Microbiology , Parasitology ,

Public Health d. .

Biogenesis Theory
↓ ↓ ↓ -

concept : preexistingcells
→
livings
cells
study of
study of Art & science of
↳* No evidence
Microorganism parasites ✓
preventing dse Rudolf Virchow →

life
Outline
✓
prolonging health
* Louis Pasteur →
microorganism
↓
✓promoting in the air, but
present
'
"
use of heat ✓
I Introduction "

efficiency through Pasteurization How

_

not come
they do
.

④ organisms
II. Bacteria
organized community 1 aseptic technique ) air
II. Virus efforts
II. Fungi Pasteurization -

home 63°C ✗ 30min,

I Parasites short-term 72°C

.

high temp , ,
✗
15sec
UHT 140°C ✗ 4 secs

Introduction :

A. General Principles Golden

e.
Age
History theory of
"
Germ
"
i. Disease

a. Robert Hooke -
cell theory -
Robert Koch
✓ Bacillus anthracis ( cattle)

11111=+00 ✓ Koch 's postulates

#① microorganisms
b. Leeuwenhoek
ED
Van cell
If
Anton
sperm ① ④
-

"

animalcules
"
-

disease health
C-
Spontaneous Generation
-

living cells will come out of

#② microorganisms
nowhere

*
opponents :
Francesco Redi
µ →

§
isolate organism }

grow
in pure culture

I >
larva

¥ -
meat

#③

A )
°

John Needham
*
Proponent :
disease
- - heavy
•
> cool >
E-

#⑨{}y→
→
≈ _

* larva
isolate
broth re
organ

Opponent Spallanzani
:
* Lazaro
Typhoid Tipus →
Tagalog
retsemble Typhus →
Rickettsias,
*
Exceptions :

Poultry pdts
° ~~ Normal flora
≈ > cool →

"
C) larva ✓ Carrier →
"
Typhoid Mary salmonellosis

broth Éka typhi fever

marry
kooks
→ Typhoid
?⃝
 :
Exception #3 Stationary Phase -
loss of nutrients

micbaterimleprae -
Hansen 's disease -
✗ ↑ in number

armadillo, mouse
food pad
#9 Decline ↓ # of organism
✗
pure culture phase
-
-

of medical
2.
Organisms important b.
Requirements thermophile
a. Prokaryote vs
Eukaryote i.
Physical
✗ true nucleus
to temperature mesophilepsychnphilelcoph.ie
✗ membrane bound * recall Fever
organelles
:

fission 37.2°C
binary mitosis morning
-

37.7°C
night
-

> 37.8°C -

clinical

"
of food
"
* recall :
danger zone

b- 3- domain system =
Carl Woese 6 -40°C

Eu bacteria Archaebgrcteria Eukarya ( fungi -5.5 )

* pH ± 6. s to 7.5

eukarya * osmotic
pressure = flow of solvent
prokaryote prokaryote i. e. algae
-

peptidoglycan >
cell wall ✗ ✗ ×
fungi SALT
animals H2O Thor
i. e.
methane
inehanogen
hyper thermophile
plants A
environment
-

shrinkage
hypertonic
:
↳ extreme heat case

extreme halophilic salt salt

salt
↓
halophiles
Salt +

3. Microbial Growth
↳°
salt
salt
a.
stages

chemo heterotroph

3
ii. Chemical
* carbon
[ -
CHO , CHON , fats
g chemo
# organism
2
autotroph
, Photoantotroph
CO2
-

time
Pseudomonas
*
Oxygen / spp
#A
Long phase obligate aerobe Mycobacterium spp
-
-

↓ Nocardia
Respiratory
d" spp
#2
Log / Exponential
causes
-

Org continuously multiply Leptospira spp

"

-
"
bactericidal →

very efficient
at

☆ bacteriostatic facultative
Log phase anaerobe E. coli
-
•

I ✓✓ 02

slow down
✓ no 02

case : "
"
Actinomyces spp
cida 1- static
" "
Obi /
growth •
gate aneorobe >
Bacteroides spp
= ↓ cidal activity → dies at presence of Oz Clostridium spp
 aero tolerant Lactobacillus spp Moist Heat Dry heat
• -

Propioni bacterium aches

autoclave over

microaerophiles -

spirochetes Leptospira sp\p MOA: Oxidation

-
needs little 02
only Treponema spp 121°C
, 15ps's ,
15 -20 mins
Borrelia
supp .

MOA : coagulation of
c. Control proteins
i.
History
Ignds Somme / Weiss ,
Joseph
↓
Lister
✓ for heat
↓ ←
Phenol Filtration = -
sensitive materials
hand Before surgery titer
washing i. e. membrane
Air
↑ infection ↓ infection High Efficiency Particulate
Filter
pregnant pregnant
in Hospital
in House
-
remove
particles > 0.3 mom

Limitation :
Mycoplasma
-

↓ spp
Autopsy
physician →
mÉrgue before spirochetes
magpaanak
✓
Low temperature : bacteriostatic
ii. Definition of terms
* microbial cell death -
irreversible loss of ✓
High pressure =
liquid pdts ( fruit juice

ability to reproduce = ( preserve taste)

✓ Dedication of
* sterilization -

complete removal of =
removal H2O
" "
all forms oforganisms freeze hypnotization
drying
-

Limitation :b
pores , viruses
-

* intermittent sterilization
Tyndall ization
-

✓
I John
Tyndall) Osmotic
pressure
animate objects Maharaj✗ ray
-

ionizing
inanimate objects >
-_ ,

disinfectant ↓ shorter wavelength

Radiation
-

* antiseptic vs -
DNA damage
# Goal level that will
>
UV
orgs to nonionizing
: ↓
. a not =

cause disease longer wavelength

-

thymine formation
-

dimer
_

* Sanitization -
# Goal : ↓
orgs
to safe

health level
4.) Chemical control
public ✓ Phenol / Carbolic acid
I
previous #
-

*
Degerming -
manual removal -

very irritating < i. ✓

* Germicide -

cause outright death -

Phenol coefficient ≤ >I

↳
Phenol coefficient.us disinfectant
.

iii. Physical control Salmonella typhi

✓ Heat
Staphylococcus aureus

denaturation proteins
MOA : of
currently used as :
lozenges
0 -

phenylphenol
Triclosan lsoap)
 ✓
'

✓
Biguanide
pre
-

operative wash Aldehydes

i. e. chlorhexidine ie .

Formaldehyde , Glutaraldehydelcidex)
↓ for MRSA decolonizition ↓ ↓
for instruments
2- weeks
pangligo
1
Formalin 137%) surgical
alternative
if MRSA
suspected Bleach Bath for
biologic specimen
-

✓
Halogens
i. e. Chlorine -
disinfectant ( Hypochlorous acid )
✓
Preservatives -
i. e. Sorbicacid Benzoic acid
,
Para bens ( methyl _
propyl )
i. e. Iodine -

antiseptic Nitrites and Nitrates

Lugo / 's solution , Povidone -

Iodine "

Saltpeter / sodium
"
↓
Salitre _
Nitrate)
"
↳
iodophore "= organic compound +
Iz imparts red color
→
prevent growth of
✓
Alcohol Clostridium botulinum

WOF :
headache
currently #I
-

i. e.
Isopropyl Alcohol Ethanol
-

,
-

↓
↓
✓ sterilization
-

rubbing alcohol 70%

Ethylene oxide -
for
gas
less rotative ( denaturation of MOA
requires
summary
-

presence of H2O)

[
" "" " " " " "" "" ^ " " "" "
P
°"

Limitation :
spores, naked viruses Alcohol, aldehyde
✗ Halogens Ethylene oxide
Clostridium difficile
"

CA :
Phenol Heavy halogen
Metals /
↳ ( ) Surfactants Oxidizing Agents
t
gram
→
pseudo membranes colitis

Quaternary Nhat salts

→
Bacilli Hand is
washing
→ a

→
spore forming must
→
Anaerobe

v.
Trends of Resistance

Heavy proteins only

✓
metals -
Prions
=

oligo dynamic property highest degree of resistance

- =

i. e. (nanoparticles) prion dse Creutzfeldt-Jakob

silver particles
=
→

prophylaxis
1% Agnos Ophathalma
Gonorrhea
Neonatomm
•
cadaver
Pacific islands
{ Kuru
Borna
↓
Erythromycin -

(t) vs C- ) bacteria
gram gram
↓ ↓
✓ community hospital
soaps and detergents ↑↑↑ resistance
-

MOA : ↓ Surface tension

-

naked vs .
enveloped virus
O' ° '
O'
Benzalkonillm
chloride ↓
→
.

o,
O'
/ etblpyridiniumchlorid
Quaternary NHqt salts =vˢ ↑↑↑ resistance
'
.

gromit

Pseudomonas -

gram
bacilli
aerobe
B- Methods of for
studying Reducing candle jar
•

organism anaerobes i.
-

e.

•
Selective -

favor the desired organism

lens
1 multiple i. Sabor and 's
.

Microscopy single
"" e. Dextrose Agar
→
fungi
-

Simple vs compound •
Differential
✗hemolytic
-
Green

partial
-

bright field vs darkfield i. e- Blood

Agar plate ≤ B hemolytic -

complete -

clear
gamma
↓ ↓ " -
non

Dark BG
Bright BG Streptococcus
-
-

( micro

spirochetes LTBraeropn.ie) i.
e.co/istin-Na1idixigacid-gram'- only
-

Lactose fermentation Mac

Conkey Agar
=

Transmission (TEM) 2D
Electro ↳ pink
tonics
microscopy
-

scanning (SEM ) 3D
Eosin
methylene Blue
=

to Black
2. stains
↳
Purple
that will contain chromophore
dye
-

Lactose Fermentcr non lactose fermcnter

④
↓
cation ↳ onion F- coli Shigella spp
b.
↳ ↓ Klebsiella Salmonella
iodye acidic dye Enterobacter
, Citrobacter Yersinia
Serratia Proteus
" "→ *
i. bacteria t basic dye green metallic sheen Pseudomonas
-
E.
-

opposite
"

stain solnof
Simple aqueous /alcoholic
a.
-

Enrichment medium fortified w/ nutrients to

single dye
-

↑
yield
b. Differential stain i. e. stain i.e Lowenstein Jensen for
gram
-
-
-
.

@
acid fast stain tuberculosis
< '
1-
egg
s
Ziehl Neelsep
Kinyon
-

Cheat) ( cold)
C. Microbe -
Host Interaction
of
India ink/Nigrosin
study relationships
'
1-
c.
special stain i.
Capsule Ecology
-

e.
- -

Cryptococcus neoformans host environment ~>

disease
agent vs vs

↳
fungi models !
epid triad

epid lever
i.
Flagella of causation
e. → carbo fuchsin web

spores
→
malachite green
Schaeffer fulton stain 2 . Normal Flora
i.e Bacillus spp , Clostridium bacterial residents in / disease
)
-

an area no
spp
.

↓ dse
- if inoculated elsewhere →

gram Cts ↳◦
-

Blood is sterile dugo]

✗, / × V11
, , /1

clothing factor
-3 Culture body
Relationship
inside 3
phlegm vitk
-

. .

pea , , expectorated
.
,
-

sputum
Culture
a.
Symbiosis normal intestinal flora
organism
mutualism ( i. e. &
Irs

sample
>
> > wait
-

Media
>
human )
Irs
susceptibility
↓

Gold standard recall : Vitk - to ✗

hemorrhage disease of the newborn

> material :
agar
=

solidyfing medium

→
agar slant ⑦ commensalism - i. e. Staphylococcus epidermis
•

Chemically -
defined -
exact composition
Examples : •
complex
-

added nutrients
y yeast
extract
protein digest
 level
Secondary
✓
prompt tx
:
b.
parasitism early dx ,
i. e. Ascari Lumbricoides and human i. e. RRPC Rapid plasma Reagin)

of disease syphilis
4.) Nature
Communicable noncommunicable
-

vs

✓
Tertiary level the
"

rapidly easily transmitted limit

"

contagious complications
-

→
-

i. e- rehab
program for stroke

5.) Occurrence of Disease .

✓
Primordial level -

④ emerging patterns that can

↑ likelihood ofdse
9. Endemic clean Air act Air pollution
→
specific group / place i. e. →

i. e. Palawan -
malaria

Samar , Leyte -
schistosomiasis 7.) Transmission of Infection

Bicol ,
Mindoro -

Filariasis a. Reservoir =
continual source of
TB organism
Philippines -

i. e. humans, animals , non -

living
↓ ↓
b.
sporadic → scattered , irregular Zoonotic i. e. soil

c.
epidemic → # of cases > expected frequency cpertringenss
" "
outbreak
b. Routes
Vehicle
vector borne
Contact
-

I 1
borne
common source Person - to -

person
✓ point source
specific
time point
( :F◦¥is◦ning) * Direct * Food borne

%
g→gy8≤ salmonellosis Dengue
i. e
✓ intermittent touching
-
-

source ,

kissing, ⑨
A-edesaegyptit.at
✓ continuous source
④ Sexual contact * waterborne DNV
/
year
Malaria
-

Leptospirosis ,

⑧ Pandemic -

worldwide * Indirect cholera ④ Female Anopheles

i. e. HIV , COVID -19 -

sharing of ④ Plasmodium spp

utensils * Airborne"7
Case : 1- case of smallpox in
Baguio City
_
fomites ( Droplet nuclei

$-31m )
fordinary
1970s eradication
>

↳
Epidemic facemask
*
Droplet
6.)
✓

Levels of prevention factor 00 < im

measles
susceptibility -_
risk TB
a. General steps getting Varicella
↑
probability of
the disease
symptomatic Preclinical
It>
(t)
organ changes
SIS
/ Pre -

symptomatic
(t) Of Infectious
tissue
changes C. Stages Disease
f) Sls
Exposure
Outcome ↓ (symptomatic

Recovery ; Disability Death infection =

presence of MO
isolation/
duration of
,

↓ incubation period →
asymptomatic)
Quarantine (
disease incubation
b. levels i. e. Ebola virus 21
days
✓
Primary levels : i. e. health promotion
( lecture seminar) Covid
SARS
:* - As
2 weeks
→ days >
,
Pr , As
=/qclays
Quarantine
"

specific measures (PPE) Nris =

lackeys →
isolation
 # 1 Prodrome Early % 3.) Immunization
-

# 2 Acme Full blown % : Edward Jenner

History
-

a.

# 3 Decline -
Gradual recovery , ↓ % -

smallpox & cow pow

#4 Convalescent Recovery
¥☐?
-
'

variation
A-
vaccination

f. Nosocomial Infections 8
→
hospital-acquired
lesions kid
-

1
antigen) (antibodies)
associated infections
"
"
-

health -
care

i. e.
dialysis center,

ESKAPE b- attenuated
pathogens Live Inactivated vaccine
-
us .

Recall :

Enterococcus faecium Naturally Artificially

④
Staphylococcus aureus
acquired acquired
Klebsiella pneumoniae active

Acinetobacter baumani prior infection passive

-

→
Iv lines active
maternal
-

passive
↳ ◦ids
Pseudomonas
-

antibodies -

antitoxin
aeruginosa '
Vaccine -

antiserum
Gmos
-

Enterobacter
Ig
-

D. Passive fast onset short DOA

Immunology
=

,
t
.

Natural / Innate
Acquired Active =
slow onset
, long DOA

to infection activated if (f) infection

present prior
-

Rabies
lymphocytes
✗
case "
3rd line :
= ✓
Ig
1st line :
epithelial barrier 4¥71 ✓ vaccine
↳ dog
Skin , mucus membrane time

2nd line : Natural killer cases : (f) Hepatitis B

cells
phagocytes
}
, ,

dendritic cell
✓
Ig
nai
✓ Vaccine

2. Cell mediated vs Humoral B. cells case 3: f) Hepatitis B

CDgtT
-

MHC
cells
Class #
-
B cells
antibodies
{} ✗

✓
Ig
Vaccine
-

multiple roles
) Live attenuated inactivated
( D8 + Tce 's
÷,
9 mimic the ✗ ✗ ✗
antigen
,
may
_
,

MHC Class I of the less affected

symptoms
-
-

directly cytotoxic actual disease -

route :IM_
dose, booster
Usually 1- dose
usually multiple
-

affected
by circulating
-

antibodies
i. e. Hepatitis B
↓
efficacy
-

=
"
maternal ↳ / anticancer vaccine /Liver )
Recall :
Immunoglobulins × { 6 Mos / Antibodies) ' PPV
Pneumococcal
IgA -
secretions
"
-

Exception : Polysaccharide DPT

vaccine
Diptheria
Pertussis children
"

IgE allergy
-

✓ Measles outbreak Tetanus

"

; chronic / past
infection
pregnant
"

IgG =/ { Gmos)
-

✓ Oral vaccines •

Tdap ↑ dose tetanus

Adult
infection ↳ acellular
indicator of acute routes :sQ , ID, nasal
-

Igm
-

i calmette Guerin HIB conjugate vaccine

'
'

Ma / aki
" "'
-

oral polio
- e ' -
BCG Bacillus [
serotype B
-
vaccine mumps , Rubella
MMR
Haemophilus influenzae
-
measles ,
-

,
'
Varicella vaccine
 CLTB) ( thin )
Expanded Program Immunization Limitations spirochetes
: •

On
1-
staining mycobacterium ( mataba)
◦
•

DPT
HepB
Birth BCG HepB \/
•

Mycoplasma ( cell wall)

AIB
Pentavalent
-

Rickettsia
6 WKS OPV , Rotavirus vaccine
vaccine PCVI :
} intracellular
chlamydia
10 wks C) PV , PCVZ Case :
Mycoplasma →
☒ cell wall
synthesis inhibitors
14 wks OP }
2.
9m05 Measles
Morphology
MMR ☒
12m05 0000 cocci
staphylo
bacilli
oooostrepto
* Live attenuated vaccine
-

pregnant →
Herd
immunity ⑤§ spirilla

immunocompromised
-

pleomorphic = varied size

shape

E. Pharmacist in Public Health 3. Virulence factors

↓
to disease
quantitative ability cause

macro -
administrative
, strategic planning policymaking
"
forward
" "
to chemotaxis
population locomotion
"
micro program
a.
Flagella
-
→

"
to
provided patient
"
→ It
antigen
i. lecture in the i. e. vibrio cholerae
-

e.
pharmacy
smoking cessation clinic -
atrichous
-

comma
-
shaped
~
monotrichous

amphitrichous
~
~

II. Bacteria A. General concepts lophotrichous

B.
≈~
A. General stain Gram⊕ cocci
peritrichous
1. Gram stain C.

D.
Gram ⊕ Bacilli
{%
Gram Cocci
E. Gram ⊖ Bacilli
✓ V
F. Gram stain limitations b. Pili -

adhesion and sexpili

v v I ↓

colorless
attachment
reproduction
V
i. e. Pfimbriae
V Red
E. coli tract
→
urinary
cell wall
Gram ⊕ Gram B c.
Capsule -
resist phagocytosis
polysaccharide
"
"
surface proteins opsonization
teichoicacid-r-_◦=°→
porins
stain : India ink / Nigrosin
K
antigen
→

=
antigen determinant outer membrane i. e. H influenzae
.

✓ Somatic E. coli
0 Antigen
✓ core polysaccharide Neisseria spp

✓
Lipid A / Endotoxin Klebsiellspp
thickpeptidog1ycan→ˢepticshock↓↓↓BP_
Periplasmic space d. Spores -
→ resist control cheat chemical) ,

(t) amino acids {disaccharidem=ÉÉw

=

"
linked
→
calcium dipicolinate
peptidoglycan
cross -

via trans peptidase thin """ ' "i "

vegetative spore form

-

↑
@ lactam Abx form germination
 stain : Schaeffer -
Fulton 1.) Staphylococcus spp
malachite -

green a. S .
aures

i. Bacillus
-

reservoir : ( nostrils)
e-
spp nares

Rot :
direct contact
Clostridium spp
droplet
-

,
-
VF :
✓ Protein A
4) hyaluronidase spreading
"

Bacterial ✓
genetics factor
"

Central ✓
recall :
Dogma staphylokinase destroy - fibrin

transcription translation ✓ capsule

s mRNA > proteins ✓ Teichoic acid
colonies
replication Lab ID : golden yellow
-

MRSA → ( t) mecltgene
*
plasmids =
extrachomosomal DNA -

Diseases :
tricuspid
i. e. R
plasmid ,
f- plasmid valve

nsigyenes
✓ Acute endocarditis →
Ivdrmgusers
*
transport
>=
contribute to resistance
✓
septic arthritis & osteomyelitis
( bones)
( joints)

✓ food poising
staphylococcal
* Methods of transfer ↳ of heat stable endotoxin
presence
gene i. e. salad Iw / in 6hrs7

conjugation
:
✓ Donor s
Recipient mayonnaise
Sexpiii * no need for Abx ,
because

is responsible
transduction the toxin
✓ Donor →
phage →
Recipient
i. ✓ scalded
e. skin
syndrome
infects bacteria
bacteriophage → virus a -
Rutter
syndrome
-

( t) exfoliation

✓ '

transformation : direct transfer of DNA

✓ Pneumonia ( t)
-

pneumatoceele
filled
= air -

cysts
5.) Endotoxin rs Exotoxin ( chest × -

rays)

Gram -0 -
Gram -0 G- tam ⑦ ✓ Skin and soft tissue infections
,

monocytogenes i. e. ① colored
Listeria - ie . entertain impetigo →
honey
crust
shock neurotoxin
septic
=

cytotoxin abscess _
puslpumlend
-
source of toxoid ,
Vaccines disharge

"" "
Furuncle /boil -
infection of
%
"

Note : Toxin subunit follicle that

B-
-

binding Furunculosis
reaches SQ

i C- diffile
- e. -

pseudo membranous layer

colitis Carbuncle
diki.t-dikitno.lt
-

) diarrhea Furuncle

surgical site
injection
↳titch
)
abscess

mastitis → breastfeed
✓ → Puss
staphylococcal toxic shock syndrome
(t) tampon use → 8. a. → TSST -1
→
(t ) hypotension
( t) rashes
f) blood culture
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 WTD ? Anti Penicillin / ✓ Scarlet Fever
Staphylococcal
-

throat
Beta lactamase Resistant sore
-
-

i. e. methicillin -

strawberry tongue
Oxacillin tongue sandpaper
-

Nafcillin
✓ Skin and soft tissue infections
IF MRSA It) → DOC :
Vancomycin i. e.
impetigo
→
Decolonization : (Bactroba
Mupirocin
Chlorhexidine bath cellulitis vs Erysipelas
-

ill-defined - well-defined
If VRSA (t) → DOC : Linezolid -

erythyma "
-

erythema
"
elevated
"
flat
-
"
-

b. S i. e. DM murdered
.

epidermidis ,

nail
-
associated w/ infections involving prosthetic
✓
devices and implants streptococcal toxic shock syndrome
( ) f) rash, (f) blood
hypotension
t
, culture

foreign bodies
-

capable of biofilm formation ✓

Antibody mediated conditions
-
-

i. e. Rheumatic Heart Disease

← °
C- S .

saphrophyticus -
#2 UTI in
sexually active from sore throat m
protein
women AB attacks →
young
-

molecular mimicry
"
"Jones_"
"

honeymoon cytitis
-
UTI until bladder criteria :

Joints → arthritis

Obviously → carditis

2.) Streptococcus spp Nodules ISQ)

Erythema marginalum
classified by
:
Sydenham cholera

carbohydrate Ag Group A, B
:

"
WTD ? ÷
Penicillin G
"
Lancefield

hemolytic pattern i. e. Post streptococcal Glomerulonephritis

skin infection
→ gp →
immune complex
a. S aka GABHS wound
pyogenes
-

.
formation
-
VF m protein
: -
=
most important =
PSGN 00
Hyaluronidase →
not
given w/ Penicillin

Streptokinase destroy Fribin clot

-

infarction
=
vs. myocardial b. S .

agalactiae aka GBS

-

strep.to/ysin--G-- antigenic Rot :

passage of the baby in the birth canal
S =
✗ ✗✗ 35-37 weeks →
perform GBS w/ swab
-

causes neonatal sepsis , meningitis

-

Streptodornase =
⊕ DNA -

WTD ? If GBS (t) → Penicillin (Amoxcillin)

If
sepsis → Doc :
Ampicillin Gentamicin>
-

Diseases :
-

✓ D
Streptococcal Pharyngitis
"
C.
Group Streptococcus
" :
throat
strep reservoir colon

>
3910 hydrolyze escnlin
-
(f) exudates
 buiong clostridium
i. Enterococcus E. faecalis WTD
e.
spp
:
Doxycyline ay BE
question
-

=
endocarditis after
abdominal surgery ii. B. cereus
ID : f) capsule ( t ) motile
Non -

Enterococcus = s .
bovis VF : heat stable toxin , heat labile toxin
Chinese fried rice
endocarditispt in Dse : syndrome
abdominal reheated rice
w/
-

malignancy
"
marantic endocarditis " WTD :
vancomy.in , clindamycin
④ B- lactams

d. Viridans Streptococcus
S endocarditis after dental
sanguis surgery
-

Intermedius abscess b. Clostridium

S
spp
-
.

main

S . mutans dental caries i. c.

perfringens
reservoir : soil
" "
e. 5.
pneumoniae
-

Pneumococcus ID : (t) Nagler rxn

shaped diplococci (t )
ID Lancet
stormy fermentation of milk
: -

(t)
Rot :
droplet Target hemolysis
(t) ( t ) Quel
capsule lung reaction swelling Disease :* clostridial
→
myo necrosis
=

Disease # A)
1
Community acquired pneumonia Diabetes Miletus
: -
→

neuropathy
: →
19-59910
↳
not common pneumonia
WTD :
amputation hyperbaric Or
,

:
WTD? Low risk Toxin Lecithinase

healthy →
Amoxicillin or macrolides
co morbid B- lactamase * C. Food diarrhea
inh
poisoning
- →
, → .
combi
± macrolide

#1 otitis media ii. C. difficile

WTD ? Amoxicillin reservoir : GIT

Prevemtio : PCV , ppv ID: Toxin A,B

p¥eumo23⑨
↓
② Risk Factor : chronic antibiotic use
Prevnar ↳ Cephalosporin
Clindamycin

✓
Disease : pseudo membranous colitis
spore
C. Gram (t )
n

;%;É;¥- B- diarrheacolon)
Bacili
✗ spore
Korea?rB%8inus spp
A -

i. Bacillus anthracis binds to

the Abx
"
-

zoonotic
"
WTD : stop Poor oral
cattle,
reservoir :
animals
-
com
Vancomycin → best
/ absorption
ID : (f) capsule f) motile Metronidazole
box car shaped Fecal Transplant
VF :
factor edema factor
protective ,

lethal factor "

PLE " iii. C. tetani A
Disease : Anthrax reservoir : soil ¥
> Cutaneous → (t) malignantpustule ID :
drumstick , lollipops ,
tennis
racket
Woo /sorter 's disease VF :
tetatospasmin
>
pulmonary
→

↓ -0

inhibit neurotransmitter
(GABA )
 -

Disease : Tetanus -
(t ) spastic paralysis C.
F-rysipe-thrixrhysiopalt.io#
-

abdominal rigidity
trismus
among fish
common
" "
handlers
-

lockjaw
-

(t ) It) whale
opisthotonus finger seal finger
-

◦¥ ^
, >

( t) sardonic smile
WTD: Tetanus antitoxin →
Arts Act
Tetanus toxoid → Art
, Pass d. Fungus - like bacteria
Diazepam -
vs
spasms
Metronidazole
recommended for pregnant
Actinomyces Israeli Non-avian asteroids
Prev : DPT
, Tdap ( t) px
anaerobe aerobe
iv. C. botulinum ✗ acid fast acid fast
infant soil
risk factor : canned
goods homey ,
→

✗ normal Floro
VF botulinum toxin inh release
atypical pneumonia
: →
.

of
Acetylcholine trauma →
eroding WTD : Sulfamethoxaaole
Disease : abscess ⑦ trimethoprim
Botulism ( t) Flaccid paralysis
It )
diplopia, dysphagia d) sulfur
Prevention :
Proper Food
Handling ÷
"
granule
-

Other clinical use : Botox →

vs. wrinkles

False
mycetoma /
Madura foot
2
"
Non
spore forming WTD : SNAP" Penicillin
-
.

a.
Corynebacterium diptheriae
ID : Chinese character appearance e. Propioni bacteria
-
aeries
Loeffler 's telluric medium
,
=
(t ) black colonies Disease : acne

(t ) Babes Ernst
granules
-

Protease
Elek test for Pa sebum coil)
toxigenicity
= →

lipase
Shick test =
for susceptibility [
ROT :
droplet Fatty acid
inflaming;
Disease : diphtheria (t)
*
Pharyngeal ( t)
papule -7
Cd B-
-
>
toxin A
protein synthesis pustule
elongation factor 2
pseudomembranous acid
cell death WTD?
Glycol id
→

soap
=

G) bull neck
Adapalene , Tretinoin Isotretinoin ,

WTF Antitoxin Penicillin ✓

Benzoyl peroxide
teratogenic
Prev : DPT
, Tdap sunscreen

* cutaneous diptheria -

from reused
hoods D. Gram f) cocci

i. e.
Neisseria
spp
b. Listeria monocytogenes moraxela eatarralis → CAP

ID :

ROT :
tumbling motility
of contaminated food, vertical i. N meningitidis
ingestion
.

VF :
ingestion reservoir
nasopharynx 00
:

0
Listeriolysin = ✗
phagocytosis ID :
kidney shaped diplococci
-

Rot :
Disease : neonatal sepsis and meningitis droplet
WTD :
Ampicillin ,
Co -
trimoxazole , ☒cephalosporin
 Lactose Fermenters
n -
m
CTE meningitis a. Enterobacteriaceae
i. E. coli
>
⑥ ⑥ meningococcemia
⑤⑥ ID : lactose ferment er
( t) cough fever
(t ) metallic sheen
A) fulminant green
purpura
"
hemorrhagic rash
"

peritrichousycps
WTD : ceftriaxone VF : heat stable toxin
Azithromycin labile toxin
Ceftriaxone ; heat
Prophylaxis :
ciprofloxacin
vaccine :
vaccine ( A ,C,Y,W -135 P fimbriae binds to the
conjugates
→
-

=
vs. .

complication ! Water -
house -
Friedrichsen syndrome urinary tract

(f) adrenal
hemorrhage K
capsular antigen
0
somatic antigen
2.) N .

gonorrhea flagella It antigen

ROT :
ID : dougnut shaped diplococci
-

Fecal-oral
ferments
glucose Diseases : * Acute
gastroenteritis
Thayer -

Martin culture medium F- TEL

Enterotoxigenic
direct ( sexual) ⇐ Traveler diarrhea
ROT : "
Nana " 's
* Gonorrhea (tuk) EIEC
purulent discharge Enter invasive
-

VI. Chlamydia -_
Clear = identical to Shigellosis
male : urethritis = blood diarrheal
female : cervicitis F- HEC Enter hemorrhagic

complication : Pelvic inflammation -

0157 : 11-7 →
Shiga
-
like toxin
" "
Disease Vero toxin

VVTD ? Ceftriaxone EPEC Enter pathogenic

give Azithromycin or
Doxycycline Pediatric
→
px
* Neonate →
Ophtalmia neonatorium gonorrhea
F- AEC Enter aggregative
Prev : 1% AIDS
AGNO
=

Now! persistant
Erythromycin infant diarrhea
=

WTD :
supportive
* septic arthritis hydration
-
→
ors

sulfate
-

HS student zinc
case : w/ joint paint -

Bacilus clansii
Sexually active → N .

gonorrhea ( Erceflora )

0¥
"
staph
"
not → aureus
"
.

# pyelonephritis G) fever
E. Gram ( ) Bacili
-
→ (
causes stomachache)
DOC : Quinoline ( Ciprofloxacin)

Cystitis
1. Entries TV Doc : Nitnturantoin
him
Lactose
✗ ✗✗ Fosfomycin
Fermenters

SSYPP ☆ Febrile
EKES
neutropenia [↓ neutrophil )
Conkey Agar Pink
malignancy chemotherapy
=
✓ Mac → +
>
✓ Eosin Blué Pus
Methylene
 used well
ii Klebsiella
Ag in Felix
-
-

pneumoniae
↓
mucoid colony melted candle
"
"
ID ?
Rickettsia
-
4A Alcoholic
diabetes
-
Widal test ( Obolete)
Abscess ( liver , lung )
Aspiration pneumonia b. Vibrios
note :
ESBL Extended spectrum Beta Lactamase i Vibrio #1 in surface
spp
-

:
- -
-

waters
producing enzyme

DOC ☆ V. cholerae
carbapenem
:

star
ID :
shooting motility
" "

iii.
S-hig.sppis.dyfinteri.gs flecks . .

boyd comma -

shaped lmonotrichous)
ID : non -
motile ④ Hzs thiosulfate
-
Citrate -

Bile sucrose
,

VF :
Shiga toxin
①
s 60s IT CBS ) =
yellow colonies ☆☆☆
ROT :
Fecal-oral VF :
cholera f heat labile toxin )
gen
Disease :
shigelkr.is
"
diarrheal Disease cholera rice water diarrhea
"

bloody
:
dysentery
→ →

Diagnosis
:
stool culture ,

WTD : ciprofloxacin
/-0¥ "
washerwoman hands
"

sign
i
É spp V.
parahemolytiais
"
* shellfish
typi
-

s
.
is , .paratyp
motile
"
ID :
@ green colonies/Tcpssj
-

swims "
, Hag
VF : Vi antigen
Rot :
Fecal-oral * V. Vulnificus -

oyster
↳ sexual / In:|) -
blue CTCBS)
green
Disease :
↑ Salmonellosis

↑ ii.ca#ba-esrjejuni32wks
Typhoid fever prolonged
fever

Ip
→

Gull wing shaped S-shaped : ,

→ Rose spots skirrow 's medium

constipation -
_
adults Rot : directs contact (domestic animals )
diarrhea
=
children Dse It) diarrhea
bloody
:

DX :
culture blood culture ( ) syndrome (GBS)
-

t Guillain -
Barre
urine culture -

ascending paralysis
stool couture
(gold standard bone culture WTD ?
marrow
Erythromycin
if GBS
Txt :
Emperic therapy
-
Ceftriaxone , Azithromy
ein
- →
IVIG
↳ not
proven
to be Salmonella
/ Helicobacter
proven Quinton -

susceptible -
Ceftriaxone iii.
pylori
Alternatives VF
protease
:
Chloramphenicol urease
-

,
↳
watch out for aplastic ↳ alter
anemia → absent / WBS ureÑÑH } 11
mucus

a,
RBC)
, VS. H'
feve
-

Drew :
Typhoid vaccine II
efficacy stomach
50%)
Disease : Peptic Ulcer Disease
Proteus P
v.
spp .mil#Lis,P.vulgaris- endoscopy
A)
Burning Abdominal Pain
-
-
.

ID :
swarming motility dyspepsia
-

VF :
Omepraaole
produce urase → convert to urea
WTD ? Triple therapy :
Bismuth sub salicylate
allow survival inthlto ammonia metronidazole /Amoxlclarithro
stomach ( HD
 breath test b.
monitoring : urea Bordetella pertusis
if (t ) →
ID : Bardet
Ganganagar G) pearly white
- -

sampled via Ca
alginate colonies
c. Pseudomonadaceae swab

i. e. Pseudomonas aeruginosa Rot :

droplet
VF Tracheal
:
cytotoxin →
④ cilia
VF Exotoxin A ( liver)
targets Hemagluttinin
: →
phagocytes
④
Fluorescein ( ),
ID :
Pigments →
green Pertussis toxin →

lymphocytosis
( blue)
pyocyanin ( ↑ /ymphocyte)
sweet / fruity odor
grape
# 1 nosocomial infection ( ESKAEE)
"
Dse
Disease ! Pertussis cough
"
:
Whooping
WTD :
Erythromycin
malignant otitis externa Prev : DPT ,
Tdap
ecthyma gangrenosum
hot tub
Legion lotion titis c.

pneumoph.li#2
) burn infection (# Is .
aureus

)
"
1 ID :
atypical
"

pneumonia hospital
DOC : Ceftazidime Buffered charcoal yeast extract
Now : Avibactamtavicefta)
Ceftazidime t
w/ d- ketoglutarate
d. Bacteriodaceae ROT : water fountain
cooling , aircon
,
Bacteroides
i. e.
Fragilis -
# 1 colonic flora ⊕ person - to -

person
DOCI Metronidazole bse : Pontiac Fever

Legionnaire 's Dse =

atypical pneumonia
2.) Predominantly Respiratory Tract infections WTD : Macrolides or Quinol ones
a.
Haemophilus spp
i. It .
influenzae factor ✗ 3) Zoonotic Infections B. abortus -

A antigen

ID : coccobacili

Chocolate
Agar Plate
- hematin

Factor V
a > Brucella
spp ,

µf%B aka
.me/itensis-mantigen
Gastric
'
N'+ ☐ ROT : direct contact _
remittent
"w
Rot droplet abortion / ④ erythritol
-

\
④ erythritol
capsule WTD : man
VF
Doxycyline
-

most virulent →
B

b.fr#,i.edge,+tu1arensis-
most D.se : Ha F- MPhil us
Common cause

strep pneu
A. influ
Epiglottis Dse : Tularemia aka rabbit fever

deerfly
"
WTD
streptomycin
:
meningitis
moraxcella Otitis media I # 2 cause)
Pneumonia [# 2 cause ) c-
Yersinia spp .

WTD : 2nd / 3rd Gen .

Cephalosporins i.
1. enterica
e.
lPi9ˢ
diarrhea
Prev vaccine
: Hi B conjugate
↳ has capsule / most virulent
i.e .

1. pestis
flea human
rodents → → .

ii It .

druceyi Pulmonic plague

-

lung hemorrhage
septicemic plague
→ "
Black Death "
-
Rot :
sexual ( uncircumcised white men )
A) buboes
Disease : chancroid / soft , painful Bubonic plague -

WTD ? : Ceftriaxone
-

lymphadenopathy
 d. P•elli multiida Confirmatory
:
Microhemaglutination assay
Fluorescent Treponema /Antibody
from Absorption spectrometry
-
cat bite
, dog bite
WTD ? Amox , Clinda false
Cloxacillin , Note : positive old
age , pregnancy
=

Doc : Pen G Thorsen symptom

4. Others WOF ! larisch -

Her heimer
✗ rxn

a.ca#a1obacteriymgranu1omatis-
→ Klebsiella
"
" b. Borrelia
spp .

Rot: sexual
A) beefy red
Dse ! Donovan osis →

velvety ulcer
B. recurrent,s B. burgdorferi
body louse ticks →
ixodes spp
Borreliosis Lyme Disease
b- Recurrent fever infection
Garda vaginalis zoonotic
=

( fever → despite tx 4)
risk factor :
change in the flora
vagina) erythema chromium
Dse !
Bacterial vaginosis migrans
(t) largest medically Impt bacteria
④ GTI fishy odor >

( t)
milky white discharge DOC !
Doxycyline
It) clue cells
Doc : metronidazole C-
Leptospira interrogates
"
ID
" "
F. !
interrogative question mark
"
Gram stain Limitations

Shepherd 'scrook "

" "
l .
Spirochetes "
ice tongs
a. trepang pallidum periplasmic Flagella
ID : axial filament → corkscrew motion

Rot : direct Csexua 'D vertical ROT :

direct contact w/
infected fluid
in Flooded water
Dse : syphilis wading
Dse
* Stages
:
Primary syphilis -
chancre / hard ,
:
Leptospirosis
painless \
self-limiting] / \
Secondary syphilis macula popular heptospiremic Leptospiuric
blood
-

rash urine
-
-

erythema palm, soles) ( t) fever (f)

1-alata
acute
kidney
condyloma (t) calf tenderness
injury
yellow papule
# ( t) suffusion
=

conjunctival
Latent
syphilis - G) neuro
syphilis Weil 's syndrome → ( t ) jaundice

tertiary syphilis 4) tabes dorsalis A)

pulmonary hemorrhage
impaired position (t ) acute
kidney injury
-

vibration

G) DX : culture ( blood,
Argyll -
Robertson pupils CSF , urine)
"
imitation test
prostitute's Lept MAT [ Microscopic Agg /
"

eyes
-

WTO ?
*
Congenital syphilis mild →
Doxycugline
A) mucus patches (t) Hutchinson 's teeth Severe →
Pen G
It) Saddle nose www

Prophylaxis
:

Doxycyline ④ pregnant
DX : Treponema / Non treponema /
q
Screening → RPR Rapid plasma reagin
VDRZ Ventral Disease Research Laboratory
2) m.lepraea.NL
Mycobacterium spp
.
b.

tuberculosis
.

dipheno VF : O -
/ oxidase

Rot
respiratory droplet
: -

VF :
my colic acid
-
④ phagocytes Dse :
Leprosy / Hansen 's dse
Sulfa tides ⊕ phagosom lysosome A)
-

hypopigmented lesion

Trehalose / cord (t )
hypesthesia
dimyco late
Factor -
↑tNF " in

( tumor necrosis Tuberculin'd Lepromatus

factor ) cell mediated humoral
fast
"

acid
"

staining
"
ID
" multi
! -

Carbo, fuchsin pauci bacillary bacillary

than 5
Ziehl Neelsen It eat more lesions
/
-

Alcohol (t) wrist drop "

lion -
like face
"

Kinyoun Methylene ( t) foot drop

blue
=
Acid fast (t ) claw hands
ROT : airborne # t infectious cause

\
Ds :c : tuberculosis of hand deformity
initial ( t) f) Lepromin test
*
Primary TB infection Lepromin test
-

(f) Gohn
if:&?
"

comp
C. M . avium
complex ( MAC)
-

HIV/AIDS
* Post TB / cD4< 50
primary secondary 11 upper -
occurs at

-
reactivation
⑧ 3) Mycoplasma spp , I. pneumoniae
* TB
military lung parenchyma
-

* Disseminated TB -
TB → othersits ID : smallest free living organism
* Extra smallest self
replication
pulmonary TB
> -

f) cell wall
✓
Scrofula -

lymph node'TB
(t) sterol
✓ Pott 's Dse -

spinal TB requires
Laryngeal
✓ TB
" "
clinical manifestation Beef heart t horse Fried
mulberry
-

serum →
,
egg
A) (t) ROT
cough weeks
weight-loss droplet
> 2 :

(t)
pneumonia I# 1)
sweats (t) Dse :
night hemoptysis Atypical
(t ) low
grade fever -
aka
walking pneumonia
cold
DX
agglutinin
!

San Lazaro TB WTOD : Macrolides , Quinoline

Hospital -

DX :
Chest ×
ray
-
•

•
✗
pert MTB/ Rif
4.) Rickettsia spp
Direct ( Dssm) borne
sputum smear Vector geographic area
specific
-
•

microscopy
-

,
↳ 3
early morning sputum
"

front "
-
( t) black eschar -
←
loading
•

Tuberculin skin test / Mantoux skin test

-

Dx : Weil -
Felix test
Purified .ricket skin test i. ticks
Ixod-esspp.lt
derivative
•

R
protein e. →

m,m;!ⁿ
) wheat
A) infection Atypical
-
-

Rocky mountain spottedfever :

> 5mm immunocompromised Legionella

4) rash that starts in the

distal
> 10mm
high
risk * PH
extremity
Hmm low risk related :

b;!
>

WTD ? DOTS at least Gmos -

④ vector
↳Tx
partner
 ( atypical )
5.) Chlamydia spp
i. Penicillin

a.
Gtrachomatis -

obligate intracellular parasite -

MOA : ① transpeptidade Kriss inking) -

History : Alexander Fleming ④ ⑦⑤

Tract
Eyes Genital Florey & coworkers
staph .
aureus

* Trachoma *
Chlamydia
Serotype clear discharge Beta-lactam
-

A B, C Ring
-
-

,
antibiotic and
" "
-

assoct w/ poverty
-

silent infection
>
antigenic determinant

B- lactamase /Penicillinase
* Inclusion
Doxycyline /Azithromycin destroyed by
>
conjunctivitis WTD :
D-> K
serotypes
-

in the * Penicillin acid

ROT:
passage Lympho granuloma > Penicilloic
-

venereum
lactamase
birth canal B-
painful lymphadenopathy
-

( t) clear Pharmacokinetics Food ↓

absorption Amoxicillin
discharge :

Probenecid € tubular section

b. psittaci
:
C. Drug Interactions
-
* penicillin ① Bacteriostatic
=
↓ cida / to

birds human *
Ampillicin ⑦ Allopurinol
→
=
rashes

(parrots ) (psittacosis atypical Mnemonics)

__

* penicillin ⑤ p - blockers -

Anaphylaxis

B
f. pneumoniae
"

Pregnancy Categories
"
c. -
Taiwan Respiratory strain
Acute
human /
human atypical
pneumonia) ✓ Natural Penicillin
→

* Pen 6

G. Antibiotics i. e.
Aqueous Pena =
short DNA
" ° "m
/
"

prolonged
=

procaine Pen G DOA

organism i. e. Penicillium notum Penicillin Benza thine Penc Doc

-

rssyphi.is
-

DOC vsst-reptococc.us spp

Streptomyces orientalis -

Vancomycin
V5 leptospirosis Gerry
Limitations acid labile Cio parenteral )
-

: -

Sikes by B- destroyed
lactamases
Erythromycin
-

limited )
griseus Streptomycin activity grant vs
-
.

hypersensitivity %ˢ¥}
/
Penicillium griseofulvin -
Griseofulvin
prone
to

* Penicillin V -
_
oral
Classification ✓ Beta -

lactamase resistant / Anti staph - .

bactericidal vs bacteriostatic i. e. methicillin →

nephro toxicity
Oxacillin mild
cloxacillin
-

→ MSSA
broad spectrum empiric
-
,
vs moderate
therapy
=

based
spectrum 1- impetigo
-
on us .

narrow
spectrum =

specific therapy Nafcillin → rashes

-

based on MOA :

B- lactam
✓
Extended spectrum penicillin
1) cell wall
synthesis
inhibitors # Glycopeptides * Aminopenicillin
neonatal
Others ⊕,
lysis . v.g. gram gram "P"

w/ aminoglycosides vs{
→
g , meningitis
, -

combined
i. best oral Enterococcus
a. Beta-lactam abx e. Amoxicillin →
bioavailability
> Generalization : bactericidal vs MRSA
limited > nasal
activity atypical swab * Anti -

psuedomonas
Carboxy penicillin Carbenicillin , Ticarcilli
→

Ureido penicillin →
piperacillin , mezlocilli / Azlocillin
?⃝
 lactamase inh Combination ( Buc)
p
- .

5th Generation :
Ceftobipirole , Ceftaroline
B- lactam MRSA , URSA
^
vs
-

B- lactamase
O BL If 1+0=2 Ceftolozane = vs.
complicated UTI
suicidal
drug potentiation
"

pneumonia surgical infection

,

Atypical Piptazo
=
Vs
⊕ ⊖
anaerobes iii. monobactam { cetipime
gram , gram , maps#
i. e- Amoxicillin tclavulanincacid-co-amoxick.lu i. e. Aztreonam vs severe
-0
gram
-

Ampicillin tsulbactam infection ④ renal failure

pelvic
-
-_
vs cause

Ticarcillintclavulanic acid -
④ cross sensitivity w/ Penicillin

Vigocid)
↳Piperacillinttazobaotamcpiptaz ,

Loophole
vs ESBL iv.
Carbapenem
i. e.
meropenem ,
Imipenem , Ertapenem
↓
ii. Cephalosporins ↓ ④ active vs Pseudomonas
-
less to B- lactamase destructions + cilastatin OPAT
prone out patient
-
Abx Tx
food
-

affected
-

less to ⑦ renal
by
-

20% w/ Penicillin dehydropeptidase

cross
sensitivity
-

WOF :
serum sickness -

vs. severe gram

f) infections

pseudomembranous colitis -

vs. F- SBL

coagulation abnormality
Disulfiram -

like rxns b.
Glyo peptidase i. e.
Teicoplanin ,
Vanc;myc
Prey category B
>

* VS Pseudomonas
MOA :-O D- Ala
> Generalization
-

- D- Ala
1st ^ Ceftazidime -
DOC :vs MRSA

Cefepime -

us .

pseudo membranous
Cefpirome colitis
5ᵗʰ *
④ Vs anaerobes WOF : Red Man syndrome
slowdown
2nd Cefoxitin , Cefotetan rapid infusion
-
→

3rd Ceftizoxime ceftriaxone antihistamine

hypersensitivity
-

→
,

Cefotaxime Nephro toxicity

1st Generation
"
-

Ceph except Cefazolin , Cefadroxil

Others
'

surgical prophylaxis C.

Us severe MSSA i. e.
Fosfomycin MOA :-O N acetymuramic
- -

. →

acid
=vs . acute cytitis
2nd Generation Ccf ends he (NHM)
nothing in
-

.
y

except cefuroxime
Bacitracin -
from B. subtilis
'⊖
vs
Haemophilus
-

spp vs
gram
E- coli Neisseria spp , Streptococcus .spp topical
-

nephrotoxic
-

3Rd Generation -
Cef ,
everything ends in ne , _ine_ 2.) Protein synthesis
inhibitors

except Loracarbef , Cefdinir

,
moxalactam

Buy AT 30 "

i. e. Ceftriaxone -

us .
Neisseria
spp [ EK It 50
Cefotaxime -
Vs
spontaneous bacterial peritrichous
Ceftazidime -
DOC vs Pseudomonas a.
Tetracycline Ivs .
30s)

4th -0 tRNA
Generation Cefepime Cefpirome MOA :
aminoacyl "
-

Apt Mg
-

, "
by Ca ,

↓↓
,

Loophole : vscinaerobe Pkin : absorption is

by Food
-
 -

uses : vs unusual pathogen ii.

c-larithromyc.in
-

us .

Erythromycin
-
resistant

Doxyoyline us .

leptospirosis ,
malaria cocci
880000
( HIV/AIDS]
Iigecycline
Vs. VS MAC
gram
-
_

nfinoaycline V5
meningococcemia
-

acne ,

Demeclocyline ↑↑
photosensitivity R-oxitnromyc.in respi tract infection
-

iii. -

vs
SIADH
-

V5 .

WOF : teeth ↓ bone iv. the tissue

Doxycyline , growth Azithromycin
-
penetrate
⊕ 48g / o Tdithromax rapidly
but
slowly released

⊕ pregnant →
teratogenic -

URTI -
3
days
LRTI (pneumonia)
steatosis ,
hepatotoxicity -5
days
photosensitivity
-
WOF : QT protonation CECG)

b. Cvs 30s) d. Lincosamides

Aminoglycosides .

bactericidal inhibition )
( irreversible i. e. Li
similar activity to
-

neomycin
-

C-)
-
us .

gram macrolide clindamycin

↓
combi w/
-
uses : * in
penicillins
amino above
diaphragm
neonatal
sepsis, meningitis
V6 vs
anaerobes (above the
-

'
.

(
Ampicillin -
Gentamicin ) diaphragm)
vs Enterococcus gram G)
-
vs.
cocci MRSA
spp
.

WOF :
pseudomembranous colitis
* 2nd line vs TB enhance -
curare like C-✗
neomycin
-
WOF !
nephro toxicity Gentamicin phlebitis →
Clindamycin
Tobramycin
C. Oxalidinones i. e. Line solid (VI. 23,50s)
DOC URSA
streptomycin vs
-

vestibule MRSA
toxicity
us
-

Gentamicin WOF :
thrombocytopenia (↓ platelet)
MAO inhibitor like effect
Neomycin
Oto
toxicity Amikacin *

kahamycin
f. Streptogramin
WOF :
enhance curare -
lik effect -
i. e. Dalfropristin Quinopristin ,

Note : longer used

Streptomyces
-
no
spp →
mycin
WOF :
thrombophlebitis
-

micin
micromonosporaspp
→

c. macrolides ( vs 50s) 3.) Nucleic acid

synthesis inhibitor
Sulfonamides
Generalized us atypical a.

MOA : ⊖ translocation -
MOA :
ihydropteroate synthesis
-

bacteriostatic
i-E-rythrom.y.in
-

natural macrolide -
vs. Toxoplasmosis, Nocardiosis
"
"
i.
e.su/famethoxazole-esto1ate
I /◦
tycin
- -

) sulfa salt (best diazine =

us .
burn infection

motility agent
Uses : GI WOF : hemolysis in PD deficiency
prophylaxis O vs
-
N -

G Crystal luria

SJS → Stevens Johnson 40% BIA

WTD? Steroids ,
-

g- TEN overlap 10 -30%

WOF : GI upset TEN Tsoxi Epidermal Necroiysts > 30%
 b. Trimethoprim 5 .

Drugs vs
Mycobacterium
Tuberculosis ( Dots)
MOA : ⊖ dihydro folate reductas a.

bacteriostatic 1st dose

agents
:
> -
line
WOF :
mega
/oblastic anemia It =
Isoniazid 5mg/Kyla
,
R =
Rifampicin 10

2
c.su/famethoxazo1etTrimethNprim--Co-trimoxaao1 ,
=
Pyro inamidp
>
25
(Bactrimr
=

E Ethambutol 15

bactericidal
=
ˢ 15
-

streptomycin
pneumonia /PCB
:
DOC Cases
-
vs
Pneunomocystis Carini >

seen in HIV/AIDS -

CDgL 200 New

-

never treated ; < tm

Pretreatment
WOF : SJS , megalobastic anemia ✓ Relapse
elevation of creatinine ✓ Lost to Follow-up ✗ 2
pseudo - mos

✓ Treatment faiaur 5m05

✓ Tx completed , outcome
d. Quinol ones
unknown

- MOA : -0
topoisomerase Category I category #
acid (
Ist Gen : Nalidixic
prototype) I Pulmo
} ZHRZE
II. Pulmo
2 HRZES
2nd Gen : Otto Norfloxacin I Extra MARI Extra
Cipro , , 1 * RZE

3rd Gem : Levefloxacin Ia lens , bone joints) s HR

4th Gen : Moxifloxacin ZHRZE + to HR IIa CNS bone/ Joints

,

Generalization vs TB ZHRZES

Vs IHRZE
Atypical 9 HR
Excellent oral
bioavailability
-0
Uses :
Cipro =
best in
gram "
i Isoniazid
respiratory quinoline
"
hero =
-

⊕
Moxi =
best in MOA :
① colic acid synthesis
my
-

gram
best in
atypical
:
tybeculosidal (us rapidly dividing)
best in anaerobes -

inh
enzyme
.

WOF : QT
prolongation tendon rapture WOF : Ba deficiency →
peripheral
,

neuropathy
e.
Metronidazole
-
MOA : vs .
electron transport chain ii.
Rifampicin
⊖ RNA
DOC us Amoebiasis Giardiasis , trichomoniasis MOA :
synthesis
-
-

below the diaphragm ) ( us slowly dividing)

'

vs anaerobes / tuberculocidal
-

WOF metallic
: taste inn
enzyme
-
.

Disulfiram -
like reactions WOF :
red-orange discoloration (body fluids)

4) Urinary antiseptics ii
Pyrazinamide
a. Nitrofurantion MOA : >
Pyrazinoic Acid
MOA ? ?? acute
Acidic pH
cystitis
→
: -

vs.

-
weak tubercnlocidal
b. Methenamine there is ↑ inflammation
given when
-

-
MOA : →
formaldehyde ( intensive phase )
acidic pH

-
bacteriostatic
WOF :
hyperuricemia gouti arthritisDo ,
→
-

vs. recurrent UTI

 iv. Ethambutol
MOA ⊖ colic acid synthesis RNA
1IVims#
:
my , synthess
tuberculostatic It Basic Concepts
-

WOF :
optic neuritis -

small ,
acellular , obligate , parasite
red and green
?? ? host
requires
-

structure :
v.
Streptomycin protein cost
nucleic acid
DNA

aminoglycoside ( Im )
nucleocapsid RNA
-

WOF :
nephrototoxic , ototoxic, vestibule toxic symmetry
-

iv. 2nd -
line
agents vs MDR TB -
-
Aminoglycosides Helical /Cubic
✓
i. e. -

kanamyein ,
Amikacin, Gentamicin
Rhino
Quinoline ,
-

Rifabutin Adeno
Capreomycin
-

Cyclo serine Rifabentin Polio -

p amino salicylate
-

✓
Icosahedral Tobacco Mosaic
b.
Leprosy Virus
i.
Rifampicin Coronavirus
_

e.

Doipsone MOA:-O DNA synthesis

-

↳ WOF: ✓
hemolysis in GGPD
deficiency Complex symmetry
Pox
-

Clofazimine -

MOA :
binds to DNA of m
-

Bacteriophage
leprae
WOF : skin discoloration Life cycle :
sulfone resistant attachment
leprosy penetration
'

us
replication
-

uncoating
> >
-

s
.

virion syn <

Recall
.

: Tuberculosis -
Gmos

Lepromatus 2
yrs packaging assembly <
-

,
.

release
← /
lytic
Lysogenic
General
priciples
* DNA viruses =
Double stranded
Icosahedral

Nucleus
exception
: Pox =
complex , cytoplasm
Parvo Stranded
=

Single

Naked Enveloped
Parvo -
Herpes
Adeno B. virus
Hep
-

Papova
-
Pox virus
* RNA Viruses Helical * Other members of
Paramyxoiiridae
Enveloped ✓ Respiratory syncytial virus

cytoplasm =
URTI in children

single stranded
✓
Mumps virus

exception
:
Reo -

double stranded Rot =

droplet ,
direct, indirect /tomites )
Nucleus -
Retro , Orthomyxo Complication :
parotitis
Naked -
Picorna orchitis → inflamof testes
Reo
Calici 3.) Erythema infectiosum
"
Parvovirus slapped cheek
"
Bia
-

Positive sense 5th disease

Pico Tca Flare Par FABOR Wot : Aplastic anemia

Picorna -

Paramyxo
Corona - Filo C .
Pox infections

Toga
-
Arena 1.) Molluscan #1 infection
contagiosum pox
=

Cali direct )
Bunya Rot :
-

swimming pools
(
Flavi -

Orthomyxo M Multiple umbilicated flesh colored

Retro Reo Rhabdo
,
papules
WTD : Cidofovir
B. Viral F- ✗anthems -

fever { rash

it : Rubella / German measles 2.) smallpox humans

-
Rubi virus -

eradicated in 1970s - one

serotype
"

]
""
ROT :
droplet lifelong
-

A)
lymphadenopathy ragin immunity
Disease
"
fever "

day Forcheimer spots rashes

-

3- -

Note :
Congenital rubella soft palate
-
-

A WTD :
mental retardation
supportive
hiii
↳

blindness W
loss SP
hearing CP

dse
congenital →
monomorphic Polymorphic
-

muffin spots
blueberry
WTD ?
Supportive D.
Herpes
-

-
Prev :
MMR -
latent stage in the nerves

④ for HHV
pregnant Herd
-

~>
immunity I
HSVI oral ulcer
2 . Rubeola / Measles 2 Its V2
genital ulcer
-

Morbilivims ( Paramyxoviridae) 3 Varicella zoster virus

-

Rot : 4 Ebstein
airborne B.q.rs Virus
Dse : stepladder fever cough Koplikspots 5
3C
Cytomegalovirus
→
-

coring
=

#onjuctivitisbuaaha.iq 6-7 Roseolo virus

inf / am
of mucosa 8
Kaposi sarcoma assoc .
virus (Alb)
WOE : Otitis media,
brannydesquamatim rash
-

< ←

Pneumonia 1 .

Herpes simplex virus

'Ñb
pan encephalitis direct
ROT :
subacute sclerosing contact F-
Fran
-

WTD : supportive ,
Vita HSVI →
oral utuen →
encephalitis E⑤
Prev MMR Measles Hsvz genital ulcers meningitis
-
: →
→

,
recurrent vesicles papules , WTD : Acyclovir
'
-
"
, ulcers
2. Varicella zoster virus E. Viral Gastroenteritis
Varicella / chicken pox mostly RNA
Aden↓ovirusI
a. virus
except
-

ROT : airborne
# f-
initial infection pharyngocanjuetival
Transmission : before fever
I -3
days rash →

4-5 after rash

days Norovirus
honor i. e. Human Calicivimg
"
# / adults
"
dow petal saponins # Child
drop
-

vesicular rash -
on a rose

WTD : ( adolescent)
Acyclovir →
ax a
day Rotavirus # 1- child
1- 3
ylo →
④ drugs Prev : vaccine

Prev : Varicella vaccine WTD : ORS

supportive,

b. Herpes zoster / Shingles F. Viral Hepatitis

-

reactivation 1.) Hepatitis A virus

-

common in the
elderly immunocompromised
, Picornaviridae
-

* Acute infection
-
"
derma tornal rash "
-
unilateral -
Rot : fecal-oral
( t)
post -

herpetic neuralgia
→
Pregabalin ; Gabapentin -
acute infection
only
Diagnosis
:
HAV
IgM
-

3.
Epstein-Barr virus
>
adolescent
WTD :
supportive
Rot : direct contact ( kissing) neonates
Previ Vaccine →
not for
everyone
>

Dse : Infectious mononucleosis

↳
for tourist
It) fever , fatigue
It ) sore throat 2.) Hepatitis virus

( t)
lymphadenopathy only DNA virus
among Hepa virus
-

WOF : Burkitt 's lymphoma

-

Rot : sexual
,
vertical parenteral
,

Nasopharyngeal
-

carcinoma

DX : adolescent Course : ↑# 1-
- →
Monospot test = liver

injury
Heterophil Ab acute > Chronic
6m05
Hep B Hep B

WTD : ↓
supportive Immune Tolerance
↑ Hep B DNA
⑧ ALT
5.) Cytomegalovirus
,

cell
→
enlargement ↓
a. Vertical transmission Immune response
-
chono retinitis ⊖•
↑ Hep B DNA , ↑ ALT
-

#1 infectious congenital problem

WTD ↓
Gancyclouir
-

Immune control
b. Horizontal Hep B DNA
, @ DNA
4in Limits
-

via blood transfusion

-

retinitis

Hepa B
profile
* Note :
Baby Blueberry muffin * HBVDNA
→
spots
-

"
virion particle
Dane
complete
"

particle :

5) Rose lovins
①
core +
envelope
Roseola / F- ✗ anthem subitum HB
.sAg✓ surface of infection
=
marker
general
-
-

>

fever → f) fever 4) Nagayama spots ⊖

Anti HBsAg
recovery /immunity
-

(t ) rash "
rose rash
"
hvulotpalato global
-

junction
 HBC
Ag = actual infection
-

core

Anti HBC
↓
Igm⊕= acute infection

chronic / past infection

=

only detected IgG

intens

HBE envelope active replication ; infectious

Ag
=

Anti
HBeAg= ✗ active replication ✗ infectious ,

case :
#I #2 #3

HBsAg It) (t) f)

Anti ( t)
HBsAg f) f)
Anti HBC IgM (7) f) f)
IgG f) It)

Acute vaccine
Hepps Chronic
↓
supportive
-

antivirals :
Tenofovir

( reverse transcriptase in.h)

Wbf : liver
cancer
consider liver
transplant

3.) Hepatitis C virus

-
Flaviridae

ROT : ( blood transfusion )

parenteral
-

Chronic infection : It )
waxing & waning spots
# 1 indication for liver transplant
-

WTD ? Interferon PEG , Ribavirin , Sofosbuvir

-

-2
,

Prev :
vaccine
multiple serotypes
-

④
lifelong immunity

4. Hepatitis D virus
"
Delta "
-

virus
ROT similar to Hep B
-

confection B & Hep D

Hep
-

super infection Hep & Hep D

5.) Hepatitis E virus

Rot: fecal-oral "

TAE
"

most acute viral hepatitis

-

common

contaminated beverages
-
Prov :
?? vaccine

"
G :
A-rbovi.ms
"
Arthropod -
borne

geographic specific
-

area

i. e.
Togaviridae Bunyaviridae
Flavoviridae
Reoviridae
 1) Bunyaviridae C.
Yellow fever virus
Bunyaviridae →
encephalitis Hedy, aegypti
-

"
Congo
_

Hemorrhage Panama Puzzle

"
Nain virus →
Crimean , Fever Dr. Walter
Phk bovines fever, Rift valley Fever ( t) fever
sandfly
→

( t) bradycardia
jaundice
=

It)
2.) Flaviviridae Paget jaundice
-

Prev : vaccine

/
a.
Japanese encephalitis West Nile virus
3.
Chikungunya virus
culex bukidna culex mosquito Aedes Aegyti
-
→

llamok) ↓ -

may ibon
jointmopnainn
horses -

fever +

b. Dengue Virus not that low

-

platelet
"
Aedes day biter
"
vector :
aegypti
-

4.)
-

DNV : 1,2 3,4 Eastern

,
Equine Encephalitis
-

Dengue fever = fever >

daye endemic area -

most common several arbouiral

w/o warning sign → home

complication
-
w/ WS → admit hospital
severe dengue →
adm hospital
It .

Hemorrhagic fever virus

warning signs lws) 1.) Arenaviridae

-

abdominal pain -

sandy appearance

bleeding i. Junin Machupo

-

e. Lassa, ,

clinical of fluid accumulation Rot :

signs rodent to human
-
-

persistent vomiting (feces

lethargy
-

liver
-

enlargement 2.) Filoviridae

↓ ⑦ output for ≥ 6hr
long Filamentous threads
-
or urine
-

i. e. virus
Marburg
Phases of
severe
Dengue Dengue :
Ebola virus → reservoir : ? ??

organ dengue
(7) Febrile Phase fruit bat
" +24 -48ha
(t) severe
bleeding critical Manage →
no fever
Rot: direct endemic

(t) plasma leakage Recovery in Africa

-

PH : Ebola Reston in pigs

WTP :
hydration
-

supportive
→

ORs , 0.9% NaCl ( Nss) , LRS

ttspiin 3.) Hantavirus

-

member of Bunyauiridae
DX : CBC complete blood count -

④ arthropod """

TP
"

= ↓ WBC ↑ Hematocrit
.

Rot :
rodent to human
, renal
↓ Platelet

Dengue NSI Antigen →

Day I -4 fever I .
Rhabdoviridae
onwards
Dengue IgM IgG Days Rabies
→ -

ROT : bite ( cat, bat , fox ) , nonbite

Prev 4 'o clock habit dog
-

:
ftp.k.D , ,

IP :
-

◦
plan Kaya knlub ,
search { Destroy 20-90 days
(t) fever
vaccine →
Dengvaxiar Dse :
Prodrome -

agitation ,
nausea
?⃝
 Paralytic phase ( 10%) WTD
Carbenoxolonecrowaget)
:

[
~

quadri paresis ⑤ Generalized disease of the newborn

Furious
Encephalitis 1-90%1
/ Type 1 Diabetes mellitus ?
( t)
pharyngeal dysfunction
(t) '
K Retroviridae
hyper salivation .

( t) Human (HN)
hydrophobia -

immunodeficiency virus

comatose → Death =
Lentivirus
ROT sexual , vertical parenteral
:

WHO Category
:

Exposure of
Pathophysiology
-

I
licking touching ,
⊕ →

II. minor scratches → vaccine HIV us CD, 1- 1- Cells

(
abrasions
immunity )
✓

G) induce bleeding
t) sport bleeding ✓ acute Hiv initially
II. .
→ vaccine
ER "
syndrome →

bats ✓
→
exposure
Ig ≤ Human
Equine latent ,
asymptomatic
head , neck bite HKIG ✓ AID CDq < 200 -

Pneumocystis carinii pneumonia

↳ trimoxazole
Prophylaxis : co -

WTD : vaccine / Ig Cdg ( 100 -

toxoplasmosis , crytococcosis

soap , H2O CDq 150 -

m . avium complex
④ cover

antibiotic Ivs Pasteur ella multocidal) DX : screening ELISA → eoun

selling
. -

Blot I
confirmatory Western
-

↓
* Only have Pre { Post Explosive vaccine
proteins
recall :
SNOWesteem
horthern
Sym
J Poli virus Prev : Abstinence DROP
¥ ¥ ¥
.

- ROT : fecal -
oral Be loyal in
,

Enterovirus Condon
Disease :
Poliomyelitis
-

✓ Abortive -

most common

✓ Paralytic -
motor weakness L .
Respiratory virus

✓ Non paralytic aseptic meningitis 1 Rhinovirus cold, acute rhinitis

-

→
common
-
.

↳ → Viral
bacteria
no
meningitis Rot: contact w/
droplet ,
direct
✓ Post after initial infection
-
Polio
syndrome →
20 yrs secretions
↳ motor weakness WTD :
supportive
Prer : Salk and sabin vaccine
decongestants , i.e.tn , agonist
( Paiienterai ) total )
OPV 2 .
Coronavirus
Severe Acute (SARs)
a.
Respiratory Strain

* Other members of Enterovirus # IP: 2 weeks

ROT:
droplet? ,
airborne ? contact ?

1.) Boston ex anthem disease (t ) fever

virus (t) travel /
Human
cytopathogenic history to China
-

aseptic meningitis
-

b. COVID-19
2.) Cocks ckie virus ROT :
droplet ? ,
airborne ? direct contact
④ little) oral ulcers DX
herpangina
:
→
RT-PCR → SARS -

Covz
RNA
hand , foot , mouth disease Management : supportive , ✓ Remdesivir
anti-viral :
Favipiravir
= vs

Mulnupiravir
 ✓ hemo perfusion
④ cytokines WTD
liquid nitrogen phodophyllwm salicylic
=
: warts =
, ,
acid
✓ convalescent plasma cervical =
chemo , radiation ,
cancer
surgery
✓ Tocilizumab
=
us It -6
for inflammation
.

↳ mediator ④
Prev : Bivalent = Cervarix
②
⑦ Ivermectin Quadrivalent :
Gardasi /
④
④ Hydroxychloroquine ( Planquenil ) -

shifts
↳ WOF : QT N Antivirals
prolongation .

1. Anti -

Herpes MOA :-O DNA

⑦ Lopinavir /Ritonauir → for HIV

originally i. e. Acyclovir , Cgancyclovir
=
→
Polymerase
chain
termination
↓ ↓

Vaccines : vs : HSV 1
vs CMV
retinitis
-
inactivated → sinovac Its v2

viral rect VZV

→
AstraZeneca
Jansen EBV

Sputnik Gamaleya
2.) Antiretroviral lvs.HN)
mRNA →
Pfizer a .
NRTI -

Nucleosides Reverse Transcripts Inh .

Moderna RNA → DNA

3 .
Influenza virus i. e. Didanosine

Abacavir "
DAZZLEST
"

Orthomyxoviridae
-

ROT : Zakitabine
droplet
-

Influenza A H1N1 Zidovudine

→ swine fly
A bird fly Lamivudine
H5N1 →

Entecavir
-

antigenic shift ⑤ antigenic drift Emtricitabine

↓ ↓
stavudine
minor changes major changes
Tenofavir
(AZT)
-
② douudine =
Azithromycin
WTD : supportive antiviral -
Oseltamivir ltamiflu ) 1st anti-Hiv approved by FDA
Prer : vaccine 1
every year) vax
→
¥7
Pneumonia b. NNRTI Non nucleoside
*
-

i. e. Nevi rapine

F- favirenz

M . Human Papillomavirus ( Hpu) Delavirdine

ROT : direct contact (sexual )

HPV 4,7 warts c. Protease inhibitor

1,2
=
common
,
"
"
verruca vulgaris i. e. navir Indninavir , Saquinavir
,

Hpv
16,18
=

condyloma acuminata d. Fusion inhibitor

recall : Iata i.
condyloma ta
,
=
syphilis e. Enfuvirtide

HPV 16 , 18,31 , penile * HAART antiretroviral therapy

33 cervical anal tanker
Highly active
=
, ,

NRTI + NNRTI , NRTI 1- PI

DX : clinical warts -
_ ( cauliflower)
Papanicolau smear cervical cancer =

(t ) koilocytes fried
egg appearance
=
3) Anti -

Hepatitis II. Fungi that

feed on

Orgs matter
9. Reverse transcriptase inh .
A . Basic concepts decaying
us
Hep B eukaryote saprophyte
-
-
. ,

"
-

i. e. Tenofovir , Entecavir
-
structure .
v5 .
humans
cholesterol
%
-

bacteria
cell wall egostero /
.

→
-
✗ sterol

except Mycoplasma
b. Interferon - ✗ Cell membrane
-
MOA : degrade viral RNA
capsule →
India Ink/Negros in
-
V5 .

Hepc
i. e. Cryptococcus
neoformans

c. Ribavirin
-

MOA : ⊖ GTP formation Yeast Molds Dimorphic fungi

Hepc unicellular filamentous room
temp mold
-

us -

budding [hyphae
:
saboraud 's dextrose

4.) Anti -

a.
influenza
Amantadine
elongates
↓
to
mycelium
⊖ uncoating body tempt yeast
-

MOA : antiviral pseudo hyphae

-
→

used in Parkinson 's dse = Brain infusion

( ↑ dopamine) agar
may
-

WOF :
psychosis lived reticular is
-

( tamiflu)
b. Oseltamir B. Cutaneous fungal infection
-

MOA : ⊖ neuraminidase
" "
⊖ of viral particle
release
Dermatophyte is >
dermatophyteslmold )
-
us . Influenza i. e. Trichophyton spp
Epidermopnytonspp
microspores spp
-
secretes keratinase (hair ,
skin , nails)

i. tinea corporis trunk

-
e.
" "
" "

buni ringworm
-

central
clearing

Tinea
capitis :
scalp
i. e. kerion ( baldness )

Tinea
unguium (nails ) "

jock itch
"
tinea cnn.is
"
athlete 's toot "
Tinea
pedis

Dx : KOH (t)
scrapings hyphae
wood 's (t) fluorescence
lamp
WTD :
keep area
dry
imidazole ( ketoconazole)
Topical

C. Superficial Fungal Infection

1.) Pityriasis versicolor
-
Tinea versicolor

Malassezia furfur
-

" "

hypo pigmentation
-

an - an =
 Dx : ✓
microscopy cave
explorers , spelunking
"
and meatballs "
Dse
spaghetti Histoplasmosis
:

WTD : selenium sulfide, topical imidazole b. Blastomyces dermatitis

-
risk factor : soil
,
wood
2.) Tinea
nigra
_

Blast mycosis ( North American

)
F- ✗ aka Gilchrist dse
ophiala werneckii
-

-
( t) black nodules

WTD :
selenium Sulfide, Imidazole C.
Coccidoides immil
-

Coccidioidomycosis ,

aka : San
Joaquin Valley fever
3.) Black Piedra White Piedra Desert Fever

Firmly attached attacked

loosely
- -

scalp hair public hair

axillary d. Pidiid brasiliensis
-

pie-draiahorto.es -

Trichosporon spp . Para coccidioidomycosis

-

aka south American blasted mycosis

aka south American
blastomycosis
ID : (t) mariner's wheel

D. Subcutaneous fungal infection

trauma >
fungi >
lymphatics nodules Generalization :
④ dimorphic fungi
① similarities to TB

1.) Sporotrichosis -
skin test
infection
Sporothrix schenkii lung ->9ran%
-
-

☒ ,
inhalation
system
-

9¥ →
lymphatic ① differences to TB

KISS ( Potassium Iodide sat / b)

-
WTD : . So -

lungis → G)
spores
Itraconazole
-

f) acid fast

2) Chromo blast
mycosis 3) Opportunistic →
immuno comprised
Candida albicans
pedro Sol
a.
Fonseca eq normal flora
-
-

trauma → cauliflower wart like-

lesion * Oral candidiasis → aka oral thrush

,
Monillasis
copper
-
like sclerotic, penny
A) white papules
bodies
WTD : excisics Itraconazole
WTD: Nystatin
,

-
MOA : binds ergosterol
swish and
spit
-

3) Madura foot / True Mycetoma *

Esophageal candidiasis -

Nystatin
Cswishthgwallow )
False Mycetoma Actinomycesspp
→
recall :
True
psuedallescheriaboyds.it
→

d) chronic infection Intertriginous dermatitis

granules inframammary axillary
-

i. % ,
"

diaper rash
- "

E.
Systemic Fungal Infection * Disseminated candidiasis -
severe

1.) Immunocompetent =
G) blood culture
a. Hist
plasma capsulatum
f) capsule :
DX : Beta -
D- Glucan test

risk factor : DOC: Fluconazole

 b.
Aspergillus spp .
A. tiumigatus , A. Niger 3.) Azules
MOA : -014 d sterol demethylase
-
-
-

bronchopulmonary
'

-
_

inhabitation
_
'
-
i -

→
a. Imidazole
aspergillosis
•

11¥
<
.
.

④
fungus ball more toxic less specific
-

-_
Aspergillus ,

ctscom
,
* ketoconazole

€
:( f) halo
sign 1st oral azole
cavity
-

lprev.TN -
us .

dermatophyte is
-

enzyme inh .

WOF :
hepatotoxic gynecomastia
Aspergillus -
aflatoxin -
liver cancer

: ☆ Miconazole
Diagnosis Galactomannan Ag testing
* Clotrimazole
DOC Voriconazole :

C- b. Triazole
Rhizopus spp ,
Mucor spp
Mucor
mycosis → rhino cerebral
By
-
less toxic
,
more specific
pulmonary [ * Fluconazole
candidiasis
diabeter immunocompromised Doc
-
-
vs

* Voriconazole
d- indolent infections
Cryptococcus neoformans
us
fungal
-

↓ contractile
⊖
agent
→
WOF :
inotropic ✓ §
bird not
given orally
-

inhale Cristo "" is * Posaconazole newest

dropping → → =

(
pigeons EB meningitis
seen if CHINO
4.) Glucan synthase inhibitors =
Echinocandins
India Ink / Nig rosin
caspofung.in/ArgidulafunginWTD
ID : A) i.
capsule
→ e.

Amphotericin initiation ,
:
Flucytosine B +

maintenance Fluconazole ④ liver

, kidney problem
Cida ) Candida
-

vs .

F-
Antifungal static us
Aspergillus
-

1 .

Poly one
B
i.
Amphotericin
e.
"
"
5
MOA : binds
ergosterol →
pores
.

Allyl amine
↑ i. e. Terbinafine
permeability → ⊖
squalene epoxidaee
DOC us sever fungal infections vs.
dermatophyte s
- -

" "
Queen of all antifungals
-
WOF : "
Ampho -
terrible " 6 . Griseofulvin
MOA : microtubule
✓ Fever vs
assembly
-

"
✓
neptro toxicity = affect K+, Mg -
V5
dermatophyte
.

Absorption is ↑ w/ Fatty Food

2- Flu
cytosine
cdTmph(
Flucytosine

[
> 5- Flu

WOF : bone marrow

adjunct Crypto coccosis

toxicity
-

in

monotherapy
-

never used as
 I.Parasites b.
Gia_di1amb
A. ROT : oral
Basic
concepts Fecal -

obtain nutrients via intimate contact Giardiasis → ④ =

steatotorrhea
greasy
-

(t) =
rotten egg odor
Vector gassy
parasite host
4)
gitata =
malnutrition
ecto endo Definitive
HOSA DX
fecalysis
us . •
:
"
↓ ↓
out in
= sexual maturity host trophozoite =
"
Old man 's Eyeglasses
✓ Doc : metronidazole
body
Intermediate
•

development
LEE parvin
c.
obligate
=
us

facultative -

immunocompromised (HIV/AIDS)
•
Paratenic diarrhea
Cryptosporidium's watery
-
-

-
no der 't
WTD : If A) HIV → HAART
•
Reservoir If E) HIV →
Nitazoxanide
Continuous
-

source

2.
Genitourinary Tract
i. e. Trichomonas vaginalis "
Parasite sexual
ping-pong
"
Rot :

trichomoniasis : (t )
strawberry cervix
A)
frothy greenish
Protozoa Metazoa/ Helminths
↓
discharge
1
i. e. I DOC : Metronidazole
sarcodina
platyhelminth
1 flatworms ) Nemahilminths
Sporozoa ( roundworms)

Mastigophara 1 I 3 . Tissues
trematodes cestode
A) flagella Plasmodium
1 flukes) (tapeworm) a. spp .

Ciliata -
vector : female Anopheles mosquito
(f) Cilia
falciparum

}
P .

↳ it
E malarial malaria = most important
B. Protozoa GUT P vivax
mortality
.

↑
-

Tissues
Eov€
1.) Gastrointestinal tract

histolytica
✓
Life
a. Entamoeba
cycle
ROT : Fecal -
oral Intestinal -
> clysters
f) fever

Amoebiasis A) Flask -

ulcer
shaped
° river
stage
⑤
""
" °
sporozite

/
""" "

F- ✗ """ t" "ⁿᵈ " " " "" "

M " ^" " "
-

DX
:

Fecalysis
-

amoebic liver abscess ⑤ trophozite

/b¥;!:¥
.
A)
A)
hematophage ingest RBC - anchovy - like
stage ⑥ gametocyte
DO :c
discharge *

metronidazole ( Flagg
-
:

woe
K ④ hynozoite
: metallic aftertaste +

dormant state in liver

Disulfiram like effect
-

EI , EE
-

Luminal amoebicides -
Dioxide
I. odoquinol
Paromomycin
Definitive host :
Mosquito
Intermediate host : human
 ✓ 9 mbiense West Africa
5. brucei
=
P . f. PI EI .
P.o.

48h 72h 48h 48h rhodesiense =

East Africa
Tertian Quartan Tertian Tertian

Malignant Benign Benign Benign tsetsefly

ltceierbaral →
trypomastigote
Gnggpp
All RBC OLD
young reticulate
-

= African
sleeping sickness
G) kerandel sign hyperesthesia
-

thick and blood

Dx
thin
✓
: G) Winterbotam sign lympadenopathy
smear
-

ID malaria ID species
WTD :
western early Pentamidine
✓ WTD
CNS F- flornithin
* Falciparum
1st line
uncomplicated Co artem
Easterd
:

early suramin
= -

⊕
Artemetherlumefantnine CNS Melarsoprol
2nd line :
Oral ⑦ Doxyklinda d. Others
guanine
✓ Balantidiwm ciliated
coli =
only protozoa
complicated
quinine ⊕ Doxy
:
IV /Linda → human dse

⑦ Primaquine reservoir
pigs
* Non
falciparum chloroquine ⊕ Primaquine :
-

✓
* mixed co artem ⊕ primaquine
: - Leishmania spp

✓
sandfly →
promastigate
Prophylaxis susceptible →
chloroquine
chloroquine resistant →
Doxycyiine Phibes spp
leishmaniasis
Cutaneus L
tropics
-
→ .

b-
Toxoplasma gondii mucocutaneous-bra-sim.is
-

Cat feces Visceral / Kala

Toxoplasmosis
-

-
azar
> 1.
donoam.lt
-

>
cyst
_

meat ) retinitis
vertical IH muffin spots WTD : stibo gluconate
blueberry sodium
WTD? Sulfa diazine / sulfonamide
⊕
Pyrimethamine B. Metazoa / Helminths
⊖
dihydro folate reductase 1) Nematodes / Roundworm
a.) Ascari 's lumbrieoides
c.
Trypanosoma spp
. = Giant intestinal Roundworm

✓ F. cruzi -

kissing bug i embryonatedegg

{ingestion
Reduviid
Triaomspp
n-←£→§→i%÷
1117
ingestion
.me

DX : Kato Katz
-

American WTD : Albendazole B

Trypanosomiasis MOA : binds
=

Haute :
Romanos
sign periorbital edema tubulin
-

nodule at bite site

Chagomna
-

WTD:
Nifurtimox Chronic
:
myocarditis
=
MOA : ① Hrypanothione Mega colon
reductase
 b. Hookworm e-

Strngyides stercoralis
Old world
Anymq dnedenate
€)
-

C) teeth
enter colitis
New world

{ paradoxical asthma
→

Neeator ameri ⑦ cutting

-

tilariform plate
fila form DX : Harada - Mori culture

"
larva WTD : Ivermectin
secretes MOA : ttt GABA
anemia
signals
→
worm
→

WOF :
_anti -

hypochromia maazoti reaction

↳
worsening
DX ! Kato -

Katz

WTD : Albendazole f. Capili philippinensis

enterocolitis
0
→
* →
protein losing enteropathy
bqgsit WTD : Albendazole

migrator birds iii

C.
Trichuris triuhuria =
whipworm g. Blood and tissues

§
¥
barrel-shaped If Filarial
✓
parasites
embryonated.ba
> →
culex
eggs
Wuchereria bancroft; Aedes
ingestion
=

-
Anopheles
-

MET
malayi -
Mansoni a

•
A ↑ peristalsis =
↑ rectal mosquito
intestine Prolapse pg →
GIBBER → ↳ Larva

Dx : Stool
f) adult
↓
parasite
abaca
block lymphatic
WTD : mebendazote
farmer

Pinworm
W b
d. Enterobius vermicul hydrocele
scrotum
enlarge
→
= →
seat worm .

B. "
limbs
ephantiasis
m →

D- shaped
eggs
HE =3 DX ! DEC test $☆%
/ /[ §
"
provocation
11,
A) pruritus ani
insomnia WTD : DEC
Diethylcarbamaeine
←
1 It) →
* enteritis
MOA : immobilize filarial parasite
¥7
pseudoappendicitis
inhalation ✓
Tri9 spiralis
DX of infected pork
Graham
ingestion
:
scotch tape test -

WTD
Pyrantel pamoatelcombantrin )
eifysEE-m-uc.de
:

MOA : neuromuscular blocker

-

Treat all (t ) nurse cells

-
Dx :
biopsy
-
WTD : Thiabendq -0k
 0ravow
!%fwesterm
✓ •

river blindness ) craps

black fly →
_
snail [ Ante melania spp 1

lizard skin
Simuliumspp dermal nodules
→
metacercaria →
Paragonimiasis
It)
cough
WTD : Ivermecti -
↑ eosinophils ( t) hemoptysis
SI : Romantic Dr .

Ep6( Family)

/ Flatworms bacterial
Platyhelminths
2- recall :
neutrophils
-
-

viral
Praziquantel lymphocytes
__
Doc :
"
MOA : ↑
permeability to ca DX : NaOH ( reagent)
flatworms trematodes lflukes ) DOC :
:
Praziquantel
cestodes (tapeworm)
✓
Cis sinensis , opistarchisspp
ñ Trematode / Fluke -
liver fluke
-
snails , crabs → metacercaria
✓
Schistosoma spp tract →
cholangiocarcinoma
biliary
. →

⊖ £ japonicum lateral knob/ ( reagents)

.
→
spinel rounded -

Dx :
RMNOQ
Q £ . haematobium →
terminal spine ↳ mineral chameleon
① É
mansoni → lateral spine
DOC : praziquantel
*
Japonicum b. Cestodes / tapeworm

ceFarF=porta
Taenia
saginata
✓
snails Taenia sollium
,
/
circulation
- - -

°ⁿ°?¥pⁿg
-
→

pork beef
↓
↳ 530 Gintestinal obstruction

.¥÷÷:
adults
nenrocysticerosis

# Sex Forever

÷ ↓ ✓
Hymenolepsis nana
=
dwarf tapeworm
eggs - -

✓
tatum fish tapeworm
Diphybhriucn
-
-

I
f
u

instead of
-
assoc w/

s.bg?n;t0ybiuy,m-dder
"" Vit Br
)
2
u
grooves
deficiency
↓
leaf -

shaped anemia
Megaloblastic
DX :
Kato - Katz
COPT Circumoval Precipitin test ✓
Echinus granulating
ultrasound
Imaging
µn,ip definitive host dogs
: :
,
intermediate : sheep ,
cattle

Dse : accidental humans :

"
acute →
acute dermatitis, "
swimmer 's itch (t)
Hydatid cyst →
rupture
→
anaphylaxis
Katayama fever >
hypersensitivity > 1 organ
chronic →
cirrhosis → hepatocellular system
carcinoma

WTD : Praziquantel