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What is the mechanism of vancomycin? What is the mechanism of it's resistance? Inhibits cell wall synthesis Altered cell wall (unable to bind)
What is the mechanism of quinolones? DNA gyrase inhibition
What is the mechanism of amphotericin binds sterols to alter fungal cell wall
Which antibiotics are bacteriocidal, with irreversible binding to 30S ribosome subunit, and resistance due to decreased active transport? Aminoglycosides (gentamicin, neomycin, tobramycin)
What vitamin deficiency causes hyperglycemia (relative diabetes) and neuropathy? Chromium
What vitamin deficiency causes perioral rash, hair loss, poor healing, and change in taste? Zinc
What vitamin deficiency causes weakness (respiratory) and encephalopathy? Phosphate
What vitamin deficiency causes anemia and neutropenia? Copper
What two electrolyte abnormalities cause hyperexcitability (increased reflexes, tetany)? Hypocalcemia and hypomagnesemia
What phase of the cell cycle is most sensitive to radiation therapy? Mitosis
What are the effects of TGF-B? stimulates fibroblasts and chemotactic for neutrophils (too much/too long can cause fibrosis)
What is the effect of PDGF? Attracts fibroblasts and increases smooth muscle to speed matric deposition and collagen formation
Describe the anatomical relationship of the Portal triad Portal vein posterior to CBD (on R) and hepatic artery (on L)
What is Diabetes Insipidus? Alcohol and head injury inhibit ADH release - high UOP, low urine SG, high serum osmolarity/Na
What is SIADH? Increased ADH release most often by head trauma/tumors or SCLC. Oliguria, high urine osmolarity, low serum osmolarity/Na
What three fractures are prone to compartment syndrome? Calcaneous, tibia, supracondyle of humerus
What are the signs of gastrinoma? Severe ulcer disease, diarrhea (lipase destruction by acid, malabsorption, incr secretion)
What are the symptoms of a somatostatinoma? gallstones steatorrhea pancreatitis
What are the symptoms of a glucagonoma? Treatment? diabetes glossitis stomatitis necrolytic migratory erythema (presenting problem in 70%) Rx = streptozocin/doxorubican (selectively destroy alpha cells) and octreotide (inhibits release)
What are the symptoms of VIP-oma? WDHA syndrome = watery diarrhea hypokalemia achlorydia
What other abnormalities can a patient with a tracheoesophageal fistula have? VACTERL - vertebral, anal atresia, cardiovascular, TEF, esophageal atresia, renal, limb defects - structures derived from embryonic mesoderm
What are the characteristics of gastroschisis? Congenital abd wall defect, intrauterine rupture of umbilical cord, no associated defects, lateral (right) defect, no sac
What are the characteristics of omphalocele? midline defect, may contain liver or other non-bowel contents, frequent anomalies, has peritoneal sac.
What is Conn's syndrome? hyperaldosteronism = 80% adenoma, 20% bilateral hyperplasia - HTN, low K, high Na
What is Addison's disease? low aldosterone and glucocorticoids = low Na, high K, hypoglycemia. Crisis presents similar to sepsis with hypoTN, fever; steroids are diagnostic and therapeutic
What is Cushing's disease? Excessive secretion of ACTH from the anterior pituitary, usually from a pituitary adenoma. Causes 70% of non-iatrogenic Cushing's syndrome.
What is Cushing's syndrome? hormone disorder with high levels of cortisol - symptoms include characteristic weight gain (truncal obesity, moon face, buffalo hump), purple striae, hirsutism, polyuria, htn, insulin intolerance
What is the classic vision change with pituitary mass effect? Bitemporal hemianopsia - vision missing in outer half of both right and left visual fields
What is the #1 pituitary adenoma? What are the symptoms? Prolactinoma - galactorrhea, irregular menses
What type of cancer demonstrates "peripheral palisading" of nuclei and "retraction artifact" Basal cell carcinoma
What is the most common cause of flap necrosis? venous thrombosis
What type of melanoma has the best prognosis? worst prognosis? best = lentigo maligna; worst = nodular
What is MALT a precursor to? gastric lymphoma - regresses with H. pylori treatment
What drugs peripherally block conversion of T4 to T3? PTU, Propanolol, Prednisone (& other steroids) and methimazole
What is MEN I? Wermer's syndrome - parathyroid, pancreas, pituitary (prolactinoma most common)
What is MEN IIa? Sipple syndrome - Parathyroid, adrenal (pheochromocytoma), and thyroid
What is MEN IIb? Thyroid, adrenal, mucosal neuromas/marfan
What is the mechanism of azathioprine (Imuran)? 6MP derivative, purine analog that acts as an antimetabolite, decreases DNA synthesis
What is the mechanism of cyclosporine? Calcineurin inhibitor - inhibits mRNA encoding of IL-2
What is the mechanism of mycophenolate (cellcept)? blocks purine synthesis to decrease T and B cell proliferation
What is the mechanism of tacrolimus (FK506)? Calcineurin inhibitor - blocks IL-2 expressions/production from T cells - more potent than cyclosporine
What is the mechanism of immunosuppression of prednisone? blocks IL-1 from macrophages
What is the mechanism of sirolimus (Rapamune)? mTOR inhibitor - inhibits the response of IL-2 thereby blocking the activation of T and B cells
How does aging affect PFTs? reduces FEV1 and FRC
What are the effects of PEEP on the lungs? Increased FRC, increased compliance
What is functional residual capacity (FRC)? air in lungs after normal exhalation
What is inspiratory capacity? maximum amount of air able to be inhaled (TV + inspiratory reserve volume IRV)
What is vital capacity? greatest volume that can be exhaled (IRV + TV + ERV)
What are the characteristics of silvadene? good activity against candida/pseudomonas, poor eschar penetration. risk of neutropenia
What are the characteristics of mafenide acetate (sulfamylon)? painful, can cause acidosis due to carbonic anhydrase inhibition
What are the characteristics of silver nitrate? Can cause hyponatremia and hypochloremia due to leeching of NaCl
What is a side effect of carbapenems? Seizures
What are side effects of aminoglycosides? Reversible nephrotoxicity, irreversible ototoxicity
What is the mechanism of metronidazole? produces oxygen radicals that breakup DNA
What are side effects of metronidazole? Disulfiram-like reaction, peripheral neuropathy
What vitamin deficiency causes dermatitis, diarrhea and dementia? Niacin - this syndrome is called Pellegra
What vitamin deficiency causes dermatitis, hair loss, and thrombocytopenia? Essential fatty acid deficiency
What does a RQ >1 indicate? What does a RQ <0.7 indicate? >1 = lipogenesis (overfeeding); <0.7 = ketosis and fat oxidation (starving)
Created by: jclanton82
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