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40 Cards in this Set
- Front
- Back
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PCN MOA
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bactericidal, interferes with cell wall synthesis by inhibiting transpeptidases that crosslink peptidoglycan, result in damage to cell wall and lysis
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Why don't PCNs affect all gram neg?
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Require porin for entry through outer hpsopholipid membrane. certain PCNs can with altered configurations amp, carbenicillin, piperacillin etc.
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How are most PCNs excreted?
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Renally, exception is biliary excretion of naficillin
BONUS: don't cross placenta therfore not teratogenic |
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Antipseudomonal PCNs
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Carbenicillin, piperacillin, ticaricillin
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Sensitivity of 1st gen cephalosporins?
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PEcK
Gram + and proteus, E coli and Klebsiella |
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Sensitivity to 2nd gen cephalosporins?
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HENPEcK
HiB, enterobacter, neiserria + proteus, e coli, klebciella |
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3rd gen cephalosprin sensitivties?
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HENPEcK + enterics (intestinal bacteria)
Hib, Enteroacter, neiserria, proteus, E coli, klebsiella cefTAzidime, cefoTAxime, cefTriAxone |
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4th gen cephalopsorins used for...
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psuedomonas
cefipime, cefpirome |
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Patient presents with NV, tachycardxia, paolpitations, hypotension taking an ABX and well um drinking. Cause and possible drugs
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Disulfarim-like rxn- build up of acetaldehyde from alcohol from inhbition of p450 by ABX
metronidazole, chloarmphenicol, ceftamanadole, fcefotetan, sulfas, nitro, lots of ABX |
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Ceftriaxone used in renal patients
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not renally excreted but biliary
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Pulmonary edema occurs when...
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filtration is more than resoprption and lymph flow
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Patient presents with sudden fever, cough, sptum and dspnea, x-ray shows lobar pneumonia, most likely organism?
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Pneumococcus
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Bronchopneumonia typically caused by
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HiB and pseudomonas
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Legionarres Dz transmission and most frequent type of patient
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elderly patients, spread via water reservoirs not person-person
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Smoker presents with a central lung mass, signs of hyperparthyroidism, most likely Dx?
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Small cell CA, central and PTH-like peptide paraneoplastic syndrome
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Patient presents with hematuria, RBC casts. most likely Dx?
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Nephritic syndrome- most often diffuse proliferative GN AKA poststreptococcal GN
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Patient has severe protenuria, hypoalbuminemia, hyperlipdiemia and edema, most likely Dx?
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Nephrotic syndrome- adult membranous GN, children minimal change GN
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Glomerulonepropathy with subendothelial deposits of immune complexes and tram track appearance. Prognosis?
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Poor, membranoproliferative GN
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Patient with uric acid precipitation in urine, DDx?
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gout, leukemia
tends to precipitate in acidic urine |
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Patient presents with excruciating intermittent pain, radiationg from flank across abdomen, most likely D/t?
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calcium stone, rpecipitates in alkaline urine, treat with thiazides and postassium phosphate
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child with testicular mass, what tumor DDx?
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yolk sac, serum AFP increased, very aggressive
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Choriocarcinoma in ovary
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germ cell tumor, produces HcG
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Risk factors for endometrial adenocarcinoma?
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over 40, early menarche, late menopause, nuliparity, obesity
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older pregnant woman comes in with uterus larger than expected, grape like material, HCG elevated. Dx and concerning sequalae
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hydatifiorm mole, concern is malignant transformaiton to choriocarcinoma
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Patient has bilateral, multiple breast nodules, varies with menstrual variation, regresses during pregnancy, most likely...
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firocystic change, vs. breast CA unilateral, single mass, no cyclic variaitons
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Patient has glossitis, cheilosis, smooth beefy red tongue, what is the most likely cause?
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B12 deficiency
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What's the diff beween Zenker's and traction diverticula of esophagus?
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Zenker's more proximal, and only through mucosa layer (pseudodiverticula), also dysphagia and regurge. traction asymptomatic and through all layers
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Primary concer with Chronic Type A gastritis?
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pernicious anemia, achlorhydria
Type B associated with H. pylori |
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Gardner's vs. Turcot's vs. Peutz Jeghers?
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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 |
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Ulerative colitis complications
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- continuous from retum with pseudopolyps, increased risk of colon CA and toxic megacolon
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Patient presents with malabsorption, anemia and arthritis, causative organsim?
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tropheryma whippeli (Whipple's Dz.) Tx with PCN or tetracycline
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Crohn's vs. UC
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Crohn's- skip lesions, transmural, granulomas, more pain less bleeding
UC- rectum and continuous proximal, mucosa/submucosa only, crypt absecesse, pseudopolyps, more bleeding |
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Patient presents with acute fever, sepsis, RUQ pain and jaundice, suspect?
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CHOLANGITIS
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Gallbladder CA vs. bile duct CA
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Galbladder- female w/ cholelithiasis, porcelain gallbladder
Bile duct CA- male, chronic infection w/ liver flucke |
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Crigler Najar
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congenital cause of jaundice, very severe, AD or AR
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HBs-Ag and HBe-Ag, businessman who frequents the red light district indicates?
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Hep B infection, HBe-Ag indicates infective state, 10% chance of becoming chronic
anti-HBsAg- w/o others indicates recovery and immunity |
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Drugs that can cause toxic hepatitis
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Predictable- acetaminophen, amanita, carbin tetrachloride, methotrexate (all dose dependant and predictavble)
Idiosycratic- severe and dose-independant- halothane, isonizaid, methyl-DOPA |
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Alcoholic liver biopsy with micronodular cirrhosis what might you expect to see in acute bout of hepatitis?
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Mallory bodies- swollen hepatocytes that contain cytoplasmic inclusions of a fibrillar protein, common but not specific to alcoholism
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Wilson's disease
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accumulation of copper in liver -> cirrhosis, decreased serum ceruloplasmin
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Osteoarthrits vs. RA at interphalangeal joints
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Osteo- DIP
RA- PIP, metacarpophalangela joints |
