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Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.

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)  


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