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Infectious Diseases

Infectious Diseases

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Published by: amarysia2003 on Feb 26, 2010
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INFECTIOUS DISEASES
Dr. J. Keystone, and Dr. S. WalmsleyEsther Bui and Sharmistha Mishra, chapter editorsGeena Joseph, associate editor 
BACTERIA
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Glossary of Bacterial Terms
 AEROBIC BACTERIA
. . . . . . . . . . . . . . . . . . . . . . .
3
Gram Positive CocciGram Positive BacilliGram Negative CocciGram Negative Bacilli
 ANAEROBIC BACTERIA
. . . . . . . . . . . . . . . . . . .
14
Gram Positive CocciGram Positive BacilliGram Negative Bacilli
OTHER BACTERIA UNDETECTABLE
. . . . . . .
16BY GRAM STAIN
 Acid-FastSpirochetesIntracellular Parasitic BacteriaMiscellaneous
 VIRUSES
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20DNA VIRUSES
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
Herpes VirusesPapovavirus AdenovirusesOther DNA Viruses
RNA VIRUSES
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
RetrovirusesPicorna VirusesOrthomyxo VirusesParamyxo VirusesToga VirusesRhabdo VirusesOther RNA Viruses
FUNGI
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
Primary Pathogenic FungiOpportunistic Fungi
PARASITES
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30PARASITES (PROTOZOA)
. . . . . . . . . . . . . . . . .
30
Intestinal and VaginalBlood and Tissue
PARASITES (HELMINTHS)
. . . . . . . . . . . . . . . .
34
IntestinalBlood and Tissue
 ANTIMICROBIALS
. . . . . . . . . . . . . . . . . . . . . . . . . . .
39
General Principles
MCCQE 2002 Review NotesInfectious Diseases ID1
 ANTIBACTERIALS
. . . . . . . . . . . . . . . . . . . . . . . .
39
Cell Wall Synthesis Inhibitors (Bactericidal)Protein Synthesis Inhibitors- Via 50S Ribosome (-static)- Via 30S Ribosome (-cidal)- Via 30S Ribosome (-static)Folic Acid Metabolism Inhibitors (-static)DNA Gyrase Inhibitors (-cidal)DNA-Directed RNA Polymerase Inhibitors (-cidal)DNA Complex Damaging Agents (-cidal)
 ANTIMYCOBACTERIALS
. . . . . . . . . . . . . . . . . . .
42
 Anti-Tuberculosis (TB) Drugs Anti-
M. Avium-Intracellulare
Complex Drugs Anti-Leprosy Drugs
 ANTIVIRALS
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
43
Non-Nucleoside Polymerase InhibitorsNucleoside Analogs
 ANTIFUNGALS
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
45
PolyenesImidazolesTriazoles
 ANTIPARASITICS
. . . . . . . . . . . . . . . . . . . . . . . . . .
46
 Anti-Protozoal Drugs Anti-Malarial Drugs Anti-Helminthic Drugs
INFECTIONS IN THECOMPROMISED HOST
. . . . . . . . . . . . . . . . . . . .
47
HIV and AIDSFebrile NeutropeniaTransplant or Leukemia/LymphomaInfections in a Diabetic Patient
FEVER OF UNKNOWN ORIGIN
. . . . . . . . . . . . .
49HIV AND AIDS
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
50COMMON INFECTIONS
. . . . . . . . . . . . . . . . . . . .
57REFERENCES
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
62
 
ID2Infectious Diseases MCCQE 2002 Review Notes
BACTERIA
Figure 1. General Schematic of Bacterial StructureFigure 2. Bacterial Morphology 
Illustrations by Miyuki Fukuma
GLOSSARY OF BACTERIAL TERMS
 Virulence Factors
Flagellaprotein filament tails that propel the bacteria (motility)
Pilishorter than flagella, serve as adherence factorssome bacteria use sex pili for reproduction
Capsulesprotective layer surrounding cell membranes, usually made of secreted carbohydrate residues, helps to evade host immune response
Endospores
metabolically dormant forms of bacteria, may lie dormant for yearsonly Bacillus and Clostridium
Toxins
Exotoxinsproteins released by bacteria that cause disease independent of the bacterianeurotoxins act on nerves or motor endplatesenterotoxins act on the GI, etc.
Endotoxinsnormal part of the bacterium that may be shed while living, oreleased during cell lysis causing disease processes (i.e. septic shock)
capsulepeptidoglycanlayer cytoplasmicmembraneDNAribosomesplasmidouter membrane(with lipopolysaccharides)flagellum
Gram PositiveGram NegativeGram PositiveComplex Formations
clusterschainsdiplococci
Major Shapes
coccibacilli or rodsspiral formspleomorphic
 
MCCQE 2002 Review NotesInfectious Diseases ID3
BACTERIA
. . . CONT.
Table 1. Bacterial Classification
GramAerobesAnaerobesStainCocciRods
Gram +veStaphylococcusCorynebacterium diphtheriae Streptococci/Peptostreptococci-S.aureusListeria monocytogenes-S.epidermidisBacillus cereusClostridium-S.saprophyticusNocardia-C.tetaniStreptococcus-C.botulinum-S.pyogenes (Group A)-C.perfringens-S.agalactiae (Group B)-C.difficile-Group D Strep (S. bovis)-S.viridans-S.pneumoniaeEnterococcusGram -veNeisseriaEscherichia coliBacteroides-N.meningitidisKlebsiella pneumoniae-B.fragilis-N.gonorrheaEnterobacter spp.FusobacteriumMoraxella catarrhalisProteus mirabilisShigellaSalmonella-S.typhi-S.enteritidisPseudomonas aeruginosaCampylobacter jejuniHelicobacter pyloriVibrio choleraeHemophilus-H.influenzae-H.ducreyiBordetella pertussisLegionella pneumophila Yersinia-Y.enterocolitica-Y.pestisPasteurella multocidaUn-detectableMycobacterium, Spirochetes, Chlamydia, Bartonella, & Mycoplasma spp. (due to lack of cell wall)
 AEROBIC BACTERIA
GRAM POSITIVE COCCI
Staphylococcus aureus (S. aureus) 
microbiologyGram positive, catalase-positive cocci in grape-like clusters/tetradsits production of catalase differentiates it from Streptococcuscoagulase-positive more virulent; coagulase-negative strains only cause disease in the setting of prosthesis/foreign body
mode of transmissionnormal flora of human skin, respiratory and gastrointestinal tracts25% of healthy adults are colonized in anterior naresperson-to-person transmission and via contaminated fomitesimportant cause of hospital-acquired infectionsrisk factors for infection include: broken skin, young, old, foreign bodies
clinical featuresEXOTOXIN DEPENDENTstaphylococcal gastroenteritis (enterotoxin)sudden onset of vomiting and diarrheaassociated with cream, ham, poultryheat stable therefore not destroyed by cookingtoxic shock syndrome (TSS toxin-1)from focal infections and/or colonizationacute onset of high fever, nausea and vomiting, watery diarrheadesquamation of skin (palms and soles)hypotension, renal/liver dysfunctionassociated with tampon use (rare), nasal packing, wound infections

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