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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
Q

Pleural TB tx

A

Rifampicin, isoniazid, pyrazinamide, ethambutol

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26
Q

Most common organism in VAP

A

PsA and Staph aureus

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27
Q

Recommended surgical prep

A

Chloraprep

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28
Q

Altered penicillin-binding protein produced by MRSA is encoded by which gene

A

mecA

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29
Q

Uninfected operative wounds in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tracts are not entered; wound calss

A

Clean

30
Q

Operative wounds in which the respiratory, alimentary, genital, or urinary tract is entered under controlled conditions and without unusual contamination; wound class

A

Clean-contaminated

31
Q

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

A

Contaminated

32
Q

Old traumatic wounds or wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera; wound class

A

Dirty

33
Q

SSI risk clean wounds

A

1-5%

34
Q

SSI risk clean-contaminated wounds

A

3-11%

35
Q

SSI risk contaminated wounds

A

10-17%

36
Q

SSI risk dirty wounds

A

> 27%

37
Q

HIV periop medical management

A

Continued without break

38
Q

Sulbactam MOA

A

beta-lactamase inhibitor

39
Q

Infected diabetic foot ulcer and signs of septic shock

A

Amputation

40
Q

Only monotherapy regimen approved for parenteral tx of amp-susceptible enterococci infections

A

Augmentin

41
Q

Ampicillin-resistant E faecium

A

Linezolid and daptomycin

42
Q

Abx that lacks cross-reactivity to other beta-lactams

A

Aztreonam

43
Q

Suspected colonic injury, appropriate pre-op abx

A

Ancef + flagyl, cefoxitin, Cefotetan, Augmentin

44
Q

Risk factor for gastric adenocarcinoma

A

Nitroso compounds

45
Q

Bite wound, first line abx

A

Augmentin, cefoxitin, bactrim + clinda

46
Q

Immunocompromised, pulmonary fungal infection; dx and tx

A

Invasive aspergillosis, Voriconazole

47
Q

Indication for palliative gastrectomy with Stage IV gastric lymphoma

A

Bleeding or obstruction

48
Q

STOP-IT trial guidelines

A

Abxs 4 days from source control

49
Q

Immunosuppressed with brain abscess; dx

A

Aspergillus brain abscess

50
Q

MOA fluoroquinolones

A

Inhibit DNA gyrase

51
Q

MOA macrolides

A

Inhibit 50S ribosomal subunit

52
Q

MOA aminoglycosides

A

Inhibit 30S ribosomal subunit

53
Q

MOA vancomycin

A

Inhibit cell wall synthesis

54
Q

CMV tx

A

Ganciclovir, Foscarnet, Cidofovir

55
Q

Immunotherapy Non-Small-cell lung cancer; tx and target

A

Pembrolizumab -> PD-L1

56
Q

Immunotherapy Melanoma; tx and target

A

Ipilimumab, CTLA-4

57
Q

Immunotherapy Medullary thyroid MEN IIa/IIb; tx and target

A

Selpercatinib, RET

58
Q

Immunotherapy ER+ breast cancer; tx and MOA

A

Anastrozole, Aromatase inhibitor

59
Q

Immunotherapy HER2+ breast cancer; tx and target

A

Trastuzumab, HER2 receptor

60
Q

Immunocompromised with fever, chills, weight loss, crackles and rhonci in lower lung fields, pancytopenia, diffuse bilateral infiltrates from perihilar region; dx and prevention

A

Pneumocystis Jiroveci, Bactrim ppx

61
Q

Cavitating lung lesion

A

Mycobacterium tuberculosis

62
Q

Ohio River Valley spelunker

A

Histoplasmosis

63
Q

Pneumonia or meningoencephalitis

A

Cryptococcus neoformans

64
Q

Southwest US lung lesion

A

Coccidioidomycosis

65
Q

Immunosuppressant associated with gallstone formation

A

Calcineurin inhibitors like Tacrolimus and Cyclosporine

65
Q

Immunosuppressant associated with gallstone formation

A

Calcineurin inhibitors like Tacrolimus and Cyclosporine

66
Q

Immunosuppressant that disrupts purine synthesis and causes GI SE

A

Mycophenolate

67
Q

Immunosuppressant that inhibits cytokines and lymphocytes, SE include DM, impaired wound healing

A

Steroids like prednisone

68
Q

Immunosuppressant that blocks nucleotide synthesis and has GI SEs

A

Azathioprine

69
Q

Immunosuppressant that inhibits mammalian target of rapamycin, SEs include impaired healing, mouth ulcers, pneumonitis

A

mTOR inhibitors like sirolimus and everolimus

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