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PAS 511 - Exam III
Pharm/Preventative Medicine/Infectious Disease MO = Microorganism
Terms in this set (81)
What is an aerobe MO?
Can use oxygen in metabolism and can detoxify it
What is an obligate aerobe MO?
Can use oxygen for metabolism and cannot growth without oxygen
What is an microaerophile MO?
Cannot grow at normal atmospheric concentrations of oxygen but requires a small amount of it in metabolism
What is an facilitative anaerobe MO?
Perfers aerobic but can growth without oxygen using processess such as fermentation
What is an anaerobe MO?
Does not use oxygen
What is an obligate anaerobe MO?
Cannot survive in oxygen
What is an aerotolerant anaerobe MO?
Does not use oxygen but can survive and grow in it
What is an capnophile MO?
Grows best at higher CO2 levels than in normal atmosphere
How does it take to design a new drug?
What is a "selectively toxic" drug?
Term used for drugs aimed at killing - such as unwanted cells (cancer-chemotherapy) or parasites, without harming the host
What factors influence selectivity of drugs? (3)
1. Chemical nature of drug
2. Dose and route of administration
3. Features specific to person taking drug, such as genetic makeup, underlying disease, age, ect.
How much do you think the design of a new drug costs?
>250 million dolla bills y'all!
What drug names should be used when writing orders or in scientific publications?
Generic (Official) names
Do drugs create new signals in the body?
No, drugs either block or mimic signals or receptors already present in the body
What are the three dose response curves? (3)
- ED50 - effective dose, 50% of patients respond at this dose
- TD50 - toxic dose in 50% of "patients"
- LD50 - lethal dose in 50% of "patients"
How do you calculate therapeutic index (TI) and is a larger or small value safer?
TI is a measure of the drug's safety and the bigger the value the safer the drug
TI = TD50 / ED50
What is the efficacy of a drug?
"effectiveness" - inherent ability of the drug to couple receptor activation to production of a biological effect, refers to the maximal response that can be achieved by a drug (MORE IMPORTANT THAN POTENCY)
• Different drugs can bind to the same receptor, but some might produce a stronger response = "effective!"
What is a drug agonist?
A drug that activates receptors by mimicking endogenous ligands, binding differs by the drug's potency and efficacy
What is a partial agonist drug?
A drug that has the same potency as the endogenous compound, but not the same efficacy
What do you call a drug that binds to a receptor but produces no response, have full binding affinity (potency), but not efficacy?
What is the most pathogenic staphylococcus species?
What are two tests to identify staphylococcus?
1. Catalase test - presence of oxygen bubbles when bacterial colonies are exposed to hydrogen perioxide
2. Coagulase test - coagulase reacts with plasma factors to initiate clot formation
What are S. aureus's three types of toxins?
1. Blood cell toxins
2. Intestinal toxins
3. Epithelial toxins
What causes toxic shock syndrome?
Toxic Shock Syndrome Toxin (TSST) - an epithelial toxin by S. aureus, causes toxic shock syndrome
What is the primary bacteria that causes infections from another infected site or medical devices?
S. aureus, gram (+) or (-)?
Streptococci, gram (+) or (-)?
How is Streptococci classified? (2)
1. Types of Hemolysis
- Alpha Hemolysis: incomplete/partial hemolysis
- Beta Hemolysis: complete RBC lysis
2. Lancefield groups (based on carbohydrate on cell wall)
- Group A
- Group B
What are the two major species of Streptococci?
1. S. agalarase (lancefield group B)
2. S. pyrogenes (lancefield group A)
What is the most serious streptococcal pathogen?
B-hemolytic S. pyogenes (GABHS), can cause streptococcal pharyngitis and skin infections
What are long term complications of GABHS? (2)
rheumatic fever and acute glomerulonephritis
What two infections are caused from endogenous Streptococcus pneumonia? (2)
2. Otitis Media
Diphtheria, gram (+) or (-)?
What is the toxin produced by Diphtheria?
Diphtherotoxin: exotoxin produced by toxigenic strains that effect the upper respiratory system, peripheral nervous system, and heart
What are the two clinical stages of Diphtheria?
1. Local Infection = upper respiratory infection (majority) or cutaneous diphtheria
2. Toxin Production and Toxemia = toxin absorbed from throat and targets heart and nerves
What is the main conditions indicative of upper respiratory diphtheria?
"bullneck" pseudomembrane that can cause asphyxiation
How do you treat C. diptheriae infections?
What does the DTaP vaccine vaccinate from?
Diphtheria, Tetanus, acellular Pertussis
Clostridum bacteria are, gram (+) or (-)?
Why are Clostridum bacteria so difficult to kill?
They from heat resistant endospores
What are the three common strains of Clostridum? (3)
1. C. difficile: abx associated colitis
2. C. tetani: tetanus
3. C. botulinum: Botulism
What medication is used to treat C. diff infections?
A patient with toxic megacolon is likely to have what bacterial infection?
C. diff aka pseudomembranous colitis (CDI)
What is the effect of C. botulinum's exotoxin botulin?
A potent exotoxin that leads to faccid paralysis, prevents the release of ACh
Why is improper canning a perfect environment for C. botulinum?
Because C. botulinum is an obligate anaerobe and improper canning leads to anaerobic conditions that induces spore germination
How is botulism treated? (3)
2. Respiratory and cardiac support
3. Antibiotic Penicilins
What toxin does C. tetani release?
Tetanospasm: neurotoxin agent of tetanus that causes spastic paralysis by binding to motor nerve ends, blocking the release of neurotransmitter for muscular contraction inhibition (opposite of botulism)
How do you treat tetanus?
Antitoxin therapy: Tetanus immune globulin (TIG)
Salmonellosis are, gram (+) or (-)?
What is the most serious strain of Salmonellosis?
S. typhi, causes Typhoid Fever
Is Salmonella a part of normal human flora?
What bacteria invades the villus cells of the SMALL intestine and DOES invades the blood stream and cause intestinal perforation?
What bacteria causes food poisoning?
Shingellosis are, gram (+) or (-)?
What bacteria invades the villus cells of the LARGE intestine and DOES NOT invades the blood stream and cause intestinal perforation?
What toxin does S. dysenterriae produce?
Shinga toxin, an exotoxin that can cause damage to nerve cells, kidneys, and intestines
How is S. dysenterriae transmitted? (5)
The 5 F's
1. Feces to food
Cholera are, gram (+) or (-)?
What is the toxin produced by Vibrio cholerae?
Enterotoxin cholera toxin (CT) - disrupts normal physiology of intestinal cells and large amounts of electrolytes come into the intestine causing profuse water loss
What bacteria causes rice water stool?
How do you gram stain a mycobacteria?
With an acid-fast gram stain
What exotoxins and enzymes are produced by Mycobacterium tuberculosis?
What is the minimum infectious dose of TB for a lung infection?
Clinical course of TB is divided into what? (2)
1. Primary tuberculosis (initial infection)
2. Secondary tuberculosis (reactivation or reinfection)
What is a primary tuberculosis tubericle?
Granulomas with a central core contain TB bacilli and enlarged marophages surrounded by WBC
What is secondary tuberculosis?
Reactivation or reinfection of TB i fthe patient doesn't recover from primary tuberculosis, the tubercles expand and drain into the bronchial tubes/upper respiratory tract
Can CXR findings be used as a diagnosis for TB?
Never, suggestive but never diagnostic
Mantoux test false tests. (2)
False positive - from BCG vaccine
False negative - given to early, pt unable to mount IR
What are two primary spirochaeta pathogens?
1. Treponema: Syphilis
2. Borrelia: Lyme disease
What technique is used to better visualize spirochetes?
What bacteria causes syphilis?
What are the four phases of syphilis?
1. Primary: painless genital ulcer (chancre), serologic tests (-)
2. Secondary: spirochete multiples in the bloodstream, serologic tests (+)
3. Tertiary: cardiac or ophthalmic manifestations, serologic tests (-)
4. Latent: asymptomatic, serologic tests (-)
What causes "Hutchinson teeth" in toddlers?
Late congenital syphilis, teeth look notched and indented
What are "snuffles"?
syphilitic rhinitis, 1st week of life, not common
What bacteria causes lyme disease and how does one get it?
Borrelia bugdorferi through Ixodes species tick (deer tick only)
What is a clear indication that a bite is a ixodes species bite?
Erythema migrans - "bull's eye"
How is Lyme Disease treated?
When should you prophylaxically treat against lyme disease?
1. Attached tick is an adult Ixodes
2. Tick is estimated to have been attached for >36 hr
3. Prophylaxis is begun within 72 hrs of tick removal
What is Rickettsia?
An obligate parasite that requires arthropods for part of their life cycle which serves as vectors
What causes Rocky Mountain Spotted Fever? (RMSF)
The Rickettsia rickettsii, transmitted by all other ticks other than the deer tick
Ironically infrequent in western US
What is the hallmark manifestation of RMSF?
Blanching erythematous rash with macules (1-4mm) that become petechial (spotty and red) over time
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