May 17th

Question 1

Destruction to what region of the hypothalamus will result in hyperphagia?

Answer 1

Ventromedial nuclei

Question 2

Destruction to what region of the thalamus will result in anorexia?

Answer 2

Lateral

Question 3

Prostatic cancer metastasized to bone how?

Answer 3

Hematogenous spread - usually vertebral venous plexus which communicates with the prostatic plexus

Question 4

What is the appearance of a lung hamartoma on biopsy?

Answer 4

Contain islands of mature hyaline cartilage, fat, smooth muscle and clefts lined by respiratory epithelium

Question 5

Cephalosporin used prior to surgery to prevent staph aureus

Answer 5

Cefazolin - 1st gen

Question 6

What must be administered with imipenem? Why?

Answer 6

Cilastin; blocks dehydropeptidase I decreasing inactivation of drug in renal tubules

Question 7

What are the side effects of vancomycin?

Answer 7

Nephrotoxic, ototoxic, thrombophlebitis; flushing (Red Man syndrome) - IgE mediated due to release of histamine (pretreat with antihistamine and slow infusion rate

Question 8

MOA of aminoglycosides

Answer 8

Bind 30s - inhibit initiation complex; inhibit translocation; can cause mRNA misreading; need O2 for uptake (ineffective against anaerobes)

Question 9

What is streptomycin used to treat?

Answer 9

Tularemia and yersinia pestis

Question 10

How is resistance against aminoglycosides formed?

Answer 10

Acetylation, phosphorylation, or adenylation by bacterial enzymes

Question 11

MOA of tetracycline

Answer 11

Bind 30s and inhibit attachment of aminoacyl-tRNA

Question 12

MOA of clindamycin

Answer 12

Binds 50S inhibits translocation (peptide transfer)

Question 13

MOA of linezolid

Answer 13

Binds 50s and inhibits initiation complex formation

Question 14

AEs of linezolid

Answer 14

Bone marrow suppression (esp thrombocytopenia), peripheral neuropathy, serotonin syndrome

Question 15

MOA of macrolides

Answer 15

Bind 23subunit of 50s and block translocation

Question 16

When combined with what drug, fluoroquinolones can predispose an individual to tendon rupture?

Answer 16

Prednisone

Question 17

MOA of daptomycin

Answer 17

Lipopeptide that disrupts cell membranes of gram + cocci by creating transmembrane channels

Question 18

Why is daptomycin not used in pneumonia

Answer 18

Inactivated by surfactant

Question 19

What are the AEs of daptomycin?

Answer 19

Myopathy, rhabdo; monitor CK

Question 20

MOA of metronidazole?

Answer 20

Contains nitro group that acts as electron sink; captures electrons and free radicals, resulting in cytotoxic intermediates that damage DNA

Question 21

Patient complains of metallic taste after starting new antibiotic

Answer 21

Metronidazole

Question 22

What can be treated with metronidazole?

Answer 22

Giardia, entamoeba, trichomonas, gardnerella, anaerobes, h.pylori (get gap)

Question 23

What is used to treat MDR pseudomonas and acinetobacter?

Answer 23

Polymyxins B and E (colistin); could see these organisms as nosocomial infection due to mechanical ventilation or endotracheal intubation