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40 Cards in this Set

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PCN MOA
bactericidal, interferes with cell wall synthesis by inhibiting transpeptidases that crosslink peptidoglycan, result in damage to cell wall and lysis
Why don't PCNs affect all gram neg?
Require porin for entry through outer hpsopholipid membrane. certain PCNs can with altered configurations amp, carbenicillin, piperacillin etc.
How are most PCNs excreted?
Renally, exception is biliary excretion of naficillin

BONUS: don't cross placenta therfore not teratogenic
Antipseudomonal PCNs
Carbenicillin, piperacillin, ticaricillin
Sensitivity of 1st gen cephalosporins?
PEcK

Gram + and proteus, E coli and Klebsiella
Sensitivity to 2nd gen cephalosporins?
HENPEcK

HiB, enterobacter, neiserria + proteus, e coli, klebciella
3rd gen cephalosprin sensitivties?
HENPEcK + enterics (intestinal bacteria)

Hib, Enteroacter, neiserria, proteus, E coli, klebsiella

cefTAzidime, cefoTAxime, cefTriAxone
4th gen cephalopsorins used for...
psuedomonas

cefipime, cefpirome
Patient presents with NV, tachycardxia, paolpitations, hypotension taking an ABX and well um drinking. Cause and possible drugs
Disulfarim-like rxn- build up of acetaldehyde from alcohol from inhbition of p450 by ABX
metronidazole, chloarmphenicol, ceftamanadole, fcefotetan, sulfas, nitro, lots of ABX
Ceftriaxone used in renal patients
not renally excreted but biliary
Pulmonary edema occurs when...
filtration is more than resoprption and lymph flow
Patient presents with sudden fever, cough, sptum and dspnea, x-ray shows lobar pneumonia, most likely organism?
Pneumococcus
Bronchopneumonia typically caused by
HiB and pseudomonas
Legionarres Dz transmission and most frequent type of patient
elderly patients, spread via water reservoirs not person-person
Smoker presents with a central lung mass, signs of hyperparthyroidism, most likely Dx?
Small cell CA, central and PTH-like peptide paraneoplastic syndrome
Patient presents with hematuria, RBC casts. most likely Dx?
Nephritic syndrome- most often diffuse proliferative GN AKA poststreptococcal GN
Patient has severe protenuria, hypoalbuminemia, hyperlipdiemia and edema, most likely Dx?
Nephrotic syndrome- adult membranous GN, children minimal change GN
Glomerulonepropathy with subendothelial deposits of immune complexes and tram track appearance. Prognosis?
Poor, membranoproliferative GN
Patient with uric acid precipitation in urine, DDx?
gout, leukemia

tends to precipitate in acidic urine
Patient presents with excruciating intermittent pain, radiationg from flank across abdomen, most likely D/t?
calcium stone, rpecipitates in alkaline urine, treat with thiazides and postassium phosphate
child with testicular mass, what tumor DDx?
yolk sac, serum AFP increased, very aggressive
Choriocarcinoma in ovary
germ cell tumor, produces HcG
Risk factors for endometrial adenocarcinoma?
over 40, early menarche, late menopause, nuliparity, obesity
older pregnant woman comes in with uterus larger than expected, grape like material, HCG elevated. Dx and concerning sequalae
hydatifiorm mole, concern is malignant transformaiton to choriocarcinoma
Patient has bilateral, multiple breast nodules, varies with menstrual variation, regresses during pregnancy, most likely...
firocystic change, vs. breast CA unilateral, single mass, no cyclic variaitons
Patient has glossitis, cheilosis, smooth beefy red tongue, what is the most likely cause?
B12 deficiency
What's the diff beween Zenker's and traction diverticula of esophagus?
Zenker's more proximal, and only through mucosa layer (pseudodiverticula), also dysphagia and regurge. traction asymptomatic and through all layers
Primary concer with Chronic Type A gastritis?
pernicious anemia, achlorhydria

Type B associated with H. pylori
Gardner's vs. Turcot's vs. Peutz Jeghers?
All polyposis of colon, APC gene

Gardners- AD- skin and bone CA

Turcots- AR, CNS tumors

Peutz-Jeghers- melanin pigmentation of lips, palsma and soles, AD, low risk of cancer

If polyps develop, need to take out colon
Ulerative colitis complications
- continuous from retum with pseudopolyps, increased risk of colon CA and toxic megacolon
Patient presents with malabsorption, anemia and arthritis, causative organsim?
tropheryma whippeli (Whipple's Dz.) Tx with PCN or tetracycline
Crohn's vs. UC
Crohn's- skip lesions, transmural, granulomas, more pain less bleeding

UC- rectum and continuous proximal, mucosa/submucosa only, crypt absecesse, pseudopolyps, more bleeding
Patient presents with acute fever, sepsis, RUQ pain and jaundice, suspect?
CHOLANGITIS
Gallbladder CA vs. bile duct CA
Galbladder- female w/ cholelithiasis, porcelain gallbladder

Bile duct CA- male, chronic infection w/ liver flucke
Crigler Najar
congenital cause of jaundice, very severe, AD or AR
HBs-Ag and HBe-Ag, businessman who frequents the red light district indicates?
Hep B infection, HBe-Ag indicates infective state, 10% chance of becoming chronic

anti-HBsAg- w/o others indicates recovery and immunity
Drugs that can cause toxic hepatitis
Predictable- acetaminophen, amanita, carbin tetrachloride, methotrexate (all dose dependant and predictavble)

Idiosycratic- severe and dose-independant- halothane, isonizaid, methyl-DOPA
Alcoholic liver biopsy with micronodular cirrhosis what might you expect to see in acute bout of hepatitis?
Mallory bodies- swollen hepatocytes that contain cytoplasmic inclusions of a fibrillar protein, common but not specific to alcoholism
Wilson's disease
accumulation of copper in liver -> cirrhosis, decreased serum ceruloplasmin
Osteoarthrits vs. RA at interphalangeal joints
Osteo- DIP

RA- PIP, metacarpophalangela joints