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#biotics

100

These two bacteria are treated by penicillin G

Syphilis, GAS (pharyngitis)

200

XDR TB is resistant to at least these three agents

 isoniazid, rifampin, and a fluoroquinolone

300

Treatment of Lyme with ______ may induce a ______ reaction

doxycycline, Jarisch-Herxheimer reaction.

400

Chlamydia trachomatis can be treated using these two classes of antibiotics

tetracyclines and macrolides

500

B-lactamase inhibitors include these two

Clavulanic Acid
Sulbactam
Tazobactam

Novel B-lactamase inhibitors
target newer, problematic
B-lactamase enzymes:
Avibactam
in combo w ceftazidime
Vaborbactam
in combo w meropenem
Relebactam
in combo with imipenem +
cilistatin

Urine Trouble

100

The most common cause of a UTI

E. Coli

200

These three pathogens, though transmitted sexually, cannot be tested for with PCR on a urine test or genital swab and must be tested for in the blood

Syphilis, HBV, HCV

300

This diagnostic test is the gold standard for detecting Chlamydia trachomatis infections, especially in cases of suspected urethritis

nucleic acid amplification testing (NAAT)?

400

The approximate proportion of Chlamydia urethritis in penises that is asymptomatic

Varies by population and can range from 50 to 96 percent

500

Urine submitted for NAAT for Chlamydia should be

first-catch

Lana del Ray Charles

100

The tx for disseminated histoplasmosis + a common cause of toxigenic food poisoning

Amphotericin B. cereus

200

Drug of choice in Strongyloides infection + infection caused by Malassezia furfur

IvermecTinea Versicolor

300

Population with highest rates of syphilis transmission and infection + bacterial strain used for BCG vaccine

MSM. Bovis

400

A common pathogen in cystic fibrosis patients + a neuroaminidase inhibitor

Pseudomonas aerginOseltamivir

500

Disease caused by a bacteria that induces a host antibody response which reacts to a cardiolipin-cholesterol-lecithin antigen + A short gram-positive rod that grows well at refrigeration temperatures

SyphiListeria monocytogenes

drugs

100

MoA and indication of aminopyridine

voltage-dependent potassium channel blocker, has been shown to improve walking in patients with MS

200

MoA and indication of baclofen

Baclofen is an agonist at the β subunit of gamma-aminobutyric acid on mono- and polysynaptic neurons at the spinal cord level and brain. Baclofen is thought to reduce the release of excitatory neurotransmitters in the presynaptic neurons and stimulate inhibitory neuronal signals in the postsynaptic neurons, resulting in spasticity relief.

MS, spinal cord lesions

300

An indication for the use of pyridostigmine OTHER than Myasthenia Gravis

Bonus: a drug pyridostigmine is being replaced by for this indication

Reversal of non-depolarizing muscle relaxants (ie, Pancuronium) 

Sugammadex

400

A mixed alpha/beta blocker (labetalol) is used in the treatment of severe hypertension.

Labetalol is often chosen as treatment of acute hypertension as it produces a dose-related decrease in blood pressure without reflex tachycardia without significant reduction in heart rate. These effects are produced through a mixture of its alpha- and beta-blocking effects.

500

The MOA and use of nimodipine in the prevention of vasospasm

During the depolarization of smooth muscle cells of blood vessels, there is an influx of calcium ions. The primary function of nimodipine is to block voltage-gated L-type calcium channels and keep them in their inactive conformation, preventing vasoconstriction. Nimodipine preferentially acts on cerebral blood vessels because it is lipophilic and can cross the blood-brain barrier.[26] Proposed mechanisms leading to a beneficial effect include decreased angiographic vasospasm, increased fibrinolytic activity, and enhanced neuroprotection.

holes

100

These CN pass through the foramen ovale

V3

lesser petrosal (a branch of glossopharyngeal)

200

The jugular foramen contains these CN

the glossopharyngeal nerve, the vagus nerve, and the accessory nerve.

300

These CN fibers synapse in the solitary nucleus

• Gustatory (taste) sensation from facial nerve (CN VII) via the chorda tympani (from anterior 2/3 of tongue), glossopharyngeal nerve (CN IX) (from posterior 1/3 of tongue), and vagus nerve (CN X) (from epiglottis).
• Chemoreceptors and mechanoreceptors of the general visceral afferent pathway (GVA) from the carotid body and carotid sinus via CN IX; from aortic bodies and aortic arch via CN X.
• Chemoreceptors and mechanoreceptors of the general visceral afferent pathway (GVA) with endings located in the heart, lungs, airways, gastrointestinal system, pharynx, and liver via the glossopharyngeal and vagus nerves.

400

This branch of CN V enters the mandibular foramen under the ______

inferior alveolar nerve, lingula

500

SURPRISE!!!!! Discuss the mechanisms, consequences, and treatments of cerebral vasospasm.

Mechanisms

1. Blood breakdown products: The primary trigger appears to be the presence of blood breakdown products, particularly oxyhemoglobin, in the subarachnoid space
2. Calcium-dependent and independent vasoconstriction: Both calcium-dependent and independent mechanisms contribute to the narrowing of cerebral arteries
3. Oxidative stress: Free radical reactions play a role in the development of vasospasm1.
4. Imbalance of vasoactive substances: There is a disruption in the balance between vasoconstrictors (e.g., endothelin) and vasodilators (e.g., nitric oxide)

Consequences

The consequences of cerebral vasospasm can be severe:

1. Delayed cerebral ischemia (DCI): Vasospasm can lead to reduced cerebral blood flow and subsequent ischemia
2. Neurological deficits: Symptoms can include weakness, aphasia, confusion, and reduced level of consciousness, depending on the affected vascular territory
3. Cerebral infarction: Vasospasm significantly increases the risk of cerebral infarction, particularly in the middle cerebral artery territory
4. Mortality: A meta-analysis reports 30% mortality in patients with vasospasm

Treatments

Treatment strategies for cerebral vasospasm include:

1. Hemodynamic augmentation: The current focus is on euvolemic-induced hypertension, aiming for systolic blood pressures of 180-220 mmHg or cerebral perfusion pressures above 80 mmHg
2. Calcium channel blockers: Oral nimodipine is recommended for all patients with SAH to prevent vasospasm and DCI
3. Endovascular therapies:
   • Percutaneous transluminal angioplasty (PTA): Effective for proximal vessel segments but carries risks of complications
   • Intra-arterial vasodilators: Agents such as verapamil, nicardipine, or papaverine can be administered, though the optimal protocol is not clearly established