I & D exam 2

watery, no inflammatory cells, blood

Clinical features of travelers enteric condition

thrombocytopenia

result of untreated hemolytic uremic syndrome characteerrized by low platelet levels

poor sanitation (fecal-oral trransmission)

key risk factor for Salmonella enterica serovar
Typhi

should not be treated with antibiotics due to release of toxins

what is important to note in the treatment of hemolytic urea syndrome

pseudomembrane colitis

caused by C. difficile enterotoxin, can occur after antibiotics, yellow pseudomembrane in the colon, symptoms include diarrhea, fever, and pain

abrasions, mucous membranes, or across placenta

how does syphilis spread

ETEC, EPEC, EAEC, vibrio cholerae, rotavirus, norovirus, adenovirus, giardia, cryptosporidium

Causative agents of travelers enteric condition

bloody stools mucousy from pus, hemolytic uremic syndrome

Clinical features of inflammatory enteric condition

H . pylori

strongest risk factor for gastric cancer if left untreated, second to smoking as defined cause of cancer

syphilis

what disease is gumma necrosis associated with

H. Pylori

what bacterial. species has been associated with chronic gastritis

 EHEC, EIEC, shigella, campylobacter jejuni, non-typhi salmonella, entamoeba histolytica 

Causative agents of inflammatory enteric condition

watery, inflammatory if due to C. difficile 

Clinical features of abx-associated enteric condition

C. difficile

Causative agents of abs associated enteric condition

food poisoning, not contagious, short duration

Clinical features of intoxication enteric condition

S. aureus, B. cereus

Causative agents of intoxication enteric condition:

C. difficle

The main cause of healthcare-associated infections

intoxication (toxin-mediated)

Which enteric condition would antibiotics not be effective:

typhoid fever/enteric fever

Humans are the only reservoir for which disease:

enteric fever/ typhoid fever

prolonged fever, bowel perforation, meningitis osteomyelitis, septic arthritic, chronic carriage

fecal-oral route

How is typhoid fever transmitted

salmonella enterica typhi and para-typhi

Causative agents of typhoid fever/enteric fever

urease, vacA, cagA, modified LPS, mutated flagella

Virulence factors of H pylori

gastric-oral,oral-oral, and oral-fecal

Transmission modes of H, pylori

elevate gastric pH

Function of H. pylori urease

triggers reorganization of actin cytoskeleton in epithelial cells

Function of H. pylori CagA

apoptosis of gastric epithelial cells and induces inflammatory cytokines

Function of H pylori  VacA

stool ag test, urea breath test, stool pcr, culturing biopsy

Diagnostic test for H. pylori

Haemophilus influenzae

normal flora of nasopharynx, associated with meningitis, pneumonia, and epiglottitis

Bordetella pertussis

Causative agent of whooping cough

Bordetella pertussis

pertussis toxin, inhibits ciliary function, disrupts cytokine production and neutrophil recruitment

Legionella pneumophilia

transmitted through water supply, legionnaires disease (atypical pneumonia), pontiac fever, no human-to-human transmission

Chlamydia pneumoniae

atypical pneumonia, most common in school age children

Mycoplasma pneumoniae

atypical pneumonia, mild illness, “walking pneumonia”

Typical pneumonia

pneumonia responsive to cell wall antibiotics, causative agents streptococcus pneumoniae and Haemophilus influenza, presents with severe acute infection

Atypical pneumonia

not responsive to penicillin, mild symptoms, causative agents mycoplasma pneumonia, legionella pneumophilia, chlamydia pneumoniae, subacute

mycoplasma pneumonia, legionella pneumophilia, chlamydia pneumoniae

Causative agents of atypical pneumonia

streptococcus pneumoniae and Haemophilus influenza

Causative agents of typical pneumonia

B-lactams

 bactericidal cell wall membrane disruption agent

penecilins and cephalosporins 

Examples of B lactams

macrolides, tetracyclines, clindamycin

Bactriostatic protein synthesis inhibition agents

trimethoprim/sulfamethoxazole, metronidazole

Bacteriocidal DNA/RNA function disruption agents

disrupt bacterial cell walls

What is the mechanism of action of cephalosporins

tetracyclines

What drug class does doxycycline belong to

lysis of bacterial cell walls

MOA of penicillin

penicillin

Drug of choice for strep pharyngitis, adverse drug reactions rare

lysis of bacterial cell walls

MOA of amoxicillin

amoxicillin

More stable than penicillin against b-lactamases, diarrhea most common ADR (adverse drug reaction)

binds bacterial 50s ribosomal subunit and inhibits protein synthesis

MOA of clindamycin

clindamycin

Most commonly used as an alternative to penicillin, C. diff associated diarrhea common ADR, serum conc. can be altered by other drugs,

destabilizes anaerobic cell DNA

MOA of metronidazole

metronidazole

reactions when taken with alcohol, ADR metallic taste, furry tongue, nausea, can use in tandem with other abx with strep and staph coverage

diarrhea

What is the most common adverse reaction for amoxicillin-clavulanates

stabilizes amoxicillin against b-lactamases

What does clavulanate do in amoxicillin-claculanate

limit uptake, inactivate drug, modify target, efflux pump

Mechanisms bacteria develop resistance

Limit uptake

bacterial resistance mechanism characterized by high lipid content restricts hydrophilic drug access, thickened cell wall limits access, reducing the number of membrane porin channels

inactivation

mechanism of bacterial resistance in which B-lactamases produced by gram-negative bacteria inactivate drug

Modifying drug target

mechanism of bacterial resistance characterized by alteration in structure or function of penicillin-binding proteins (PBPs), ribosomal mutation or subunit methylation, mutation in enzymes involved in folate biosynthesis

without clavulanate amoxicillin can be cleaeved by penicillinases

What is the benefit of adding clavulanate to amoxicillin

Intrinsic resistance

mechanism of antibiotic restistant in which mycoplasma do not have cell wall so are not inactivated by antibiotic that target cell wall

Acquired resistance

bacteria mutate or can transfer resistance between one another

mycobacteria,staph aureus, enterobacteriaceae

Examples of bacteria that limit uptake of an antibiotic

Type I drug hypersensitivity/Anaphylactic

IgE associated, decreased BP or difficulty breaething, hives, angioedema

Type II drug hypersensitivty/cytotoxic

IgM associated, decrease number of affected cells

Type III drug hypersensitivity/immune complex

IgG associated, Fever, arthrralgias, fatigue, rarsh in 25% of cases

Type IV drug hypersensitivity/cell-mediated

no atb, contact dermatitis, masculopapula rash, SCARs

Viral infection masquerading as allergic reaction to drug

Why are people often misdiagnosed as allergic to antibiotics

Chlamydia trachomatis

#1 sexually transmitted bacterial disease in north america

C. trachomatis, C. pneumoniae, C. psittaci

Important bacteria related to chlamydial diseases in humans

mucous membrane disease

Chlamydial disease caused by C. trachomatis

respiratory

Chlamydial disease caused by C. pneumoniae

psittacosis

Chlamydial disease from birds caused by C psittaci

Gonococcal stomatitis

 usually asymptomatic infection that can spread by kissing an infected pearson as well as genital contact

pharyngitis, tonsillitis, fever,and swollen lymph nodes

Symptoms of gonococcal stomatitis

treponema pallidum

Causative agent of syphilis

stage of syphilis characteized by chancre lesion on male or female genitalia

Primary syphilis

Secondary syphilis

stage of sphilis with skin rash in palms and soles, mucous patches, condylomata lata

Tertiary syphilis

stage of syphilis characterized by gummatous lesions (gummas), cardiovascular syphilis, neurosyphilis

1-30 years

Latency time of syphilis

Gumma, luetic glossitis, painless swelling of parotid gland

Clinical manifestations of tertiary syphilis

hutchinson triad, rhagades, frontal bossing, short maxilla, perforated palate, saddle nose, mucous patches

Orofacial features of congenital syphilis

Deaf, Blind, malformed teeth

Hutchinsons triad

bartonella henselae

Causative agent of Cat Scratch Disease

Klebs-loeffler bacterium/corynebacterium

Causative agent of diphtheria

Diphtheria

heart develops conduction problems, palate can become paralyzed, diptheric membrane in throat can suffocate the patient

diarrhea caused by clostridiodes difficle

what is. a potential. concerning advrse reaction for a pateeint taking clindamycin

inhibits bacterial protein synthesis

what is the mechanism of action for clindamycin

penicillins

to which drug class does amoxicillin belong

sanford guide

which resource on the care provider toolkit would give information solely about infectious diseases and agents used to treat them

haemophilus influenzae

causative agent of otitis media (ear infection) among young children

EHEC, EIEC, shigella ect.

infection by which type of bacteria would lead to hemolytic uremic syndrome

purple ecchymosis,petechiae, gingivial hemorrhage

oral manifestations of hemolytic uremic syndrome (HUS) thrombocytopenia

legionella pneumophila, chlamydia pneumoniae, mycoplasma pneumonae

causitive agents of atypical pneumonia

C. trachomatis

Which Chlamydia species would cause infant pneumonia, ocular infection, or primary lesions in the oral cavity?

inactivate drug

by what mechanism do beta-lactomases confer bacterial resistance?

metronidazole

for which antibiotic will patients need to avoid alcohol?