Part 6 Flashcards

1
Q

Service Learning

A

Involves students in community service activities and applies the experience to personal and academic development resulting in equal benefit for both the student’s learning and action in the community

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2
Q

Pedagogy definition

A

The art and science of teaching using an array of teaching strategies because there is no universal approach that suits all situations to support intellectual engagement and connectedness and prommote wellbeing of students, teachers, and community

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3
Q

Public Health

A

The science and art of preventing disease, prolonging life, and promoting health through organized efforts and informed choices of society, organizations, public and private communities, and individuals

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4
Q

Epidemic/outbreak

A

Occurence in a community or region of cases of an illness, specific health related behavior, or other health related event clearly in EXCESS of normal expectancy. Both terms are used interchangeably, however epidemic usually refers to a larger geographic distribution

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5
Q

Pandemics definition and history

A

Pandemic is seen throughout the world

  • 1918 500 million infected around world (spanish flu)
  • 2009 19000 deaths from influenza outbreak
  • 1955 Polio vaccine development
  • HIV decrease in 20% since 2001
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6
Q

Public health approach steps (4)

A

1) Surveillance - what is the problem
2) Risk factor identification - what is the cause
3) Intervention evaluation - What works to fix while considering cultural and practical barriers
4) Implementation - How do you do it

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7
Q

John Snow

A

Father of modern epidemiology, studied outbreak of cholera cases in 1854 to determine what factors were contributing to that disease process

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8
Q

Health determinants (4) and their percentages

A
  • Genes and biology (5%)
  • Health behaviors (20%)
  • Social or societal characteristics (50%)
  • Health services or medical care (25%)
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9
Q

4 Types of disease prevention

A

1) Primary - prevention of a disease before it happens (Immunizations, etc.), health promotion
2) Secondary - treatment of complications of a disease to prevent it from worsening or progressing (B-blockers, drug therapy), pre-symptomatic diagnosis and treatment
3) Tertiary - Assistance mitigating an already established bad outcome (OT, PT, rehab), disability limitation, preventing CKD in diabetics
4) Quaternary - Avoidance of unnecessary medical interventions (error in medicine)

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10
Q

Sensitivity

A

Ability of a test to identify all individuals who actually are positive, including false positives (example of all spirochetes opposed to specifically syphilis)

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11
Q

Specificity

A

Ability of a test to differentiate between individuals who are positive and negative, such as ignoring false positives

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12
Q

The greatest predictor of health is ____, and the greatest predictor of that is _____

A

socioeconomic status, education

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13
Q

Reliability vs validity

A

Reliability is ability of a measure to get the same results each time regardless (precision), validity is the accuracy of the results to their truth

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14
Q

3 Levels of evidence

A

Level A - meta-analysis, high quality randomized, controlled trials that considers all important outcomes, using comprehensive search strategies Always followed
Level B - Other evidence, well designed, nonrandomized clinical trial, quantitative systematic review with well substantiated conclusions, Almost always followed
Level C - Consensus/expert opinion, only sometimes used
Level D - against providing intervention in an asymptomatic patient because the harms outweigh the benefits

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15
Q

Staph aureus

A
  • Gram +
  • Pustules, boils, abscess, cellulitis (red swollen skin affecting lower leg), scalded skin syndrome (babies and children), food poisoning, TSS
  • Anti staph PCN or 1st gen cephalosporin
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16
Q

Staph epidermidis grap type, common infection type, and treatment

A
  • Gram +
  • Surgical wound infections, medical procedural infections, - Part of normal flora, causes infection on prosthetic implants as it attaches to the plastic
  • Vancomycin (has resistance to PCNs)
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17
Q

Strep pyogenes

A
  • Gram +
  • impetigo (often in children or daycares), erysipelas (bright aised lesions on skin), pharyngitis, scarlet fever (strawberry tongue), pneumonia, cellulitis and necrotizing fasciitis (flesheating disease), TSS, acute glomerulonephritis (antibody complexes in kidney), Rheumatic fever
  • PCN’s
  • important human pathogen capable of producing infections and post infection diseases
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18
Q

Viridans strep gram type, common infections it causes, antibiotics to treat

A
  • Gram +
  • S. mutans, S. salivarius, S. Sanguis, cause dental caries and bacterial endocarditis
    -Beta lactams, IV meds depending on type
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19
Q

Strep pneumoniae gram type, common infections it causes and treatment

A
  • Gram +
    • 80% of cases of bacteria pneumonia, also meningitis, otis media, septicemia
  • B Lactams, sometimes IV needed
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20
Q

Enterococci gram type, common infections caused, treatment

A

Gram pos cocci part of normal fecal flora, can persist on fomites for a long time, common cause of nosocomial infections, sensitive to synergistic combo of B-lactam and aminoglycosides, except some resistant, including other classes like VRE

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21
Q

Niesseria gonorrhoeae gram type, diseases caused, treatment

A
  • gram -
  • Cause gonorrhea,, PID, and sterility in females
  • ceftriaxone
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22
Q

Niesseria meningitidis gram type, diseases caused, treatment

A
  • gram -
  • Cause contagious spinal meningitis, hemorrhagic rash
  • IV ceftriaxone
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23
Q

One key differentiatior between niesseria meningitidis and niesseria gonorrhoeae is the latter….

A

….does NOT produce a capsule

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24
Q

Moraxella catarrhalis gram type, common infections it causes, treatment

A
  • Gram -
  • Infection of respiratory system, middle ear, eye, CNS, joints
  • Treatment depends on results of sensitivity testing
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25
Q

Bacillus anthracis gram type, disease caused, treatment

A
  • gram +
  • anthrax (woolsorter’s disease - inflammation, edema, hemorrhage), Normally found in livestock
  • PCN
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26
Q

Clostridium perfringens gram type, diagnosis, treatment

A
  • Gram +
  • Enterotoxin, food poisoning, gangrene, shock
  • IV zosyn
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27
Q

Zosyn (piperacillin and tazobactam) drug class and use

A

a combo of a penicillin and a beta-lactamase inhibitor used for serious infections given IV

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28
Q

Clostridium tetani gram type, common disease caused, treatment, note about organism

A
  • Gram +
  • Tetanus exotoxin causing tetanus
  • IV metronidazole
    -spores have tennis racket appearance
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29
Q

Clostridium botulinum gram type, disease caused, treatment

A
  • Gram +
  • Botulinin toxin resulting in paralysis/paresis
  • antitoxin treatment
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30
Q

Clostridium difficile gram type, common diseases caused, treatment

A
  • Gram +
  • Cytopathic exotoxins from antibiotic induced pseudomembranrous colitis
    -oral vancomycin
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31
Q

Lipopolysaccharide (LPS)

A

virulence factor released by gram neg bacteria causing inflammation in tissues by inducing cells to secrete proinflammatory mediators (cytokines, prostaglandins)

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32
Q

E. coli gram type, common diseases caused

A
  • gram -
  • UTI, gastroenteritis
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33
Q

Klebsiella pneumoniae gram type and common diseases it causes

A
  • gram -
  • pulmonary disease, nosocomial UTI, epidemic diarrhea of newborn
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34
Q

Serratia marcescens gram type and common infections caused

A
  • gram -
  • Nosocomial UTI, bacteriemia, lower respiratory tract infections
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35
Q

Vibrio cholerae gram type, common diseases caused, treatment

A
  • gram neg
  • Human cholera diarrhea syndrome
  • fluid resuscitation and antibiotics sometimes including macrolides, fluorquinolones, or tetracyclines
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36
Q

Helicobacter pylori gram type, diseases caused, treatment, notes about it

A
  • gram -
  • acute gastritis and gastric ulcers, chronic gastritis
  • triple therapy (clarithromycin, amoxicllin and PPI) or quadruple therapy (metronidazole, tetracycline, PPI, and bismuth subsalycylate
  • releases urease to protect self from stomach acid
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37
Q

Bacteroides fragilis gram type, common infections, treatment and fun fact

A
  • gram -
  • Peritonitis, gynecologic infections, endocarditis
    -Often metronidazole
  • may acount for 99% of fecal flora
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38
Q

Pseudomonas aeruginosa gram type, common infections, treatment

A
  • gram -
  • nosocomial infections from long term antibiotic treatment
  • often zosyn, fluorquinolones orally
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39
Q

Haemophilus influenzae gram type, common infections caused, treatment

A
  • gram -
  • respiratory and meningeal infections in children
  • ampicillin or chloramphenicol
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40
Q

Haemophilus ducreyi gram type, disease caused, treatment

A
  • gram -
  • chancre on genitals (soft unlike syphilis)
  • Bactrim
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41
Q

Bordatella pertussis gram type, disease caused, treatment

A
  • gram - coccobacilli
  • whooping cough (three stages, catarrhal stage cough, paroxysmal stage explosive cough, convalescent)
  • tetracyclines, macrolides
  • vaccine available
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42
Q

Chlamydia trachomatis gram type, disease caused, treatment

A
  • gram neg
  • trachoma leading to blindness, inclusion conjunctivitis, genital infections, venereal disease
  • tetracycline
  • sexual activity very similar to gonorrhea
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43
Q

Chlamydia psittaci gram type, disease caused, treatment

A
  • gram neg
  • pneumonitis frquently carried by bird feces
  • tetracycline
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44
Q

Rickettsia rickettsii grma type, disease caused, treatment

A
  • gram -
  • rocky mountain spotted fever (maculopapular rash,) high fever
  • tetracycline
  • transmitted via ticks
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45
Q

Cornyebacterium diphtheriae gram type, disease caused, treatment

A
  • gram +
  • diptheria (sore throat, neck swelling, airway closur)
  • antitoxins
  • immunization is part of DPT vaccine
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46
Q

Timeline day 0 (embryonic age)

A
  • Day 0 is fertilization forming a zygote in distal third of fallopian tube
  • Division into morula (ball of cells will become placenta and embryo, each cell is totipotential)
  • Division into blastocyst (blastocele (cavity) containing embryoblast, trophoblast at other pole form placenta)
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47
Q

Timeline week 1 (embryonic age)

A

-up to week 1 implantation on uterine wall of blastocyst

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48
Q

All or nothing concept of pregnancy

A

During the first 3 weeks any insult will result in immediate miscarriage, or there will be no impact on the wellbeing of the fetus, no in-between

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49
Q

Timeline week 2 (embryonic age)

A
  • Bilaminar disk formation, evolution of embryoblast to bilaminar blastocyst with cell layers epiblast and hypoblast (primitive ecto and endoderms) sandwiched between 2 cavities - amniotic cavity and yolk sac
  • Trophoblast divides into cystotrophoblast (inner single cell layered) and syncytiotrophoblast (thicker outer layer releases hGC to prevent menstruation)
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50
Q

“I just missed my period, what is embryonic age and gestational age?”

A

Week 2 embryonic age, week 4 gestational age

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51
Q

Zygote definition

A

Union between sperm and egg, quickly begins divisions into morula

52
Q

Morula definition

A

Ball of cells that will become placenta and embryo, divided from a zygote, each cell is totipotential

53
Q

Blastocele definition

A

Part of a blastocyst, fluid filled cavity that forms from a morula and will house an embryoblast

54
Q

Embryoblast definition

A

Part of a blastocyst, early embryo formed from a morula and contained in a blastocele

55
Q

Trophoblast definition

A

Part of a blastocyst, early placenta formed from a morula surrounding a blastocele

56
Q

Blastocyst definition

A

Continuation from a morula, houses a blastocele containing an embryoblast, and a trophoblast layer of cells surounding

57
Q

Bilaminar blastocyst definition

A

Continuation from blastocyst contains inner hypoblast and outer epiblast layers out of the embryoblast

58
Q

Amniotic cavity definition

A

Forms around the epiblast to create a fluid filled cavity to house the embryoblast in a bilaminar blastocyst

59
Q

Yolk sac definition

A

Forms extending out of the hypoblast to eventually give rise to the umbilical cord in a bilaminar blastocyst

60
Q

Cystotrophoblast definition

A

Division from the trophoblast into a single inner cell layer in a bilaminar blastocyst, will be important for implantation

61
Q

Snynctiotrophoblast definition

A

Division from the trophoblast into a thick outer cell layer in the bilaminar blastocyst, releases hCG to maintain high progesterone levels in the mother to prevent menstruation and maintain pregnancy

62
Q

What occurs in week 3-8 (embryonic age) and why is this the most susceptible time?

A

-Organogenesis occurs, most susceptible because 90% of birth defects will occur here

63
Q

Timeline week 3(embryonic age)

A
  • Gastrulation (transition from blastocyst to a gastrula)
  • Primitive streak (structure forming posterior side, determines site of gastrulation and bilateral symmetry), notochord (becomes nucleus pulposis of intevertebral disks), and neural plate (basis for nervous system) form here, as well as division of the hypo/epiblasts into ecto/meso/endoderms
64
Q

Gastrulation definition

A

Transition of a blastocyst into a multilayered gastrula

65
Q

Primitive streak definition

A

Stucture of the gastrula forming posterior side that determines site of gastrulation and creates bilateral symmetry

66
Q

Notochord definition

A

Structure of the gastrula forming nucleus pulposis of intervertebral disks

67
Q

Neural plate definition

A

Structure of gastrula forming nervous system basis (and dermatome distribution)

68
Q

Ecto/meso/endoderm form…

A
  • Ecto forms epithelium and nervous system
  • Meso forms bone, muscle, cartilage, blood
  • Endo forms excretory strutures, GI, respiratory, urinary
69
Q

Folate deficiency at week 3 (embryonic age) can cause this developmental disorder

A

Spinal bifida upon neural plate formation

70
Q

Timeline week 4 (embryonic age)

A
  • Heartbeat, 4 chambers, 4 limb buds, 4 branchial arches (gill like structures that give rise to features of the head and neck)
  • tongue lungs GI and diaphragm development too
71
Q

Critical period for autism spectrum disorder, ventricular septal defect, and tricuspid atresia

A

Week 4-6 (embryonic age)

72
Q

Critical period for limb defect

A

Week 4-5 (embryonic age)

73
Q

Critical period for cleft lip defect

A

Week 5-6 (embryonic age)

74
Q

Timeline weeks 5-7 (embryonic age)

A

-gonad differentiation, kidney, bladder, rectum formation

75
Q

Timeline week 8 (embronic age)

A

fetal movement, strong resemblance to baby

76
Q

Critical period for external genitalia formation

A

Week 8 (embryonic age)

77
Q

At what time can you tell the sex of the fetus?

A

Week 10 (embryonic age)

78
Q

6 cells of connective tissue

A

1) Fibroblasts - produce fibers and ground substance
2) Macrophages - WBC phagocytose foreign material
3) Neutrophil - suicide bomber
4) Plasma cells - release antibodies
5) Mast cells - secrete histamine and heparin inhibit clotting and dilate blood vessel
6) Adipocytes - store triglycerides

79
Q

Pectoralis major function, insertion, nerve

A

Function: Flexion of humerus at shoulder, adduction of humerus at shoulder, medial rotation of humerus at shoulder
Insertion: clavicle and sternum to intertubular groove of humerus
Nerve: medial and lateral pectoral nerves

80
Q

Pectoralis minor function, insertion, nerve

A

Function: Protraction of scapula at scapulothoracic joint, elevate ribs, depress scapula a scapulothoracic joint
Insertion: ribs 3-5 to corocoid process of scapula
Nerve: medial pectoral nerves

81
Q

Deltoid function, insertion, nerve

A

Function: Flexion, extension, medial rotation, lateral rotation, abduction of humerus at shoulder joint
Insertion: clavicle/acromion to deltoid tuberocity of humerus
Nerve: axillary

82
Q

Teres major function, insertion, nerve

A

Function: adduction, medial rotation, and extension of humerus at shoulder joint
Insertion: Lateral border of scapula to intertubular groove of humerus
Nerve: subscapular

83
Q

Coracobrachialis function, insertion, nerve

A

Function: adduction of humerus at shoulder joint
Insertion: corocoid process to medial humerus
Nerve: musculocutaneous

84
Q

Supraspinatus function, insertion, nerve

A

Function: Abduction of humerus at shoulder joint
Insertion: supraspinous fossa of scapula to greater tubercle of humerus
Nerve: suprascapular

85
Q

Infraspinatus function, insertion, nerve

A

Function: Extension of humerus at shoulder joint
Insertion: infraspinous fossa of scapula to greater tubercle of humerus
Nerve: suprascapular

86
Q

Teres minor function, insertion, nerve

A

Function: adduction of humerus at shoulder joint
Insertion: lateral scapula to greater tubercle of humerus
Nerve: axillary

87
Q

Subscapularis function, insertion, nerve

A

Function: adduction of humerus at shoulder joint
Insertion: subscapular fossa to lesser tubercle
Nerve: subscapular nerve

88
Q

Biceps brachii function, insertion, nerve

A

Function: supination of radius at elbow, flexion of forearm at elbow, flexion of humerus at shoulder
Insertion: radius to corocoid (short head) or glenoid fossa (long head)
Nerve: Musculocutaneous

89
Q

Brachialis function, insertion, nerve

A

Function: flexion of forearm at elbow
Insertion: humerus to ulna
Nerve: musculocutaneous

90
Q

Triceps brachii function, insertion, nerve

A

Function: extension of forearm at elbow, adduction of humerus at femur
Insertion: Inferior glenoid (long head) posterior humerus (lateral and medial head) to olecranon process
Nerve: radial nerve

91
Q

Anconeus function, insertion, nerve

A

Function: extension of forearm at elbow
Insertion: lateral epicondyle of humerus to olecranon process
Nerve: radial

92
Q

Brachioradialis function, insertion, nerve

A

Function: flexion of forearm at elbow
Insertion: radial styloid process to lateral epicondyle of humerus
Nerve: radial

93
Q

Brachioradialis function, insertion, nerve

A

Function: flexion of forearm at elbow
Insertion: radial styloid process to lateral epicondyle of humerus
Nerve: radial

94
Q

Pronator teres function, insertion, nerve

A

Function: pronation of forearm at elbow
Insertion: medial epicondyle of humerus to radial shaft
Nerve: median

95
Q

Supinator function, insertion, nerve

A

Function: supination of forearm at elbow
Insertion: lateral epicondyle of humerus to radial shaft
Nerve: dorsal interosseous (radial nerve)

96
Q

Flexor carpi radialis function, insertion, nerve

A

Function: flexion of hand at wrist, radial deviation of hand at wrist
Insertion: medial epicondyle to metacarpals
Nerve: median

97
Q

Flexor carpi ulnaris function, insertion, nerve

A

Function: flexion of hand at wrist, ulnar deviation of hand at wrist
Insertion: medial epicondyle to metacarpals
Nerve: ulnar

98
Q

Palmaris longus function, insertion, nerve

A

Function: flexion of hand at wrist (barely relevant)
Insertion: medial epicondyle to palmar aponeurosis
Nerve: median

99
Q

Flexor digitorum profundus function, insertion, nerve

A

Function: flexion of hand at wrist, flexion of phalanges at DIP and PIP, and MP joints
Insertion: interosseous ulna to distal phalanges digits II-V
Nerve: Median nerve

100
Q

Flexor pollucis longus function, insertion, nerve

A

Function: flexion of the first digit at the IP joint
Insertion: radius to distal phalanx digit 1
Nerve: median

101
Q

Flexor digitorum superficialis function, insertion, nerve

A

Function: flexion of phalanges at PIP and MP joints and flexion of hand at wrist
Insertion: radius to middle phalanges digits II-V
Nerve: median

102
Q

Extensor carpi radialis brevis function, insertion, nerve

A

Function: extension of hand at wrist, radial deviation of hand at wrist
Insertion: lateral epicondyle to metacarpals
Nerve: radial

103
Q

Extensor carpi radialis longus function, insertion, nerve

A

Function: extension of hand at wrist, radial deviation of hand at wrist
Insertion: lateral epicondyle to metacarpals
Nerve: radial

104
Q

Extensor digitorum function, insertion, nerve

A

Function: extension of phalanges at MP joint
Insertion: lateral epicondyle to distal phalanges II-V
Nerve: radial

105
Q

Abductor pollocis longus function, insertion, nerve

A

Function: abduction and extension of digit I at MP joint
Insertion: posterior trapezium and radius to metacarpal I
Nerve: radial

106
Q

Extensor pollocis longus function, insertion, nerve

A

Function: Extension of digit 1 at MP joint
Insertion: shaft of ulna to distal phalanx 1
Nerve: radial

107
Q

Extensor pollocis brevis function, insertion, nerve

A

Function: extension of digit 1 at MP joint
Insertion: shaft of radius to proximal phalanx 1
nerve: radial

108
Q

Extensor carpi ulnaris function, insertion, nerve

A

Function: extension of hand at wrist
Insertion: lateral epicondyle to 5th metacarpal
Nerve: radial

109
Q

Extensor digiti minimi function, insertion, nerve

A

Function: extension of digit 5 at the MCP joint
Insertion: lateral epicondyle to distal phalanx of digit 5
Nerve: radial

110
Q

Extensor indices function, insertion, nerve

A

Function: extension of digit 2 at the mcp joint
Insertion: posterior ulna to distal phalanx of digit 2
Nerve: radial

111
Q

Certain decongestants and BPH

A

sudafed or other vasopressors can tighten the muscles in the prostate and the bladder neck worsening symptoms of retention

112
Q

how many days after scope to hold nsaids

A

7 days

113
Q

Aminoglycocides general notes

A

Narrow spectrum antibiotics, used primarily against gram neg bacilli aerobes, cannot be absorbed from GI and entering CSF and therefore must be given parenterally, can damage kidneys and inner ear

114
Q

Aminoglycosides mechnaism of action

A

Disrupt bacterial protein synthesis by binding 30S ribosimal unit, causing abnormal or decreased protein synthesis, rapidly bactericidal

115
Q

This drug class half lives decrease dramatically with kidney disfunction, and therefore it is essential to reduce dosage or increase dosing interval in patients with disease

A

aminoglycosides

116
Q

Aminoglycosides common adverse effects

A
  • Ototoxicity, disruption of balance
  • nephrotoxicity, proteinuria, serum creatinine and BUN elevation (reversible)
  • neuromuscular blockade (flaccid paralysis and respiratory depression)
117
Q

Fluoroquinolones general notes and ADRS’s (5)

A

Narrow spectrum antibiotic used often for UTI’s, side effects usually mild, potentially tendon rupture and mental health effects and peripheral neuropathy and contraindicated in anuerysm patients due to increased risk of rupture, photosensitivity

118
Q

Pneumoniae carinii (jirovecci) definiton

A

Rare, opportunistic fungal lung infection commonly seen in HIV/AIDS patients indicative of the disease

119
Q

5 classes of HIV drug treatment

A

1) Fusion/entry inhibitors
2) Non-nucleotide reverse transcriptase inibitors
3) Nucleoside analogues
4) Integrase inhibitors
5) Protease inhibitors

120
Q

MIC and MBC definitions

A

Minimum inhibitory conc. to stop microbial growth, want at least this conc. from dosage to be achieved, minimum bacteriocidal conc. is lowest conc that produces a 99.9% decline in number of bacterial colonies, want to shoot for this

121
Q

How is sickle cell, thalassemias, and G6PD deficiency an evolutionary advantage?

A

Sickle cell protects against malaria (plasmodium falciparum) by impairing ability of parasite to manipulate adhesins so they become sticky against capillary walls, thasallemias decreases hemoglobin, G6PD deficiency causes blood cell breakdown prematurely, all are protective against malaria

122
Q

List the 4 virulence factors

A

1) adhesins
2) invasins
3) evasins
4) toxins

123
Q

7 criteria to be pathogenic

A

1) enter host
2) establish and adhere
3) acquire nutrients
4) avoid immune defenses
5) replicate
6) disseminate
7) transmit to new host

124
Q

Currant jelly sputum makes you think of this organism

A

Klebsiella

125
Q

Grape smelling drainage makes you think of this organsim

A

Pseudomonas