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Professional Development > Part 7 > Flashcards

Part 7 Flashcards

1
Q

B lactam antibiotics mechanism of action

A

Disrupt bacterial cell wall causing them to take up water and burst through inhibiting transpeptidases that catalyze cell wall formation and activation of autolysins that cleave bonds in wall by binding Penicillin binding proteins

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2
Q

B-lactamases definition

A

Coded for by a plasmid between bacteria to promote synthesis of proteins that release into the space around them to cleave certain PCNs

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3
Q

PCN drug interactions (3 to know)

A

1) probenecid - delay excretion
2) aminoglycosides - inhibed by PCNs and need to be administered separately
3) Bacteriostatic antibiotics - PCNs work best on fast dividing

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4
Q

Anti pseudomonal penicillin name

A

-Piperacillin

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5
Q

1st -5th gen cephalosporins trend (3)

A
  • 1st gen most susceptible to B lactamases, 5th is highly resistant
  • Increased activity against gram - bacteria
  • increased ability to reach csf
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6
Q

List example 1st-5th gen cephalosporins

A

1) cephalexin (keflex)
2) Cefaloxin
3) ceftazidime, cefdinir (omnicef), or ceftriaxone (roecephin)
4) cefipime
5) ceftaroline (effective gainst MRSA)

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7
Q

Disulfiram like reaction can occur with metronidazole. What other drug class can it possibly occur with?

A

Cephalosporins (apparently)

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8
Q

Carbapenems drug class and MOA

A

B-lactam antibiotis that like penicillins and cephalosporins, inhibit bacterial cell wall synthesis, have very broad antimicrobial spectrum

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9
Q

Vancomycin adverse effects (3)

A
  • Renal failure (dose related)
  • Ototoxicity
  • Red man syndrome (histamine release resulting in rashes, flushing, potential to go into shock)
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10
Q

These two antibiotic classes should never share an IV bag

A

PCNs and aminoglycosides

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11
Q

What is the broadest spectrum aminoglycoside

A

Amikacin

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12
Q

Tetracyclines mechanism of action

A

Broad spectrum antibiotics that inhibit protein synthesis at the ribosome 30s subunit after being transported via energy dependent processes

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13
Q

Tetracycline absorption

A

Via GI, but form insoluble chelates with cations preventing absorption and thus require administration 1-2 hours after ingestion of a chelate

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14
Q

Tetracycline common side effects (3)

A
  • GI upset
  • bones and teeth coloraion
  • photosensitivity
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15
Q

Macrolides mechanism of action

A

Broad spectrum antibiotics that act by inhibiting bacterial protein synthesis, bind 50S ribosome and are bacteriostatic

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16
Q

Macrolide common adverse effects (2)

A

-GI effects
-QT prolongcatoin which can precipitate torsades de pointes

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17
Q

Chloramphenicol MOA and why is it not commonly used? What is it drug of choice for? What is another condition this is linked to?

A

Similar to a macrolide, not commonly used because has adverse effect of aplastic anemia requiring close monitoring, is still sometimes used as drug of choice in eye infections and typhoid or meningitis. In pediatrics, this is linked to gray baby syndrome which is where it builds up to toxic levels causing abdominal distension, gray coloration of skin, possibly shock and death

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18
Q

Fluorquinolones mechanism of action

A

Passive diffusion, inhibit DNA replication on bacterial gyrase and toposioromase, rapidly bactericidal

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19
Q

3 common B-lactamase inhibitors to be combined with penicillinase sensitive PCN

A

1) clavulanic acid
2) tazobactam
3) sulbactam

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20
Q

IV calcium gluconate with ceftriaxone injection

A

contraindicated due to calcium precipitate formation

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21
Q

Teicoplanin

A

Similar action and structure to vancomycin, but largely devoid of any ADRs

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22
Q

Fosfomycin

A

Similar action and structure to vancomyscin, often used in uncomplicated UTI

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23
Q

Telavancin

A

Similar action and structure to vancomycin, treats complex skin infections and causes taste disturbance and foamy urine

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24
Q

4 tetracyclines available

A

1) tetracycline (short acting, no food)
2) denecocycline (medium acting, no food)
3) doxyxcline(long acting, no food)
4) minocycline (long acting, food okay)

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25
Q

Fanconi syndrome

A

A type of Ingestion of proximal renal tubular acidosis sometimes due to ingestion of outdated tetracycline can cause proximal renal tubular dysfunction leading to renal failure

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26
Q

Name the 3 macrolides

A

1) erythromycin
2) azithromycin
3) clarithromycin

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27
Q

Clarithromycin and azithromycin are often prescribed over erythromcyin because of one distinct advantage

A

They do not typically cause nausea and diarrhea

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28
Q

Clindamycin mechanism of action

A

Inhibition of the 50S ribosome to prevent protein synthesis

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29
Q

Clindamycin ADR

A

Can cause psudomembranous colitis from Cdiff

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30
Q

Dalflopristin/Quinipristin mechanism of action and what do they treat?

A

Streptogamins, together become bactericidal, treat VRE and MRSA

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31
Q

Linezolid mechanism of action, what does it treat and what is an ADR

A

Binds 23s portion of 50s subuinit of ribosome, cross resistance therefore unlikely, treates VRE and MRSA, myelosupression

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32
Q

Metronidazole spectrum

A

Protozoa or anaerobic bacteria, DOC for Cdiff, amoeba, and trichomonas vaginalis

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33
Q

Metronidazole mechanism of action

A

Taken up passively, converted to active form in anaerobic bacteria, break up DNA helical structure

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34
Q

Metronidazole ADRs (3)

A

Neurologic effect, urine darkening, disulfarim like rxn

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35
Q

Sulfonamides mech of action

A

Inhibition of synthesis of folic acid by binding where PABA does to be bacteriostatic

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36
Q

Sulfonamide spectrum

A

Broad, gram + including MRSA and some gram neg, DOC for acute UTI

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37
Q

Sulfonamide ADRs (5)

A
  • Photosensitivity
  • drug fever
  • Steven Johnson syndrome (widespread lesions)
  • acute hemolytic anemia
  • Kernicterus (bilirubin buildup in newborn brain
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38
Q

Osteon/Haversion canal definition

A

Hollow tubes in cortical bone that serves as passage for the vessels to supply the structure

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39
Q

Lamella definition

A

One of the layers of an osteon/havarsion system that radiate outward from the canal center

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40
Q

Lacunae definition

A

A hole in hydroxapatite matrix that stores osteocytes (inactive form of osteoblasts)

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41
Q

Osteoblast

A

Functionally lay down hydroxapatite matrix forming cortical bone, stimulated by calcitonin and inhibited by PTH

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42
Q

Osteoclast

A

Functionally remove hydroxapatite matrix by removing cortical bone via phagocytosis, inhibited by calcitonin

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43
Q

Low blood calcium causes release of ____, high blood calcium causes release of ______

A

PTH, calcitonin

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44
Q

Osteomalacia (rickets disease in children)

A

Caused by inadequate vit. D intake (and treated with supplement), causes weakness and bone pain

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45
Q

Ligament definition and function

A

Attachment of tissue from bone to bone, function to stabilize the joint and to facilitate the desired motion set by the ligament’s orientation

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46
Q

Sacrotuberous ligament insertion and function

A

Insertion: Sacrum to ischial tuberosity
Function: Houses a nerve, intertwined with the sacrospinous ligament

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47
Q

Sacrospinous ligament insertion and function

A

Insertion: Sacrum to ischial spine
Function: Anterior to the sacrotuberous ligament, forms the greater sciatic foramen, functionally prevents the ileum from sliding posterior to sacrum, intertwined with sacrotuberous ligament

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48
Q

Sacroiliac ligament (SI joint) insertion and function

A

Insertion: Sacrum to Iliac
Function: Tightly intermingle the sacrum with the ileum

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49
Q

Acetabular labrum insertion and function, does it often cause symptoms if torn?

A

Insertion: Femur head to acetabolum of pelvic bone
Function: Tightly wrap around the ball and socket joint of the femur with the pelvic girdle.
It does not often cause symptoms when torn.

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50
Q

Iliofemoral ligament

A

Insertion: Anterior inferior iliac spine to femur
Function: Strongest ligament in the body, Y ligament, helps us remain upright while walking

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51
Q

Ischiofemoral ligament insertion (no function given)

A

Insertion: Ischium to femur
Function: Not much to say

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52
Q

Pubofemoral ligament insertion and function

A

Insertion: Superior ramus of the pubis to the femur
Function: prevents hyper-abduction at the hip joint (god help when you do the splits yo)

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53
Q

Anterior cruciate ligament insertion and function

A

Insertion: Femur to tibia, crossing anteriomedially over the PCL
Function: limit anterior displacement of tibia

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54
Q

Posterior cruciate ligament insertion and functiom

A

Insertion: femur to tibia, crossing posteriolaterally behind the ACL
Function: limit posterior displacement of tibia

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55
Q

Medial collateral ligament insertion and function

A

Insertion: Medial femur to tibia
Function: prevent medial directed force on the tibia and femur

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56
Q

Lateral collateral ligament insertion and function

A

Insertion: lateral femur to lateral fibula
Function: prevent lateral directed force on fibula and femur

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57
Q

Medial/Lateral Meniscus insertion and function

A

Insertion: between tibia and femur
Function: Shock absorber, provide stability

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58
Q

Anterior tibiofibular ligament insertion (no function listed)

A

Insertion: anterior face of inferior space between tibia and fibula
Function: mmmk

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59
Q

Anterior talofibular ligament insertion and function

A

Insertion: Lateral malleolus to anterior talus
Function: Most commonly injured in an ankle sprain, prevents foot from sliding forward during a sprain

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60
Q

Calcaneofibular ligament insertion (no function listed)

A

Insertion: Lateral malleolus to calcaneous posterioinferiorally
Function:

61
Q

Posterior talofibular ligament insertion (no function listed

A

Insertion: Lateral malleolus to posterior talus
Function:

62
Q

Posterior tibiofibular ligament insertion (no function listed)

A

Insertion: posterior face of inferior space between tibia and fibula
Function

63
Q

Acromioclavicular ligament insertion and function

A

Insertion: Lateral clavicle to acromion
Function: 1 of 2 attachments between clavicle and scapula

64
Q

Coracoclavicular ligament insertion and function

A

Insertion: Inferior clavicle to coracoid process
Function: 1 of 2 attachmentts between clavicle and scapula

65
Q

Coracoacromial ligament insertion and function

A

Insertion: Coracoid process to acromion
Function: Forms a roof over the humerus attachment, has passage underneath

66
Q

inferior/anterior/posterior glenohumoral ligaments insertion and function

A

Insertion: Space around glenoid fossa to humerus
Function: limit movement, none exists superiorally allowing for reach amirite

67
Q

Glenoid labrum insertion and function

A

Insertion: Glenoid fossa to humerus head
Function: Increase bony contact area

68
Q

Radial collateral ligament insertion and function

A

Insertion: Proximal radius to distal humerus
Function: resist lateral directed force on the elbow joint

69
Q

Ulnar collateral ligament insertion and function

A

Insertion: proximal ulna to distal humerus
Function: resist medial directed force on elbow joint

70
Q

Annular ligament insertion and function

A

Insertion: Radius to ulna proximally
Function: protect integrity of radius in radial notch of the ulna but allow for supination and pronation

71
Q

FRISBE acronym for critically evaluating a study

A

Follow up - were patients outcomes accounted for at end of study
Randomization - Equal chance being assigned to experimental or control group
Intention to treat analysis - are the results analyzed based on intended original treatment
Similar baseline characteristics - did patients have characteristics that could cause even outocome distribution
Blinding - study blinded
Equal treatment - controlling for any other confounding variables not being tested

72
Q

Case control study characteristics

A

Analysis of a patient with the disease (case) and without (control) to analyze effect of known risk factors with specific outcome, study rare conditions

73
Q

Cohort study characteristics

A

Dividing up of patient with one characteristic versus another who all already have a disease to follow them to see differences in outcome to determine cause and effect of characteristic

74
Q

Randomized clinical trial characteristics

A

Often used to study intervention or cure of disease state, highest level of causality because can be blind

75
Q

Systematic review definition

A

Belongs to synthesis 5S model. Seeks to answer a specific clinical question by analyzing all the findings from an entire body of primary research regarding the topic. Involves several experts collaborrating over a long time

76
Q

Type I and type II error

A

A false positive and false negative

77
Q

Retrospective cohort study definition

A

Study medical records of a group of similar individuals in order to determine which factors are related to a certain outcome

78
Q

Meta analysis definition

A

statistical procedure for combining data from multiple studies

79
Q

Superficial clots require work up as sometimes they are treated if they are in close proximity to a….

A

deep vein

80
Q

Subclavian artery derived from and empties to and path

A

Derived from: brachiocephalic trunk on the right side, aortic arch on the left
Empties into: axillary artery
Travels along and passes under the clavicle where it will change names

81
Q

Axillary artery is derived from and empties into and path

A

Derived from: subclavian artery
Empties into: brachial artery
Travels across the axillary region, has thoracoacromial trunk branch most medial, then lateral thoracic, then posterior and anterior humeoral circumflex, then subscapular before finally changing names into brachial artery

82
Q

Posterior and anterior humoral circumflex arteries derived from and course

A

Derived from: axillary artery
Travel around the surgical and anatomical neck of the humerus (respectively) and anastamose together

83
Q

Lateral thoracic artery derived from and course

A

Derived from: axillary artery
Travels along the chest wall before dipping around to supply the lats

84
Q

Subscapular artery derived from and course

A

Derived from: axillary artery
Travels around to supply the posterior shoulder and eventually the lats

85
Q

Brachial artery derived from and empties into and course

A

Derived from:axillary artery
Empties into: radial and ulnar arteries
Travels from name change of the axillary artery at the beginning of the arm, has a branch profunda brachial artery coming off, continues into the cubital fossa and the forearm where it divides into radial and ulnar arteries

86
Q

Profunda brachial artery derived from and course

A

Derived from: brachial artery
Travels deep to supply the posterior arm

87
Q

Radial artery derived from and empties into and course

A

Derived from: brachial artery
Empties into: deep palmar arch artery
Travels from the brachial artery to supply along the radius, can be palpated, empties into the deep palmar arch artery

88
Q

Ulnar artery derived from empties into and course

A

Derived from: brachial artery
Empties into: superficial palmar arch artery
Travels from brachial artery to supply along the ulna, empties into superficial palamr artery

89
Q

Superficial and deep palmar arteries derived from and course

A

Derived from: ulnar and radial arteries respectively
Travel along the palmar face of the hand and anastamose together for recurrent blood supply of the hand

90
Q

Cephalic vein course

A

Travels on the superficial anterior face of the forearm, has a branch in the cubital fossa of the median cubital vein, then travels up the arm over the beceps brachii before turning 90 degrees and draining into the axillary vein

91
Q

Basilic vein course

A

Travels along the medial face of the forearm, has a branch in the cubital fossa of the median cubitla vein, then travels up the medial arm before draining into the border between brachial and axillary veins

92
Q

Muculocutaneous nerve derivation and course

A

Derived from: lateral cord of the brachial plexus,
Travels to innervate the anterior arm

93
Q

Axillary nerve derived from and course

A

Derived from: posterior cord of the brachial plexus
Travels to innervate deltoids and teres minor

94
Q

Radial nerve derived from and course

A

Derived from: posterior cord of the brachial plexus
Travels to innervate the posterior arm and deep next to the profunda brachii artery before moving anteriolaterally around the lateral epicondyle of the humerous through the cubital fossa to then supply the dorsum of the forearm and dorsum of hand up to digit four

95
Q

Median nerve derived from and course

A

Derived from: Lateral and medial cords of the brachial plexus
Travels deep in the anterior arm alongside profunda brachii artery into the cubital fossa, it continues into the anterior forearm to supply most of that bad boy and travels through the carpal tunnel to supply the palmar hand up to digit four

96
Q

Ulnar nerve derived from, course

A

Derived from: the medial cord of the brachial plexus
Travels posteriomedially down the arm, through the medial epicondyle (where it can be easily struck), and then down the medial forarm (only supplying the flexor carpi ulnaris muscle) before reaching the hand to supply the 5th and part of the 4th digit dorsally and palmar

97
Q

Globe definition

A

Surface of the eyeball proper

98
Q

Orbit definition

A

Bony cavity housing the eye

99
Q

7 bones that comprise the orbit

A

1) lacrimal
2) maxilla
3) frontal
4) zygomatic
5) sphenoid
6) ethmoid
7) palatine

100
Q

Vision falls within the spectrum of 400nm to 750nm. Anything below 400 nm ____ the cells while anything above 750 nm ____ the cells

A

Kills, doesn’t carry enough energy to cause a photochemical reaction

101
Q

Medial and lateral in regards to the eye

A

Nasal and temporal

102
Q

Conjunctiva definition

A

Clear coating that covers the anterior sclera of the eye and eyelid (continuous so nothing can get trapped behind the eye)

103
Q

Medial and lateral commissure/canthus definition

A

Skin areas outside the eye where the corners meet

104
Q

Lacrimal caruncle definition

A

The red area of the nasalmost portion of the eye

105
Q

Orbicularis oculi muscle

A

Surrounds the eye allowing for closure of eyelid

106
Q

Tarsal/meibomian glands

A

Holocrine glands on the tarsal plate that secrete an oily substance to reduce tear evaporation in the eye

107
Q

Tarsal plate definiiton

A

The superior and inferior connective tissue that form the inside of the eyelid

108
Q

Bulbar vs palpebral conjunctiva

A

Palpebral covers the inside of the eyelid, bulbar covers the sclera

109
Q

Levator pallpebrae superioris muscle function and innervation

A

Functions to lift the eyelid, CN III

110
Q

3 tunics of eyeball and features

A

Tunica fibrosa - sclera and cornea
Tunica vasculosa - choroid, ciliary body and iris
tunica interna - retina and optic nerve

111
Q

Ciliary body definition

A

Functions to produce aqueous humor that flows from the posterior to anterior chamber through the pupil where it is reabosrbed into canal of schlemm

112
Q

Failure of aqeuous humor to drain into canal of schlemm can lead to what pathology?

A

Glaucoma

113
Q

Components of the forebrain (3)

A

Telencephalon, diencephalon, and retina

114
Q

Fovea definition

A

Region of the macula that is most dense with only cones,

115
Q

Blind spot definitnion

A

Area of the eye where the optic disk lies (where the optic nerve and vessels exit the posterior face of the eyeball) often filled in by the brain

116
Q

A large cup to disk ratio implies…

A

…glaucoma or other pathology

117
Q

Ectopic pupil definition

A

When a pupil does not form at the center of the iris

118
Q

The near response

A
  • Constriction of pupil
  • Contract ciliary muscle and relax suspensory ligaments to relax lens into more convex shape
  • Convergence of eyes
  • increased refraction
119
Q

The far response

A
  • Relaxation of pupil
  • Relax ciliary muscle and contract suspensory ligament to tighten lens into more straight shape
  • no convergence of eyes
  • decreased refraction
120
Q

Hyperopia definition

A

Farsighted, eyeball too short

121
Q

Myopia definition

A

Nearsighted, eyeball too long

122
Q

Rods have ____, cones have ____

A

rhodopsin, iodopsin

123
Q

Rods of the eye mech of action

A

Produce steady ion flow in dark that causes inhibitory post synaptic potential that produces no signal in the optic nerve, upon light the dark current ceases so excitatory post synaptic potential occurs in the optic nerve

124
Q

Auricular hematoma definition

A

Collection of blood underneath perichondrium of ear often leading to deformity known as cauliflower ear

125
Q

distal 1/3rd of external ear is ____, proximal 2/3rd is ____ and is painful when touched

A

cartilage with ceruminous glands and hair follicles, temporal bone painful when touched

126
Q

Umbo definition

A

Where the malleus bone attaches to the tympanic membrane

127
Q

Cone of light definition

A

Reflected light on the anterior inferior quadrant of the tympanic membrane when viewed via otoscope, points at the umbo and if distorted could indicate ottitis media

128
Q

Ossicles order

A
  • Tympanic membrane
  • Malleus
  • Incus
  • stapes
  • oval window
129
Q

Tympanic reflex

A

Protect the cochlea in response to loud noises via the tensor tympani and stapedius muscles, does not protect against prolonged loud noises only building noise like thunder

130
Q

Tensor tympani and stapedius muscle functions

A

stapedius - reduces mobility of stapes
Tensor tympani - pull eardrum inward tightening it

131
Q

3 parts of the inner ear

A

Vestibule
Cochlea
semicircular canals

132
Q

Vestibule definition

A

Central cavity of bony labrynth containing the utricle and saccule

133
Q

Utricle and Saccule definition

A

Hold equilibrium receptor regions within the vestibule that respond to the pull of gravity and the changes in head position in a straight line

134
Q

Semicircular canals definition

A

Part of the bony labyrinth that have an ampula on one end that respond to movements of the head in rotational movement

135
Q

Otolith definition

A

Free moving ear stone that moves linearly in the utricle and saccule to stimulate hair cells to detect linear acceleration

136
Q

Ampulla definition

A

Located on the end of a semicircular canal and houses a cupula

137
Q

Cupula definition

A

Cap where hair cells are located within an ampula within a semicircular canal that contains endolymph and hair cells stimulated to detect rotational acceleration

138
Q

Cochlea definition

A

Part of the bony labrynth that houses the organ of corti and extends in a spiral shape from the oval window to the round window, with a varying basalr membrane on the floor throughout that is stimulated by different frequencies

139
Q

Hearing mechanism

A
  • Sound hits tympanic membrane
  • tympanic membrane vibrates ossicles
  • Ossicles fibrate oval window
  • fluid wave stretches the basilar membrane at a certain frequency
  • Basilar membrane oscillates
  • Organ of corti hair cells at that frequency locus bend
  • Hair cells send an ap down cochlear nerve
140
Q

Organ of corti definition

A

Sensory organ of hearing, spans width of the cochlea, is vibrated by the basilar membrane at varying frequency loci to send an AP interpreted as sound to the brain

141
Q

Ala nasi definition

A

Wing like protrusions at the base/entrance of the nose

142
Q

Nasal conchae/turbinates definition

A

Scroll shaped bony elements that increase the surface area of the nose and allow for humidifaction and cleansing of bacteria

143
Q

Olfactory mucosa definiton

A

Lines the roof of the nasal fossa at the cribiform plate of the ethmoid bone to allow for olfaction

144
Q

Wharton’s duct definition

A

Opening of the submandibular salivary gland under the tongue near the frenulum

145
Q

Stenson’s duct definition

A

Opening of the parotid duct on the inner cheek near the 2nd molar

146
Q

3 intrinsic salivary glands of the mouth

A

Parotid
Submandibular
Sublingual

147
Q

Facial nerve provides taste on the…

A

…anterior 2/3 of the tongue

148
Q

Glossopharyngeal nerve provides taste on the….

A

…posterior 1/3 of the tongue

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