5 Heart Block *6 Low Complement Hookworms 1 dose Tx for

(LSD Loves Company) Associated Nephrotic  Necatur Americanis Chlamydia

 Lyme Disease Syndromes  Enterobius Azithromycin
 Salmonella  Serum Sickness Vermicularis
 Chagas  SLE  Ankylostoma “Big Mama” Anaerobes
 Legionella  SBE Duodenale  Strep. Bovis
 Diptheria  PSGN  Trichuris Trichurium  Bacteroides fragilis
 MPGN II  Ascaris  C. melanogo-speticus
Reiter’s Syndrome  Cryoglobulineima. Lumbriocoides  C. difficile
 Shigella  Strongyloides
 Yersina Induce P450 *If blood cultures show
 Crohn’s (BAG for CpR QTS) X-linked Enzymes S. bovis or C. melanogo-
 IBD  Barbiturates Deficiencies septicus = rule out colon
 Chylamydia  Alcohol (Fabry and Lesh go cancer.
 Griseofulvin Hunting for Candy, Pie
Low Complement Bugs  Carbamazepine and Gum) Tx for “Big Mama”
(I AM HE)  Rifampin  G6PD anaerobes
 Influenza  CGD (NADPH)  Metranidazole
 Quinidine
 Adenovirus  Pyruvate DH  Clindamycin
 Tetracyclines
 Mycoplasma  Spironolactones  Fabry’s  Cefoxitin
 Hep B & C  Hunter’s
 Lesh-Nyhan Serum Values for Low
 EBV Inhibit P450
(I’D SMACK Quin) Volume State
 K - ↓
Drugs Induced SLE  INH Screen Newborns
 Na - ↓
(HIPPPE)  Dapsone (Please Check Before
 Hydralazine Going Home)  Cl - ↓
 Sulfa Drugs
 INH  PKU  pH - ↑
 Macrolides
 Procainamide  Congenital Adrenal  BP - ↑
 Amiodarone
 Penicillamine  Cimetidine Hyperplasia
 Phenytoin  Ketoconazole  Biotidinase 1 dose Tx for
 Ethosuximide  Quinolones  Galactosemia Gonorrhea
 Hypothyroidism  Ceftriaxone
 Cefixime
Drugs that blast BM P450 Dependent
Action of Steriods  Cefoxitin
 AZT (WEPTeD)
(KIIISS)  Ciprofloxacin
 Benzene  Warfarin
 Chloramphencol  Estrogen  Kills T-cells and  Ofloxacin
Eosinophils  Gatifloxicin
 Vinblastin  Phenytoin
 Inhibit MӨ migration
 Theophylline
 Inhibit Phospholipase Psammoma Bodies
Common Shaped Bugs  Digoxin
A  Papillary CA of
 Vibrio
 Campylobacter SE of Statins  Inhibit mast cell Thyroid
degranulation  Serous Cystadenoma
 Listeria  Myositis
 Stabilizes endothelium of ovary
 H. pylori  Hepatitis
 Stimulates protein  Meningioma
 ↑ Liver enzymes
synthesis  Mesothelioma
Chinese Letters
Corynebacter Painful Genetial
Causes of Severe Drugs that Cause
Lesions
Monocytosis (STELS) Cardiac Fibrosis
Crescent Shaped  Herpes
 Salmonella  Adriamycin
Protozoa  Chancroid (H.ducreyi)
 TB  Phen-Fen
Giardia Lamblia  Lymphogranuloma
 EBV
venereum
TB Treatments  Lymphogramuloma  Listeria Indication for PUD
(RESPI) inguinale  Syphilis surgery
 Rifampin  (IHOP)
 Ethambutol Macrolides  Intractable Pain
Disulfide Bonds
 Streptomycin  Azithromycin  Hemorrhage
(PIGI)
 Pyrozinamide  Clarithromycin  Obstruction
 Prolactin
 INH  Inhibin  Erythromycin  Perforation
 GH
 Insulin
Urease +ive Bacteria IgA Nephropathies Dihydrofolate
(PPUNCHES)  Henoch-Schoenlein Reductase Inhibitors SE of Thiazides and
 Proteus Purpura (HSP)  Pyremethamine/Sulfad Loop dieuretics
 Pseudomonas  Berger’s iazine  Hyperglycemia
 Ureaplasma  Alport’s  Trimethroprim/Sulfam  Hyperuricemia
urealyticum ethoxazole  Hypovolemia
 Norcardia Massive Eosinophilia  Methotrexate  Hypokalemia
 Cryptococcus  (NAACP)
neoformans  Neoplasms Sulfa Containing Drugs MӨ in Various Tissues
 H. pylori  Allergies/Asthma  Sulfonamides Brain…………Microglia
 S. saprofiticus  Addison’s  Sulfonlureas Lung……Type I Pneumo
 Collagen Vascular  Celecoxib (COX2 Liver……….…...Kupffer
Drugs that Cause Disease inhibitor) Spleen………..RES cells
Pulmonary Fibrosis  Parasites Kidney………Mesangial
(BBAT) Silver Staining Bugs LN……………Dendritic
 Bleomycin Risk Factors for  Legionella Skin……...…Langerhans
 Busulfan Primary Liver Cancer  Pneumocystis Bone……..…Osteoclasts
 Amioderone  Hep B and C  H. pylori CT………..…Histiocytes
 Bartonella henselae ………...…Giant cells
 Tocainide  Aflatoxin
 Candida ..…………Epithelioid
 (methotrexate &  Vinyl Chloride
cormustine)  Alcohol
Rashes of Palm & Soles
 Carbon Tetrachloride Blood Gas w Restrictive
(TRiCKSSSS)
Salmonella Typhi  Anyline dyes Lung Disease
 TSS (Toxic Shock)
 High fever  Smoking  Tachypnea
 Rocky Mt. Spotted
 Rose spots  Hemochromatosis  ↓ pCO2
Fever
 Intestinal fire  Benzene  ↓ pO2
 Coxsackie A (Hand,
 Monosytosis  Schistosomiasis  ↑ pH
Foot & Mouth Dis.)
 Heart block
 Kawasaki
9 Live Vaccines Blood Gas with
Obstructive Lung  Scarlet Fever
Drugs that cause  Measles  Syphilis
Myositis  Mumps Disease
(RIPS)  ↑ or Normal pO2  Staph. Scalded Skin
 Rubella  Streptobacillus
 Rifampin  Oral Polio  ↑ pCO2
 ↓ pH moniliformis
 INH  Rotavirus
 Prednisone  Small Pox
MI – Enzymes 4 Sources of Renal Acid
 Statins  BCG
Troponin I  Plasma (RTA)
 Yellow Fever  Ammonia production
Encapsulated Bacteria - appears 2 hrs
 Varicella -peaks 2 days in the collection duct –
(Some Strange Killers
-gone 7 days 10% of Urea Cycle
Have Pretty Nice
Capsules)
Autoimmune Hemolytic  Glutaminase
 Strep. Pneumo (gr. +)
Anemia CKMB -appears 6 hrs  Carbonic Anhydrase
 PTU -peaks 12 hrs
 Salmonella
 Cephalosporins -gone 2 days Hormones Produced by
 Klebsiella
 α-methyldopa Small Cell CA of Lung
 H. Flu B
 Sulfa drugs LDH -appears 1 day  ACTH (MC)
 Pseudomonas
 Anti-malarials -peaks 2 days  ADH
 Neisseria
 Penicillin -gone 3 days  PTH
 Citrobacter
 TSH
Autoimmune MӨ Deficiency  ANP
Encapsulated Yeast Thrombocytopenia  Chediak-Higashi
Cryptococcus
 Aspirin  NADPH-oxidase def 1 Dose Tx - Candidiasis
 Heparin Ketoconazole – 150mg
Jones Criteria
 Quinidine 1 Dose Tx for H.ducreyi
(J♥NES)
 Azithromycin – 1gram 1 Dose Tx – Vaginal
 Polyarthritis (joints)
Pansystolic Murmurs  Ceftriaxone – 250mg Candidiasis
 Carditis (♥)
 Mitral Regurg. im Diflucan – 1 pill
 Nodules subcutaneous
 Tricuspid Regurg.
 Erythema marginatum 1 Dose Tx –
 Ventrical Septal 1 Dose Tx -
 Sydenham Chorea Gardnerella Trichomonas
Defect
Metronidazole Metronidazole
Viruses Related to CA Cavities of Blood Loss Hormones produced by Staph. Epidermiditis
HPV…..Cervical cancer  Pericardium the Placenta Most common infection
EBV…..Lymphoma  Intracranial  hCG of shunts and central
HVB…..Liver carcinoma  Mediastinum  Inhibin lines
HVC…..Liver carcinoma  Pleural cavity  Human Placental
HIV……Kaposi  Thighs Lactogen How do you tell
 Retropritoneum  Oxytocin Catalase positive
NM Disease Concept  Abdominal  Progesterone Staphylococci apart?
 Restrictive Blood Gas  Pelvis  Estrogen (by pigment)
 ↓ pO2 ↓pCO2 ↑ pH Aureus…………....gold
 ↑ RR Uses for Pilocarpine Epidermidis……...white
Negative Stranded RNA
 ↑ Risk for Seizures Saprophyticus….…none
 1-3 week prodromal  Cystic Fibrosis
 ↓ Pulmonary Capillary period before SX  Closed angle
Wedge pressure Strep. pyogenes
 Must switch to Glaucoma
 MCC: all throat
positive stranded
PIE Syndrome infections,
before it can replicate Cause Dysguzia
lymphangitis,
(Pulmonary Infiltrate  Metronidazole
with Eosinophillia) impetigo, necrotizing
Positive Stranded RNA  Clarithromycin
 Necator Americanus faceitis, erysipelas,
 Symptoms occur  Zinc deficiency Scarlet fever
 Ascaris Lumbricoides within 1 week or less
 Schistosomiasis  2nd MCC: all other
 Don’t have to switch Carcinoid Triad skin infections
 Strongyloides before replicating  Flushing
 Ankylostoma  Exceptions – Hanta,  Wheezing Neutrophil Deficiencies
Ebola and Yellow  Diarrhea  Job-Buckley Syn.
Emzymes used by B12 Fever which are
 Methyl Malonyl CoA  NADPH Oxidase
negative stranded **Dx by measuring 5- defic.
mutase HIAA in the urine**
 Neutropenia
 Homocystine methyl Cyanotic Heart
transferase  Myeloperoxidase
Diseases **Most common primary
defic.
 Transposition of great location = appendix**
Increased Susceptibility arteries
Compartment
to pseudomonas and S.  Tetralogy of Fallot **Most common
Syndrome
aureus  Truncus Arteriosus metastatic location =
 Burn patients  Pain (always first)
 Tricuspid Atresia pancreas, ileum**
 Cystic Fibrosis  Pallor
 Total Anomalous
 Diabetes AVMs  Polkiothermia
Pulmonary Venous
 Neutropenics machinery murmur  Parathesia
Return
 Heart: PDA  Pulselessness (always
 Hypoplastic Left Heart
Crohn’s Disease  Elbow: dialysis fistula last)
Syndrome
(“GIFTS”)  Ebstein’s Anomaly  Brain: Von Hippel-
 Granuloma Itchiest Rashes
 Aortic Atresia Lindau
 Illeum  Lungs:Osler-Weber-  Scabies
 Pulmonic Atresia
 Fistula Rendu  Lichen planus
 Transmural  Urticaria
LL to Depolarize
 Skip Lesions Hemophilus Influenza  Dermatitis
 Hypermagnesemia
 Hypercalcemia (except  Gram negative rods herpetiformis
Causes of Widened S2 Atrium)  Pleomorphic
 ↑ pO2  “School of Fish” Oddities About Listeria
 Hypokalemia
 Type A = non-  Only gram positive w/
 ↑ volume Rt. Ventricle  Hypernatremia endotoxin
 Blood transfusion encapsulated, non-
 Crosses placenta
 Supplemental O2 ML to Depolarize invasive, MCC of
 Lipid A is toxic part
 Rt. sided heart failure  Hypomagnesemia sinusitis, otitis,
bronchitis  Causes granulomas
 Pregnancy  Hypocalemia (except
 Type B= encapsulated,  Causes sepsis in
 I.V. Fluids atrium)
invasive, IgA protease, neonates
 ASD (fixed)  Hyperkalemia
MCC of epiglottitis  Raw cabbage, spoiled
 Deep breathing  Hyponatremia
milk
Rust Colored Sputum
 Strep. Pneumoniae
(aka pneumococcus)
B Vitamins Heart Block Clue 5 Causes of SIADH Types of Kidney Stones
B1 – Thiamine  Increased body (SIADH)  Calcium oxalate - 80%
 Beriberi temperature with a  Small Cell Carcinoma  Struvite
 Weirnickes normal heart rate.  ↑ intracranial pressure  Uric Acid
 Korsacoff  A Pain  Cysteine
B2 – Riboflavin  HR should increase by  Drugs  Oxalate
 Angular stomalitis 10bpm for every 1  Hypoxia
B3 – Niacin degree increase in Pseudogout
 Pellagra temperature Cells of Neural Crest  Ca++ pyrophosphate
 4 d’s Origin  + birefringent crystals
B4 – Lipoic acid Macrophages (POT CLAMPS)  Rhomboid crystals
B5 – Pantothenic acid Release MHC II  Parafollicular cells  MC older patients
B6 – Pyridoxine  Odontoblast  Seen equally in both
 seizures TH1 Secrete  Tracheal cartilage genders
B9 – Folate  IL-2  Chromaffin Cells  Tx = Colchicine
B12 – Cobalamine  IF-γ  Laryngeal cartilage
 pernicious anemia  All Ganglion cells MC Non-cyanotic
 neuropathy TH2 Secrete
 Melanocytes Congenital Heart Dis.
 IL-4
 Pseudounipolar cells  VSD
 IL-5  ASD
 Spiral membrane (♥)
Periods of rapid growth  IL-6
 PDA
 Birth – 2 months  IL-10 Ions and the EKG  Coarctation of aorta
 4 – 7 years P-wave = Ca++
 Puberty TH0 Secrete QRS complex = Na+ Enzymes NEVER seen
 TH1 S-T Interval = Ca++ in Glycolysis
Only Immune  TH2 T-wave = K+ Pyruvate carboxylase
Deficiency with Low U-wave = Na+ PEP carboxykinase
Calcium T-Cytotoxic Cells Fructose-1,6-phosphatase
DiGeorge’s Syndrome  CD-8 positive Maximum Sinus Rate Glucose-6-phosphatase
 CD-4 negitive 220-age in years
Bugs with IgA Protease  Recognize MHC I Enzymes ONLY seen in
 S. Pneumonia  Also have markers Tri-Nucleotide Repeats Glycolysis
 H. Influenza CD-2 and CD-3  Huntington’s Hexokinase
 Neisseria  Fragile X Phosphofructokinase-1
(are resistant to IgA) T-Helper Cells  Myotonic dystrophy Pyruvate kinase
 CD-4 positive  Spinal/bulbar
Secretions of Mast Cells  CD-8 negative muscular atrophy Acid Fast Organisms
 Histamine  Recognize MHC II (rare)  Mycoplasma
 Slow Reacting  Also have marker CD-  Norcardia (partially,
Substance of 2 and CD-3 Low volume states with gr+)
Anaphylaxis acidosis (not alkalosis)  Cryptosporidium
 Eosinophil Elevated Cholesterol  RTA (partially, protozoa)
Chemotactic Factor of  Xanthanthomas on  Diarrhea
Anaphylaxis extensor surfaces Microsteatosis Causes
 ↑ risk for CAD MCC Croup &  Acetaminophen
Secretions of Eosinophil Bronchiolotis  Reye Syndrome
 Histaminase Elevated Triglycerides  Parainfluenza  Pregnency
 Arylsulfatase  Xanthelasmas on  RSV (ER this is #1)
 Heparin eyelids and face  Adenovirus Macrosteatosis Causes
 ↑ risk of Pancreatitis  Influenza  Alcohol
Actions of E.coli
 Secrete Vitamin K 4 Causes of Severe Pain 4 D’s of Pellagra Bacteria with Elastase
 Secrete Biotin  Pancreatitis (EtOH)  Dermatitis  Staph. aureus
 Secrete Folate  Kidney Stones (bloody  Diarrhea  Pseudomonas
 Secrete Pantothenic urine)  Dementia
acid  AAA (ripping, tearing  Death Bacteria with toxins
 Aids in absorption of pain) that inhibit EF-2
B12  Ischemic Bowel  Pseudomonas
(bloody diarrhea)  Diphtheria
Phage Medicated Gram Positive Spore Group D Streptococcus MCC of Newborn
Toxins Formers Viridans – green pigment Meningitis
(Oh BED)  Bacillus anthracis – SBE  Group B Strep
“O” antigen (Salmonella)  Clostridium perfrigens Mutans – Cavities  E. coli
Botulinum  Clostridium tetani Sanguis  Listeria
Erythrogenic toxin Salivaris
Diphtheria Used for Cold Bovis Bacteria Accociated
Agglutinin Testing with Colon Cancer
Segmented Viruses Strep. salivarius Nephritis Syndrome  C. melanogosepticus
(I sprayed ORTHO on  Hypertension  S. bovis
BUNYA at the ARENA Drugs that Cause  Hematuria
down in REO to kill Disulfram Reaction  RBC casts Gram – that are strict
SEGMENTED worms)  Chlorpropamide Anaerobes
 Orthovirdiae  Lactams Nephrotic Syndrome H. flu
 Bunyavirdiae  Antabuse  Edema Neisseria
 Arenavirdiae  Metranidazole  Hyperlipidemia
 Reovirdiae  Hypercholesterolemia Pre-renal Failure
3 Toxins of Bacillus  Hypercoaulability Serum BUN > 20
Functions of Adhesion  Lethal factor  ↓ serum albumin Serum Cr > 40
Molecules  Protective factor  ↑ urine albumin Fractional Na exc. < 1%
 Lymphocytes homing  Edema factor
 Inflammation MCC of Airway Renal Failure
 Cell-cell interaction Beta Blockers Infection Serum BUN ~ 10 to 15
B1 Selective: A-M (sinusitis, otitis, Serum Cr < 20
Esophageal/Gastric CA (except C & L) bronchitis, pneumonia) Fractional Na exc. > 2%
Risk Factors Nonselective: N-Z, C, L #1 – S. pneumonia
 Smoking #2 – H. influenza Extravasation
 Alcohol Fanconi Syndrome #3 – N. meningitides  Pavementing
 Nitrates  Defect in proximal  Margination
 Japanese tubule Gastroenteritis within 8  Diapedesis
 Can’t reabsorb hours of eating  Migration
Bladder CA Risk  Low energy state (pre-formed toxin)
Factors  Can be caused by old  S. aureus (potato If Cell Mediated is
 Smoking tetracycline salads) defective – tx for
 Aniline dyes  C. perfringens  Viral
 Benzene Glutaminase (holiday turkey/ham)  Fungal
 Aflatoxin  In collecting duct  B. cereus (fried rice)  Mycobacterium
 Cyclophosphamide  Absorbs ammonia in  Protozoa
 Schistosomiasis the liver Citrobacter  Parasite
 Von Hippel-Lindau  Cause of hepato-renal Cause of multiple  Neoplasm
cerebral abscesses in
 Tubular Sclerosis syndrome
newborns Herpes Viruses
Structures with No 3 Anatomical  I – oral
Narrowings of Ureter MCC of UTI  II – genital
Known Function
 Hilum #1 – E. coli  III – varicella zoster
 Appendix
#2 – Proteus
 Epithalamus  Pelvic Brim  IV – EBV
#3 – Klebsiella
 Palmaris longus  Entrance of bladder  V – CMV
 Pancreatic Polypeptide  VI – Roseola
Most Frequent in
Odd MCC of Death
Females 5-10 yrs and  VII – Pityriasis rosea
Progressing to RPGN SLE, endometrial and
18-24 yrs  VIII – Kaposi’s
 Goodpasture’s (#1) cervical cancer – renal
S. saprophyticus b/c they
 Diabetes Melitis failure Disease Picked up
stick things inside
 Hypertension themselves During Delivery
 Wagener’s Methotrexate Uses  Group B strep
 Dx Fragile X  S. pneumonia
S. aureus
Causes of Papillary  Tx Molar Pregnancy MCC of osteomyelitis  Herpes
Necrosis  Tx Fast growing CA MCC of infection in burn  N. gonorrhea
 Vasculities  Tx Steroid resistant patients  Chlamydia
 AIDS disease
T & B-cell Deficiencies Amino Acid Abbreviations
 WAS – Thrombocytopenia, IL-4, Eczema, ↓ IgM
 SCID – Adenosine deaminase deficiency, T> B, Glycine Gly Threonine Thr
frameshift/nonsense mutation, ↑ bacterial & fungal infx. Alanine Ala Cysteine Cys
 CVID – Tyrosine kinase deficiency, Late onset, Valine Val Tyrosine Tyr
frameshift/missense mutation Leucine Leu Asparagine Asn
 HIV (HTLV-1) – Effects CD-4 rich tissues (brian, Isoleucine Iso Glutamine Gln
testicles, cervix, rectum, blood vessels), T>B Methionine Met Aspartic Acid Asp
 Job-Buckley Syndrome – red headed female, Tyrosine Phenylalanine Phe Glutamic Acid Glu
kinase deficiency Tryptophan Trp Lysine Lys
Proline Pro Arginine Arg
B-Cell Deficiencies Serine Ser Histidine His
 Bruton’s Agammaglobulinemia – Tryosine kinase
deficiency Amino Acids Subgroups
 Leukemias  Acidic: Asp Glu
 Lymphomas
 See above for those with T-cell overlap  Basic: Arg Lys

T-Cell Deficiencies  Sulfur Bonds: Cys Met

 DiGeorge’s – hypokalemia, problem with 3rd and 4th
pharyngeal pouches, deletion of chromosome 22  O-Bonds: Ser Thr Trp
 HIV
 See above for those with B-cell overlap  N-Bonds: Asp Gln

Electron Transport Chain  Branched: Leu Iso Val

 Poisons
Complex I…….Amytal, Rotenone  Bulky (Aromatic): Phe Thr Trp
Complex II……Malonate
Complex III…..Antimycin  Smallest: Gly
Complex IV…..CN, CO, Chloramphenicol
Complex V……Oligomycin  Responsible for Bends: Pro
 Chemical Uncouplers
DNP  Ketogenic: Lys Leu
Free Fatty Acids
 Physical Uncouplers  Gluco-& Ketogenic: Phe Iso Thr Trp
Aspirin
 Glucogenic His Arg Glu Asp Gln
Places where Amino Acids feed in/out of TCA Cycle Asn Tyr Cys Pro Met
 Pyruvate…………..Gly, Ala, Ser Val Ala Gly
 Acetyl CoA……….Phe, Iso, Thr, Tyr, Lys, Leu
 α-ketogluterate……Glu, Gln Essential Amino Acids
 Succinyl CoA…….Phe, Trp, Tyr (PVT TIM HALL)
 Fumerate………….Pro Phe Trp His
 Oxaloacetate………Asp, Asn Val Iso Arg
Thr Met Leu
Amino Acid Deficiencies Lys
 PKU – Phenylalanine hydroxylase deficiency, needed to
make tyrosine, leads to a lack of Dopamine, Epi and *****If there is a deficiency in Phe then Tyr becomes
Norepi, melanin essential (like in PKU). If there is a deficiency in Met then
 Maple Syrup Urine Disease – deficiency in branched Cys becomes essential*****
amino acids (Leu, Lys, Val), defective transport in the
kidneys Restriction Enzymes
 Cystinuria – Cystathione synthase deficiency; cysteine, (Cut to the right unless otherwise specified)
ornithine, lysine and Arginine end up in urine, stones Trypsin…………………………………………….Arg, Lys
Chymotrypsin…………………………….…..Phe, Tyr, Trp
Elastase…………………………………..……Gly, Ser, Ala
Mercaptoethanol…………………………………...Met, Cys
Aminopeptidase……………………………..amino terminal
Carboxypeptidase………………….Left of carboxy terminal
Cyanobromide......……………...……………………….Met
2nd Messangers Co-factors for Pyruvate DH, α-ketogluterate DH &
cAMP……………Sympathetic, catabolic, CRH Branched Chain DH
cGMP………..…..Parasympathetic, anabolic (TLC For Nanna)
IP3/DAG……..…..Smooth muscle contraction by horm./NT  TPP………………………….Thiamin (B1)
…………All hypothalamic hormones (except  Lipoic Acid……………………………..B4
CRH)  CoA………………..Pantothentic Acid (B5)
Ca:Calmodulin…..Smooth muscle contraction by distention  FAD……………………….Riboflavin (B2)
Ca++…………….Gastrin  NAD…………………………...Niacin (B3)
Tyrosine Kinase…Insulin and all growth factors
NO…………….…Nitrates, Viagra, ANP and LPS Diseases with X-linked Inheritance
Recessive
Autoimmune Antibodies  Burton’s Agammaglobulinemia
Disease Anti-  CGD (NADPH Oxidase deficiency)
SLE  Smith  Duchenne’s Muscular Dystrophy
 Double stranded  Color Blindness
DNA
 Hemophilia
 Cardiolipin
 G6PD
Drug Induced SLE  Histone  Lesch-Nyhan
Progressive Systemic Sclerosis  Topoisomerase  Pyruvate DH deficiency
Graves  TSH Receptor  Fabry’s
CREST  Centromere  Hunter’s
Goodpasture’s  Glomerular Basement Dominant
Membrane  Huntington’s
 (aka. Type IV  Vitamin D resistant Rickets
Collagen)
Primary Biliary Cirrhosis  Mitochondria Nephrotic Patterns of Vasculitis
Alopecia Areata  Hair follicle Renal Artery Stenosis…………..Clot in front of renal artery
Rheumatoid Arthritis  IgG Renal Failure…………………….Clot off entire renal artery
Multiple Sclerosis  Myelin Receptors GN…………………………..…………..Inflamed glomeruli
Celiac Sprue  Gliaden/gluten Papillary Necrosis…………………………....Clot in papilla
Type I Diabetes  Islet cell receptor Interstitial Nephritis………………………...Clot of medulla
Focal Segmental GN…………….Clot off pieces of nephron
Vitiligo  Melanocyte
Rapidly Progressive GN…………..Clot off lots of nephrons
Myathenia Gravis  Acetylcholine
receptor MC Nephrotic Disease in Adults…………Membranous GN
Mixed Connective Tissue  Ribonuclear protein MC Renal Dis. in Blacks/Hispanics..…Focal Segmental GN
Disease MC Renal Disease in HIV/drug users...Focal Segmental GN
Pernicious anemia  Parietal cell receptor MC Renal Mass…………………………………..……Cyst
 (aka. Intrinsic factor) MC Malignant Renal tumor in adults……..adenocarcinoma
Pemphigus vulgaris  Epidermal anchoring MC Malignant Renal tumor in kids……….....Wilm’s tumor
protein receptor
 (aka. Intercellular MCC of Rapidly Progressive GN……...…….Goodpasture’s
junctions of MC Nephrotic Disease in kids…....Minimal Change Disease
epidermal cells
Bullous pemphigoid  Epidermal basement ***RPGN – crescent formations
membrane protein ***Minimal Change Disease – 2 weeks post URI
Hashimoto’s  Thyroglobulin
 Microsomal Thrombolytics and Rescues
Scleroderma  Smooth Muscle  tPa………………………………..Amioncaproic acid
 SCL-70  Streptokinase…………………….Aminocaproic acid
Sjogren’s  Rho  Warfarin………………………………..…Vitamin K
 La  Heparin…………………………….Protamine Sulfate
 SSA
If active hemorrhage give Fresh Frozen Plasma (FFP)
 SSB
Wegener’s  Proteinase
 C-ANCA
Polyarteritis Nodosa  P-ANCA
Idiopathic Thrombocytic  Platelet
Purpura  (aka glycoprotein
IIb/IIIa)
Rashes Associated with Cancer
 Urticaria (hives)………..any, but especially lymphoma
 Paget’s Disease……………….....intraductal carcinoma
 Seborrheic keratosis……colon cancer (HIV is sudden ↑)
 Actinic keratosis……...squamous cell carcinoma of skin
 Dermatomyositis (heliotropic, malar)...……colon cancer
 Akanthosis nigricans....visceral CA & end organ damage
 Erythema nodosum………granulomatous (nonbacterial)
Lipoprotein Transport
 Chylomicrons: takes triglycerides from GI to liver &
endothelium
 VLDL: takes triglycerides from liver to adipose
 IDL: takes triglycerides from adipose to tissue
 LDL: only one to carry cholesterol
 VLDL: only made in the liver
 IDL + LDL: break down products of VLDL

Cancer Grading – Severity of microscopic changes Meningitis (MCC)

0 months - 2 months……Group B strep
Cancer Staging – Degree of dissemination of tumor ……E. coli
……Listeria
Tumor Markers/Oncogenes
2 months - 10 years……S. pneumoniae
l-myc Small cell carcinoma ……Neisseria meningitides
of the lung
c-myc Burkitt’s Lymphoma 10 years – 21 years……Neisseria meningitides
n-myc Neuroblastoma
c-abl CML, ALL Over 21 years…………S. pneumoniae
c-myb Colon, AML
c-sis Osteosarcoma, Indications for Pneumovax
glioma,  Covers MC 23 strains
fibroscarcoma  Given at 2, 4 & 6 months
ret MEN II, MEN III  Given to anyone over 65 years old
k-ras Lung, Colon  Anyone who is asplenic
bcl-2 Follicular lymphoma  Anyone with end organ damage (CF, RF, Nephrotic)
(can show up in
Burkitts – pick HIV
follicular first) Most Common Infection.…...…….……………….…..CMV
Rb Retinoblastoma Most Common Cause of death...……………..…………PCP
CEA Colon, Pancreas p41.……………………………………just a surface marker
S-100 Melanoma GP120…..……………………………….attachment to CD4
HER-II, Neu, Erb, Breast Pol….……………………….………………….transcription
BRCA-I & II, p53, CSF-1 Reverse transcriptase….………...……………….integration
p17 and p24 antigens….…………..……………….assembly
Translocations
9:22 Philadelphia Chromosome (CML) Normal CD4 count: 800-1200 in adults (up to 1500 in kids)
8:14 Burkitt’s Lymphoma  <500: begin treating with 2 nucleotide
14:18 Follicular Lymphoma inhibitors and 1 protease inhibitor (750 in kids)
15:17 Promyelblastic leukemia  <200: is AIDS, add treatment for PCP
11:14 Mantle Cell Lymphoma  <100: add treatment for MAC
11:22 Ewing’s Sarcoma
17:22 Neurofibromatosis Characteristics of Autosomal Dominant Inheritance
 Affects males and females equally
Enzymes Needed to Make Glycogen  Manifests in heterozygous state
 Glycogen synthase  Can be transmitted by either parent
 Branching enzymes  Often delayed onset (adult dx)
o glycogen α-1,4 glycosyl transferase  Vertical transmission
o glycogen α-1,6 glycosyl transferase  New mutations occur in germ cells of older fathers
 Can exhibit reduced penetrance & variable expressivity
Enzymes Needed to Break Down Glycogen  Usually structural defects
 Phosphorylase
 Debranching enzyme Characteristics of Autosomal Recessive Inheritance
 Α-1,6-Glucosidase  Disease usually does not effect parents
 Phosphatase  Disease may be seen in siblings and uncles
 Often early onset (early dx)
 Disease only present when both alleles are mutant
 Horizontal transmission
 Usually enzyme defects (Inborn errors of metabolism)
Characteristics of Mitochondrial Inheritance Oxalate Stones
 All females will pass on the disease  In 3 y.o. white female – Cystic Fibrosis
 No males will pass on the disease  In 5 y.o. black female – Celiac Sprue
 All offspring of affected females will be affected  In Adult female – Whipple’s Disease
 Often affects CNS, heart and skeletal muscle  In Adult male or female – Crohn’s Disease
 Due to uneven cytokinesis during meiosis/oogenesis
Pituitary Hormones
Immune System Timeline Anterior: GH
< 24 hours → swelling Prolactin acidophilic
At 24 hours → neutrophils show up
Day 3 → neutrophils peak TSH
Day 4 → T-cells and MØ show up ACTH basophilic
Day 7 → Fibroblasts show up LH
1 month → Fibroblasts peak FSH
3-6 months → Fibroblasts are gone
Posterior: ADH (supraoptic nucleus)
Mitochondrial Diseases Oxytocin (paraventricular nucleus)
Leigh’s Disease: subacute necrotizing
encephalopmyelopathy, progressive ↓IQ, seizures, ataxia,
cytochrome oxidase deficiency Sub-Acute Bacterial Endocarditis
Leber’s Disease: hereditary optic atrophy  MC bacteria is Strep. veridans
 Roth Spots
Tx for Hypercholesterolemia  Janeway lesions (toes)
Statins: P – Provostatin (only one renally excreted)  Osler’s nodes (fingers)
A – Atorvastatin  Splinter hemorrhages
L – Lovastatin liver enzymes every 3 months  Endocarditis
S – Simvastatin  Mycotic aneurysm (septic emboli)
MoA: Inhibit HMG CoA reductase Emphysema Types
 Most active around 8pm Bullous…………..Due to #1 = Staph. aureus
 Must take at night for max efficiency …………Due to #2 = Pseudomonas
Centroacinar……..Due to smoking
Atrial Action Potential Distalacinar ……..Due to normal aging
Phase 0 – depolarization Panacinar………..Due to α1-antitrypsin deficiency
Phase 1 – No name
Phase 2 – Plateau (A-V Node) Erythropoiesis
Phase 3 – Repolarization 4 months gestation……….Yolk Sac
Phase 4 – Automaticity (S-A Node) 6 months gestation……….Spleen, Liver, Flat Bones
8 months gestation……….Long Bones
Pneumonia (MCC) 1 year of age……………..Long Bones
6 wks – 18 yrs: RSV (infants only)
Mycoplasma **If long bones become damages the spleen can take over,
Chlamydia pneumonia resulting in splenomegaly**
Strep. pneumonia
Diphtheria
18 yrs – 40 yrs: Mycoplasma  It’s toxin ADP ribosylated EF-2
Chlamydia pneumonia  Stops cell synthesis
Strep. pneumonia
 Gram positive
 Acquired exotoxin from a virus via transduction
40 yrs – 65 yrs: Strep. pneumonia
 Causes heart block
H. influenza
Anaerobes  Never scrap the membrane b/c it is highly vascular so it
Viruses will bleed and it will also release toxin
Mycoplasma
Cystic Fibrosis
Elderly: Strep. pneumonia  Sweat Test: >60 – definitive positive
Viruses <20 – Normal
Anaerobes 30-60 – Heterozygous
H. influenza  2nd messenger is IP3/DAG
Gram negative rods  Gene is on chromosome 7
 Pilocarpine can be used to treat
Inclusion Bodies Chelaytors
Howell-Jolly…………….………………Sickle Cell  Methylene Blue – Methemaglobinemia
Heinz…………………….…………………G-6-PD  Sodium Thiosulfate – Cyanide
Zebra…………………….………..…Niemann Pick  CaEDTA – Lead (to test)
Donovan……………….…………….Leishmaniasis  Penicillamine – Lead (in plasma)
Mallory……………………………..…..Alcoholism  Dimeraprol – Lead (in bone marrow)
Negri………………………………….……..Rabies
Councilman………………………….Yellow Fever **Tx for cyanide poisoning:
Call-Exner…………………………Ovarian tumors  Amyl Nitrate
Lewy……………………………………Parkinsons
 Sodium thiosulfate
Pick…………………………………Pick’s Disease
 Methylene Blue
Barr Bodies…………………………………Female
 Transfusion
Aschoff………………………..….Rheumatic Fever
Cowdry Type A……………………………..Herpes
Auer Rods……………………………………..AML Renal Tubular Acidosis (acidosis & hypokalemia)
Type I – High urine pH
Globoid…………………………...Krabbe’s Disease
Acidosis
Russell………………………..….Multiple myeloma
Frequent UTI
Schiller-Duvall………………….…..Yolk Sac tumor
Stones
Basal Bodies………………………...Smooth Muscle
Babies die <1 year
Allergic Response
Type II – Low urine pH (2)
Primary – CONTACT
Hypokalemia
 Neutrophils work in the first 3 days
NO carbonic anhydrase
 Then B-cells produce IgM
o Shows up at 3 days
Type III – Combo of Type I and II
o Peaks at 14 days Normal urine pH
o Gone in 2 months
Hypokalemia
 IgG
o Show up at 2 weeks Type IV – Diabetics
o Peaks in 2 months Hyperkalemia
o Gone in 1 year NO aldosterone (Infarcted JG apparatus)
Secondary – MEMORY Hemolytic Properties of Streptococcus
 IgG shows up at day 3 with 5x the concentration α- partial hemolysis Green zone
o Highest affinity for antigen β- Complete hemolysis Clear zone
o Peaks in 5 years γ- No hemolysis Red zone
o Stays for 10 years
Transduction
Bacteria becomes deadly when a virus injects its DNA
Amyloidosis
Transformation
AL Portion Primary amyloidosis, In a hospital or nursing home the bacteria has become
homologous with multiple myeloma deadly by this mechanism
Ig Light chain
Conjugation
AA Unique N- Chronic active disease, Only occurs if bacteria has PILI
terminal sequence Hodgkin’s disease,
Coumadin vs Heparin
Pre-albumin Single amino acid Hereditary neuropathy, Extrinsic Intrinsic
/transthyretin substitution nephropathy and Tissue Blood
cardiopathy PT PTT
Factors 2,7,9,10 Factor 3
AB Β2 microglobin Cerebral artery p.o. i.v.
amyloid, Alzheimers, 8-10 hrs delay immeadiate
Downs, C/I in preg. Ok in preg.
AE Endocrine Aging Inhib Vit K dependant factor DOC for DVT

AP Universally associated with all amyloids (Keep the PeT out side – extrinsic)
(PeT is Cujo who bites – p.o.)
RASHES

Erythrma marginatum  small red spots with bright red margins, sand papery, Rheumatic fever

Erythrma chronicum migrans  target lesion, bullseye, Lyme disease

Measles  morbiliform rash, preceded by cough and conjunctivitis

Roseola  fever for 2 days then rash pops up (rash only after fever is gone), HHV 6

Erythema nodosum  tender nodules and redness on the anterior aspect of the legs
 red macules, target lesions, allergy and viruses
o Mild – Most common cause is viral (2nd is drugs)
Erythema multiforme
o Moderate – Stevens Johnson Syndrome
o Severe – Toxic Epidermal Necrolysis
Seborrheic dermatitis  scaly skin with oily skin on the hairline

Seborrheic keratosis  stuck on wart appearance

Psoriasis  silvery white plaques on extensor surfaces, scaly skin, pitted nails
 red macules, papules, vesicles, pustules then scabs: different stages at the same
Varicella Zoster
time, HHV 3
 rash/blisters on anterior thigh, associated with diarrhea due to Celiac Sprue flare
Dermatitis herpetiformis
up
Typhoid fever  rose spots associated with “intestinal fire”, Salmonella Typhi

Dermatomyositis  heliotropic rash

Erysipelas  reddened area with raised borders, does not blanch

Tinea cruris  redness, itchy groin

Pityriasis rosea  herald patch: dry skin patched that follow skin lines, HHV 7

Tinea versicolor  hypo-pigmented macules on the upper back in a “V” pattern

Scabies  linear excoriation on belt line and finger webs

Hepatitis B
Incubation: 4-26 weeks (8 wk average)
Acute Disease: 4-12 weeks
Convalescence: 4-20 weeks
Recovery: years

Acute recent infection HBcAg+, HBsAg+, (HBcAb +/-)

Recent Immunization (within previous 2 weeks) HBsAg+ only
Immunization (more than 2 weeks previous) HBsAb+ only
Previous infection, now immune HBcAb+, HBsAb+, HBsAg-
Infectious HBeAg+
Non-infectious HBeAg-
Chronic carrier HBsAg+ for more than 6 months (HBsAb+/-)
Window period HBeAb+, HBcAb+, HBsAg-
HLA Markers Diseases Pneumonic
2 Itchy Sheep (Mary and Sarah), Sleep in a
DR-2 Narcolepsy, Allergy, Goodpasture, MS Goodpasture
DR-3 Sjogren’s, SLE, Celiac Sprue, Chronic Active Hepatitis 3 S’s and Chronic Active Hepatitis
DR-3 & 4 IDDM Type I
DR-4 Rheumatoid Arthritis, Pemphigus vulgaris RAP
DR-5 Juvenille Rheumatoid Arthritis, Pernicious Anemia JRAP
DR-7 Steroid Induced Nephrotic Syndrome
DR-3 & B-8 Celiac Disease
A-3 Hemochromotosis
B-8 Myathenia Gravis
B-13 Psoriasis w/o arthritis
Psoriasis w/ arthritis, Ankylosing Spondylitis, IBD,
B-27 Reiter’s, Postgonococcal arthritis 2PAIR
BW-47 21-α-Hydroxylase deficiency (Vitamin D)

Immunoglobulins

 Monomer in the blood

IgA  Dimer in secretions
 Protects the mucoscal surfaces and body secretions
IgD  Only known function is as a surface marker on mature B-cells
 Mediator of Type I hypersensitivity (anaphylaxis)
 Parasite defense
IgE  Responsible for allergies
 Fc portion binds to mast cells and basophils
 Does not fix complement
 Second to be produced during the primary immune response
 Only one to be produced during the secondary immune response
 In memory (secondary) response
o Shows up a 3 days with 5x the concentration of primary response
o Peaks around 5 years
IgG o Some remain in circulation for 10 years
 Has 4 subclasses (antigenic differences in heavy chains and with disulfide bonds)
o IgG1 – crosses the placenta due to Fc portion
o IgG2 – most common deficiency, susceptible to encapsulated organisms
o IgG3 – Most memory antibodies
o IgG4 – Only one that does not fix complement
 Present only in the primary immune response
IgM  Most effective in agglutination and complement fixation
 Defense against bacteria and viruses

Hyperlipidemias

Type Deficiency Component ↑ Misc Information

I Lipoprotein Lipase – defect of the liver type only Chylomicrons
II Receptor or receptor enzyme – IIa, IIb, or B100 LDL Most common in general population
III APO E receptor IDL
IV Lipoprotein Lipase – defect of the adipose type only VLDL
V Enzyme and receptor defect – APO CII Chylomicrons & VLDL Associated with diabetes melitis
Interleukins and Other Inflammatory Mediators

 Secreted by macrophages
IL-1  Causes fever and other non-specific symptoms of illness
 Recruits Thelper cells
 Secreted by T cells
 Most potent
IL-2
 Most powerful Chemotactic factor (recruits everyone)
 Must be inactivated prior to transplantation
 Secreted by T cells
IL-3  Causes B cell proliferation
 Labeled by Thymidine
 Secreted by T cells
IL-4  Causes B cell differentiation
 Responsible for class switching to IgG and IgE
 Secreted by T cells
IL-5
 Responsible for class switching to IgA
IL-8  Neutrophil Chemotactic factor
 Suppresses cell mediated response
IL-10
 Tells macrophages and T-cells to stay away if there is a bacterial infection
 Promotes cell mediated response
 If infection in non-bacterial it is released to recruit macrophages and T cells
IL-12  Activates NK cells to secrete IF-γ
 Inhibits IL-4 induced IgE secretions
 Changes TH cells into TH1 cells
 Secreted by Leukocytes
 Inhibits viral replication and tumor growth
IF-α  Increases NK activity
 Increases MHC (class I and II) expression
 Interferes with protein synthesis
 Secreted by fibroblast
 Inhibits viral replication and tumor growth
IF-β  Increases NK activity
 Increases MHC (class I and II) expression
 Interferes with protein synthesis
 Secreted by T-cells and NK cells
 Increases NK activity
 Increases MHC (class I and II) activity
IF-γ
 Increases macrophage activity
 Co-stimulates B-cell growth and differentiation
 Decreases IgE secretion
 aka Cachectin
 Secreted by monocytes and macrophages
 Induces IL-1
TNF-α  Increases adhesion molecules and MHC class I on endothelial cells
 Is a pyogen
 Induces secretion IF-γ
 Cytotoxic/Cytostatic
 aka Lymphotoxin
TNF-β  Secreted by T-cells
 Cytotoxic
 Secreted by solid tumors (carcinoma<sarcoma) and monocytes
TGF-α
 Induces angiogenesis, keratinocyte proliferation, bone resporption and tumor growth
 Secreted by platelets, placenta, kidney, bone, T-cells and B-cells
 Induces fibroblast proliferation, collagen synthesis and fibronectin synthesis
TGF-β
 Inhibits NK, Lymphokine Activated Killer Cells, Cytotoxic T Lymphocytes, T cell & B cell proliferation
 Enhances wound healing and angiogenesis
**IL = Interleukin** **IF = Interferon** **TNF = Tumor Necrosis Factor** **Transforming Growth Factor**
EKG Breakdown

Portion of EKG Portion of Heart Phase of Action Potential

P-wave Atrium 0
P-R interval AV node 2
Q-wave Septum 2
R-upstroke Anterior wall 2
S-downstroke Posterior wall 2
S-T interval Ventricle 2
T-wave Ventricle 3
U-wave Ventricle 4

Adhesion Molecules

IgCAM ICAM-1, ICAL-2,  Homing of lymph nodes to site of inflammation

ICAM-3  Found on T-cells, endothelial cells, dendritic cells

LFA-3  Mediate T-cell interactions

BINDING PROTEINS
 Found on lymphocytes, APC

LFA-2 (CD2)  Found on T-cells, NK cells

Integrins VLA-1 (β1)  Migration thru extracellular matrix

 Widely distributed

LFA-1 (β2)  Tight binding to endothelium

 Found on lymphocytes

CR3 (β2)  Tight binding to epithelium

STOPS THE LEUKOCYTES
 Phagocytosis
 Mac-1
 CD11/CD18

CR4 (β2)  Phagocytosis

 Opsonin receptor

Selectins E-selectins  Leukocyte migration and homing

 Found on activated endothelium

L-selectins  Initial binding to endothelium BIND CARBOHYDRATES

 Found on leukocytes MEDIATES “ROLLING”
(slows leukocytes)
P-selectins  Leukocyte migration to inflammatory sites
 Found on activated endothelium and platelets

Hypersensitivities
(ACID)
Type I - Anaphylaxis
 IgE binds to mast cells – degranulates mast cells
 IgA activates IP3 cascade – degrades mast cells
Type II - Cytotoxic (humoral) – Goodpasture, Autoimmune hemolytic anemia
Type III - Immune Complex mediated – Rheumatoid arthritis, SLE
Type IV - Delayed (cell mediated) – TB skin test, contact dermatitis, transplant rejection
Mechanisms of Actions

Drug Mechanism
5FU Inhibits thymidylate
Methotrexate Inhibits dihydrofolate reductase
Hydroxyurea Inhibits ribonucleotide reductase
Vincristine/Vinblastin Inhibit microtubule formation
Paclitaxel Inhibits microtubules from migrating
Levamisole Stimulates Natural Killer (NK) cells
1. Kills T-cell and Eosinophils
2. Inhibits macrophage migration
Steroids 3. Inhibits phospholipase A
4. Inhibits mast cell degranulation
5. Stabilizes endothelium
Statins Inhibit HMG CoA reductase
Niacin Decreases VLDL production in the liver
1st generation - Block potassium channels in the islet cells preventing insulin release
Sulfonylureas
2nd generation – Promote insulin release and inhibit gluconeogenesis in the liver
Miglitol/Ascarbose Inhibit glucose absorption from the GI
Metformin Stops gluconeogenesis in the liver
Troglitazone Increases the sensitivity of insulin receptors
Anti-psychotics Block dopamine receptors
Aspirin Irreversible inhibitor of cyclo-oxygenase
K+ Sparing Diuretics Competitive aldosterone receptor antagonist
Topical Anesthetics Block Na+ channels
Quinalones Block topoisomerase (supercoils)
Aminoglycosides Blocks Initiation Factor (IF) 2 on the 30S subunit
Tetracyclines Blocks tRNA binding on the 30S subunit
Rifampin Blocks beta subunit of RNA polymerase
Sulfa Drugs Blocks Para-Amino Benzoic Acid (PABA)
Cephalosporins Inhibit the cell wall
Penicillins Block transpeptidase
Chloramphenicol Blocks peptidyl transferase on the 50s subunit
Clindamycin/Lincomycin Blocks translocase on the 50s subunit
Macrolides Blocks translocase on the 50s subunit
Mitronidazole Increases production of free radicals
Vancomycin Blocks cell wall (phopholipid)
Benzodiazepine Increase the frequency of the GABA receptors via Cl- channels
Barbiturates Increase the duration of the GABA channels via Cl- channels
TCAs Block reuptake of catacholamines, AV conduction and alpha receptors
SSRIs Block reuptake of Serotonin
MAOIs Inhibit MAO
Lithium MOA is unknown but is suspected to be related to it mimicking of Na +
Valproic Acid Blocks Na+ and sometimes Ca2+
Carbamizapine Blocks Na+ and Ca2+
Epinephrine Blocks Beta (2>1) receptors and then Alpha receptors
1st generation – blocks H1 and H2 receptors (H1>H2)
Antihistimines
2nd generation – blocks H2 only
Decongestants Alpha agonists
Antibiotic Coverage

Simple
Gram+ & All Gram- &
Gram+ Gram- Atypicals1 Anaerobes Richetisia Other
S.aureus pseudomonas
only3
Quinolones X X X
Aminoglysides X
Tetracyclines X X X X
Cephalosporins 2
X X X
Penicillins X X2
Macrolides X X X
Sulfa Drugs X X
Chloramphenicol X X X
Clindamycin X X X
Vancomycin X X *
Mitronidazole X **
Rifampin ***

1
Includes chylmydia, Mycoplasma, ureaplasma and legionella)
2
Simple only (no “Big Mama”)
3
H.Flu (not B) and E. coli)
* pseudomembranous colitis, MRSA and enterococcis
** protozoa
*** TB