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BONUS:
OTHER QUESTIONS 2
| Question | Answer |
|---|---|
| health inequalities | differences in health status or in distribution of health determinants BETWEEN different population groups |
| health inequities | AVOIDABLE inequalities in health between groups of people within countries and between countries |
| IMD | index of multiple deprivation which measures relative deprivation for small populations using income, employment, education and crime etc |
| Streptococcus pneumoniae | Gram-positive diplococcus Most common cause of CAP. Has a capsular polysaccharide (protects against phagocytosis, detected in urine). Rapid onset, productive cough, signs of consolidation. Relative resistance to penicillin. |
| Haemophilus influenzae | Gram-negative rod making COPD worse |
| Staphylococcus aureus | Gram-positive cocci in clumps causes secondary bacterial pneumonia (after influenza or measles). Common in cystic fibrosis and IV drug abusers. Yellow sputum |
| Klebsiella pneumoniae | Gram-negative fat rod Common cause of lobar pneumonia and typical pneumonia in elderly patients in nursing homes and alcoholics. Red Currant Jelly" sputum (thick, blood-tinged) |
| Pseudomonas aeruginosa | Gram-negative rod with capsule Loves water" (often transmitted by ventilators - HAP/VAP). Produces green sputum (pyocyanin). |
| Legionella pneumophila | Gram-negative rod (poorly stained) Cause atypical pneumonia (common in alcoholics, smokers, immunosuppressed). "Loves water." high fever, dry cough, flu-like symptoms. Antigens detected in urine. Poorly stained |
| Mycoplasma pneumoniae | no cell wall Most common cause of atypical pneumonia (20% CAP). In adolescents + military. Insidious onset, low-grade fever penicillin doesn't work, use ribosomal antibiotics like macrolides). Common in younger, active adults. |
| normal V:Q ratio (ventilation to perfusion ratio) | 0.8 |
| gram positive staining means | lack outer membrane and made of peptidoglycan and acid polymer and thicker wall |
| gram negative staining means | have complex lipopolysaccharide outer membrane and thinner wall (more resistant to antibiotics) |
| anaerobic bacteria | clostridium ones |
| examples of B-lactam antibiotics (4) - PCCM | penicillins, cephlasporins, carbapenams, and monobactams |
| B-lactam antibiotics | inhibit cell wall synthesis |
| slide 20 got some good points bro | |
| penicillin | bactericidal (cause lyses of bacteria) by binding irreversibly to transpeptidase which inhibits cell wall synthesis |
| penicillin allergy side effects | in general relatively free of side effects, can see hypersensitivity reactions eg skin rashes, anaphylactic shock rare but fatal and broad spectrum can cause GI disturbances and candida |
| resistance to penicillins | some penicillins are inactivated by b-lactamases |
| how to overcome penicillin resistance | combine with drugs which inhibit b-lactamases (clavulanic acid + amoxicillin = co-amoxiclav) or just give other penicillins which are resistant to b-lactamases eg flucloxacillin |
| cephalosporins | B-lactam antibiotics with similar mode of action to penicillin, given parenatally, some penicillin sensitive patients may have allergic reaction to this still examples include cefalexin, cefaclor (anything with cef bro) |
| glycopeptidases | stop peptidoglycan biosynthesis by bind to D-Ala-D-Ala terminal of growing peptide = stop transpeptidase = no cell wall synthesis |
| examples of glycopeptidases | vancomycin |
| vancomycin | glycopeptide, bactericidal given IV for MRSA or orally for pseudomembranous colitis, side effects of ototoxicity and nephrotoxicity |
| which drugs inhibit protein synthesis (3) | tetracycline, macrolides, aminoglycosides |
| tetracyclines mechanism of action | bind to 30s ribosomal subunit -> block binding of tRNA to mRNA -> inhibits protein synthesis -> bacteriostatic effect (used in exacerbations of bronchitis and acne) |
| difference between bactericidal and bacteriostatic effects | bacteriostatic stops bacteria from growing and reproducing but bactericidal KILL BACTERIA MWAHAHAH |
| macrolides mechanism of action | P450 inhibitors which increase conc of interacting drugs eg warfarin + prevent translocation 50s bacterial ribosome -> inhibit protein synthesis -> bacrerostatic + bactericidal is similar to penicillin |
| good alternative for pencillin | macrolide as has similar antimicrobial spectrum |
| examples of macrolides (end in mycin) | erythromycin, clarithromycin etc |
| side effects of macrolides | nausea (Especially erythromycin) |
| aminoglycosides | binding to aminoacyl site of 16s ribosomal RNA within 30S ribosomal subunit -> misread code -> inhibit translocation + protein synthesis |
| explain synergy of aminoglycosides with penicillins | penicillin breaks down cell wall which increases uptake of aminoglycosides |
| examples of aminoglycosides | gentamicin, neomycin |
| gentamicin | aminoglycoside most widely used against gram NEGATIVE bacteria to treat sepsis, endocarditis given via injection with half life of 2-3 hours with NTI and drug monitoring needed. SE= otoxicity and nephrotoxicity |
| drugs which inhibit bacterial DNA (3) | quinolones, sulphonamides, trimethoprim |
| quinolones | bactericidal and ihibits P450 enzymes (which inhibit type II isomeraseses (DNA gyrase and topoisomerase IV) -> stop DNA synthesis) |
| examples of quinolones | ciprofloxacin and norfloxacin |
| metronidazole | pro drug (inactive) needing to be activated by ANAEROBIC BACTERIA -> damages helical structure of DNA -> fragmentation -> HAHA INHIBIT DNA SYNTHESIS L (used against aerobic bacteria + protozoa, surgical prophylaxis, alcohol interaction) |
| sulfonamides | bacteriostatic - inhibit growth of bacteria by competitively inhibiting enzyme dihydropteroate synthetase (needed to make folate) -> reduce DNA -> INHIBIT DNA SYNTHESIS L |
| examples of sulfonamides | sulfasalazine - in IBD and RA |
| VERY VERY BAD THINGS ABOUT SULFONAMIDES | high degree of bacterial resistance, side effects (skin rash, nausea, headache) |
| what is used for infected burns from sulfonamides | silver sulfadiazine |
| trimethoprim | bacteriostatic - structurally related to folate (is a folate antagonist), inhibit bacterial dihydrofolate reductase (needed to convert folate -> tetrahydrofolate), is less potent against human form of enzyme but treats UTI, high resistance, limited SE |
| trimethoprim vs pregnancy | avoid trimethoprim for the first three months of pregnancy |
| co-trimoxazole | trimethoprim + sulfamethoxazole (limited use except in treatment of pneumonia) |
| bactericidal drugs | B-lactam antibiotics, macrolides, quinolones, and aminoglycosides |
| bacteriostatic drugs | macrolides, tetracyclines, and folate inhibitors |
Created by:
kablooey
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