton?	Via actin depolymerization
What organism causes Pseudomembranous colitis?	C. difficile
What is the MCC of Pseudomembranous colitis?	Secondary use of antibiotic, especially clindamycin or ampicilin
Which are often the most associated antibiotics that cause Pseudomembranous colitis?	Clindamycin and Ampicillin
What is the treatment of C. difficile infection?	Metronidazole or oral vancomycin
Treatment for recurrent cases of Pseudomembranous colitis (C. diff infection)?	Fidaxomicin, or fecal microbiota transplant
What encodes for the diphtheria exotoxin?	B-prophage
Coryne =	Club shaped
Color of Corynebacterium diphtheriae colonies on cysteine-tellurite agar?	Black
What are the clinical manifestations of C. bacterium?	1. Pseudomembranous pharyngitis (grayish-white membrane) 2. Lymphadenopathy, myocarditis, and arrhythmias
Common test for Corynebacterium diphtheriae toxin	(+) Elek test
What type of vaccine is made from Corynebacterium diphtheria?	Toxoid
What are the ABCDEFG of Corynebacterium diphtheria?	A. ADP-ribosylation B. Beta-prophage C. Corynebacterium D.- Diphtheriae E. Elongation Factor 2 G. Granules (blue and red)
What color are granules found in C. diphtheriae?	Blue and red
What biochemical process causes the elongation of factor 2 by C. diphtheriae exotoxin?	ADP-ribosylation
Listeria is an __________________________________.	Gram (+), facultative intracellular rod
What are the MC modes of acquiring Listeria monocytogenes?	1. Ingestion of unpasteurized dairy products and cold deli meats 2. Transplacental transmission 3. Vaginal transmission during birth
Which bacteria grows well at refrigerator temperatures 4-10 C ?	Listeria monocytogenes
How are the "rocket tails" in Listeria made?	Via actin polymerization that allow intracellular movement and cell-to-cell spread across cell membranes, thereby avoiding antibody
Tumbling motility	Listeria monocytogenes
"Cold enrichment"	Listeria monocytogenes
What is caused by L. monocytogenes infection?	1. Amnionitis, septicemia, and spontaneous abortion in pregnant women 2. Granulomatosis infantiseptica 3. Neonatal meningitis, 4. Meningitis in immunocompromised
What is the treatment for Listeria monocytogenes infection?	Ampicillin
Nocardia and Actinomyces both are:	Gram (+) and form long, branching filaments resembling fungi
Nocardia is:	Anaerobe, acid fast (weak), and is found in soil
Where is Nocardia often or most commonly found?	Soil
What is caused by a Nocardia infection?	- Immunocompromised --> Pulmonary infections (mimic TB) - Immunocompetent --> Cutaneous infections after trauma
Common spread of Nocardia infection is to the _______.	CNS
What is the treatment for Nocardia infections?	TMP-SMX (sulfonamides)
Where is Actinomyces often found?	Normal oral, reproductive, and GI flora
Actinomyces is _______________________ and not __________________.	ANAerobe ; acid fast
What are some clinical manifestation of Actinomyces infection?	1. Oral/facial abscesses that drain through sinus tracts 2. Yellow "sulfur granules" 3. PID with IUDs
What organism is associated with dental caries/extraction ian dother maxillofacial trauma, along with oral abscesses?	Actinomyces
Yellow "sulfur granules"	Actinomyces
SNAP	Sulfonamides --------Nocardia Actinomyces ------- Penicillin
Common subtypes of Mycobacterium?	1. M. tuberculosis 2. M. avium-intracellulare 3. M. scrofulaceum 4. M. marinum
Which mycobacteria is often resistant to multiple drugs?	M. tuberculosis
Which mycobacteria specie causes disseminated non-TB disease in AIDS?	M. avium-intracellulare
What antibiotic is used in prophylaxis of M. avium intracellulare infection in AIDS patients?	Azithromycin
M. scrofulaceum causes:	Cervical lymphadenitis in children
Hand infection in aquarium handlers is often due to __________________ infection.	M. marinum
All mycobacteria are _____________________ organisms.	Acid-fast
What are the most significant TB symptoms?	Fever, night sweats, weight loss, cougu (non productive or productive), and hemoptysis
Shape of the Cord factor in Mycobacteria?	Serpentine cord
"Serpentine cord" indicates:	M. Tuberculosis infections
What is the role of the Cord factor of M. tuberculosis?	1. Activates macrophages (promote granuloma formation) 2. Induces release of TNF-alpha
What are the components of the Ghon complex?	Hilar nodes and Ghon focus
Where in the lung are Ghon focus most commonly located?	Mid/lower lobes
Which lung lobes usually develop secondary tuberculosis cavitary lesions?	Upper lobes
What does a PPD (+) indicate?	Current infection or past exposure
What does a negative PPD test indicate?	NO infection and in sarcoidosis or HIV infection
Which pathological conditions can produce a negative PPD test?	1. Sarcoidosis 2. HIV infection (especially with low CD4+ count)
What is an important characteristic of Secondary TB?	Caseating granulomas with central necrosis and Langerhans giant cell
Caseating granulomas with central necrosis are key sign of ___________.	Secondary Tuberculosis
Secondary TB that is disseminated into the vertebrae. Dx?	Pott Disease
Another name for Leprosy?	Hansen disease
Why bacteria causes Leprosy?	Mycobacterium leprae
What are some features of M. leprae?	1. Acid-fast bacillus 2. Likes cool temperatures 3. Produces a "glove and stocking" loss of sensation 4. Cannot be grown in vitro
Which two lab techniques are used to Dx Leprosy?	Skin biopsy and PCR
What is the MC reservoir of M. leprae in the U.S.A?	Armadillos
What are the 2 forms of Hansen disease?	1. Lepromatous 2. Tuberculoid
Lepromatous leprosy:	Presents diffusely over skin, with leonine facies, and is communicable. It can be lethal Low cell-mediated immunity with a humoral Th2 response
What are the characteristics of Tuberculoid leprosy?	Few hypoesthetic, hairless skin plaques; High cell-mediated immunity with Th1 immune response and low bacterial load
What is the treatment for Leprosy?	Tuberculoid form: Dapsone and Rifampin Lepromatous form : Dapsone and Rifampin + CLOFAZIMINE
Gram negatives are stained _________________. (color)	Pink
What characteristic have all gram (-) comma-shaped rods?	Oxidase (+)
What are the 3 comma shaped gram negative organisms?	1. Campylobacter jejuni 2. Vibrio cholerae 3. Helicobacter pylori
Grown in 42 C.	C. jejuni
C. jejuni features:	Gram negative, Comma shaped Oxidase (+) Grows in 42 Celsius
What is a key characteristic of V. cholera growth?	Grows in alkaline media
What organism, gram negative, grown in basic media?	Vibrio cholerae
H. pylori is ___________-shaped, oxidase _________, and produces ________________.	Comma-shaped; Oxidase (+); Urease
Which gram negative comma-shaped rod produces urease?	H. pylori
What are the 4 MC shpates of gram negative bacteria?	Diplococci, Coccobacilli, Bacilli, and Comma-shaped
WHich are the gram (-) diplococci?	N. gonorrhoeae and N. meningitidis
N. meningitis is:	Gram negative, diplococci, Aerobic, and (+) Maltose fermentation
N. gonorrhoeae does not ferment _________________.	Maltose
Which a lesser known Maltose negative gram (-) diplococci?	Moraxella
N. gonorrhoeae shares most laboratory characteristics with?	Moraxella
Which are the 2 MC gram negative coccobacilli?	1. H. influenzae 2. Bordetella pertussis
Which are 3 not so common gram negative coccobacilli?	Pasteurella, Brucella, and Francisella tularensis
What is the first test done to different gram negative bacilli?	Lactose fermentation
Lactose (+) fermenters then are divided into:	Fast and slow fermenters
Which are the most common gram negative fast lactose fermenters?	E. coli and Klebsiella
What is a key distinguish features of Citrobacter and Serratia?	Slow lactose fermenters
If bacilli are Lactose negative (non-fermenters), which is the next applied test to differentiate bacteria?	Oxidase
Which bacteria is a lactose non fermenter, oxidase positive, gram negative bacilli?	Pseudomonas
Oxidase positive lactose fermenter bacilli, are finally categorized as:	H2S producers or non produces
Salmonella is a H2S __________________.	Producers
Which are the 2 H2S non-production?	Shigella and Yersinia
According to the Gram (-) algorithm, E. coli is:	Gram negative bacilli, Fast Lactose fermenter
What characteristics are shared by all Neisseria species?	Metabolize glucose and produce IgA proteases. 2. Contain lipooligosaccharides (LOS) with strong endotoxin activity
N. gonorrhoeae is often intracellular, as it is found within ___________________.	Neutrophils
N. meningitidis ferments _______________ and _______________.	Glucose and Maltose
Which Neisseria species has a polysaccharide capsule?	Meningococci
Which features are present in N. meningococci and not in N. gonorrhoeae?	Polysaccharide capsule, maltose fermentation, and Vaccine
Mode of transmission of N. meningitidis?	Respiratory and oral secretions
What are conditions caused by N. meningococci?	1. Meningococcemia with petechial hemorrhages and gangrene of toes 2. Meningitis 3. Waterhouse-Friderichsen syndrome
What is the prevention or prophylaxis of N. meningococcal infection?	Rifampin, ciprofloxacin, or ceftriaxone
Most commonly used treatment of N. meningococci infection?	Ceftriaxone or penicillin G
What penicillin is used to treat N. meningitidis?	Penicillin G
What are the most common complications due to N. gonorrhoeae infection?	Gonorrhea, septic arthritis, neonatal conjunctivitis, PID, and Fitz-Hugh-Curtis syndrome
N. gonococci causes which important syndrome?	Fitz-Hugh-Curtis syndrome
N. meningococci causes with important syndrome?	Waterhouse-Friderichsen syndrome
What is seen in Waterhouse-Friderichsen syndrome?	Adrenal insufficiency, fever, DIC, and shock
What measures are taken to prevent or reduce N. gonorrhoeae infections?	Condoms in sexual transmission, and erythromycin eye ointment prevent neonatal blindness
What is the treatment of N. gonorrhoeae infection?	Ceftriaxone
Which antibiotic is often co-adiminter with Ceftriaxone in N. gonorrhea infections?	Azithromycin or doxycycline
Why is azithromycin added to treatment of N. gonorrhoeae?	Due to possible chlamydia coinfection
Which a common small gram negative coccobacillary rod?	Haemophilus influenzae
Which type or form of H. influenzae is most common to cause disease?	Nontypeable (unencapsulated)
Which type of H. influenzae has a vaccine developed?	Type b
What type of virulence factor is produced by H. influenzae?	IgA protease
Which common gram positive bacteria can be co-cultured with H. influenzae to promote its growth?	S. aureus
Why is Staph aureus co-cultured with H. influenzae?	Provides factor V via RBC hemolysis
What factors are needed for culture growth of H. influenzae?	Factors V (NAD+) and X (hematin)
What are some common conditions caused by H. influenzae infection?	EMOP: E - epiglottitis M - Meningitis O - Otitis media P - pneumonia
What signs are seen in Epiglottitis?	1. Epiglottis appears "cherry red" 2. Lateral neck X-ray shows the "thumb sign"
What is the treatment for H. influenzae mucosal infections?	Amoxicillin +/- clavulanic acid
H. influenzae meningitis is treated with ______.	Ceftriaxone
What is H. influenzae vaccine conjugated with:	Diphtheria toxin or other protein
At what age is H. influenzae type b vaccine applied?	Between 2-18 months of age
What are the virulence factors of Bordetella pertussis?	1. Pertussis toxin 2. Adenylate cyclase toxin 3. Tracheal cytotoxin
What is the function of Pertussis toxin?	Disables Gi
Why is Bordetella pertussis infection often confused by a viral infection?	Due to lymphocytic infiltrate results in form immune response
Which vaccines prevent Bordetella pertussis infection?	Tdap and DTaP
What is the 1st stage of Bordetella pertussis infection?	Catarrhal -- low-grade fever, and Coryza
The "whooping cough" in B. pertussis infection is seen in which stage of the infection?	Paroxysmal (2nd)
Describe the Paroxysmal stage of B. pertussis infection:	Paroxysms of intense cough followed by inspiratory "whoop", posttussive vomiting
What stain is used for Legionella?	SIlver stain. Grow on charcoal yeast extract medium with iron and cysteine.
What is the most common way to detect legionella?	Antigen in the urine
What important electron imbalance is seen in Legionella pneumophila?	Hyponatremia
What is the MC mode of transmission of Legionella?	Aerosol transmission from environmental water source habitat (AC systems, hot water tanks)
Legionella pneumophila treatment?	Macrolide or quinolone
What is Legionnaires' disease?	Severe pneumonia (often unilateral na lobar), fever, GI, an CNS symptoms.
Mild flu-like syndrome due to Legionella pneumophila infection?	Pontiac disease
Low sodium levels in the blood is a key characteristic of ____________________________ infection.	Legionella pneumophila
What gram negative oxidase (+) organism is often described to produce a grape-like odor?	Pseudomonas aeruginosa
What is Ecthyma gangrenosum?	Rapidly progressive, necrotic cutaneous lesion caused by Pseudomonas bacteremia. Most likely seen in immunocompromised
What does the mnemonic PSEUDOMONAS describe?	Condition and features caused by Pseudomonas aeruginosa: P- Pnuemonia S- Sepsis E- Ecthyma grangrenosum U- UTIs D - Diabetes O- Osteomyelitis M- Mucoid polysaccharide capsule O - Otitis externa N - Nosocomial infections A - Addicts to drugs S - Skin infections
What is a common skin infection due to Pseudomonas aeruginosa?	Hot tub folliculitis
Common skin condition in which hair follicles become inflamed?	Folliculitis
What time of Otitis is associated with Pseudomonas infection?	Externa
Which patients are at higher risk of pseudomonas pneumonia?	Cystic fibrosis patients due to Mucoid polysaccharide capsule and biofilm production
What are some features produced by Pseudomonas aeruginosa?	1. Phospholipase C 2. Exotoxin A 3. Endotoxin 4. Pigments
What pigments are produced by Pseudomonas aeruginosa?	Pyoverdin and Pyocyanin (blue-green pigment)
Swimmers ear is:	Otitis externa caused by P. aeruginosa
What are some common treatments for Pseudomonas?	1. Carbapenems 2. Aminoglycosides 3. Monobactams 4. Polymyxins 5. Fluoroquinolones 6. Third and Fourth generation cephalosporins 7. Extended-spectrum penicillins
How do Shigella and Salmonella invade the GI tract?	Via the M cells of Peyer patches
How is the spread of all Salmonella types?	Hematogenously
How does Shigella spread?	Cell to cell
Salmonella has a _______________, and Shigella does not.	Flagella
Salmonella has an ________________ and Shigella has an ____________.	Salmonella ---- endotoxin Shigella ----- Exotoxin (Shiga toxin)
Which is more infectious, Salmonella or Shigella?	Shigella; requires a very small inoculum
What is the GI manifestation of Shigella infection?	Bloody diarrhea (or bacillary dysentery)
What is the pathogenesis of Salmonella infection affecting the GI tract?	Constipation, followed by diarrhea
What is the vaccine of Salmonella typhi?	Oral vaccine contains live attenuated S. typhi IM vaccine contains Vi capsular polysaccharide
Typhoid fever is caused by:	Salmonella typhi
What are the clinical features of Typhoid fever?	Rose spots on abdomen, constipation, abdominal pain, fever
What is the normal treatment of Typhoid fever?	Ceftriaxone or fluoroquinolone
What are the 4 F's associated with Shigella?	Fingers, Flies, Food, and Feces
Which the most severe subtype of Shigella?	Shigella dysenteriae
What defines the severity of Shigella species?	The amount of toxin produced
Order of Shigella species severity:	S. dysenteriae > S. flexneri > S. boydii > S. sonnei
What are possible developments of Yersinia enterocolitica infection?	Acute diarrhea or Pseudoappendicitis
What is Pseudoappendicitis?	Right lower abdominal pain due to mesenteric adenitis and/or terminal ileitis.
Lactose fermenting enteric bacteria have pink colonies when cultured in _________________.	MacConkey agar
What enzyme is produce by E. coli that breaks down Lactose?	B-galactosidase
Lactose is broken down by E. coli's beta galactosidase into:	Glucose and Galactose
What color do all lactose fermenters, except E. coli, when cultured in EMB agar?	Purple/black colonies
E. coli on EMB agar produces:	Colonies with a green sheen
What are E. coli virulence factors?	1. Fimbriae 2. K capsule 3. LPS endotoxin
What is caused by fimbriae of E. coli?	Cystitis and Pyelonephritis
K-capsule in E. coli causes:	Pneumonia and Neonatal meningitis
What Virulence factor of E. coli is responsible for septic shock development?	LPS endotoxin
Which E. coli strain is a microbe that invades intestinal mucosa an causes necrosis and inflammation?	Enteroinvasive E. coli
EIEC ahs similar clinical presentation to:	Shigella
Enterotoxigenic E. coli:	Produces heat labile and heat-stable enterotoxins No inflammation or invasion
Whe E. coli strain is responsible for Traveler's diarrhea?	ETEC
What is the toxin and mechanism of Enteropathogenic E.coli?	NO toxin produced Adheres to apical surface, flattened villi, prevents absorption
What E. coli strain causes diarrhea in children?	EPEC
What is the most common E. coli strain in the United States?	Enterohemorrhagic E. Coli (O157:H7)
How is EHEC transmitted?	Via undercooked meat, raw leafy vegetables
What is the toxin name of EHEC?	Shiga-like toxin
Shiga-like toxin in EHEC cause?	Hemolytic-uremic syndrome (HUS)
What is HUS?	Triad of anemia, thrombocytopenia, and acute renal failure due to microthrombi forming on damaged endothelium
What kind of RBCs are seen in HUS?	Schistocytes
Dysentery toxin ca cause:	Necrosis and inflammation
What fermentation features is different in strain EHEC than other E. coli presentations?	EHEC does NOT ferment sorbitol
What are the 5 Ks of Klebsiella?	Aspiration pneumonia Abscess in lungs and liver Alcoholics diAbetes "currAnt jelly" sputum
Found in intestinal flora that causes lobar pneumonia in alcoholics and diabetics when aspirated. What is the most likely bacteria?	Klebsiella
Why Klebsiella produces very mucoid colonies?	Due to abundant polysaccharide capsules
What is the description of sputum in a Klebsiella patient?	Dark red "currant jelly"
What organism is the MCC of bloody diarrhea in children?	Campylobacter jejuni
C. jejuni infection is a common antecedent to:	Guillain-Barre syndrome and reactive arthritis
Which animal contact may cause a C. jejuni infection?	Dogs, cats, pigs
Gram (-) , comma or "S" shaped, oxidase (+), grown at 42 Celsius	Campylobacter jejuni
What is the most common mode of transmission of vibrio cholerae?	Contaminated water or undercooked food (raw shellfish)
What is the mechanism of action of V. cholerae toxin?	Permanently activates Gs, leading to increase in cAMP.
Grows in alkaline media?	V. cholerae
How is it possible for H. pylori to survive in gastric acidic mucosa?	It is Urease positive which produces ammonia, creating an alkaline environment
What part of the stomach is most likely colonized by H. pylori?	Antrum of stomach
What are the most common type of peptic ulcers caused by H. pylori infection?	Duodenal ulcers
H. pylori is a risk factor for:	Peptic ulcer disease, gastric adenocarcinoma, and MALT lymphoma
What lymphoma is associated with H. pylori infection?	MALT
What is the term or therapy denomination for H. pylori infection?	Triple therapy
What is the composition or parts of the Triple therapy in treatment of H. pylori?	Amoxicillin (metronidazole if penicillin allergy), + Clarithromycin + Proton pump inhibitor (PPI)
Category of bacteria of spiral-shaped and with axial filaments?	Spirochetes
What are common spirochetes?	Borrelia, Leptospira, and Treponema
How can treponema be visualized?	Dark-field microscopy or direct fluorescent antibody (DFA) microscopy
What organism causes Lyme disease?	Borrelia burgdorferi
What transmits BOrrelia burgdorferi?	Ixodes deer tick
The Ixodes deer tick is a vector for:	1. Borrelia burgdorferi 2. Anaplasma spp. 3. Protozoa Babesia
Which area of the USA is Borrelia burgdorferi commonly found?	Northeastern United States
Description of Stage 1 of Lyme Disease:	Early localized; erythema migrans and flu-like symptoms
What is the description of Erythema migrans?	"Bulls-eye" configuration
Stage 2 Lyme disease is seen with:	Early disseminated; Secondary lesions, carditis, AV block (3), facial nerve (Bell) palsy, and migratory myalgias/transient arthritis
3 AVB and Bell palsy are part of the ________________ stage of Lyme disease.	Second
What are the symptoms seen in the Third and last stage of Lyme disease?	Encephalopathy and chronic arthritis
What is the 1st line of treatment in Lyme disease?	Doxycycline
What are secondary treatment options of Lyme disease?	Amoxicillin and cefuroxime in pregnant women and children
Leptospira interrogans is:	Spirochete with hook-shaped ends found in water contaminated with animal urine
Animals urinating in bodies of water. Which is a common bacteria to be found?	Leptospira interrogans
What are the two conditions due to Leptospira interrogans infection?	1. Leptospirosis 2. Weil Disease
What is Weil disease?	Icterohemorrhagic leptospirosis; Severe form with jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, and anemia
What is a key clinical finding of Leptospirosis?	Photophobia with conjunctival suffusion (erythema without exudate)
What condition is common or prevalent among surfers ?	Leptospirosis
What organism causes syphilis?	Treponema pallidum
What is the main characteristic of Primary syphilis?	Genital painless chancre
Is the chancre in Primary syphilis painful?	NO
Which stage of syphilis is seen with condylomata lata?	Secondary
What are the key features of Secondary syphilis?	Maculopapular rash, condylomata lata, lymphadenopathy, and patchy hair loss
What is Condylomata lata?	Smooth, painless, wart-like white lesions on genitals
Gummas are found in?	Tertiary syphilis
What are "gummas"?	Chronic granulomas in tertiary syphilis
What are some key features of Tertiary syphilis?	Gummas, aortitis, neurosyphilis, Argyll Robertson pupil, broad-based ataxia, and positive Romberg, Charcot joint, stroke without hypertension
What is seen with aortitis in syphilis?	Vasa vasorum destruction
Tabes dorsalis and "general paresis" are part of _________________	Neurosyphilis in Tertiary stage
What fluid is tested to Dx for Neurosyphilis?	Spinal fluid
What are some key features of Congenital syphilis?	Facial abnormalities such as rhagades, snuffles, saddle nose, notched (Hutchinson) teeth, mulberry molars, and short maxilla
What Cranial Nerve cause deafness in congenital syphilis?	CN VIII
What are rhagades?	Linear scars at angle of mouth
What are conditions that can produce VDRL false positives?	Pregnancy, Viral (EBV) infection, Drugs, Rheumatic fever, and Lupus and Leprosy
What is detected by VDRL?	Nonspecific antibody atha reacts with beef cardiolipin
Flu-like syndrome after antibiotics are started. MC Dx?	Jarisch-Herxheimer reaction
What does a Jarisch-Herxheimer reaction occurs?	Due to killed bacteria (usually spirochetes) releasing toxins
A pleomorphic, gram-variable rod involved in bacterial vaginosis.	Gardnerella vaginalis
What is the most common presentation of Gardnerella vaginalis?	Gray vaginal discharge with a fishy smell; nonpainful
What histoloigical finding is key for Gardenela vaginosis?	Clue cells
What are Clue cells?	Vaginal epithelial cells covered with Gardnerella
What is the best treatment option of Gardnerella vaginalis?	Metronidazole or clindamycin
What is the Amine whiff test?	Mixing vaginal discharge with 10% KOH enhances fishy odor
When is the Amine whiff test often used?	To diagnose bacterial vaginosis by Gardnerella vaginalis
What are the 2 forms of Chlamydiae?	1. Elementary body 2. Reticulate body
What of Chlamydiae is infectious?	Elementary body
Reticulate body of Chlamydiae serves to:	Replicate in cell by fission
Chlamydia psittaci causes:	Atypical pneumonia
What is the preferred treatment for chlamydia infection?	Azithromycin or doxycycline
Why does chlamydia lack the classic peptidoglycan wall?	Due to reduced muramic acid rendering B-lactam antibiotics ineffective.
What are the cytoplasmic inclusions seen with Chlamydia?	Reticulate bodies
Chlamydia trachomatis causes:	Reactive arthritis (Reiter's syndrome), neonatal and follicular adult conjunctivitis, nongonococcal urethritis, and PID
Chlamydia pneumoniae and Chlamydophila psittaci cause:	Atypical pneumonia
Which species of chlamydia is the most important?	Chlamydia trachomatis
What is caused by C. trachomatis Types A, B, and C?	Chronic infection, cause blindness due to follicular conjunctivitis in Africa
What conditions are associated to C. trachomatis types D-K?	Urethritis/PID, ectopic pregnancy, neonatal pneumonia (staccato cough) with eosinophilia, neonatal conjunctivitis (1-2 weeks after birth)
What condition is associated to C. trachomatis types L1, L2, and L3?	Lymphogranuloma venereum
What is Lymphogranuloma venereum?	Small, painless ulcers on genitals --> swollen, painful ighilan lymph nodes atha ulcerate (boubous).
What is the treatment for Lymphogranuloma venereum?	Doxycycline
Ulcer due to C. trachomatis type L1-L3 are ___________________.	Painless
Bartonella spp causes?	Cat scratch disease and Bacillary angiomatosis
Relapsing fever is caused by:	Borrelia recurrentis
What condition is due to a Borrelia recurrentis infecion?	Relapsing fever
What conditions are due to Brucella infection?	Brucellosis and Undulant fever
Q fever is due to _____________________ infection.	Coxiella burnetii
What condition is due to Francisella tularensis?	Tularemia
What is the source animal of Francisella tularensis?	Ticks, rabbits, and deer flies
Dog bites often cause a _____________ infection.	Pasteurella multocida
What some associated condition to Pasteurella multocida infection?	Cellulitis and Osteomyelitis
Rickettsia rickettsii infection causes	Rocky Mountain spotted fever
Dermacentor is:	Source of Rickettsia rickettsii
What is the name of a dog tick?	Dermacentor
What are the common sources of Salmonella species, except for Salmonella typhi?	Reptiles and poultry
The plague is due to _________________ infection.	Yersinia pestis
What is the main treatment Rickettsial diseases and vector-borne illnesses?	Doxycycline
Description of rash of RMSF?	Rash starts at wrist and ankles and then spreads to trunk, palms, and soles
RMSF rash is similar in spread to:	Secondary syphilis, Coxsackievirus A infection
Typhus rash:	Start centrally and spreads out, sparing palms and soles
Systemic mycoses, all this can cause:	Pneumonia and can disseminate
All mycoses are:	Dimorphic fungi
Which is the only systemic mycoses that is not eyats at 37 Celcius?	Coccidioides
Systemic mycoses are ________________ at 20 C.	Mold
At 37 C, all systemic mycoses are in _____________ form.	Yeast
What is a common characteristic between systemic mycoses and TB?	Can form granules
What i the treatment for local infections of systemic mycoses?	Fluconazole or Itraconazole
Disseminated infection of a systemic mycoses is treated with:	Amphotericin B
What is the Endemic location of Histoplasmosis?	Mississippi and Ohio River Valleys
What is the pathologic features of Histoplasmosis?	Macrophage is filled with Histoplasma
Which systemic mycose is smaller than RBC?	Histoplasma
Histoplasma is often associated with:	Bird or bat droppings
What are the unique clinical signs of Histoplasmosis?	Palatal/ tongue ulcers, and splenomegaly
Person with oral ulcer. Which is the most likely responsible systemic mycoses?	Histoplasma
What is nte endemic region of Blastomycosis cases?	Eastern and Central United States
Broad-based budding of Blastomyces	Pathologic features of Blastomycosis
What are the unique signs of Blastomycosis?	Inflammatory lung disease, can disseminate to skin/bone. Verrucous skin lesions can stimulate SCC Forms granulomatous nodules
What systemic mycoses is same size as RBC?	Blastomyces
Endemic region of Coccidioidomycosis?	Southwestern US, and California
Pathologic features of Coccidioidomycosis?	Spherule filled with endospores of Coccidioides
Endospores association with which systemic mycosis?	Coccidioidomycosis
Coccidioides is ________________________ than an RBC.	Much larger
"Captain's wheel"	Paracoccidioidomycosis
Latin America Is the endemic region for cases of whcat type f systemic mycosis?	Paracoccidioidomycosis
Paracoccidioidomycosis is more ofnen in ___________ than _______.	Males >>> Females
Which two systemic mycoses are much larger than an RBC?	Paracoccidioides and Coccidioides
What are the most common dermatophytes?	Microsporum, Trichophyton, and Epidermophyton
Branching hyphae visible on KOH preparation with blue fungal stain. Associated with pruritus.	Dermatophytes
What area of the body is Tinea capitis referred to?	Head and scalp
What are the associated conditions or symptoms of Tinea capitis?	Lymphadenopathy, alopecia, and scaling.
Tinea corporis occurs on the _______________.	Torso
What are some characteristics by Tinea corporis?	Erythematous scaling ringins ("ringworm") and central clearing
What type of Tinea occurs in the inguinal area?	Tinea cruris
What are the varieties of Tinea pedis?	1. Interdigital 2. Moccasin distribution 3. Vesicular type
Associated to Tinea ungutum?	Onychomycosis; occurs on nails
Which cutaneous mycoses occurs in the nails?	Tinea ungutum
What causes Tinea (Pityriasis) versicolor?	Malassezia spp
"Spaghetti and meatballs" appearance on microscopy.	TInea (pityriasis) versicolor
What is the MC treatment of Tinea versicolor?	Selenium sulfide, topical and/or oral antifungal medications
List of Opportunistic fungal infections:	1. Candida albicans 2. Aspergillus fumigatus 3. Cryptococcus neoformans 4. Mucor and Rhizopus spp. 5. Pneumocystis jirovecii 6. Sporothrix schenckii
alba =	white
Which opportunistic fungal infection forms a pseudohyphae and budding yeast at 20 C , germ tus at 37 C.	Candida albicans
A candida albicans in immunocompromised usually causes:	Oral and Esophageal thrush
What type of patients get a vulvovaginitis by c. albicans infection?	Diabetics and those with of antibiotics
What condition/patients have increased risk of disseminated candidiasis?	Neutropenic patients
What are some pathologic associations with c. albicans?	- Oral and Esophageal thrush - Vulvovaginitis - Diaper rash - Endocarditis (IV drug users) - Disseminated candidiasis - Chronic mucocutaneous candidiasis
WHat is the most treatment for vaginal c. .albicans infections?	Oral fluconazole/topical azole
Oral/esophageal thrush candidiasis is treated with:	Nystatin, fluconazole, or echinocandins
Systemic disseminated candidiasis is treated with:	Fluconazole, echinocandins, and amphotericin B
Monomorphic septate hyphae that branch at 45 Acute angle.	Aspergillus fumigatus
Invasive aspergillosis in immunocompromised causes:	Neutrophil dysfunction
What is the associated risk of Aspergillus fumigatus infection in those with TB history?	Aspergillosis in pre-existing lung cavities
What is produced by Aspergillus fumigatus that is associated with development of Hepatocellular carcinoma?	Aflatoxins
WHat is ABPA?	Allergic bronchopulmonary aspergillosis
What is the pathogenesis of ABPA?	Hypersensitivity response associated with asthma and cystic fibrosis; may cause bronchiectasis and eosinophilia.
45 degree angle sepate?	Aspergillus fumigatus
Aflatoxins are associated with which opportunistic fungus?	Aspergillus fumigatus
Fungal opportunistic infection with narrow budding?	Cryptococcus neoformans
Narrow budding, heavy encapsulated yeast, not dimorphic, and found in soil and pigeon droppings?	Cryptococcus neoformans
How is Cryptococcus neoformans mostly found?	In soil and bird droppings
C. neoformans travels via the blood system into the ____________.	Meninges
What agar is used to culture C. neoformans?	Sabouraud agar
Which opportunistic fungus is highlighted with India ink, creating a clear halo?	Cryptococcus neoformans
What are pathologies caused by Cryptococcus neoformans infection?	1. Cryptococcosis 2. Cryptococcal meningitis 3. Cryptococcal encephalitis
"Soap bubbles" in the brain of an AIDS patient?	Cryptococcus neoformans infection
What is the treatment for Cryptococcal meningitis?	Amphotericin B + Flucytosine
Description of Mucor and Rhizopus spp.	Irregular, broad, nonseptate hyphae branching at wide angles
Ir septate is at wide angles, which is the most common opportunistic fungal infection reference?	Mucor and Rhizopus spp
Acute angle branching of septate is seen with______________ opportunistic fungal infection.	Aspergillus fumigatus
What is the most common pathology caused by Mucor and Rhizopus spp infection?	Mucormycosis
What patients are at increased risk of Mucormycosis?	Ketoacidotic diabetic and/or neutropenic patients
After Mucor and Rhizopus species proliferate in the blood vessel walls, what is the course of the infection followed by?	Penetrate Cribriform plate and then enter the brain.
Areas affected by CNS mucor and rhizopus infection?	Rhinocerebral, frontal lobe abscess Cavernous sinus thrombosis
What are clinical signs of Mucor and Rhizopus infection?	Headache, facial pain, black necrotic eschar on face, with or without cranial nerve involvement.
Black necrotic eschar in face is most commonly associated with which opportunistic fungal infection?	Mucor and Rhizopus spp infection
What is the indicated treatment for Mucor and Rhizopus spp infection?	Surgical debridement and then amphotericin B or isavuconazole
What is the abbreviation for Pneumocystis jiroveci pneumonia?	PCP
What is PCP?	Pneumocystis pneumonia, a diffuse interstitial pneumonia, caused by Pneumocystis jirovecii.
What is CRX/CT description of PCP?	Diffuse, BILATERAL ground-glass, opacities, with pneumatoceles.
Disc-shaped yeast seen in methenamine silver stain of lung tissue. Dx?	PCP
What is the treatment for PCP?	TMP-SMX, pentamidine, dapsone (prophylaxis only), and atovaquone.
What is the drug used for PCP prophylaxis?	Dapsone
Prophylaxis treatment in AIDS patient for PCP starts when CD4+ T cell count drops below:	200 cells/mm3
What fungal organism causes Sporotrichosis?	Sporothrix schenckii
What is the description of Sporothrix schenckii?	Dimorphic, cigar-shaped budding yeast that grows in branching hyphae with rosettes of conidia;
Which fungal organism lives in vegetation?	Sporothrix schenckii
What disease is due to trauma (break of skin) by a thorn with S. schenckii?	Rose gardener's disease
What is the treatment for Rose Gardener's disease?	Itraconazole or Potassium iodide
S. schenckii infection is drains along with lymphatics causing?	Ascending lymphangitis
Most common Protozoal GI infectious organisms are:	Giardia lamblia, Entamoeba histolytica, and Cryptosporidium
What disease is caused by Giardia lamblia?	Giardiasis
What is Giardiasis?	Infection with Giardia lamblia; bloating, flatulence, foul-smelling, fatty diarrhea
Which type of people are often at higher risk of Giardiasis?	Campers and/or hikers
What is the treatment for Giardia lamblia infection?	Metronidazole
How is the diagnosis of Giardiasis made?	Multinucleated trophozoites or cysts in stool, antigen detection
Oocysts in water. Transmission of?	Cryptosporidium
What is the mode of transmission of Giardia lamblia and Entamoeba histolytica?	Cysts in water
What disease is due to Entamoeba histolytica infection?	Amebiasis
What is the clinical presentation of Amebiasis?	Bloody diarrhea (dysentery), liver abscess ("anchovy paste" exudate), RUQ pain
What is the histology of Entamoeba histolytica?	Colon biopsy shows flask-shaped ulcers
What is the treatment of Entamoeba histolytica and Giardia lamblia?	Metronidazole
Severe diarrhea in AIDS due to Protozoal GI infection?	Cryptosporidium
Diagnosis of Cryptosporidium	Oocysts on acid-fast stain , antigen detection
Cysts with up to 4 nuclei in stool. Dx?	Entamoeba histolytica
Trophozoites with engulfed RBCs in the cytoplasm?	Entamoeba histolytica
What is the treatment for Cryptosporidium for healthy individuals?	Nitazoxanide
Filtering city water supplies is a mode of prevention of what organism infection?	Cryptosporidium
Protozoa-- CNS infection list:	1. Toxoplasma gondii 2. Naegleria fowleri 3. Trypanosoma brucei
Mode of transmission of Toxoplasma gondii	1. Cysts in meat (most common); 2. Oocysts in cat feces
Why do pregnant women should avoid contact with cat feces?	May be contaminated with Toxoplasma gondii oocysts which can cross the placenta
What is congenital toxoplamois presented?	Triad of: 1. Chorioretinitis 2. Hydrocephalus 3. Intracranial calcifications
Tachyzoite, often seen to diagnose infection with:	Toxoplasma gondii
What is the treatment for Toxoplasma gondii infection?	Sulfadiazine + Pyrimethamine
Sulfadiazine co administer with Pyrimethamine. Most likely infection?	Toxoplasmosis
Brain abscesses; seen as multiple enhancing ring lesions on MRI. Dx?	Toxoplasmosis
What are the labs seen by Toxoplasma infection to a immunocompetent individual?	1. Mononucleosis-like symptoms 2. (-) heterophile antibody test
Rapidly fatal meningoencephalitis is caused by an infection with:	Naegleria fowleri
Amoebas in CSF is diagnostic for infection with:	Naegleria fowleri
Where is the typical place/area for a possible Naegleria fowleri infection?	Swimming in warm freshwater
What is "freshwater"?	Water from rivers, lakes, reservoirs, underground streams, and other sources.
Infection with Trypanosoma brucei causes which disease?	African sleeping sickness
What organism causes African sleeping sickness?	Trypanosoma brucei
What is "African sleeping sickness"?	Enlarged lymph nodes, recurring fever, somnolence, and coma due to T. brucei infection
Reason for recurring fever in African sleeping sickness?	Due to antigenic variation
What is the transmission mode of Trypanosoma brucei?	Tsetse fly, a painful bit
How is the diagnosis for Trypanosoma brucei infection made?	Trypomastigote in blood smear
What is the treatment for blood-borne Trypanosoma brucei infection?	Suramin
Melarsoprol is used for:	Treatment of Trypanosoma brucei infection for CNS penetration
What are the main two protozoa that cause hematological infections?	Plasmodium (species) and Babesia
What is the most common disease caused by Plasmodium infection?	Malaria
What are the main clinical signs of Malaria?	Fever, headache, anemia, and splenoagay
Which type of Plasmodium specie causes a 48-hr cycle of fever?	P. vivax/ovale
Which plasmodium type causes a tertian cycle?	Pl vivax/ovale
What does a tertian cycle of fever by P. vivax/ovale means?	Fever on first day and third day, thus been 48 hours apart from each other
WHat is the form name of the dorman P. vivax/ovale in the liver?	Hypnozoite
P. falciparum cause an__________ fever pattern.	Irregular
Which plasmodium causes a quatrain or (72-hr) fever cycle or pattern>	P. malariae
What is the mode of transmission of the Plamodium?	Anopheles mosquito
Anopheles mosquito transmits what organism?	Plasmodium spps
What medication is used for sensitive Plasmodium infection?	Chloroquine
What is the MOA of chloroquine?	Blocks Plasmodium heme polymerase
Which Plasmodium enzyme is blocked by Chloroquine?	Heme polymerase
In case of Plasmodium been resistant to Chloroquine, what is an alternative treatment option?	Mefloquine or atovaquone/proguanil
What test should be done to patients about to be treated with IV quinidine or artesunate?	Test for G6PD deficiency
When should IV quinidine or Artesunate should be used?	In life-threatening situations only, and hth previous test for G6PD deficiency.
What treatment is added to P. vivax/ovale infecton?	Primaquine for hypnozoite
What drug is used to treat Hypnozoite found in liver of patient with a P. vivax/ ovale infection?	Primaquine
What organism causes Babesiosis?	Babesia
What is the presentation of Babesiosis?	Fever and hemolytic anemia; predominantly Northeastern United States
MOde of transmission Babesi?	Ixodes tick
Blodo semar shows: ring form, "Maltese cross". Dx?	Babesiosis
What is the characteristic finding of Babbeiosis in order to make dx?	"Maltese cross" in blood smear
Treatment of Babesia infection	Atovaquone + azithromycin
Ixodes tick carries which two organisms?	Babesia and Borrelia burgdorferi
Babesiosis and Lyme disease share the same ___________________.	Ixodes tick
What are some common findings in Blood smear of Plasmodium sp?	1. Trophozoite ring form within RBC 2. Schizont containing merozoites 3. Red granules throughtout RBC in P. vivax/ovale
What are Schuffner stippling?	Red granules found in Blood smear of Plasmodium infection.
Common protozoan visceral infectious organisms:	Trypanosoma cruzi and Leishmania donovani
What disease is caused by T. cruzi infection?	Chagas disease
What are some symptoms and signs of Chagas disease?	1. Dilated cardiomyopathy with apical atrophy 2. Megacolon 3. Megaesophagus 4. (+) Romana sign
Big heart, big esophagus, and big colon. Dx?	Chagas disease
What is the endemic region for Chagas disease?	South America
What is the Romana sign?	Unilateral periorbital swelling
(+) Romana sign. Dx.	Chagas disease
"Kissing" bug causes	Chagas disease
THe kissing bug is a type of ______________ bug, which carries ___________________, causing __________________ diseases.	Reduviid bug; Trypanosoma cruzi ; Chagas disease
What is the common treatment for Chagas disease caused by T. cruzy?	Benznidazole or Nifurtimox
Patient on Nifurtimox. Dx?	Chagas disease
Suspect Chagas disease or T. cruzi infection in a person that:	1. Traveled recently to South America (Brazon MC) 2. Shows enlarged heart (DCM) 3. Complains of unilaerl eye swelling
The Sandfly transmit:	Leishmania donovani
What two pathologies are due to Leishmania donovani infection?	1. Visceral leishmaniasis 2. Cutaneous leishmaniasis
Waht is hantoher name for Visceral leshimanisis?	Kala-azar
What is the clinical presentation of Kala-azar?	Spiking fevers, hepatosplenomegaly, and pancytopenia
What is the treatment for Leishmania donovani infection?	Amphotericin B, and sodium stibogluconate
Macrophages containing amastigotes. Dx?	Leishmania donovani infection
What is the most common sexually transmitted protozoan infection?	Vaginitis due to Trichomonas vaginalis infection
What is Trichomonas vaginalis?	Sexually transmitted protozoan
Clinical profile of Trichomonas vaginalis vaginitis?	Foul-smelling, greenish discharge; itching and burning;
How is Trichomonas vaginal s infection diagnosed?	Motile trophozoites on wet mount; "strawberry cervix"
The term "strawberry cervix" most likely indicate:	Trichomonas vaginalis infection
What the treatment for patient and partner with Trichomonas vaginalis infection?	Metronidazole
Which is nematodes are ingested?	Enterobius, Ascaris, Toxocara, Trichinella, and Trichuris
Which nematodes enter body via cutaneous?	Strongyloides, Ancylostoma, and Necator
Which nematodes are acquired through a bite?	Loa Loa, Onchocerca volvulus, and Wuchereria bancrofti
Common name for nematodes	Roundworms
What is the common name for Enterobius vermicularis?	Pinworm
What disease is caused by Enterobius vermicularis?	Anal pruritus
How is anal pruritus caused by E. vermicularis diagnosed?	By the tape test
What is the treatment of Enterobius vermicularis infection?	Pyrantel pamoate or Bendazoles
Giant roundworm scientific name is:	Ascaris lumbricoides
What is the common name for Ascaris lumbricoides?	Giant roundworm
What disease is caused by Ascaris lumbricoides?	1. Obstruction of ileocecal valve, 2. Biliary obstruction 3. Intestinal perforation
From where does Ascaris lumbricoides migrate?	Nose/mouth
What is the best treatment option for Ascaris lumbricoides?	Bendazoles
Threahewromd =	Strongyloides stercolaris
Larva in soil penetrate skin; rhabditiform larva seen under microscope.	Strongyloides stercolaris
Autoinfection is most likely seen with which roundworm infection?	Strongyloides stercolaris
What is the treatment for Strongyloides stercoralis infection;?	Ivermectin or bendazoles
How does Ancylostoma duodenale, Necator americanus cause anemia?	Sicking bloood form interinal (duodena) wall
Cutaneous larva migrans is due to what infection?	Ansylostoma doudenale, na ENcator Amricansis infcherion
Pruritic, serpiginous rash from walking barefoot on contaminated beach	Cutaneous larva migrans
In which tissue does trichinella spiralis takes home when it penetrates the host?	Striated muscle
Which disease is caused by Trichinella spiralis infection?	Trichinosis
Trichinella and Trichuris are both treated with _________________.	Bendalzoles
Whipworm is known as:	Trichuris trichiura
Hookworms are:	Ancylostoma duodenale and Necator americanus
List of Intestinal Nematodes	1. Enterobius vermicularis 2. Ascaris lumbricoides 3. Strogyloides stercolaris 4. Ancylostoma duodenale, Necator americanus 5. Trichinella spiralis 6. Trichuris trichiura
A list of Tissue nematodes	1. Toxocara canis 2. Onchocerca volvulus 3. Loa loa 4. Wuchereria bancrofti
What condition is due to Toxocara canis infection?	Visceral larva migrans
What causes Visceral larva migrans?	Toxocara canis infection
What important effects of Visceral larva migrans?	Myocarditis, liver damage, and eye damage (visual impairment, and blindness), and CNS symptoms (seizures, coma)
What is the best treatment for Toxocara canis?	Bendazoles
What are clinical features of Onchocerca volvulus infection?	Skin changes, loss of elastic fibers, and river blindness
Black flies, black skin nodules, "black sight" is a mnemonic to describe what infection?	Onchocerca volvulus
What is the treatment for Onchocerca volvulus?	Ivermectin
The clue "river blindness" refers to _________________________ infection.	Onchocerca volvulus
What organism is transmitted by the Female Backfly?	Onchocerca volvulus
What two tissues are affected mainly by Loa loa?	1. Swelling of the skin 2. Worm in conjunctivitis
Which flies transmit Loa loa?	Deer, horse, and mango flies
What is the best treatment option for Loa loa and Wuchereria bancrofti?	Diethylcarbamazine
Diethylcarbamazine is used to treat which tissue nematodes?	Loa loa and Wuchereria bancrofti
What condition is commonly caused by Wuchereria bancrofti?	Lymphatic filariasis (elefantiasis)
What is the common name of the condition caused by W. bancrofti?	Elephantiasis
Describe the cause of lymphedema in Elephantiasis?	Wuchereria bancrofti organisms (worms) invade the lymph nodes leading to inflammation and subsequent lymphedema
How long after initial infection does Elephantiasis present clinically?	After 9 months to a 1 year.
What is the vector for Wuchereria bancrofti?	Female mosquito
Female backfly -----> Female mosquito ------>	Onchocerca volvulus Wuchereria bancrofti
Common name for cestodes	Tapeworms
Which are the most relevant cestodes?	1. Taenia solium 2. Diphyllobothrium latum 3. Echinococcus granulosus
Treatment for Taenia solium?	Praziquantel
Which is the mode of transmission bo the T. solium?	1. Ingestion of larvae encysted in undercooked pork (intestinal tapeworm) 2. Ingestion of eggs in food contaminated with human feces
What conditions are related to the acquisition of T. solium by ingestion of eggs in contaminated food?	Cysticercosis, neurocysticercosis
What is the specific treatment option for Neurocysticercosis?	Albendazole
What is neurocysticercosis?	CNS infection with T. solium due to ingestion of eggs in human feces contaminated food
What are the CNS symptoms seen with Neurocysticercosis?	Cystic CNS lesions and seizures
What disease is due to Diphyllobothrium latum infection?	Megaloblastic anemia due to Vitamin B12 deficiency.
Why does D. latum infection causes a Vitamin B12 deficiency?	Tapeworm competes for B12 in intestine --> megaloblastic anemia
What is the MC mode of transmission of Diphyllobothrium latum?	Ingestion of larvae in raw freshwater fish
Which tapeworms are treated with Praziquantel?	Diphyllobothrium latum and Taenia solium
What conditions are associated with Echinococcus granulosus infection?	1. Hydatid cysts ("eggshell calcification") in liver 2. Cyst rupture can cause anaphylaxis
Why are E. granulosus cysts handled with extreme care during surgery?	Rupture can cause anaphylaxis
What animal is the intermediate host for Echinococcus granulosus?	Sheep
What is the MC mode of transmission of E. granulosus?	Ingestion of eggs in food contaminated with dog feces
Another name for flukes?	Trematodes
What are the most common Flukes?	1. Schistosoma 2. Clonorchis sinensis
What organism is associated by ingestion of undercooked fish?	Clonorchis sinensis
What is the treatment option for all trematodes?	Praziquantel
Snails are the intermediate host for ____________________.	Schistosoma
What are common actions that predispose Schistosoma infections?	Swimming or bathing in contaminated fresh water
What are the two most referred subspecies of Schistosoma?	S. mansoni and S. haematobium
What is caused by S. mansoni?	Liver and spleen enlargement, fibrosis, inflammation , and portal hypertension
What are the two most significant symptoms of Schistosoma mansoni infection?	Portal hypertension and Hepatosplenomegaly
What Schistosoma spp is associated with development of Squamous cell carcinomas of the bladder?	S. haematobium
Painless hematuria may be a sign of:	Squamous cell carcinoma of the bladder due to chronic S. haematobium infection.
What type of hypertension is associated with S. haematobium infection?	Pulmonary hypertension
Scabies are due to __________________________ infection.	Sarcoptes scabiei
Describe Scabies?	Pruritus and serpinginous burrows in webspace of hands and feet.
What areas of the body are classically seen with serpiginous burrows in Scabies?	Hands and feet
What are treatment options for Scabies?	1. Permethrin cream 2. Washing/drying all clothing/bedding
What are common Ectoparasites?	Sarcoptes scabiei and Pediculus humanus/ Phthirus pubis
What are Pediculus humanus/ Phthirus pubis?	Blood-sucking lice that cause intense pruritus with associated excoriations, commonly on scalp and neck or waistband and axilla.
Epidemic typhus is caused by:	Rickettsia prowazekii
Trench fever is caused by:	Bartonella quintana
What is the common treatment for Pediculus humanus/ Phthirus pubis?	Pyrethroids, malathion, or ivermectin lotion, and nit combing.
What parasite is associated with Biliary tract disease and cholangiocarcinoma?	Clonorchis sinensis
Brain cysts, seizures are associated with:	Taenia solium (neurocysticercosis)
Hematuria, squamous cell bladder cancer is seen with:	Schistosoma haematobium
What is the the most common associates of Echinococcus granulosus?	Liver (hydatid) cystss
Microcytic anemia can be caused by:	Ancylostoma, Necator
What type of anemia is seen with Ancylostoma, Necator?	Microcytic anemia
What are common associations (symptoms) of Trichinella spiralis?	Myalgias, periorbital edema
Swelling around the eye is often associated with which parasite?	Trichinella spiralis
What is the organism responsible for Perianal pruritus?	Enterobius
Enterobius causes:	Perianal disease
Portal hypertension is caused by:	Schistosoma mansoni and Schistosoma japonicum
Vitamin B12 deficiency is seen with:	Diphyllobothrium latum
What parasite can cause a megaloblastic anemia?	Diphyllobothrium latum
Viral recombination:	Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology
Which type of viral genomes undergo viral reassortment most readily?	Segmented genomes
What is a very common virus to undergo viral reassortment?	Influenza virus
Viruses with segmented genomes exchange genetic material. What is the name of this genetic viral process?	Viral reassortment
Viral reassortment can cause ____________________ shift.	Antigenic
What is viral complementation?	When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein, the non mutated virus "complements" the mutated one by making a functional protein that serves both viruses
In case that one virus gets mutated and produces a nonfunctional protein, but another virus picks the problem and creates a protein for both viruses to work. This process is called_________________.	Complementation
What is a common association or example of viral complementation?	Hepatitis D virus requires Hepatitis B for survival
When does Phenotypic mixing occurs?	In simultaneous infection of a cell with 2 viruses
In phenotypic mixing of 2 viruses, which virus determines the tropism (infectivity)?	VIrus B (one with the surface proteins reacting to Virus A)
Which is the only DNA virus with single stranded DNA?	Parvoviridae
Which are the circular DNA viruses?	Papilloma-, polyoma-, and hepadna viruses
Which is the only RNA virus with a double stranded RNA?	Reoviridae
Reoviridae is the only RNA virus with:	Double stranded RNA
List of (+) stranded RNA viruses:	1. Retrovirus 2. Togavirus 3. Flavivirus 4. Coronavirus 5. Hepevirus 6. Calicivirus 7. Picornavirus
How many (+) stranded RNA viruses exist (USMLE important)?	7
What conditions are known to always produce a non infectious virus?	Naked nucleic acids of (-) ssRNA and dsRNA viruses
All (+) strand ssRNA and most dsDNA virus have _____________nucleic acids, which makes them __________.	Purified; infectious
Naked DNA viruses are:	Papillomavirus, Adenovirus, Parvovirus, adn Polyomavirus
Naked RNA viruses are:	Calicivirus, Picornavirus, Reovirus, and Hepevirus
The PAPP mnemonic is used to remember:	Non Enveloped DNA viruses
CPR and hepevirus (mnemonic)	Used to remember non-enveloped RNA viruses
All DNA viruses are ___________________, except for:	ICOSAHEDRAL; Pox (complex)
What is the shape of most (except Pox) DNA viruses?	ICOSAHEDRAL
Which is the only DNA virus that does NOT replicate in the nucleus?	Poxvirus
Where do all DNA viruses, except Pox, replicate?	In the nucleus
What are the most common DNA viruses?	Hepadna, Herpes, Adeno, Pox, Parvo, Papilloma, and Polyoma.
Poxvirus structure:	Enveloped, dsDNA linear virus
Associated conditions with Poxvirus:	1. Smallpox 2. Cowpox 3. Molluscum contagiosum
What virus causes Molluscum contagiosum?	Poxvirus infection
Which is the largest DNA virus?	Poxvirus
Poxvirus is the _________________ DNA virus.	Largest
Flesh-colored papule with central umbilication caused by Pox virus.	Molluscum contagiosum
Which is the only DNA hepatitis virus?	Hepatitis B
What is the structure of Hepadnavirus?	Enveloped, partially double stranded and circular DNA virus
Which DNA viral family has a partially ds DNA?	Hepadnavirus
Associated conditions with Adenovirus:	1. Febrile pharyngitis - sore throat 2. Acute hemorrhagic cystitis 3. Pneumonia 4. Conjunctivitis - "pink eye" 5. Gastroenteritis 6. Myocarditis
What is the most common viral family responsible for viral sore throat?	Adenovirus
Adenovirus a a ______________________________________ virus.	Naked, linear, dsDNA
Common viral cause of "pink eye"?	Adenovirus
HPV pertains to which viral family?	Papillomavirus
What is the structure of Papillomavirus?	Naked, double-stranded circular DNA
What conditions/pathologies are associated with Papillomavirus?	1. HPV - warts 2. CIN 3. Cervical cancer
Which papilloma stereotypes are most commonly associated with HPV warts?	1, 2, 6, 11
Cervical cancer serotypes of Papillomavirus are:	16 and 18
Naked, double stranded circular DNA describes which DNA viruses?	Papillomavirus and Polyomavirus
What are associated medical conditions of Polyomavirus?	1. JC virus --> Progresive multifocal leukoencephalopathy (PML) in HIV 2. BK virus --> transplant patients, commonly targets the kindney
Which organ is most affected/targeted by BK virus?	Kidney
JC virus causes what condition in HIV patients?	Progressive multifocal leukoencephalopathy (PML)
What is the unique structure of Parvovirus?	Naked, single stranded, and linear DNA virus
Which is the smallest DNA virus?	Parvovirus
Parvo =	Small
What subtype of Parvovirus is very important?	B19 virus
What causes B19 Parvovirus infection?	Aplastic crisis in sickle cell disease, "slapped cheek" rash in children
What condition(s) are associated with "slapped cheek" rash in children?	Erythema infectiosum or (fifth disease)
What is another name for Erythema infectiosum?	Fifth disease
How does Parvovirus cause Hydrops fetalis in pregnant women?	It promotes RBC destruction in fetus
What is the possible result of parvovirus infection in healthy adult?	Pure RBC aplasia and rheumatoid arthritis- like symptoms
Which population, other than children, is in high risk of an B19 virus infection?	Sickle cell disease patients
What is the structure description of Herpesviruses?	Envelope, DS, and linear DNA viruses
Herpesviruses are DNA or RNA?	DNA
What is the clinical significance of Herpes simplex virus-1?	Gingivostomatitis, keratoconjunctivitis, herpes labialis, herpetic whitlow on finger, temporal lobe encephalitis, esophagitis, and erythema multiforme
Erythema multiforme is seen with what type of Herpes virus?	HSV 1
What type of encephalitis is often seen with HSV 1 infection?	Temporal lobe encephalitis
Which cranial lobe is most commonly affected by HSV 1?	Temporal lobe
Herpes labialis, Temporal lobe encephalitis and erythema multiforme are all due to HSV _____ infection.	1
Which ganglia is most commonly seen with LATENT HSV 1?	Trigeminal ganglia
What is the most common cause of Sporadic Encephalitis?	HSV-1 infection
What are common symptoms of HSV-1 induced sporadic encephalitis?	Mental status changes, seizures, and/or aphasia
What are the two conditions seen with HSV -2 infections?	1. Herpes genitalis 2. Neonatal herpes
Genital ulcers due to __________ are painful.	HSV-2
Route of transmission of HSV-2?	Sexual contact and Perinatal
Zoster virus refers to which herpes type?	HHV-3
What is the MC complication of Varicella-Zoster-shingles?	Post-herpetic neuralgia
What are common conditions caused by HHV-3 infection?	Varicella-zoster (chickenpox, shingles), encephalitis, and pneumonia
What ganglia are associated with latent HHV-3?	Dorsal root and trigeminal ganglia
Associated ganglia of HSV-2?	Sacral ganglia
Viral meningitis is more common with HSV-1 or HSV-2?	HSV-2
What CN V branch is responsible for Herpes zoster ophthalmicus?	V1
Infection to CNV1 with Varicella-Zoster virus causes?	Herpes zoster ophthalmicus
What is the common name of HHV-4?	Epstein-Barr virus
"Kissing disease" is due to infection with:	EBV
EBV is the same as ______________ .	HHV-4.
What is the Monospot test?	Form of the heterophile antibody test.
Rapid test for infectious mononucleosis due to Epstein–Barr virus (EBV)	Monospot test
A positive Monospot test indicates?	Mononucleosis due to EBV
CMV mononucleosis has a _______________ Monospot test.	Negative
What are clinical features of EBV mononucleosis?	Fever, hepatosplenomegaly, pharyngitis, and lymphadenopathy
Which lymph nodes are most affected by EBV mononucleosis?	Posterior cervical nodes
Posterior cervical node enlargement is most likely due to:	Mononucleosis due to EBV infection
Malignancies associated with EBV are:	1. Lymphoma (Burkitt) 2. Nasopharyngeal carcinoma (Asian adults) 3.. Lymphoproliferative disease in transplant patients
What cells are most affected by EBV?	B cells through CD21
What receptor is use by EBV in B cells to better infect?	CD21
What is the result of treating EBV mononucleosis with amoxicillin?	Characteristic maculopapular rash
Burkitt lymphoma is commonly seen with _______________ infection.	EBV
What is the mode of transmission of CMV?	Congenital transfusión, sexual contact, saliva, urine and transplant
Which kind of patients are more susceptible for (-) monospot mononucleosis?	Immunocompetent
Which population is at risk of severe complications with CMV infection?	ImmunoCOMPROMISED
What are some conditions associated with CMV infection in those immunocompromised?	1. Pneumonia -- transplant patients 2. Esophagitis 3. AIDS ---> Retinitis
Which cells keep latent form of CMV?	Mononuclear cells
What is the histologic key feaute of CMV infected cells?	"Owl eye" intranuclear inclusions
What is the common name for HHV-5?	Cytomegalovirus
How is CMV retinitis presented?	Hemorrhage, cotton-wool exudates, and vision loss
Cotton-wool exudates is a key finding for:	CMV-retinitis
Which two forms of herpesvirus give rise to Roseola?	HHV-6>> HHV-7
How is Roseola clinically described?	Fever first, Rosy (rash later)
Another name for Roseola infantum?	Exanthem subitum
High fevers for several days that can cause seizures, followed by diffuse macular rash.	Roseola infantum
Key fever for Roseola infantum?	High fever for several days
Kaposi Sarcoma is due to what infectious agent?	HHV-8
Neoplasm of endothelial cells due to HHV-8 infection in HIV patient.	Kaposi sarcoma
What is the description of Kaposi sarcoma?	Dark/violaceous plaques or nodules representing vascular proliferations
What organs are most affected by Kaposi sarcoma?	Skin>>>> GI tract and lungs
What HSV identification is used for herpes encephalitis?	CSF PCR
What virus is identified with the Tzanck test?	Herpes simplex
A smear of an opened skin vesicle detect multinucleated giant cells commonly seen in HSV-1, HSV-2, and VZV infection.	Tzanck test
What histological finding is seen in HSV-1, HSV-2, and VZV?	Intranuclear eosinophilic Cowdry A inclusions
What receptors are used by CMV?	Integrins (heparan sulfate)
Heparan sulfate or integrins are used as receptor by __________.	CMV
CD 21 are the receptors used by __________.	EBV
Which receptors are used by EBV?	CD21
What are the receptors used by HIV?	CD4, CXCR4, and CCR5
What receptors are used by Parvovirus B19?	P antigen on RBCs
Where is the P antigen used by Parvovirus B19 located?	On the RBCs
Which virus used Nicotinic AChR (receptor) for infection?	Rabies
The ICAM-1 serves as receptor for which virus?	Rhinovirus
What is the receptor used by Rhinovirus?	ICAM-1
Which are the exceptions to RNA viruses all replicating in the cytoplasm?	Retrovirus and Influenza virus
What are the medically relevant conditions associated with Reovirus infection?	1. Coltivirus - Colorado tick fever 2. Rotavirus - cause of fatal diarrhea in children
What virus is responsible for the Colorado tick fever?	Coltivirus
The Rotavirus is part o the _______________ viral family.	Reoviridae
What is the structure of Reovirus?	Naked, ds-stranded, linear RNA virus
What is the capsid shape of reoviruses?	Icosahedral (double)
How many segments does Reoviruses usually have?	10-12
NOn-enveloped, (+) single-stranded, linear RNA viral families?	Picornavirus, Hepevirus, Caliciviruses
What mnemonic is used to recall the associated pathologies due to Picornaviruses?	PERCH
PERCH stands for:	P- Poliovirus -polio Salk/Sabin vaccines - IPV/OPV E- Echovirus - aseptic meningitis R- Rhinovirus - "common cold" C- Coxsackievirus - aseptic meningitis; herpangina; hand, foot, and mouth disease, myocarditis; pericarditis H- HAV - acute viral hepatitis
Which two Picornaviruses are causative of aseptic meningitis?	Echovirus and Coxsackie virus
What is herpangina?	Mouth blisters and fever
What virus causes Hand, foot, and Mouth disease?	Coxsackievirus
The Rhinovirus is the most common cause of the _______________.	Common cold
What is the organism that causes the common cold?	Rhinovirus
HEV is part of the _____________ viral family.	Hepeviridae
What is the most common Calicivirus?	Norovirus
What is the result a Norovirus infection?	Viral gastroenteritis
Enveloped, SS (+) linear, Icosahedral capsid. Seen with which RNA viruses?	Flaviviruses and Togavirus
What is the difference between the structure of Togaviruses and Flaviviruses, to that of Coronavirus?	Coronavirus family have a helical caspied while Togaviruses and Flaviviruses have a Icosahedral capsid symmetry
What are the Medical relevant Flaviviruses pathologies?	1. HCV 2. Yellow fever 3. Dengue 4. St. Louis encephalitis 5. West Nile virus - meningoencephalitis 6. Zika virus
HCV is a _______________________.	Flavivirus
What is the molecular shape of HCV and Yellow fever?	Enveloped SS(+), linear icosahedral
Rubella is caused by _______________ viral family	Togavirus
What are the 3 main associated conditions of Togaviruses?	Rubella, Western and Eastern equine encephalitis, and Chikungunya virus
Chikungunya virus is part of the _________ viral family.	Togaviridae
What is very special about retroviruses?	Have reverse transcriptase
What are two common Retroviruses?	HTLV ---> T-cell leukemia HIV ----> AIDS
Coronavirus is :	Enveloped, single stranded (+) sense, linear and with a helical capsid
What are common Coronavirus conditions?	"Common cold", SARS, MERS, and COVID-19.
SARS and MERS are both _______________.	Coronaviruses
How many segments are in Orthomyxoviruses?	8 segments
What is the most common Orthomyxovirus?	Influenza virus
The influenza virus is an ____________________, that replicates in the ____________.	Orthomyxovirus; nucleus
What are the 4 main Paramyxoviruses?	Parainfluenza, RSV, and Measles, Mumps
Parainfluenza virus is an ___________________ that causes _________.	Paramyxovirus; Croup
MCC of bronchiolitis in babies?	RSV
RSV is an _________________.	Paramyxovirus
Measles and Mumps, both are _______________.	Paramyxoviruses
What the genomic structure of Rhabdoviruses?	Enveloped, SS (-) linear, helical RNA virus
What is the condition caused by Rhabdoviruses?	Rabies
Common types of Filovirus?	Ebola/Marburg hemorrhagic fever
Ebola is a type of __________.	Filovirus
How many segments are in Arenavirus?	2
2 Conditions due to Adenovirus?	1. LCMV- Lymphocytic choriomeningitis virus 2. Lassa fever encephalitis
What animals spread the Lassa fever encephalitis virus?	Rodents
Viral genome of Bunyaviruses is seen in _______ segments	3
What are 4 conditions/viruses of the Bunyaviridae family?	1. California encephalitis 2. Sandfly/Rift Valley fevers 3. Crimean-Congo hemorrhagic fever 4. Hantavirus - hemorrhagic fever, pneumonia
HDV is a ____ virus	Delta
Which is known as a "defective" virus	HDV
Negative stranded viruses must --->	Transcribe (-) strand to (+)
What is "brought by negative stranded virions" in order to transcribe into (+ ) strand?	RNA-dependent RNA polymerase
Which are the negative stranded viruses?	Arenavirus, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, Filoviruses, and Rhabdoviruses
BOAR stands for:	Bunyavirus, Orthomyxoviruses, Arenaviruses, and Reoviruses
Which mnemonic is used to remember the Segmented viruses?	BOAR
What are the common symptoms of the Yellow fever virus?	High fever, black vomit, and jaundice
What the key histological findings of liver bx in a patient with Yellow fever virus?	Councilman bodes
What are the Councilman bodies?	Eosinophilic apoptotic globules
What condition is seen with the appearance of Councilman bodies on liver biopsy?	Yellow Fever
What are the two most common reservoirs of Yellow fever virus?	Monkeys and humans
Flavi =	Yellow, jaundice
Yellow fever virus is an ________________________.	Flavivirus
What is the most important cause of infantile gastroenteritis?	Rotavirus
A rotavirus is recommended for all infants except for those with:	Hx of Intussusception or SCID
What virus is the MCC of acute diarrhea in winter in places such as day care centers and kindergartens?	Rotavirus
What is the result of the villous destruction with atrophy caused by Rotavirus?	Decreased absorption of Na+ and loss of K+
Rotavirus is a ___________________________________.	Segmented dsRNA virus (a reovirus)
Influenza viruses are:	Orthomyxovirus. Enveloped, (-) ssRNA viruses with 8-segment genome.
What are two important antigens in the Influenza viruses?	1. Hemagglutinin 2. Neuraminidase
What is the role of Hemagglutinin in the influenza virus?	Binds sialic acid and promotes viral entry
What influenza antigen promotes viral entry?	Hemagglutinin
What is the function of the Neuraminidase antigen in Influenza viruses?	Promotes progeny virion release
Which influenza virus antigen promotes the release of progeny virion?	Neuraminidase
A coinfection with some bacteria and the Influenza virus leads to a:	Fatal bacterial superinfection
Which are the most common bacteria that produce a fatal bacterial superinfection as they are co-infectious with influenza virus?	S. aureus, S. pneumoniae, and H. influenzae
What does the"flu shot" contain?	Viral strains most likely to appear during the flu season, due to virus' rapid genetic change
The "flu shot" is a vaccine for what organism?	Influenza virus
What route is used for the Live attenuated Influenza vaccine?	Intranasal
What is special about the Live attenuated influenza vaccine?	Contains a temperature-sensitive mutant that replicates in the nose bu not in the lung.
What type of antigenic change are responsible for PANDEMICS?	Genetic/antigenic shift
What is a antigenic shift?	Reassortment of viral genome segments
What is an antigenic drift?	Minor changes based on random mutation in hemagglutinin or neuraminidase genes
The combination of human flu A virus reassortant with swine flu A virus.	Antigenic shift
An antigenic shift or antigenic drift is more severe?	Antigenic shift
What was the old name of Rubella?	German (3-day) measles
What are the clinical symptoms of Rubella?	Fever, postauricular and other lymphadenopathy, arthralgias, and fine, maculopapular rash that starts on face and spreads centrifugally to involve trunk and extremities
How is the rash seen in Rubella spread?	Starts on face; Spreads centrifugally to involve trunk and extremities
German (3-day) measles is also known as:	Rubella
What are some important features of Congenital Rubella?	"blueberry muffin" appearance due to dermal extramedullary hematopoiesis.
What is the expression of dermal extramedullary hematopoiesis in Rubella?	"blueberry muffin" appearance
What population is most affected by Paramyxoviruses?	Children
What diseases are caused by Paramyxoviruses?	Parainfluenza (croup), mumps, measles, RSV, and human metapneumovirus, which causes bronchiolitis or pneumonia in infantas
What is the function of surface F (fusion) protein in Paramyxoviruses?	Respiratory epithelial cells to fuse and form multinucleated cells
What is the best treatment for RSV infection in infants?	Palivizumab
Palivizumab is n:	Monoclonal antibody against F protein
What condition is treated with Palivizumab?	Infant-bronchiolitis caused by RSV
What is the typical description of cough seen in Croup?	"seal-like" barking cough and inspiratory stridor
What are classign findings on x-ray of Croup?	Narrowing of upper trachea and subepiglottic leads to characteristic steeple sign
X-ray finding --> "Steeple sign". Dx?	Croup
What is a possible complication of severe croup?	Pulsus paradoxus secondary to upper airway obstruction
What are the 3 C's of measles?	Cough Coryza Conjunctivitis
What vitamin supplementation has proven to reduce morbidity and mortality of Meals (rubeola)?	Vitamin A
What is another name used for Measles?	Rubeola
What are the bright red spots with blue-white center on buccal mucosa seen in Measles?	Koplik spots
What is happens 1-2 days later appearance of Koplik spots in a Measles patient?	Maculopapular rash that starts at the head/neck and spreads downward
How does the measles (rubeola) rash spreads?	Downward
What are histological findings in the lymphadenitis caused by Measles?	Warthin-Finkeldey giant cells in background of paracortical hyperplasia.
What are three possible sequelae of Measles virus infection?	1. SSPE (Subacute Sclerosing Panencephalitis) 2. Encephalitis 3. Giant cell pneumonia
What viral family causes Mumps?	Paramyxovirus
What vaccine is used to prevent mumps?	MMR vaccine
What are the most significant signs and symptoms of mumps?	Parotitis, Orchitis, aseptic Meningitis, and Pancreatitis
If mumps happen after ____________________-, it is much highly probable to cause infertility.	Puberty
What is severe complication of mumps after puberty?	Infertility
What is orchitis?	Inflammation of testes
Bulle-shaped virus.	Rabies virus
Which virus has Negri bodies (cytoplasmic inclusions)?	Rabies virus
Where are Negri bodies found in the patient infected with Rabies?	Purkinje cells of cerebellum and in hippocampal neurons
What is post exposure prophylaxis to Rabies virus?	Wound cleaning plus immunization with killed vaccine and rabies immunoglobulin.
What is the incubation period of Rabies virus?	Weeks to months
Rabies virus travels to the CNS in a ______________________ fashion.	Retrograde
What receptors do Rabies virus bind to in order to retrogradely travel to the CNS?	ACh receptors
What is the progression of Rabies?	Fever, malaise --> agitation, photophobia, hydrophobia, hypersalivation --> paralysis, comma --> death.
Patient with too much saliva, bothered by lights and refuse to drink water. Dx?	Rabies
What are the most common animal bites that transmit rabies?	Bat, raccon, and skunk
Person in a bat cave is possible to contract what via aerosol transmission?	Rabies virus
What is the target of the Ebola virus?	Endothelial cells, phagocytes, hepatocytes.
What are some severe complications of Ebola virus infection?	DIC, diffuse hemorrhage, shock
Ebola's mode of transmission.	Requires direct contact with bodily fluids, fomites, infected bats or primates.
What is the incubation period (time) of Ebola?	21 days
What laboratory technique is used to diagnose Ebola?	RT-PCR within 48 hours of symptoms onset
What is the mosquito that transmits ZIka virus?	Aedes mosquito bites
Common flavivirus	Zika virus
What are fetal complications of Zika virus infection?	Congenital microcephaly or miscarriage
What areas are most commonly affected by Zika virus?	Tropical and subtropical climates
Besides Aedes mosquito bites, how else is Zika virus transmitted?	Sexual and vertical transmission
What are common symptoms of Zika virus infection?	Conjunctivitis, low grade pyrexia, and possible itchy rash
What are the signs and symptoms of all hepatitis viruses?	1. Episodes of fever 2. Jaundice 3. Elevated ALT and AST
Which two hepatitis viruses are NOT destroyed by the gut?	HAV and HEV
Why are HAV and HEV not destroyed by the gut?	They lack envelope
What is a unique activity or feature of HBV?	HBV DNA polymerase has DNA- and RNA-dependent activities
Why is there variation in antigenic structures of HCV envelope proteins?	HCV lacks 3'-5' exonuclease activity --> no proofreading ability
HAV belongs to which viral family?	RNA picornavirus
WHat is the viral family of HBV?	DNA hepadnavirus
Which is the only DNA hepatitis virus?	HBV
Which hepatitis virus is of RNA flavivirus family?	HCV
HDV is part of the _______________________ viral family.	RNA deltavirus
RNA hepevirus gives rise to which hepatitis virus?	HEV
Which two hepatitis viruses have long incubation periods?	HBV and HCV
Which hepatitis infection ins seem clinically mostly asymptomatic and acute?	HAV
Clinical presentation of HBV infection.	Initially like serum sickness (fever, arthralgias, rash); then may progress to carcinoma
HCV is clinically presented with:	Possible progression to cirrhosis or carcinoma
Which Hepatitis virus a similar clinical view as HBV?	HDV
Fulminant hepatitis in expectant (pregnant) women?	HEV
Which hepatitis infection has a high mortality in pregnant women?	HEV
What is the most common prognosis of an HAV infection?	Good prognosis
Hepatitis infection associated with Superinfection?	HDV infection after HBV
Coinfection of HDV and HBV produces a ____________ incubation period.	Long
Which hepatitis viruses carry HCC development risk?	HBV, HCV, and HDV
HAV and HEV have short incubation periods and both do not --->	Progress to HCC
What are the findings in HAV liver biopsy?	Hepatocyte swelling, monocyte infiltration, and Councilman bodies
What histologic finings is characterisctic of HAV infection ?	Councilman boides
What is the description to liver biopsy in a HBV (+) patient?	Granular eosinophilic "ground glass" appearance; cytotoxic T cell mediated damage
Lymphoid aggregates with focal areas of macrovesicular steatosis	HCV liver biopsy
Which hepatitis liver bx finding is described as "ground glass" appearance?	HBV infection
Macrovesicular steatosis is found in _______ liver biopsy	HCV
Description of HEV liver biopsy.	Patchy necrosis
Which two hepatitis have carrier states?	HBV and HCV
What is the hematologic extrahepatic manifestation of Hepatitis B infection?	Aplastic anemia
What are the most common hematological manifestations of HCV infection?	1. Essential mixed cryoglobulinemia 2. Increased risk B-cell NHL 3. Autoimmune hemolytic anemia
Which are the renal extrahepatic manifestations of HBV and HCV infections?	1. Membranous GN 2. Membranoproliferative GN
HBV infection has more cases of __________________________ as an renal extrahepatic manifestation.	Membranous GN
What is the most common vascular extrahepatic manifestation of Hepatitis B infection?	Polyarteritis nodosa
Leukocytoclastic vasculitis is often associated with HBC as:	Vascular extrahepatic manifestation
Which infection, HBV or HCV, has more extrahepatic manifestations?	HCV
How are some forms of cutaneous manifestation of HCV infection?	Sporadic porphyria cutanea tarda, and lichen planus
What are endocrine manifestations of HCV infection?	Increased risk of diabetes mellitus and autoimmune hypothyroidism.
Serologic marker for acute hepatitis A	Anti-HAV (IgM)
IgG antibody indicates prior HAV infection and/or prior vaccination.	Anti-HAV (IgG)
Which hepatitis A serologic marker indicates protection against reinfection?	Anti-HAV (IgG)
Which HBV antigen indicates Hepatitis B infection?	HBsAg
Where is HBsAg found?	On surface of HBV
What does Anti-HBs indicate?	Immunity to hepatitis B due to vaccination or recovery from infection
Which hepatitis serologic marker is associated with core of HBV?	HBcAg
What is Anti-HBc?	Antibody to HBcAg
IgM Anti-HBc indicates:	Acute/recent infection
IgG Anti-HBc indicates:	Prior exposure or chronic infection
What is the sole marker during the window period of HBV infection?	IgM anti-HBc
Which Hepatitis B serum marker indicates active viral replication and high transmissibility?	HBeAg
Anti-HBe indicates?	Low transmissibility
What hepatitis B serum marker is secreted by infected hepatocyte into circulation?	HBeAg
Active HBV replication is indicated by which serologic marker?	HBeAg
Which serum marker is (+) in an immunized Hepatitis B virus?	Anti-HBs
Acute infection with HBV is positive for the following serum markers:	HBsAg + HBeAg + IgM anti-HBc
HBsAg + HBeAg + IgG anti-HBc	Chronic HBV (high infectivity)
A patient in HBV infection recovery is seen with (+) serum markers:	Anti-HBs + Anti-HBe + IgG anti-HBc
What patient HBV infection status has (+) for all antibodies?	Recovery
Which serum marker distinguishes a patient with low and high HBV infectivity?	Low infectivity is (+) Anti-HBe, and high is (+) for HBeAg
Which are the 2 HIV envelope proteins?	gp41 and gp120
In HIV, which protein is the "Docking glycoprotein"?	gp120
How are gp41 and gp120 (HIV envelope proteins) acquired?	Budding from host cell plasma membrane
How is the HIV genome?	Diploid genome (2 molecules of RNA)
What doe it mean the HIV has a diploid genome?	2 molecules of RNA
What are the 3 structural genes of HIV?	1. env (gp120 and gp41) 2. gag (p24 and p17) 3. pol
The gag gene in HIV is:	Composed of p24 and p17, which code for capsid and matrix proteins respectively.
gag p24 component codes for:	Capsid of HiV
What are the components (enzymes) of the HIV structural gene "pol"?	Reverse transcriptase, aspartate protease, and integrase
What is the primary receptor for HIV?	CD4
What are co receptors used by the HIV?	1. CCR5 on macrophages (early infection) 2. CXCR4 on T cells (late infection)
The binding of HIV to CCR5 indicates:	1. Early infection 2 Binding to macrophages
HIV binds to CXCR4 on which cells?	T cells
HIV binding to CXCR4 on T cells indicaties:	Late infection
What does a homozygous CCR5 mutation produce?	Immunity to HIV
What mutation is needed to create a slower course for HIV infection?	Heterozygous CCR5 mutation
What lab technique is used to diagnose Presumptive HIV?	HIV-1/2 Ag/Ab immunoassays
What is detected with HIV-1/2 Ag/Ab immunoassay?	Viral p24 Ag capsid protein and IgG Abs to HIV-1/2
What is the confirmatory test for HIV?	HIV-1/2 Ab-differentiation immunoassays
Four stages of untreated HIV infection:	1. Flu-like (acute) 2. Feeling fine (latent) 3. Falling count 4. Final crisis
What happens during latency phase of HIV?	Virus replicates in lymph nodes
When does a an AIDS-defining illnesses emerge?	< 200 CD4+ cells/mm3
What is the presentation of candida albicans infection when the CD4+ count is < 500?	Oral thrush; a scrapable white plaque, pseudohyphae on microscopy .
Describe Oral hairy leukoplakia	Un-scrapable white plaque on lateral tongue
Which oral plaque is unscrapable?	Oral hairy leukoplakia
Which opportunistic organisms cause Oral hairy leukoplakia in HIV patients with CD4+ count < 500?	EBV
List of organisms that cause opportunistic infections in HIV patients with CD4+ count < 500?	Candida albicans, EBV, HHV-8, and HPV
Kaposi sarcoma?	Caused by HHV-8 in AIDS patients with CD4+< 500
What is the presentation of HPV infection when CD4+ count is < 500 cells?	Squamous cell carcinoma, commonly in anus ( men who have sex with men) or cervix (women)
HPV affects homosexual men in the ______________.	Anus
Which anatomical part is affected in females with HPV infection and CD4+ cell count less than 500?	Cervix
What are common organisms that produce disease in HIV patients with a CD4+ count < 200?	Histoplasma capsulatum, HIV, JC virus, and Pneumocystis jirovecii
Presentation of Histoplasma capsulatum infection in HIV patient?	Fever, weight loss, fatigue, cough, dyspnea, nausea, vomiting ,and diarrhea
AIDS patient with CD4+ of 198, shows clear signs of dementia. MC affecting organism?	HIV
What organism (virus) presents with this finding "Non Enhancing areas of demyelination on MRI"	JC virus (reactivation)
"Ground-glass" opacities on CXR	Pneumocystis jirovecii
What are the findings of Aspergillus fumigatus infection in AIDS patient with CD4 + cell count of < 100?	Cavitation or infiltrates on chest imaging
What organism causes Bacillary angiomatosis in AIDS patient?	Bartonella henselae
What is the clinical presentation and findings of C. albicans infection in an AIDS patient with CD4+ count <100?	Esophagitis; White plaques on endoscopy; yeast and pseudohyphae on biopsy
CMV causes an opportunistic infection with the CD4+ count is less than:	100
What are the clinical presentation of CMV infection in a patient with AIDS?	Retinints, esophagitis, colitis, pneumonitis, and encephalitis
Linear ulcers on endoscopy + cotton-wool spots on fundoscopy?	Retinitis and esophagitis caused by CMV in AIDS patient
EBV clinical presentation in patient with CD4+ cell count of 99?	B-cell lymphoma (non-Hodgkin lymphoma, CNS lymphoma)
CNS lymphoma caused by EBV is found on MRI as:	Solitaire ring enhancing lesion
Multiple ring-enhancing lesions on MRI.	Toxoplasma gondii infection AIDS patient
What organism causes the development of brain abscesses in AIDS patient with a CD 4+ < 100?	Toxoplasma gondii
What are three common Prion diseases?	1. Creutzfeldt-Jakob disease 2. Bovine spongiform encephalopathy 3. Kuru
Rapidly progressive dementia, typically sporadic, caused by prions. Dx?	Creutzfeldt-Jakob disease
What is another name for Bovine spongiform encephalopathy?	Mad Cow disease
Which population is commonly seen to develop Kuru?	Human cannibals
What condition is an acquired prion disease noted in tribal population practicing human cannibalism?	Kuru
What is the main reason for Prion disease development?	Conversion of a normal (predominantly a-helical) protein termed prion protein (PrpP c) to a B-pleated form.
What are the shared clinical manifestation of all prion disease?	Spongiform encephalopathy and dementia, ataxia, and death
Which form of prion protein is resistant to protease degradation?	B-pleated form (PrP sc) protein
What is the most common normal flora in the skin?	S. epidermidis
What microorganism are the MC flora in the nose?	S. epidermidis; colonized by S. aureus
What gram positive bacteria is known to readily colonize the nose?	S. aureus
What is the dominant flora found in the Oropharynx?	Viridans group streptococci
Viridans group streptococci are dominant flora in the __________________.	Oropharynx
Which microorganism is found normally in dental plaque?	S. mutans
What are the two dominant microorganisms that colonize the colon?	B. fragilis > E. coli
Normal dominant flora of the vagina?	Lactobacillus
What microoganism are nkonw to colonize the vagina floara?	E. coli and group B strep
What delivery method gives neonates no flora?	C-section
Which microorganisms are known to cause food poisoning that starts quickly and ends quickly?	S. aureus and B. cereus
Source of infection of B. cereus?	Reheated rice
What kind of microorganism is associated with reheated rice?	B. cereus
Which are some source os C. botulinum infection?	Improperly canned food (toxins), raw honey (spores)
Which food type commonly provides spore form of C. botulinum?	Raw honey
What form of C. botulinum is found in improperly canned foods?	C. botulinum toxins
Reheated meat?	C. perfirengs
What organism is found to be causing disease in undercooked meat?	E. coli O157: H7
Which food type is classically known wth cause an E. coli O157:H7 infection?	Undercooked meat
L. monocytogenes causes foodborne illness by the consumption of :	Deli meats and soft cheeses
What are common sources of food-illness caused by Salmonella?	Poultry, meat, and eggs
Meats, mayonnaise, custard; preformed toxin. MC microorganism?	S. aureus causing food-borne illness
Contaminated seafood causes an foodborne illness by the infection with:	V. parahaemolyticus and V. vulnificus
V. vulnificus can cause:	1. Foodborne illness by ingestion 2. Wound infections by contact with contaminated water or shellfish.
List of bugs that cause BLOODY diarrhea	1. Campylobacter jejuni 2. E. histolytica 3. Enterohemorrhagic E. coli 4. Enteroinvasive E. coli 5. Salmonella (non-typhoidal) 6. Shigella 7. Y. enterocolitica
Which comma-or S-shaped organism that grows at 42 C causes bloody diarrhea?	C. jejuni
What are some features of E. histolytica?	Protozoan; amebic dysentery; liver abscess
Which is a protozoan cause of bloody diarrhea?	E. histolytica
Amebic dysentery is caused by:	E. histolytica
O157:H7; can cause HUS; makes Shiga-like toxin	Enterohemorrhagic E. coli
Which type of E. coli invades the colonic mucosa?	Enteroinvasive E. coli
Why type of Salmonella causes bloody diarrhea?	Non-typhoidal
Features of nontyphoidal Salmonella:	Lactose (-); flagellar motility; has animal reservoir, especially poultry and eggs
What bloody causing microorganism produces the Shiga toxin?	Shigella
What type of dysentery is seen with Shigella?	Bacillary
Bacillary dysentery. MC infective microorganism?	Shigella
Common cause of Daycare bloody diarrhea outbreaks?	Y. enterocolitica
What infection is responsible for bloody diarrhea and pseudoappendicitis?	Y. enterocolitica
List of bugs that are known to cause Watery diarrhea	1. C. difficile 2. C. perfringens 3. Enterotoxigenic E. coli 4. Giardia and Cryptosporidium (protozoans) 5. V. cholerae 6. Viruses (rotavirus, norovirus, enteric adenovirus)
C. difficile causes diarrhea?	Watery mostly but sometimes bloody
Pseudomembranous colitis is due to infection with:	C. difficile
What organism causes watery diarrhea and gas gangrene?	C. perfringens
What E. coli type causes Travelers' diarrhea?	Enterotoxigenic E. coli
What are the types of protozoa that cause watery diarrhea?	Giardia and Cryptosporidium
Rice water diarrhea is due to ___________________ infection.	V. cholerae
What are the common viruses that provoke watery diarrhea?	Rotavirus, Norovirus, and enteric adenovirus
Viruses are more prone to cause ________________ diarrhea.	Watery
What are the two main causes of pneumonia in neonates (<4wk)?	1. Group B streptococci 2. E. coli
MCC of Pneumonia in children of 4 weeks old to 18 years?	1. Viruses (RSV) 2. Mycoplasma 3. C. trachomatis (infants - 3 year old) 4. C. pneumoniae (school aged children) 5. S. pneumoniae
What is the MCC of pneumonia in an adult of 18-40 yr?	Mycoplasma
What is the MCC of pneumonia in adults over 40 and elderly?	S. pneumoniae
Which virus is most common shared causes of pneumonia in all adults over 18 years of age?	Influenza virus
What is the second MCC of pneumonia in an 50 year old adult?	H. influenzae
What are the most common causes of pneumonia in alcoholics?	1. Klebsiella 2. Anaerobes due to aspiration
IV drug user MCC of pneumonia are:	S. pneumoniae and S. aureus
Anaerobes are the MCC of pneumonia due to ______________.	Aspiration
What are the MCC of atypical pneumonia?	Mycoplasma, Chlamydophila, Legionella, viruses (RSV, CMV, influenza, adenovirus)
A patient with Cystic fibrosis most commonly will develop pneumonia due to the following infections:	Pseudomonas, S. aureus, S. pneumonie, and Burkholderia cepacia
Pseudomonas infection often causes pneumonia in _____________ patients.	Cystic fibrosis
What are the MCC of nosocomial acquired pneumonia?	S. aureus, Pseudomonas, and other enteric gram (-) rods
What are the MCC of pneumonia to the immunocompromised?	S. aureus, enteric gram (-) rods, fungi, viruses, P. jirovecii
An HIV patient MCC of pneumonia is due to _______________ infection.	P. jirovecii
What are post viral causes of pneumonia?	S. pneumoniae, S. aureus, and H. influenzae
Top 3 causes of Meningitis in the Newborn	1. Group B streptococci 2. E. coli 3. Listeria
Top causes of meningitis in children between 6 months and 6 years old	S. pneumoniae N. meningitis H. influenzae type b Enteroviruses
What is the #1 causes of meningitis in teens?	Neisseria meningitidis
What is the most common cause of meningitis for any person over the age of 6 years old, except for teens?	S. pneumoniae
What is the second MCC of meningitis in the elderly?	Gram (-) rods
What is the empiric treatment of bacterial meningitis?	Ceftriaxone and vancomycin
What medication is added to the empiric treatment of bacterial meningitis if Listeria is suspected to be the cause of the infection?	Ampicillin
What are the most common causes of viral meningitis?	Enteroviruses, HSV-2, HIV, West Nile virus, and VZV
Which is the most common enterovirus that causes viral meningitis?	Coxsackievirus
MCC of meningitis in HIV patient	Cryptococcus spp
As of today, most cases of H. influenzae type b meningitis, are due to:	Unimmunized children
What cell type is predominant in Bacterial meningitis?	PMNs
Decreased levels of glucose are seen in which type(s) of meningitis causes?	Bacterial and fungal/TB
Increased lymphocytes in CSF are found in ____________ and ____________ causes of meningitis.	Viral and Fungal/TB
Which are the two distinguish CSF findings for Bacterial meningitis?	1. Predominant PMNs in CSF 2. Decreased glucose levels in CSF
CSF findings of Fungal/TB meningitis are distinctive due to:	Increased levels of lymphocytes and decreased glucose level
Elevated protein levels are seen in which type of meningitis?	All have increased protein levels
What are the MCC of infections cause brain abscesses?	Viridans streptococci and Staphylococcus aureus
What is the most common reason for multiple brain abscesses due to infections?	Due to bacteremia
Toxoplasma gondii reactivation in HIV patients causes?	Multiple brain abscesses
What lobe is often affected by multiple brain abscess in cases of Otitis media and mastoiditis?	Temporal lobe and cerebellum
What conditions lead to appearance of multiple brains abscesses in the frontal lobe?	Sinusitis or dental infection
In healthy individual, what is the MCC of Osteomyelitis?	S. aureus
MCC of osteomyelitis in sexually active individual?	Neisseria gonorrhoeae
What is the MCC of Osteomyelitis in a patient with Sickle cell disease?	Salmonella and S. aurus
What infections are prone to cause osteomyelitis in a patient with a prosthetic joint replacement?	S. aureus and S. epidermidis
What microorganisms are involved in infections of osteomyelitis when there in vertebral involvement?	S. aureus, M. tuberculosis
What is Pott disease?	Osteomyelitis with M. TB reactivation and vertebral involvement
What risk factor is commonly seen in Pasteurella multocida-osteomyelitis?	Cat and dog bites
What are the most common causes of Osteomyelitis in IV drug users?	S. aureus; also Pseudomonas and Candida
What is the best diagnostic tool for diagnosing Osteomyelitis?	MRI
What two inflammatory proteins are elevated in osteomyelitis but are not specific enough for diagnosis?	Elevated C-reactive protein (CRP) and ESR
What are the main presenting signs of cystitis?	Dysuria, frequency, urgency, suprapubic pain, and WBCs (not WBC casts) in urine.
What is the main reason for development of cystitis?	Ascension of microbes from urethra to bladder
The ascension of microbe from bladder to kidney results in development of:	Pyelonephritis
What are the presenting signs of Pyelonephritis?	Fever, chills, flank pain, costovertebral angle tenderness, hematuria, and WBC casts.
Which urinary disorder presents with WBC casts, cystitis or pyelonephritis?	Pyelonephritis
Key: Costovertebral angle tenderness and WBC casts. Dx?	Pyelonephritis
Which gender is more common to develop an URI?	Women
What is the main reason women are more prone to develop an URI?	Shorter urethras colonized by fecal flora
What are the diagnostic markers of URIs?	1. (+) Leukocyte esterase 2. (+) Nitrite test 3. (+) Ureae test
A positive leukocyte esterase test indicates:	Evidence of WBC activity in the urine sample
(+) Nitrite test indicates --->	Reduction of urinary nitrates by bacterial species (E. coli)
Which bacterial infections produce an (+) Urease test in urine sample?	S. saprophyticus, Proteus, and Klebsiella
What is the leading cause of UTIs?	E. coli infection
What is the second leading cause of UTI in sexually active women?	S. saprophyticus infection
What is the third MCC of UTI?	Klebsiella infection
What organism produces a red pigment, and is often seen in nosocomial and drug resistant UTIs?	Serratia marcescens
What are the features of UTI due to Proteus mirabilis infection?	Motility causes "swarming" on agar; associated with struvite stones
Blue-green pigment and fruity odor; usually nosocomial and drug resistant?	Pseudomonas aeruginosa
What are the signs and symptoms of Bacterial vaginosis?	- No inflammation - Thin, white discharge with fishy odor
What some key lab findings of bacterial vaginosis?	Clue cells pH > 4.5
What is the treatment of Gardenella vaginosis?	Metronidazole or clindamycin
What are the most significant signs and symptoms of Trichomonas vaginitis?	1. Inflammation ("strawberry cervix") 2. Frothy, yellow-green, foul-smelling discharge
What are some lab findings in Trichomonas vaginitis?	Motile trichomonads and pH > 4.5
What is the treatment for patient and patient's partner of Trichomonas vaginitis?	Metronidazole
Candida vulvovaginitis is clinically presented with:	1. Inflammation 2. Thick, white, "cottage cheese" discharge
What are lab findings in Candida vulvovaginitis?	- Pseudohyphae - pH normal (4.0-4.5)
What is the best treatment option for Candida vulvovaginitis?	Azoles
Thin, white discharge with fishy odor	Bacterial (gardenella) vaginosis
Frothy, yellow-green, foul-smelling discharge	Trichomonas vaginitis
Thick, white, "cottage cheese" discharge	Candida vulvovaginitis
Which common vaginal infection is seen with pH> 4.5?	Bacterial vaginosis and Trichomonas vaginitis
How is the pH in Candida vulvovaginitis?	Normal (4.0-4.5)
Clue cells are seen in :	Bacterial vaginosis
Metronidazole is the best option to treat which common vaginal infections?	Bacterial vaginosis and Trichomonas vaginitis
"Strawberry cervix"	Trichomonas vaginitis
Which vaginal infection is seen histologically, with Pseudohyphae?	Candida vulvovaginitis
Azoles are the main option to treat which vaginal infection?	Candida vulvovaginitis
Microbes that may pass from mother to fetus, produce ___________ infections.	Torches
What is the most common type of transmission of TORCHES infections?	Transplacental, except for HSV-2 which is via delivery
What are the nonspecific signs and symptoms of TORCHES infections?	Hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation
What are some common organisms that cause meningitis in neonates?	Strepto agalactiae, E. coli, and Listeria monocytogenes
Parvovirus B19 infection in fetus causes:	Hydrops fetalis
Neonatal manifestations of Toxoplasma gondii infection:	Classic triad: 1. Chorioretinitis 2. Hydrocephalus 3. Intracranial calcifications +/- "blueberry muffin" rash
Modes of maternal transmission of Toxoplasma gondii	Cat feces or ingestion of undercooked meat
What are the maternal manifestations of Toxoplasma gondii infection?	Usually asymptomatic; lymphadenopathy (rarely)
How is the maternal transmission of Rubella?	Respiratory droplets
What are the maternal manifestations of Rubella?	Rash, lymphadenopathy, polyarthritis, and polyarthralgia
What are the neonatal manifestations of Rubella infection?	Classic triad of: Abnormalities of eye (cataract) and ear (deafness and congenital heart disease (PDA). +/- "blueberry muffin" rash
Cataracts, deafness, and PDA, plus "blueberry muffin" rash. Dx?	Rubella infection neonatal manifestations (Torches)
How is CMV (torches) maternally transmitted?	Sexual contact and/or organ transplant
Which TORCHES infection cause the mother to present mononucleosis-like illness?	Cytomegalovirus
What are the most common neonatal features with CMV infection?	Hearing loss, seizures, petechial rash, "blueberry muffin" rash, chorioretinitis, periventricular calcifications
What are the most common ways a mother can acquire HIV?	Sexual contact and needlestick
What are neonatal presentation of HIV infection?	Recurrent infections and chronic diarrhea
What are , if any, the clinical manifestations of a mother with HSV-2 infection?	Herpetic (vesicular) lesions
Meningoencephalitis, herpetic (vesicular) lesions.	Neonatal manifestations of HSV-2 infection
What syphilis stages are the most common to cause neonatal syphilis infection manistains?	Primary and secondary
What are neonatal manifestations of a TORCHES infection due to Syphilis?	Often result in stillbirth, hydrops fetalis. If child survives, presents with: facial abnormalities, saber chin, and CN VIII deafness
What are some facial abnormalities seen in a neonatal syphilis?	Notched teeth, saddle nose, short maxilla
What type of deafness is produced in a child with neonatal syphilis?	CN VIII (8) deafness
Saddle nose, saber chin, deafness, and notched teeth. Represents what?	Neonatal manifestations of Syphilis
What are the TORCHES infections?	Toxoplasma gondii Rubella CMV HIV HSV-2 Syphilis
What is the syndrome or disease of Coxsackievirus type A?	Hand-foot-mouth disease
Rash seen in Hand-foot-mouth disease?	Oval-shaped vesicles on palms and soles; vesicles and ulcers in oral mucosa.
Red oval-shaped vesicles in hands (palms) and foot (soles), plus vesicles and ulcer in the oral mucosa. Associated disease?	Hand-foot-mouth disease
What is the associated conditions of HHV-6?	Roseola (exanthem subitum)
Descrioption of Roseola rash	Asymptomatic rose-colored macules appear on body after seveal days of high fever; can present with fevrile seizures; usually afect infants
Which population is at highest risk of HHV-6 Roseola?	Infants
A new red rash appears after 3-4 days of high fever. Dx?	Roseola due to HHV-6 infection
Common name for exanthem subitum	Roseola
What is another name for measles?	Rubeola
Description of measles rash	Confluent rash beggining at head and moving down
What are preceding symptoms and signs to the appearance of the red rash of measles?	Cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa
Koplik spots. Dx?	Measles
Where in the body do Koplik spots appear?	Buccal mucosa
What is the old name of Erythema infectiosum?	Fifth disease
What is the description or clinical presentation of the rash caused by Parvobirus B19?	"Slapped cheek" rash on face
What is the most severe risk of Parvovirus B19 infection to a pregnant women?	Hydrops fetalis
Suspect infection of Rubella with which important clinical sign?	Postauricular lymphadenopathy
Where does Rubella and Rubeola rashes start and move?	Start at head and move down
Fine desquamating truncal rash, that began at the head and moved down. Dx?	Rubella
Which rash, Rubella or Measles, start at the hairline?	Rubeola
Rubella's red rash starts at the _____________ and moves down.	Face
German measles =	Rubella
What mouth feature is seen with Rubella?	Forchheimer spots on soft palate
Forchheimer spots appear on _______________________________ infection.	Soft palate of Rubella
What is the associated rash syndrome of Strep pyogenes?	Scarlet fever
Describe the rash seen in Scarlet fever.	Flushed cheeks and circumoral pallor on the face; erythematous, sandpaper-like rash from neck to trunk and extremities and sore throat.
If the red rash starts at the neck and moves down to the trunk and arms, it can be suspected to be?	Scarlet fever
Scarlet fever is due to infection with:	Strep pyogenes
What is the disease that causes a red rash in VZV infection?	Chickenpox
Vesicular rash begins on trunk; spreads to face and extremities with lesions of different stages.	Chickenpox
Where does the Chickenpox rash starts?	Trunk
Red rash, with lesions of different stages.	Chickenpox
What virus produces a chancroid?	Haemophilus ducreyi
What is a chancroid?	Painful genital ulcer with exudate, and inguinal adenopathy
What are the clinical fatures of chlamydia infection?	Urethritis, cervicitis, epididymitis, conjuntivitis, reactive arthritis, and PID
Which subtypes of Chlamydia are the ones causing sexually transmitted diseases?	Chlamydia trachomatis (D-K)
Condylomata acuminata is seen with with organism infection?	HPV-6 and -11
What is condylomata acuminata?	Genital warts; seen with Koilocytes
Clinical features of Genital herpes:	Painful penile, vulvar, or cervical vesicales and ulcers
Which, HSV-2 or HSV-1, is more common to cause genital herpes?	HSV-2
What conditions are associated with Gonorrhea?	Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge
What is the description of the discharge often seen with N. gonorrhoeae infection?	Creamy purulent discharge
Another name for Granuloma inguinale?	Donovanosis
Painless, beefy red ulcer that bleeds readily on contact.	Granuloma inguinale
What organisms are associated in the development of Granuloma inguinale?	Klebsiella granulomatis;
What are histological findings in Granuloma inguinale due to Klebsiella granulomatis infection?	Cytoplasmic Donovan bodies (bipolar staining)
What organism causes Lymphogranuloma venereum?	Chlamydia trachomatis (L1-L3)
Infection of lymphatics; painless genital ulcers, painful lymphadenopathy (buboes)	Lymphogranuloma venereum
Painless chancre	Primary syphilies
What are the clinical features seen in secondary syphilis?	Fever, lymphadenopathy, skins rashes, and condylomata lata
Condylomata lata is seen in:	Secondary syphilis
What organism causes syphilis?	Treponema pallidum
What are the main features of Tertiary syphilis?	Gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil
Gummas are seen in:	Tertiary syphilis
Tabes dorsalis is a neurological manifestation often seen in:	Tertiary syphilis
What are the main bugs causing Pelvic inflammatory disease?	Chlamydia trachomatis and N. gonorrhoeae
What organism is the MCC of bacterial STI in the United States?	C. trachomatis
What are the signs of PID?	Cervical motion tenderness, adnexal tenderness, purulent cervical discharge
What are some conditions that may be part of PID?	Salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess.
Salpingitis is a risk factor for which disorders?	Ectopic pregnancy, infertility, chronic pelvic pain, and adhesions.
What is another name for perihepatitis?	Fitz-Hugh-Curtis syndrome
What is Fitz-Hugh-Curtis syndrome?	Infection and inflammation of liver capsule and "violin string" adhesions of peritoneum to liver.
What organism is causative of development of Fitz-Hugh-Curtis syndrome?	C. trachomatis
What is the risk factor for nosocomial infection with Clostridium difficile?	Antibiotic use
What are the unique signs/symptoms of Nosocomial infection by C. difficile?	Watery diarrhea and Leukocytosis
What are the 2 MCC of nosocomial infections?	E. coli (UTI) and S. aureus (wound infection)
Hospital infections due to aspirations are due infections of which pathogen?	Polymicrobial, gram (-) bacteria, often anaerobes
Clinical presentation of nosocomial infection due to aspiration issues?	Right lower lobe infiltrate or right upper/middle lobe (patient recumbent); purulent malodorous sputum
What are common infectious agents in patients in intravascular catheters?	S. aureus (including MRSA), S. epidermidis (long term), Enterobacter
Infection with Poliovirus to an unvaccinated child will lead to:	Lead to myalgia and paralysis
Asplenic patient are highly susceptible to which organisms?	Encapsulated microbes
Branching rods in oral infection , sulfur granules	Actinomyces israelii
Chronic granulomatous disease	Catalase (+) microbes, especially S. aureus
"Currant jelly" sputum	Klebsiella
Dog or cat bite	Pasteurella multocida
Facial nerve palsy (typically bilateral)	Borrelia burgdorferi (Lyme disease)
Fungal infection in diabetic or immunocompromised patient	Mucor or Rhizopus spp.
Health care provider	HBV, HCV (from needlestick)
Neutropenic patients	Candida albicans (systemic), Aspergillus
Organ transplant recipient	CMV
PAS (+)	Tropheryma whipplei (Whipple disease)
Pediatric infection	Haemophilus influenza (including epiglottis)
Pneumonia in cystic fibrosis, burn infection	Pseudomonas aeruginosa
Pus, empyema, abscess	S. aureus
Rash on hands and feet	Coxsackie A virus, Treponema pallidum, and Rickettsia rickettsii
Sepsis/meningitis in newborn	Group B strep
Surgical wound	S. aureus
Traumatic open wound	Clostridium perfringens
What are the most common Sulfonamides?	Sulfamethoxazole (SMX), Sulfisoxazole, and Sulfadiazine
Trimethoprim is:	Folic acid synthesis and reduction (DNA methylation)
What two categories of antibiotics disrupt the cell wall?	1. Peptidoglycan synthesis 2. Peptidoglycan cross-linking
What two common Glycopeptides?	Vancomycin and Bacitracin
Common Penicillinase-sensitive penicillins:	Penicillin G, V Ampicillin Amoxicillin
Which are some Penicillinase-resistant penicillins?	Oxacillin Nafcillin Dicloxacillin
Common Antipseudomonas?	Ticarcillin and Piperacillin
What is the most common Monobactam?	Aztreonam
What are common Carbapenems?	Imipenem, Meropenem, Ertapenem, and Doripenem
The 30S subunit ribosomes is attacked by:	Aminoglycosides, Glycylcycline, and Tetracyclines
What are the most common aminoglycosides?	Gentamicin Neomycin Amikacin Tobramycin Streptomycin
Three tetracyclines	Tetracycline, Minocycline, and Doxycycline
Which ribosomal subunit do Tetracyclines attack?	30S
Which antibiotic categories act by inhibiting protein synthesis through inactivation of the 50S ribosomal subunit?	Chloramphenicol, Clindamycin, Linezolid, Macrolides, and Streptogramins
What are the MC streptogramins?	Quinupristin and Dalfopristin
Common macrolides?	Azithromycin, Clarithromycin, and Erythromycin
Common antibiotic that disrupts DNA integrity via free radicals?	Metronidazole
Rifampin works by:	Inhibition of mRNA synthesis by the use of an RNA polymerase
Which are the two types of Gyrase antibiotic categories?	Fluoroquinolones and Quinolones
Common Fluoroquinolones	Ciprofloxacin, Levofloxacin
Nalidixic acid is an _________________	Quinolone
Daptomycin works by inhibiting the ______________ _____________.	Membrane integrity
The 50S ribosomal subunit is attacked by:	Chloramphenicol, Clindamycin, Linezolid, Macrolides, and Streptogramins
What medication prevents the formation of THF?	TMP
Which antibiotics are known to inhibit PABA?	Sulfonamides
DNA gyrase is inhibited by _____________________.	Fluoroquinolones
Which antibiotics work on the Cell Wall?	Penicillins and Glycopeptides (vancomycin andbacitrancin)
What forms is Penicillin G found?	IV and IM forms
Penicillin V is only found in the ____________ form.	Oral
Which penicillin, G or V, is administered orally only?	Penicillin V
What are the prototype B-lactam antibiotics?	Penicillin G, V
What is the mode of action of Penicillin G and Penicillin V?	Binds penicillin-binding proteins --> blocks transpeptidase cross-linking of peptidoglycan in cell wall. Activate autolytic enzymes
What are the clinical uses for Penicillin G, V?	1. Mostly gram (+) organisms (S. pneumoniae, S. pyogenes, Actinomyces) 2. Gram (-) cocci (mainly N. meningitidis) 3. Spirochetes (T. pallidum)
Penicillin G, V, is bactericidal or bacteriostatic?	Bactericidal
What are the adverse effects associated with Penicillin G, V?	1. Hypersensitive reactions 2. Direct Coombs (+) hemolytic anemia 3. Drug-induced interstitial nephritis
Mode of resistance of Penicillin G, V?	B-lactamase cleaves the B-lactam ring. ---> MUTATIONS in PBP
Another name for Penicillin-binding proteins?	Transpeptidases
The MOA is same as Penicillin. Wider spectrum; penicillinase sensitive; combine with clavulanic acid to protect against destruction by B-lactamase.	Penicillinase-sensitive penicillins
Which hver wider spectrum of action, Penicillin G, V or Penicillinase-sensitive penicillins?	Penicillinase-sensitive penicillins
What are the clinical uses of Penicillinase-sensitive penicillins?	H. influenzae, H. pylori, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, and enterococci.
What mnemonic is used to remember the coverage of Penicillinase-sensitive penicillins?	HHELPSS
HHELPSS stands for:	H. influenzae H. pylori E. coli Listeria monocytogenes Proteus mirabilis Salmonella Shigella Enterococci
What are common adverse effects of Penicillinase - sensitive penicillins?	Hypersensitive reactions, rash, and Pseudomembranous colitis
Amoxicillin is an	Penicillinase-sensitive penicillin
What is the mode of acquired resistance of Amoxicillin and ampicillin?	Penicillinase (a type of B-lactamase) cleaves B-lactam ring.
Which type of penicillins are of narrow spectrum?	Penicillinase-resistant penicillins
What makes Penicillinase-resistant penicillins "resistant"?	The bulky R group blocks access of B-lactamase to B-lactam ring.
What is the use for Penicillinase-resistant penicillins?	S. aureus only
Why is MRSA not treated with Dicloxacillin?	It is resistant to Penicillinase-resistant penicillins due to altered PBP.
What are the main adverse effects of Nafcillin, Oxacillin, and Dicloxacillin?	Hypersensitivity reactions and Interstitial nephritis
What nephrotic disorder is seen as adverse effect of Penicillinase-resistant penicillins?	Interstitial nephritis
Which type of penicillins may have interstitial nephritis as an adverse effect?	Penicillin G, V and Penicillinase-resistant penicillins
Spectrum type of each: 1. Penicillinase-sensitive penicillins 2. Penicillinase-resistant penicillins 3. Antipseudomonal penicillins	1. Broad 2. Narrow 3. Extended
Antipseudomonal are penicillinase __________________.	Sensitive
What is often added to anti pseudomonal to protect them from B-lactamase destruction?	B-lactamase inhibitors
What are the clinical uses (infections) treated with Antipseudomonal penicillins?	Pseudomonas spp. and gram (-) rods
What are the most (4) B-lactamase inhibitors?	Clavulanic acid, Avibactam, Sulbactam, and Tazobactam
What mnemonic is used to summarize the B-lactamase inhibitors?	CAST Clavulanic acid, Avibactam Sulbactam Tazobactam
What is the function of B-lactamase inhibitors?	Added to penicillin antibiotics to protect the antibiotic from destruction by B-lactamase
What is another name for B-lactamase?	Penicillinase
What is prevented by adding Clavulanic acid to Piperacillin?	Destruction of Piperacillin with B-lactamase
Cephalosporins are _________________.	Bactericidal
Mechanism of action of Cephalosporins	B-lactam drugs that inhibit cell wall synthesis but ar less susceptible to penicillinases.
Which are more susceptible to penicillinases, penicillins or cephalosporins?	Penicillins
Which organisms are NOT covered with generations 1st-4th Cephalosporins?	LAME Listeria Atypicals (Chlamydia, Mycoplasma) MRSA Enterococci
What mnemonic is used to remember the organisms not covered by generations 1-4 of cephalosporins?	LAME
What are the two main 1st generation cephalosporins?	Cefazolin and Cephalexin
Cefazolin is a _______ generation cephalosporin.	1st
What cephalosporin is generation is Cephalexin?	1st
Cefazolin and Cephalexin are both _______ generation cephalosporins?	1st
What organisms are covered by 1st generation cephalosporins?	PEcK Proteus mirabilis E. coli Klebsiella pneumoniae
What is the common use for Cefazolin?	Used prior to surgery to prevent S. aureus wound infections
HENS PEcK	Mnemonic used for organisms covered by 2nd Gen cephalosporins
What are the most common 2nd Generation Cephalosporins?	Cefaclor, Cefoxitin, Cefuroxime, and Cefotetan
Cefaclor is ______ gen cephalosporin.	2nd
Cefoxitin and Cefuroxime are both _____ generation cephalosporins.	2nd
What generation of cephalosporins are Cefaclor, Cefoxitin, Cefuroxime, and Cefotetan?	2nd
What mnemonic is used to summarize the organisms covered by 2nd generation cephalosporins?	HENS PEcK
What organisms are covered by 2nd Generation cephalosporins?	1. Gram (+) cocci 2. H. influenzae 3. Enterobacter aerogenes 4. Neisseria spp 5. Serratia marcescens 6. Proteus mirabilis 7. E. coli 8 . Klebsiella pneumoniae
Which cephalosporins can cross the BBB?	3rd generation cephalosporins
What are the 3rd generation cephalosporins?	Ceftriaxone, Cefotaxime, Cefpodoxime, and Ceftazidime
What is the main use for 3rd generation cephalosporins?	Serious gram (-) infections resistant to other B-lactams
What re the most common uses for Ceftriaxone?	Meningitis, gonorrhea, disseminated Lyme disease
Which cephalosporin is often used to treat disseminated Lyme disease?	Ceftriaxone
What generation of cephalosporin is Ceftriaxone?	3rd generation
Which 3rd gen Cephalosporin is used to treat Pseudomonas?	Ceftazidime
Ceftazidime is a _____ generation cephalosporin	3rd
What type or generation of cephalosporins are used in seriums gram (-) infections?	3rd
Cefotaxime is a ______ generation cephalosporin	3rd
What is the MC 4th generation cephalosporin?	Cefepime
What are the clinical uses of Cefepime?	Gram (-) organisms, with increased activity against Pseudomonas and gram (+) organisms
Besides gram negative activity, what other infections can be treated with 4th generation cephalosporins?	Pseudomonas and gram (+) organisms
What is the most commonly referred 5th generation Cephalosporin?	Ceftaroline
What is the coverage of 5th generation cephalosporins?	Broad gram (+) and gram (-) organism
Unlike generations 1st --- 4th, the ______ generation of cephalosporins cover:	5th; Listeria, Atypicals (Chlamydia and Mycoplasma), MRSA, and Enterococci
MRSA is covered by ______ generation cephalosporins	5th
What is covered by the 4th generation cephalosporins, but NOT by the 5th generation?	Pseudomonas
List of adverse effects seen with Cephalosporins:	1. Hypersensitivity reactions 2. Autoimmune hemolytic anemia 3. Disulfiram-like reaction 4. Vitamin K deficiency 5. Low rate of cross-reactivity even in penicillin-allergic patients 6. Increase nephrotoxicity with aminoglycosides
What kind of anemia may be seen with Cephalosporin therapy?	Autoimmune hemolytic anemia
What common Vitamin deficiency is a possible adverse effect of prolonged use of Cephalosporins?	Vitamin K
A disulfiram-like reaction is seen with all generations of __________________.	Cephalosporins
What other type of antibiotics increase the risk of nephrotoxicity seen in Cephalosporin therapy?	Aminoglycosides
What kind of antibiotics should be avoided in patients on Cephalosporin?	Aminoglycosides
What is always coadministered with Imipenem?	Cilastatin
What is the MOA of Cilastatin?	Inhibition of renal dehidropeptidasa I
Inhibitor of renal dehydropeptidase I	Cilastatin
Which are the newer Carbapenems?	Ertapenem and Doripenem
What is the purpose of using Cilastatin with Imipenem?	Decrease inactivation of drugs in renal tubules
What are the main uses for Carbapenems?	1. Gram (+) cocci 2. Gram (-) rods 3. Anaerobes
What is the safest carbapenem?	Meropenem
What enzyme is inactivated in renal tubules by the use of Carbapenems?	Dehydropeptidase I
What are the adverse effects of carbapenems?	GI distress, rash, and CNS toxicity (seizures) at high plasma levels
What is the most significant side effect seen with Carbapenems?	CNS toxicity ---> seizures
Aztreonam is an ________________________.	Monobactam
Monobactam are less susceptible to ___________________.	B-lactamases
How does Aztreonam prevent peptidoglycan cross-linking?	Binding to Penicillin-Binding protein 3
What kind of antibiotics act by binding to PBP-3?	Monobactam
Monobactams are synergistically with ____________________.	Aminoglycosides
What is the use of Aztreonam?	Gram (-) rods only
Which patients are the ones usually treated with Monobactams?	Penicillin-allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides
Inhibits cell wall peptidoglycan formation by binding D-Ala-D-Ala portion of cell wall precursors.	Vancomycin
Vancomycin is not susceptible to ______________________.	B-lactamases
What bugs are treated with Vancomycin?	Gram (+) bugs
Examples of gram (+) bugs treated with Vancomycin?	Serious, multi resistant organisms, including MRSA, S. epidermidis, sensitive Enterococcus species, and C. difficile
Vancomycin is bactericidal except for:	C. difficile
What is the main syndrome due adverse reaction to Vancomycin?	Red man syndrome
What is the cause of Red man syndrome?	Adverse effect to Vancomycin
What is the Red man syndrome?	Diffuse flushing due to vancomycin toxicity
What are the most common adverse effects of Vancomycin?	Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing (red man syndrome), drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)
DRESS syndrome and Red man syndrome are commonly associated with:	Vancomycin toxicity
What is the amino acid modification that causes Vancomycin resistance?	D-Ala-D-Ala ----> D-Ala-D-Lac
D-Ala-D-Lac	Amino acid change causing Vancomycin resistance
How is Red man syndrome prevented?	1. Pretreatment with antihistamines 2. Slow rate of infusion of Vancomycin
What are the bacterial ribosomes targeted by protein inhibitors?	30S and 50S
30S +50S =	70S bacterial ribosome
All protein inhibitors are _______________________, except for:	Bacteriostatic; Aminoglycosides (bactericidal) LInezolid (variable)
Which kind of protein inhibitors are the only bactericidal?	Aminoglycosides
Linezolid is bactericidal or bacteriostatic?	Variable (both)
Aminoglycosides and Tetracyclines target the _______ ribosomal subunit.	30S
What are the main protein inhibitors that target bacterial 50S ribosomal subunit?	Chloramphenicol, Clindamycin, Erythromycin (macrolides) Linezolid
What protein inhibitors directly affect Translocation?	Macrolides and Clindamycin
What is the mechanism of action of Aminoglycosides?	1. Irreversible inhibition of initiation complex through binding of the 30S subunit 2. Cause misreading of mRNA 3. Block translocation
Why are aminoglycosides ineffective against anaerobes?	They require Oxygen to work
What is the result of aminoglycosides inhibition of the initiation complex by binding to the 30S subunit?	Misreading of mRNA
What is the main use of aminoglycosides?	Severe gram (-) rod infections
What aminoglycoside is used for bowel surgery?	Neomycin
Aminoglycosides work synergistic with?	B-lactam antibiotics
What are the most common adverse effects of aminoglycosides?	Nephrotoxicity Neuromuscular blockade Ototoxicity Teratogen
Ototoxicity by Aminoglycosides is increased if used with:	Loop diuretics
What kind of antibiotic should be avoided in case a patient is on Furosemide?	Aminoglycosides
What is the mechanism of resistance presented by aminoglycosides?	Bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, or adenylation.
Which protein inhibitor drug class targets/inhibits the A-site tRNA binding?	Tetracyclines
Peptidyl transferase is inhibited by _____________________.	Chloramphenicol
Linezolid inhibition of 50S subunit prevents _____________ to integrate.	Initiator tRNA
Bind to 30S and prevent attachment of aminoacyl-tRNA.	Tetracyclines
Tetracyclines have limited ______ penetration.	CNS
How is Doxycycline eliminated from the body?	Fecally
Why is doxycycline used in renal failure patients?	It is fecally excreted
Which products, meds or preparations must be avoided when taking tetracyclines?	1. Milk (Ca2+) 2. Antacids (Ca2+ and Mg2+) 3.. Iron-containing preparations
What kind of cations can inhibit tetracycline absorption in the gut?	Divalent (2+)
A person with severe GERD is taking OTC antacids, which protein inhibitor antibiotic should be avoided?	Tetracyclines
What are the clinical uses for Tetracyclines?	1. Borrelia burgdorferi 2. M. pneumoniae 3. RIckettsia and Chlamydia 4. Acne 5. Doxycycline is effective against MRSA
Which tetracycline is used for MRSA infection?	Doxycycline
Why are tetracyclines especially against Rickettsia and Chlamydia?	Drug's' ability to accumulate intracellularly
What are common adverse effects of Tetracyclines?	1. GI distress 2. Discoloration of teeth and inhibition of bone growth in children 3. Photosensitivity 4. Contraindicated in pregnancy
Discolored teeth due a medication.	Tetracycline toxicity
What is the mechanism of resistance?	Decrease uptake or increase effeflux out of bacterial cells by plasmid-encoded transport pumps
Tigecycline is a _____________________.	Glycylcyclines
What are a type of tetracycline derivatives?	Glycylcycline
What are the clinical uses of Glycylcyclines?	1. Broad-spectrum anaerobic, gram (-), and gram (+) coverage 2. MRSA and VRE 3, Infection requireing deep tissue penetration
What is the mechanism of action of Chloramphenicol?	Blocks peptidyltransferase at 50S ribosomal subunit. Bacteriostatic
What are the MC uses of Chloramphenicol?	1. Meningitis (H. influenzae, N. meningitidis, Strep pneumoniae) 2. Rickettsial diseases (Rocky Mountain spotted fever)
What are the adverse effects of Chloramphenicol?	1. Anemia (dose dependent) 2. Aplastic anemia (dose independent) 3. Gray baby syndrome
Why do infants develop gray baby syndrome in Chloramphenicol?	They lack liver UDP-glucuronosyltransferase
What is the mode of resistance of Chloramphenicol?	Plasmid-encoded acetyltransferase inactivates the drug
MOA of Clindamycin:	Blocks peptide transfer (translocation) at 50S ribosomal subunit. Bacteriostatic
What are common uses of Clindamycin?	- Anaerobic infections in aspiration pneumonia, lung abscess, and oral infections. - Also effective against invasive group A streptococcal infetion
What are adverse effects associated with Clindamycin?	Pseudomembranous colitis (C. difficile overgrowth), fever and diarrhea.
Clindamycin treats infections _________________________ diaphragm.	Above
What is the most common Oxazolidinones?	Linezolid
What type of antibiotic is Linezolid?	Oxazolidinones
What is the mode of action of Linezolid?	Inhibit protein synthesis by binding to 50S subunit and preventing formation of the initiation complex.
What organisms are commonly treated with Linezolid?	Gram (+) species including MRSA and VRE
What are most important adverse effects of Linezolid?	1. Bone marrow suppression (especially thrombocytopenia) 2. Peripheral neuropathy 3. Serotonin syndrome
What syndrome is adversely seen in the use of Linezolid?	Serotonin syndrome
How can Linezolid acquire resistance?	Point mutation of ribosomal RNA
What are the MC macrolides?	Azithromycin, clarithromycin, and erythromycin
What cell process is inhibited by Macrolides?	Translocation
What is the mechanism of action of Macrolides?	Inhibit protein synthesis by blocking translocation; bind to the 23S rRNA of the 50S ribosomal subunit
Where do macrolides bind to prevent protein synthesis?	23S of the 50S ribosomal subunit
What are the MC clinical uses of Macrolides?	1. Atypical pneumonias (Mycoplasma, Chlamydia, Legionella) 2. STIs (Chlamydia) 3. Gram (+) cocci (streptococcal infections in patients allergic to penicillin), 4. B. pertussis
What antibiotics can be used to treat atypical pneumonias?	Macrolides
Mnemonic of adverse effects seen in macrolides	MACRO
What are the most common adverse effects of Macrolides?	1. Gastrointestinal Motility issues 2. Arrhythmia caused by prolonged QT interval 3. acute Cholestatic hepatitis 4. Rash 5. eOsinophilia
What macrolides inhibit cytochrome P-450?	Clarithromycin and Erythromycin
Methylation of 23S rRNA-binding site prevents binding of drug.	Mechanism of resistance of macrolides
What are the most common Polymyxins?	Colistin (polymyxin E), polymixin B
MOA of Polymyxins	Cation polypeptides that bind to phospholipids on cell membrane of gram (-) bacteria.
What is the clinical use for Polymyxins?	Salvage therapy for multidrug-resistant gram (-) bacteria (P. aeruginosa, E. coli, Klebsiella pneumoniae).
What is a common use for Polymyxin B?	Component of a triple antibiotic ointment used for superficial skin infections
What are the most significant adverse effects seen with Polymyxins?	Nephrotoxicity, Neurotoxicity (slurred speech, weakness, paresthesias), and respiratory failure.
What enzyme is primarily blocked or inhibited by Sulfonamides?	Dihydropteroate synthase
What is the end result of inhibition of dihydropteroate synthase by sulfonamides?	Inhibition of folate synthesis
When are sulfonamides bactericidal?	When combined with TMP
Sulfonamides are bacteriostatic or bactericidal, when used alone?	Bacteriostatic
What are the most significant clinical uses of Sulfonamides?	Gram (+), gram (-), Nocardia
TMP-SMX is used in treating?	Simple UTI
What is a problems seen in a G6PD deficiency patient on Sulfonamides?	Hemolysis
What are some adverse effects seen with Sulfonamides?	- Hypersensitivity reactions - Hemolysis (in G6PD deficiency) - Nephrotoxicity (Tubulointerstitial nephritis) - Photosensitivity -Stevens-Johnson syndrome - Kernicterus in infants - Displacement of other drugs form albumin
What is the teratogenic adverse effect of Sulfonamides?	Kernicterus
Which patients are at higher risk of hemolysis by using sulfonamides?	G6PD deficient
What is the way of resistance of Sulfonamides?	Altered enzyme (bacterial dihydropteroate synthase), decrease uptake, or increase PABA synthesis
What acid is prevented from forming by the use of Sulfonamide and/or Dapsone?	Dihydropteroic acid
What is the MC use for Dapsone?	1. Leprosy, 2. Pneumocystis jirovecii prophylaxis
Two serious adverse effects of Dapsone therapy?	1. Hemolysis of G6PD deficient 2. Methemoglobinemia
What does TMP stand for?	Trimethoprim
What is the mechanism of action of TMP?	Inhibits bacterial dihydrofolate reductase; Bacteriostatic
What antibiotic combination cause a sequential block of folate synthesis?	TMP-SMX
What infections are treated with TMP in combination with Sulfonamides?	UTIs, Shigella, Salmonella, Pneumocystis jirovecii pneumonia, and toxoplasmosis prophylaxis
What is a common treatment for Toxoplasmosis prophylaxis?	TMP-SMX
List of TMP adverse effects:	1. Megaloblastic anemia 2. Leukopenia 3. Granulocytopenia
How can granulocytopenia seen with TMP can be avoided?	Coadministration of folinic acid
What is the common suffix seen fluoroquinolone nomenclature?	-floxacin
Mechanism of action of fluoroquinolones	Inhibit prokaryotic enzymes topoisomerase II (DNA gyrase) and topoisomerase IV.
What should never be taken with fluoroquinolones?	Antacids
Antacids should be avoided when also taking:	Fluoroquinolones and Tetracyclines
Clinical uses of Fluoroquinolones:	1. Gram (-) rods of urinary and GI tracts 2. Some gram (+) organisms 3. Otitis externa
Why pregnant women cannot take fluoroquinolones?	May cause cartilage damage
What populations are at risk of cartilage damage by Fluoroquinolone use?	Pregnant women, nursing mothers, and children < 18 years old.
What is a possible ECG adverse effect of fluoroquinolones?	QT prolongation
What is a risk of fluoroquinolone therapy in persons over 60 years old or those using prednisone?	May cause Tendonitis or tendon rupture
Which two organs or tissues are at risk of damage in Fluoroquinolone therapy?	Cartilage and tendos
What effect does ciprofloxacin have on the CYP450 system?	Inhibits
How do fluoroquinolones acquired resistance?	Chromosome-encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pumps
What is the mode of action of Dapsone?	Lipopeptide that disrupts cell membranes of gram (+) cocci by creating transmembrane channels
What drug is known to destroy cell membrane by creating transmembrane channels?	Daptomycin
What are the most common uses for Daptomycin?	1. S. aureus skin infections (especially MRSA) 2. Bacteriemia 3. Endocarditis 4. VRE
VRE and MRSA can be treated with ________________, by disrupting the cell membrane.	Daptomycin
Why is Daptomycin not used in pneumonias?	It tends to avidly bind to and is inactivated by surfactant
What medication is known to bind to surfactant and also by inactivated by surfactant as well?	Daptomycin
Adverse effects seen in Daptomycin?	Myopathy and rhabdomyolysis
What is the mechanism of action of Metronidazole?	Forms toxic free radicals metabolites in the bacterial cell that damage DNA
Metronidazole is ______________ and _______________.	Bactericidal and antiprotozoal
GET GAP	Mnemonic used to summarize organisms trated with Metronidazole
What does GET GAP stand for:	G- Giardia E- Entamoeba T- Trichomonas G- Gardnerella vaginalis A- Anaerobios (Bacteroides, C. diff) P. H. Pylori
What medication can substitute Amoxicillin in triple therapy for H. pylori infection?	Metronidazole
Metronidazole treat ANAEROBIC infections _________ the diaphragm.	Below
Clindamycin treats anaerobic infections ______________ the diaphragm.	Above
What adverse effect is seen with Metronidazole + ETOH?	Disulfiram-like reaction
What is disulfiram-like reaction presented?	Severe flushing, tachycardia, and hypotension
What are the lesser adverse effects of Metronidazole?	Headache and metallic taste
What DNA damaging antibiotic may provoke a disulfiram -like reaction if combined with alcohol?	Metronidazole.
What is used for prophylaxis is use for M. tuberculosis?	Isoniazid
What is the common treatment for M. tuberculosis?	Rifampin, Isoniazid, Pyrazinamide, and Ethambutol
RIPE	Mnemonic for M. tuberculosis treatment
What drugs are use for prophylaxis for M. avium-intracellulare?	Azithromycin, rifabutin
What is the empiric treatment for M. avium-intracellulare?	Azithromycin or clarithromycin + ethambutol. Can add rifabutin or ciprofloxacin
What is the long-term treatment of Tuberculoid M. leprae?	Dapsone and rifampin
What drug is added to leprae treatment in the Lepromatous form?	Clofazimine
What are the two most common Rifamycins?	Rifampin and Rifabutin
What is the mechanism of action of Rifamycin?	Inhibit DNA-dependent RNA polymerase
What are some clinical uses for Rifamycins?	1. Mycobacterium tuberculosis 2. Delay resistance to dapsone when used for leprosy 3. Meningococcal meningitidis prophylaxis 4. Chemoprophylaxis in contacts of children with H. influenzae type b.
Why is are rifamycins used with Dapsone in treating Leprosy?	It helps delay the resistance to Dapsone
What drug causes orange body fluids?	Rifampin
Which rifamycin is favored in HIV?	Rifabutin
Why is rifabutin used in HIV patients and not Rifampin?	RIfabutin has less cytochrome P-450 stimulation
What are the adverse effects seen with Rifamycins?	1. Minor hepatotoxicity 2. Induction of CYP450 system 3. Orange body fluids
What is the mode of resistance of Rifamycins?	Mutations reduce drug binding to RNA polymerase
What is a risk of rifampin monotherapy?	Rapid development of resistance to medication
What is the mode of action of Isoniazid?	Decreased synthesis of mycolic acids
Enzyme required to convert Isoniazid into active metabolite	Bacterial catalase-peroxidase
What is encoded by KatG?	Bacterial catalase-peroxidase
A deficiency or mutation to KatG gene can result in:	Defective function of INH due to inactivation
What is the main infection treated with Isoniazid?	M. tuberculosis
Which is the only agent (RIPE), that can be used in monotherapy prophylaxis of TB?	Isoniazid
Monotherapy for latent TB?	Isoniazid
What defines INH half-lives?	Fast vs Slow acetylators
Fast and slow acetylators. Association?	Represent possible Isoniazid half-lives
List of Isoniazid adverse effects:	1. Hepatotoxicity 2. P-450 inhibition 3. Drug-induced SLE 4. Vitamin B6 deficiency --->Neuropathy and Sideroblastic anemia
What vitamin may be depleted by use of Isoniazid?	Vitamin B6
What are clinical manifestations of Vitamin B6 deficiency due to INH toxicity?	Peripheral Neuropathy and Sideroblastic anemia
What anemia may be seen as side effect of INH toxicity?	Sideroblastic anemia
What is co administered with Isoniazid in order to prevent Vitamin B6 deficiency?	Pyridoxine
Mutations leading to underexpression of KatG	Mechanism of resistance of Isoniazid
What two cell types are most affected by Isoniazid?	Neurons and Hepatocytes
What does RIPE stand for?	Rifampin Isoniazid Pyrazinamide Ethambutol
What is the clinical use for Pyrazinamide?	M. tuberculosis
Which are the two associated adverse effects of Pyrazinamide?	Hyperuricemia and hepatotoxiciy
What is the best pH level for Pyrazinamide to function properly?	Acidic
What is the mechanism of action of Ethambutol?	Decreased carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase
What is the associated adverse effects of Ethambutol?	Optic neuropathy
Description of the Optic Neuropathy due to Ethambutol use?	Red-green color blindness
Which RIPE drug works by blocking arabinosyltransferase?	Ethambutol
Inhibition of mycolic acids in Mycobacterium tuberculosis is done with ___________________.	Isoniazid
Decrease the carbohydrate polymerization of mycobacterium cell wall.	Ethambutol
What is a second line drug for the treatment of M. tuberculosis?	Streptomycin
Which ribosome component is interfered by Streptomycin?	30S
What are associated side effects of Streptomycin?	Tinnitus, vertigo, ataxia, and nephrotoxicity.
Agent used as prophylaxis in cases of high risk for endocarditis and undergoing surgical or dental procedures?	Amoxicillin
Prophylaxis in cases of exposure to gonorrhea?	Ceftriaxone
What agent is used in prophylaxis o recurrent UTIs?	TMP-SMX
Ceftriaxone, Ciprofloxacin, or rifampin, are used as prophylaxis in:	Cases of exposure to meningococcal infection
What is the prophylaxis for pregnant women (+) group B strep?	Intrapartum penicillin G or ampicillin
Erythromycin ointment on eyes. Prophylaxis?	Prevention of gonococcal conjunctivitis in newborn
Which cases is Cefazolin used as prophylaxis measure?	Prevention of postsurgical infection due to S. aureus
Benzathine penicillin G is used a prophylaxis of:	Syphilis
What can be used as prophylaxis measures for strep pharyngitis in child with prior rheumatic fever?	Benzathine penicillin G or oral penicillin V
What is the most most common infection in HIV patient with CD4+ count < 50, and what is the prophylaxis drug?	Mycobacterium avium complex (MAC); Azithromycin or clarithromycin
TMP-SMX is used as prophylaxis in HIV patients with which possible infections?	Pneumocystis pneumonia and toxoplasmosis
Medications for MRSA?	Vancomycin, daptomycin, linezolid, tigecycline, ceftaroline, and doxycycline
What medications can be used to treat VRE?	Linezolid and streptogramins
What is the most common medication used for Multi-drug resistant P. aeruginosa?	Polymyxins B and E (colistin)
What enzyme is inhibited by Terbinafine?	Squalene epoxidase
What enzyme is inhibited by Azoles?	14-a-demethylase
Which antifungals interfere in Ergosterol synthesis?	Azoles
Antifungals that disrupt cell wall synthesis	Ehinocandins
What are some importnat echinocandins?	Anidulafungin, Caspofungin, and Micanfungin
What is the common ending in nomenclature azoles?	-azole
What antifungal disrupts nucleic acid synthesis?	Flucytosine
What are common Polyenes?	Amphotericin B and Nystatin
What kind of antifungals inhibited cell membrane integrity?	Polyenes
What is the MOA of Amphotericin B?	Binds ergosterol; forms membrane pores that allow leakage of electrolytes
What cell structure is unique to fungi?	Ergosterol
Forms membrane pores that allow leakage of electrolytes. MOA of?	Amphotericin B
What important antifungal is used in serious, systemic mycoses?	Amphotericin B
What are some organism treated with Amphotericin B?	Cryptococcus, Blastomyces, Coccidioides, Histoplasma, Candida, Mucor.
What electrolytes should be supplemented in a patient on Amphotericin B?	K+ and Mg2+
Why is K+ and Mg2+ supplemented in a patient on Amphotericin B?	Due to altered renal tubule permeability
What are adverse effects of Amphotericin B?	Fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis
IV phlebitis is associated with:	Amphotericin B
What are the most important adverse effects of Amphotericin B?	Nephrotoxicity, arrhythmias, andmia and phleblitis.
Which antifungal is used topically and not as toxic as Amphotericin B, and with the same mechanism action of Amphotericin B?	Nystatin
What is the clinical use of Nystatin?	"Swish and swallow" for oral candidiasis (thrush); topical for diaper rash or vaginal candidiasis.
What is a common medication for diaper rash or vaginal candidiasis?	Nystatin
What are 3 common Azoles?	Ketoconazole, Itraconazole, fluconazole
Inibito fungal sterol (ergosterol) synthesis by inhibiting that CYP450 enzyme that converts lanosterol to ergosterol	Azole mechanism of action
Associated adverse effects of Azoles	1. Testosterone synthesis inhibition 2. Liver dysfunction
Which azole is the most likely to cause Gynecomastia?	Ketoconazole
Which antifungals are used for local and less serious systemic mycoses?	Azoles
What is the MOA of Terbinafine?	Inhibits the fungal enzyme squalene epoxidase
What is the most common use for Terbinafine?	Dermatophytosis
What is the most common dermatophytose treated with Terbinafine?	Onychomycosis
What is Onychomycosis?	Fungal infection of finger or toe nails
What are some adverse effects associated with Terbinafine?	GI upset, headaches, hepatotoxicity, and taste disturbance.
What is the MOA of Echinocandins?	Inhibit cell wall synthesis by inhibiting synthesis of B-glucan
Decrease synthesis is B-glucan is achieved by which kind of antifungals?	Echinocandins
What are the most common uses for Echinocandins?	1. Invasive aspergillosis 2. Candida
Why is there flushing in the use of Caspofungin?	Echinocandins release histamine --> flushing
What process of the cell cycle is disrupted by Griseofulvin?	Mitosis
What is the MOA of Griseofulvin?	Interferes with microtubule function; disrupts mitosis.
Where is Griseofulvin commonly deposited?	Keratin-containing tissues (nails)
What kind of infection is often treated with Griseofulvin?	Dermatophytes (tinea, ringworm)
What is the most significant adverse effect of Griseofulvin therapy?	Disulfiram-like reaction
What are the effects on CYP450 and Warfarin, by the use of Griseofulvin?	Increase the metabolism of both
Suramin and melarsoprol are used to treat:	Trypanosoma brucei
T. cruzi is treated with:	Nifurtimox
Nifurtimox is a antiprotozoal agent used to treat _____________.	T. cruzi infection
Pyrimethamine is used in treating ___________________.	Toxoplasmosis
What is a common treatment option for Leishmaniasis?	Sodium Stibogluconate
List of common anti-mite/louse drugs:	1. Permethrin 2. Malathion 3. Oral Ivermectin
What is the use for Permethrin?	Scabies and lice infection
Mode of action of Permethrin?	Inhibits Na+ channel deactivation --> neuronal membrane depolarization
MOA of Malathion	Acetylcholinesterase inhibitor
What is the mode of action of Chloroquine?	Blocks detoxification of heme into hemozoin
The accumulation of heme due to Chloroquine, is toxic to which organism spp?	Plasmodia
What is a common drug used to treat plasmodial species other than P. falciparum?	Chloroquine
Why is Chloroquine not used in treating P. falciparum?	Frequency of resistance is too high
What are some common adverse effects seen with Chloroquine?	Retinopathy; pruritus
List of anti-helminthic therapy drugs	Pyrantel pamoate Ivermectin Mebendazole Praziquantel Diethylcarbamazine
Which is a antihelminthic medication that works as an microtubule inhibitor?	Mebendazole
What is the mode of action of Praziquantel?	Increased Ca2+ permeability and increased vacuolization
HIV Reverse transcriptase include:	NRTIs and NNRITs
Common NRTIs	Abacavir (ABC), Didanosine (ddI), Emtricitabine (FTC), Lamivudine (3TC), Stavudine (d4T), Tenofovir (TDF), Zidovudine (ZDV)
Commn NNRTIs include:	Delavirdine, Efavirenz, and Nevirapine
ABC	Abacavir
ddI	Didanosine
Emtricitabine	FTC
3TC	Lamivudine
Lamivudine	3TC
d4T	Stavudine
Stavudine	d4T
TDF	Tenofovir
Tenofovir is a common HIV ___________________.	NRTI
Tenofovir is abbreviated as _______.	TDF
Zidovudine	ZDV
Which to HIV antivirals prevent the entry of the virus?	Maraviroc and Enfuvirtide
What action does Maraviroc prevent that does not allow for entry of HIV to host cell?	Attachment
Maraviroc prevents ______________ of HIV to the cell.	Attachment
Penetration of HIV to host cell is prevented with ___________.	Enfuvirtide
What HIV antiviral prevents entry of HIV by blocking its penetration?	Enfurvitide
List of HIV integrase inhibitors	Dolutegravir Elvitegravir Raltegravir Bictegravir
What suffix is shared by all HIV integrase inhibitors?	-- tegravir
--tegravir	Integrase inhibitor
-tegravir is _______________ inhibitor, and --navir is _____________ inhibitor.	Integrase; Protease
Raltegravir is a very common ______________________.	HIV integrase inhibitor
What process in HIV replication/infection process is disrupted by Integrase inhibitors?	DNA integration
DNA integration occurs right after______________________ and before _____________.	Reverse transcription ; Transcription
What are 3 common protease inhibitors used in HIV therapy?	Indinavir, Saquinavir, and Lopinavir
-- navir	Protease inhibitor
What common suffix identifies all or most of HIV Protease inhibitors?	- navir
What process in HIV replication in the CD4+ cell is disrupted by Protease inhibitors?	Proteolytic processing
HIV proteolytic processing is inhibited with _____________ inhibitors.	Protease
Which are categories of antivirals (non-HIV), that disrupt Nucleic Acid synthesis?	1. Guanosine analogs 2. Viral DNA polymerase inhibitors 3. Guanine nucleotide synthesis
Name two common Guanosine analogs (antivirals):	Acyclovir and Ganciclovir
Acyclovir is a _____________________________	Guanosine analog
What action is disrupted by Acyclovir?	Nucleic acid synthesis
Cidofovir and Foscarnet both are ________________________.	Viral DNA polymerase inhibitors
What are common viral infections treated with Foscarnet and Cidofovir?	HSV and CMV
What type of nucleic acid synthesis inhibitor is Ribavirin?	Guanine nucleotide synthesis inhibitor
Which are the two most common Neuraminidase inhibitors?	Oseltamivir and Zanamivir
What are common antivirals used to treat Influenza A and B?	Oseltamivir and Zanamivir
Oseltamivir and Zanamivir are:	Neuraminidase inhibitors
What is prevented by the use of Neuraminidase inhibitors?	Release of progeny virus
Inhibit influenza neuraminidase	Mechanism of action of Oseltamivir and Zanamivir
What are the main uses for Acyclovir and other Guanosine analogs?	HSV and VZV
Which Guanosine analog has the best oral bioavailability?	Valacyclovir
What are the most significant adverse effects of Acyclovir and other Guanosine analogs?	1. Obstructive crystalline nephropathy 2. Acute renal failure if not adequately hydrated
What is the mechanism of resistance?	Mutated viral thymidine kinase
What conditions are most commonly treated with acyclovir?	HSV-induced mucocutaneous and genital lesions as well as for encephalitis.
Prodrug of acyclovir?	Valacyclovir
Why is there few adverse effects with acyclovir and its derivatives?	It monophosphorylated HSV/VZV infected cells by thymidine kinase
What is the mechanism of action of Ganciclovir?	5'- monophosphate formed by a CMV viral kinase
What is the most common use for Ganciclovir?	CMV, especially in immunocompromised patients
What is the prodrug of Ganciclovir?	Valganciclovir
Adverse effects of Ganciclovir	1. Bone marrow suppression (leukopenia, neutropenia, thrombocytopenia) 2. Renal toxicity
What is the MOA of Foscarnet?	Viral DNA/RNA polymerase inhibitor and HIV reverse transcriptase inhibitor.
Where does the Foscarnet binds?	Pyrophosphate-binding site of enzyme
Which antiviral does not require any kinase activation	Foscarnet
Pyrophosphate analog	Foscarnet
1. Viral DNA/RNA polymerase inhibitor 2. HIV reverse transcriptase inhibitor	Mechanisms of action of Foscarnet
What are the two most common uses for Foscarnet?	1. CMV retinitis in immunocompromised patients when Ganciclovir fails 2. Acyclovir-resistant HSV
List of adverse effects Foscarnet:	1. Nephrotoxicity 2. Electrolyte abnormalities ----> seizures
What are the common electrolyte abnormalities of Foscarnet?	Hypo-or-Hypercalcemia, hypo/hyperphosphatemia, hypokalemia, and hypomagnesemia
What is severe consequence seen in Foscarnet-induced electrolyte abnormalities?	Seizures
What is the mode of resistance of Foscarnet?	Mutated DNA polymerase
Mechanism of action of Cidofovir?	Inhibits viral DNA polymerase
What is the main adverse effect seen with Cidofovir?	Nephrotoxicity
What does HAART stand for?	Highly active antiretroviral therapy
What are the strongest indications for HAART?	1. AIDS-defining illness 2. Low CD4+ cell counts (<500 cells/mm), 3. High viral load
What is the regimen that composes HAART?	A total of 3 drugs; 2 NRTIs + 1 Integrase inhibitor
What is the mechanism of action of NRTIs?	Competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain
All NRTIs are nucleosides, except for ___________________.	Tenofovir (nucleoTide)
What are some unique ZDV clinical uses?	1. General prophylaxis 2. During pregnancy to decrease risk of fetal transmission
What are the associated adverse effects of NRTIs?	1. Bone marrow suppression 2. Peripheral neuropathy 3. Lactic acidosis 4. Anemia 5. Pancreatitis
What NRTI is contraindicated in a patient with HLA-B*5701 mutation?	Abacavir
How is bone marrow suppression due to NRTI toxicity reversed?	Co-administer granulocyte colony-stimulating factor [G-CSF] and erythropoietin
What is an associated adverse effect of ZDV?	Anemia
What is the associated adverse effect of Didanosine?	Pancreatitis
What adverse effect is seen with all nucleoside NRTIs?	Lactic acidosis
Efavirenz is a _____________.	NNRTI
Nevirapine and Delavirdine are both, _____________.	NNRTIs
What is the mechanism of action of NNRTIs?	Bind to reverse transcriptase at site different from NRTIs.
What are some differences of in mechanism of action between NRTIs and NNRTIs?	1. Bind different site in the reverse transcriptase 2. NNRTIs do NOT require phosphorylation
What are all the common to all NNRTIs adverse effects?	Rash and hepatotoxicity
What are adverse effects seen with Efavirenz?	Vivid dreams and CNS symptoms
Which NNRTIs are contraindicated in pregnancy?	Delavirdine and Efavirenz
What is the mechanism of action of Protease inhibitors?	Assembly of virions depends on HIV-1 protease, which cleaves the polypeptide products of HIV mRNA into their functional parts.
Which HIV antivirals prevent the maturation of new viruses?	Protease inhibitors
Which Protease inhibitor "boost" other drug concentrations by inhibiting CYP450 system?	Ritonavir
Which rifamycin is can be use with Protease inhibitors?	Rifabutin
What are shared adverse effects of Protease inhibitors?	Hyperglycemia, GI intolerance, lipodystrophy (Cushing-like syndrome)
What are associated side effects of Indinavir?	Nephropathy, hematuria, thrombocytopenia
What is the result of Protease inhibitors and Rifampin?	Reducts protease inhibitors concentrations, since Rifampin is potent CYP/UGT inducer.
Integrase inhibitor mechanism of action	Inhibits HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrase
Adverse effect of Integrase inhibitors	Increased creatine kinase
What HIV antiviral is associated with increased levels creatine kinase?	Integrase inhibitors
What is the mechanism of action Enfuvirtide?	Binds gp41, inhibiting viral entry.
Binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120.	Mechanism of action Maraviroc
What is the associated adverse effect of Enfuvirtide?	Skin reaction at injection sites
_____________ inhibits fusion.	Enfuvirtide
_____________ inhibits docking.	Maraviroc
What is the mechanism of action interferons?	Glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and antitumoral properties.
Adverse effects associated Interferons?	Flu-like symptoms, depression, neutropenia, and myopathy.
List of clinical uses for interferon therapy.	1. Chronic HBV and HCV 2. Kaposi sarcoma 3. Hairy cell leukemia 4. Condyloma acuminatum 5. RCC 6. Malignant melanoma 7. Multiple sclerosis 8. Chronic granulomatous disease
What drug is used with Hepatitis C virus and RSV?	Ribavirin
What drugs are commonly used HCV infection?	Ledipasvir, Ribavirin, Simeprevir, and Sofosbuvir.
What is MOA of Ledipasvir?	Viral phosphoprotein (NS5A) inhibitor
Ribavirin mechanism of action	Inhibitors synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase
What are adverse effects of Ribavirin?	Hemolytic anemia and severe teratogen
What is the mechanism of action Simeprevir?	HCV protease (NS3/4A); prevents viral replication
Adverse effects of Simeprevir?	Photosensitivity reactions
Which HCV antiviral works by inhibiting HCV RNA-dependent RNA polymerase (NS5B) acting as a chain terminator?	Sofosbuvir
What is the teratogenic effect of Sulfonamides?	Kernicterus
Teratogenic effect of Aminoglycosides?	Ototoxicity
Cartilage damage is teratogenic effect of:	Fluoroquinolones
Associated teratogenic effect of Tetracyclines	Discolored teeth, inhibition of bone growth
Gray baby syndrome is the teratogenic result of ______________ in pregnant women.	Chloramphenicol

Created by: rakomi

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