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ABSITE > Inflammation/Wound Healing > Flashcards

Inflammation/Wound Healing Flashcards

1
Q

Three phases of wound healing and timing

A

Inflammation (1-10days), Proliferation (5-21days) and Maturation/remodeling (3wks-1yr)

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2
Q

Proinflammatory cytokines important in modulating immune response in wound healing and promoting production of new RNA and proteins

A

Interferons

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3
Q

Central enzyme in apoptoisis

A

Caspases

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4
Q

Newborn immune protection first 6months

A

IgG across placenta and IgA through breast milk

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5
Q

Amphotericin B; MOA

A

Binds to fungal cell wall sterols

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6
Q

Most abundant collagen in human body

A

Type I

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7
Q

Platelets aggregate and growth factors/cytokines released; Phase of wound healing and time after injury

A

Hemostasis, minutes

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8
Q

Phagocytosis by neutrophils, mast cells, vasodilation; Phase of wound healing and time after injury

A

Inflammation, first few days

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9
Q

Angiogenesis, collagen deposition, granulation, epithelialization, wound contraction; Phase of wound healing and time after injury

A

Proliferation, days to weeks

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10
Q

Collagen crosslink, remodeling and strengthening; Phase of wound healing and time after injury

A

Remodeling, weeks to months

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11
Q

Primary lymphoid organs

A

Liver, bone, thymus

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12
Q

Secondary lymphoid organs

A

Lymph, Spleen, Peyers, Tonsils, Adenoids

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13
Q

Phase of wound healing in which collagen deposition is greatest

A

Proliferative

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14
Q

Collagen cross linking is dependent on this for hydroxylation of proline

A

Vit C

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15
Q

When are anastomotic leaks likely to occur

A

POD3, old collagen is being broken-down but new collagen hasn’t quite caught up

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16
Q

Single most important molecule for intestinal wall strength

A

Collagen

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17
Q

When does collagen breakdown begin in wound healing and as a result of what enzyme

A

within 24hrs from metalloproteinases

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18
Q

Promotes hemostasis in the inflammatory phase of wound healing

A

Thromboxane A2

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19
Q

Stimulates vasculogenesis and angiogenesis

A

VEGF

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20
Q

Responsible for adhesion of leukocytes to endothelial cells

A

Integrins

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21
Q

Most common pathogen causing late graft infection

A

S. Epidermidis

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22
Q

Post-op prolonged NPO on TPN now with jaw pain and leukocytosis; dx and organism

A

Postop parotitis, Staph aureus

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23
Q

Leukopenia, fatigue, retinitis s/p renal transplant; dx and tx

A

CMV, gancyclovir

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24
Q

Dx test for pleural TB, result

A

Sputum and pleural fluid sample with mycobacterium

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25
Pleural TB tx
Rifampicin, isoniazid, pyrazinamide, ethambutol
26
Most common organism in VAP
PsA and Staph aureus
27
Recommended surgical prep
Chloraprep
28
Altered penicillin-binding protein produced by MRSA is encoded by which gene
mecA
29
Uninfected operative wounds in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tracts are not entered; wound calss
Clean
30
Operative wounds in which the respiratory, alimentary, genital, or urinary tract is entered under controlled conditions and without unusual contamination; wound class
Clean-contaminated
31
Open, fresh, accidental wounds, operations with major breaks in sterile technique or gross spillage from the gastrointestinal tract, and incisions in which acute, nonpurulent inflammation is encountered; wound class
Contaminated
32
Old traumatic wounds or wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera; wound class
Dirty
33
SSI risk clean wounds
1-5%
34
SSI risk clean-contaminated wounds
3-11%
35
SSI risk contaminated wounds
10-17%
36
SSI risk dirty wounds
>27%
37
HIV periop medical management
Continued without break
38
Sulbactam MOA
beta-lactamase inhibitor
39
Infected diabetic foot ulcer and signs of septic shock
Amputation
40
Only monotherapy regimen approved for parenteral tx of amp-susceptible enterococci infections
Augmentin
41
Ampicillin-resistant E faecium
Linezolid and daptomycin
42
Abx that lacks cross-reactivity to other beta-lactams
Aztreonam
43
Suspected colonic injury, appropriate pre-op abx
Ancef + flagyl, cefoxitin, Cefotetan, Augmentin
44
Risk factor for gastric adenocarcinoma
Nitroso compounds
45
Bite wound, first line abx
Augmentin, cefoxitin, bactrim + clinda
46
Immunocompromised, pulmonary fungal infection; dx and tx
Invasive aspergillosis, Voriconazole
47
Indication for palliative gastrectomy with Stage IV gastric lymphoma
Bleeding or obstruction
48
STOP-IT trial guidelines
Abxs 4 days from source control
49
Immunosuppressed with brain abscess; dx
Aspergillus brain abscess
50
MOA fluoroquinolones
Inhibit DNA gyrase
51
MOA macrolides
Inhibit 50S ribosomal subunit
52
MOA aminoglycosides
Inhibit 30S ribosomal subunit
53
MOA vancomycin
Inhibit cell wall synthesis
54
CMV tx
Ganciclovir, Foscarnet, Cidofovir
55
Immunotherapy Non-Small-cell lung cancer; tx and target
Pembrolizumab -> PD-L1
56
Immunotherapy Melanoma; tx and target
Ipilimumab, CTLA-4
57
Immunotherapy Medullary thyroid MEN IIa/IIb; tx and target
Selpercatinib, RET
58
Immunotherapy ER+ breast cancer; tx and MOA
Anastrozole, Aromatase inhibitor
59
Immunotherapy HER2+ breast cancer; tx and target
Trastuzumab, HER2 receptor
60
Immunocompromised with fever, chills, weight loss, crackles and rhonci in lower lung fields, pancytopenia, diffuse bilateral infiltrates from perihilar region; dx and prevention
Pneumocystis Jiroveci, Bactrim ppx
61
Cavitating lung lesion
Mycobacterium tuberculosis
62
Ohio River Valley spelunker
Histoplasmosis
63
Pneumonia or meningoencephalitis
Cryptococcus neoformans
64
Southwest US lung lesion
Coccidioidomycosis
65
Immunosuppressant associated with gallstone formation
Calcineurin inhibitors like Tacrolimus and Cyclosporine
65
Immunosuppressant associated with gallstone formation
Calcineurin inhibitors like Tacrolimus and Cyclosporine
66
Immunosuppressant that disrupts purine synthesis and causes GI SE
Mycophenolate
67
Immunosuppressant that inhibits cytokines and lymphocytes, SE include DM, impaired wound healing
Steroids like prednisone
68
Immunosuppressant that blocks nucleotide synthesis and has GI SEs
Azathioprine
69
Immunosuppressant that inhibits mammalian target of rapamycin, SEs include impaired healing, mouth ulcers, pneumonitis
mTOR inhibitors like sirolimus and everolimus

ABSITE (34 decks)

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