Exam 1 Review Flashcards
Which of the following is a gram negative bacteria?
E. Coli
Clostridium
Listeria
Bacillus
E. Coli
The BIG gram negative
Which of the following is a gram positive anaerobe?
Staphylococcus
Clostridium
Klebsiella
Pseudomonas
Clostridium
Gram positive, anaerobe, spore-forming rod
Which of the following works to inhibit protein synthesis?
Cephalosporins
Fluoroquinolones
Amino-Glycosides
Sulfonamides
Amino-Glycosides!
Cephalosporins are cell-wall inhibitors
Sulfonamides folate inhibitors
Fluoroquinolones inhibit DNA
Which of the following inhibits cell wall synthesis, but is not a beta-lactam?
Ceftriaxone
PCN G
Vancomycin
Ertapenem
Vancomycin
True of False?
Beta-lactams are bacteriocidal.
True
Zosyn is a combination of:
Amoxicillin-clavulante
Ampicillin-sulbactam
Ticarcillin-clavulanate
Pipercillin-tazobactam
Pipercillin-tazobactam
What generation cephalosporin is Cefazolin (ancef)?
1st
2nd
3rd
4th
Ancef is a first-generation cephalosporin
What is the major 3rd generation Cephalosporin?
Rocephin (ceftriaxone)
What is the Major 4th generation cephalosporin?
Cefepime
Which cephalosporin has a good pseudomonas coverage?
Cefaclor
Cefepime
Cefazolin
Ceftriaxone
Cefepime
Which of the following is the most broad-spectrum?
Imipenem
Cefazolin
Vancomycin
PCN G
Imipenem
Vancomycin provides what kind of antibiotic coverage?
Gram positive aerobes
Which antibiotic is best for a patient with a PCN allergy?
Monobactams
Carbapenems
Cephalosporins
Vancomycin
Monobactams
(Sensitivity crossover with cephalosporins is 10-15%)
Vancomycin treats all of the following except/
MRSA
Staph Epidermis
Pseudomonas
Streptococcus
Pseudomonas
(MRSA is the reason vancomycin exists! 1st-line treatment)
Tetracycline works by which mechanism?
Inhibits protein synthesis
Inhibits cell wall synthesis
Folate Inhibitor
Inhibits DNA Synthesis
Inhibits Protein Synthesis
True of False?
Gentamicin is bacteriostatic.
True
(Gentamicin is part for the Macrolide group)
True or False?
Amino-Glycosides have no activity against anaerobes.
True.
Amino-Glycosides have no activity against anaerobes.
Which antibiotic is used to treat VRE?
Vancomycin
Teteracycline
Ceftriaxone
Ertapenem
Tetracyclines
(Ceftriaxone and Ertapenem are cell-wall inhibitors; won’t have a strong effect against VRE.)
Which class of antibiotic is Eryhtromycin?
Tetracycline
Macrolide
Amino-Glycoside
Carbapenem
Macrolide
All of the following about quinolones is true EXCEPT:
Good gram + coverage
Good pseudomonas coverage
Preferred for complicated UTI
Poor MRSA coverage
Good gram + coverage
(Can’t be good + and good MRSA)
Which antibiotic is first-line treatment for C. Diff?
Metronidazole
Tetracycline
PCN G
Ceftriaxone
Metronidazole (Flagyll)
(Combined therapy with Vancomycin PO)
Papilledema is seen in all of the following EXCEPT:
Subarachnoid hemorrhage
Increased ICP
Meningitis
Acute Glaucoma
Acute Glaucoma
Egophony is heard in a patient with what?
Pneumonia
Tension Pneumothorax
Cardiac Tamponade
Open Pneumothorax
Pneumonia.
Consolidations in the lung, conducting tracheal vibrations to chest wall.
(Cardiac tamponade and pneumothorax will not transmit sound.)
Capital Medusae is seen in patients with:
Cirrhosis
Portal Hypertension
Pancreatitis
Bowel Obstruction
Portal Hypertension (Direct Cause)
(Usually 2/2 cirrhosis, or some other type of liver failure)
Which of the following is not a sign of appendicitis?
Psoas Soas
Kehr’s Sign
Obturator Sign
Rovsing’s Sign
Kehr’s Sign
- Diaphragmatic injury
-Refers pain to tip of left shoulder
(Splenic laceration is one of the most common causes)
Grey-Turner’s sign indicates:
Acute Pancreatitis
Appendicitis
Acute Colitis
Hepatomegaly
Acute Pancreatitis
-Flank Contusions
Look for accompanying Cullen’s sign
-Umbilical contusions
What percentage of Oxygen exists at 100,000 feet above sea level?
21%
10%
5%
0%
21%
Atmosphere extends to 400,000-450,000’
How much will GI gas expand at 25k feet?
None
2x
3x
4x
3x
(Hydrous and Anhydrous gas expand at different rates)
Charle’s Law is the relationship between:
Volume and Temperature
Pressure and Temperature
Volume and Pressure
Sum of Partial Pressure
Volume and temperature
(Two temperature laws: Charle’s and Guy-Lussac’s)
Which gas law explains the sum of partial pressures?
Guy-Lussac’s
Dalton’s
Boyle’s
Henry’s
Dalton’s Law
(Dalton’s gang)
Describe Henry’s Law
Pressure of a gas above a liquid is equal to the pressure of a gas dissolved in a liquid
What are the two temperature laws?
Guy-Lussac’s and Charle’s laws
Fick’s Law is affected by all of the following EXCEPT:
Pressure gradient of gas
Surface of membrane
Volume of the gas
Thickness of membrane
Volume of the gas
(Fick’s Law describes factors that affect the rate of diffusion)
What drives oxygen into Plasma?
Partial Pressure
What effects thickness of alveolar membranes?
Pneumonia, COPD, Asthma
What effects the surface area of alveolar membranes?
Atelectasis, pneumonia, pulmonary edema
Which gas law states: the pressure of a gas dissolved in a liquid equals the pressure of the gas above the liquid?
Dalton’s Law
Henry’s Law
Fick’s Law
Graham’s Law
Henry’s Law
Describe Graham’s Law
The smaller the molecule, the faster it will diffuse
What type of hypoxia results from cyanide poisoning?
Hypemic
Hypoxic
Histotoxic
Stagnant
Histotoxic
(Cyanide blocks Complex 4 of the electron transport chain)
True of False?
The vibration of the aircraft can increase metabolism?
True
Which of the following occurs during descent of the aircraft?
Barotitis Media
Barobariatrauma
Barosinusitis
Barosinutrauma Media
Barotitis Media
What type of cells make up the human body?
Eukaryotes
Prokaryotes
Chitin
Mycocells
Eukaryotes
What type of bacteria stains purple?
Gram +
Haemophilus Influenzae is a common cause of:
Hepatitis
Meningitis
Viral Pneumonia
Flu
Meningitis
Which of the following is the most broad-spectrum?
Vancomycin
PCN
Tetracyclines
Isoniazid
Tetracyclines
What is the normal range for potassium?
3-5
3.5-5
4-5.5
3-5.5
3.5-5
What does metabolic acidosis do to the serum potassium?
Increases
Decreases
Remains the same
Varies with patient
Increases
(Fix the acidosis and the K+ should go back to normal)
Which EKG changes are not seen in Hypokalemia?
Spike T-Wave
U wave
ST Depression
Wide QRS
Spike T wave
(T waves flatten)
What is the most common cause of Hypokalemia?
K+ shift due to insulin
NG suctioning
Renal loss of K+
Hyperaldosernoism
Renal Loss of K+
Which Hyperkalemia treatment stabilizes the cell membrane?
Insulin
Glucose
Calcium
Bicarbonate
Calcium
(Insulin and Bicarbonate cause a fluid shift back into cell)
(Only giving glucose because we’re giving insulin)
What is the most common cause of Hypercalcemia?
Hyperparathyroidism
Hyperkalemia
Hypernatremia
Hyperthyroidism
Hyperparathyroidisim
(Top 3 most common causes of Hypercalcemia: hyperparathyroidism, hyperparathyroidism, hyperparathyroidism)
What condition presents with Chvostek’s sign?
Hyperkalemia
Hyponatremia
Hypermagnesmia
Hypocalcemia
Hypocalcemia
(Chvostek’s sign and Trusseau’s signs in Hypocalcemia)
(Hypermagnesia: Reduced DTR’s and respiratory depression)
What is the normal range of Na+?
130-140
135-145
140-150
145-155
135-145
True or False?
A common cause of hypernatremia is by giving too much sodium?
False
(Most common cause is water loss/deficit)
Hyponatremia is seen in ____, while Hypernatremia is seen in _____.
Vomiting, Diarrhea
Diarrhea, Vomiting
Diarrhea, NG Suctioning
NG Suctioning, Vomiting
Vomiting, Diarrhea
What do you expect the sodium to be in a patient that is hypochloremic?
Hyponatremic
Hypernatremic
Normal
Depends on K+
Hyponatremic
(Chloride follows the Sodium)
Which of the following would not cause an increase in the anion gap?
DKA
Lactic Acidosis
Renal Failure
Excessive emesis
Excessive emesis
(MUDPILES)
Which of the following will decrease the BUN?
Burns
SIADH
Shock
Sepsis
SIADH
(All of the others will increase BUN)
What effect do cephalosporins have on creatinine?
Decrease
Increase
Depends on the BUN
No Change
Increase
Which of the following decreases the serum osmolarity?
Hyponatremia
Azotemia
EtOH
Hyperglycemia
Hyponatremia
(Alcohol and Hyperglycemia will increase serum osmolarity)
(Azotemia is a high BUN)
Which band elevates primarily in bacterial infections?
Lymphocytes
Neutrophils
Eosinophils
Monocytes
Neutrophils
(Viral infection- Lymphocytes)
(Eosinophils- Allergies and Parasites)
Which band primarily elevates with viral infections?
Lymphocytes
Neutrophils
Eosinophils
Monocytes
Lymphocytes
A patient has a hemoglobin of 9, what is the hematocrit?
3
9
18
27
27
(Hematocrit is approximately 3x the hemoglobin)
“The rate of metabolism of the a drug is directly proportional to the concentration of the drug” is a property of:
First-order kinetics
Zero-order kinetics
Second-order kinetics
Derek Sucks
First-order kinetics
(No such thing as Second-order kinetics)
Which of the following is a Sympathetic response?
Decreased HR
Bronchoconstriction
Increased Peristalsis
Pupil Dilation
Pupil Dilation
All of these are natural catecholamines EXCEPT:
Dopamine
Epinephrine
Dobutamine
Norepinephrine
Dobutamine (Synthetic)
Also an “inodilator” (positive inotrope and vasodilator)
-Milranone is also an inodilator (but is a phospodiesterase inhibitor)
Which of the following is true in regards to epinephrine?
Causes hypoglycemia
Increases insulin release
Increased glycogenolysis
Negative inotrope
Increased Glycogenolysis
What beta adrenergic agonist is used as a tocolytic and bronchodilator?
Dobutamine
Terbutaline
Cozaar
Isoproterenol
Terbutaline
Which of the following is an Alpha-2 Agonist used in sedation?
Methyldopa
Precedex
Proventil
Brethine
Precedex
(Alpha-2 inhibits the release of norepinephrine, preventing vasoconstriction)
Which agent shortens Phase 3 replarization?
Procainamide
Lidocaine
Cardizem
Amiodarone
Lidocaine (Class Ib antiarrhythmic, Na+ channel blocker)
Which agent prolongs Phase 3 repolarization?
Lidocaine
Procainamide
Amiodarone
Diltiazem
Amiodarone is a Class III antiarrhythmic
Which beta-blocker is best at reducing heart rate?
Esmolol
Metoprolol
Lebetalol
Trandate
Metoprolol (Lopressor)
(Esmolol lowers SV w/o affecting rate, Metoprolol lowers HR w/o affecting SV)
What is the equation for Cardiac Output?
CO= SV x HR
A patient is receiving 10.5ml/hr nitroglycerin. How many mcg/min is given?
25
35
20
30
35
(10mcg/min = 3ml/hr)
Succinylcholine will increase the serum K+ about:
0.5
1
0.25
1.5
0.5
What is the proper dose of Succinylcholine in an 80kg patient?
80mg
120mg
8 mg
100mg
120 mg
(1-1.5 mg/kg)
(80 is technically right, but underdosing leads to adverse reactions! Stick to the higher doses, especially with estimated weights)
Which of the following is a treatment for malignant hyperthermia?
Increase FiO2
Increase rate
Increase Vt
Increase minute ventilation
Increase minute ventilation
(Goal: 3x higher minute ventilation)
Technically, increasing Vt AND rate
(Absolute treatment for malignant hyperthermia is Dantrolene)
