Antibiotics Mechanism of Action Quiz

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Questions and Answers

What is the mechanism of action for Cephalosporins?

  • Disrupt RNA polymerase function
  • Inhibit DNA gyrase
  • Bind to penicillin binding proteins to inhibit cell wall synthesis (correct)
  • Inhibit folate production

Which of the following drugs works by disrupting bacteria through nitro reductases?

  • Cefazolin
  • Tetracyclines
  • Metronidazole (correct)
  • Rifampin

What is a defining characteristic of fluoroquinolones?

  • They inhibit protein synthesis by binding to the 50s ribosome
  • They are bacteriostatic
  • They cause extreme deadly diarrhea
  • They inhibit DNA gyrase and are bactericidal (correct)

What distinguishes Glycopeptides from β-lactams?

<p>They bind to precursor sites different from β-lactams (B)</p> Signup and view all the answers

Which of the following best describes the action of Chloramphenicol?

<p>It reversibly binds to the 50s ribosome (A)</p> Signup and view all the answers

What is the grading system for a heart murmur that is loud and has a palpable thrill audible with a stethoscope held away from the chest wall?

<p>Grade 6 (B)</p> Signup and view all the answers

Which of the following is NOT an indication for performing an ECG?

<p>Signs of good performance (D)</p> Signup and view all the answers

Which lead placement corresponds to the left fifth intercostal space at the level of the olecranon?

<p>Black lead (D)</p> Signup and view all the answers

What effect does atrial fibrillation have on cardiac output?

<p>Decreases it by 20-30% (A)</p> Signup and view all the answers

What is the primary treatment step for atrial fibrillation once underlying pathology has been ruled out?

<p>Transvenous electrical cardioversion (D)</p> Signup and view all the answers

In which of the following scenarios is a horse advised NOT to be ridden or driven?

<p>Signs of congestive heart failure (A)</p> Signup and view all the answers

Which drug is commonly used for the cardioversion of atrial fibrillation?

<p>Quinidine sulfate (C)</p> Signup and view all the answers

What are the primary factors leading to Equine Pastern Dermatitis?

<p>Environmental, infectious, and parasitic factors (C)</p> Signup and view all the answers

What are the clinical signs of the exudative form of Equine Pastern Dermatitis?

<p>Erythema, alopecia, and serous to purulent crust (C)</p> Signup and view all the answers

Which diagnostic method is NOT typically used for Equine Pastern Dermatitis?

<p>Radiography (B)</p> Signup and view all the answers

Which of the following forms of Equine Pastern Dermatitis is characterized by excessive granulation tissue?

<p>Chronic proliferative form (D)</p> Signup and view all the answers

How is Chronic Progressive Lymphedema most commonly diagnosed?

<p>History and clinical presentation (B)</p> Signup and view all the answers

What does Chronic Progressive Lymphedema primarily affect?

<p>Lymphatic structures in all four limbs (D)</p> Signup and view all the answers

Which UV wavelength range is associated with photosensitivity in horses?

<p>320-400 nm (C)</p> Signup and view all the answers

What is a common clinical sign of Chronic Progressive Lymphedema?

<p>Swelling and thickened skin folds (B)</p> Signup and view all the answers

Which type of dermatitis is characterized by scalp lesions and epidermal hyperplasia?

<p>Mild dermatitis (D)</p> Signup and view all the answers

What is a common complication associated with cryotherapy?

<p>Hyperemia (C)</p> Signup and view all the answers

How does topical Fluorouracil function in cancer treatment?

<p>Inhibits DNA and RNA synthesis (B)</p> Signup and view all the answers

Which of the following antibiotics should be avoided for general use?

<p>Vancomycin (D)</p> Signup and view all the answers

What classification of photosensitivity is characterized by hepatotoxic plants?

<p>Hepatogenous photosensitivity (D)</p> Signup and view all the answers

Which clinical sign is NOT typically associated with photosensitivity?

<p>Hirsutism (D)</p> Signup and view all the answers

What defines time dependent antibiotics?

<p>Need to remain above MIC for a portion of the time (A)</p> Signup and view all the answers

What is a key difference between Cisplatin injections and Cisplatin beads used for chemotherapy?

<p>Injections require more frequent dosing than beads (C)</p> Signup and view all the answers

What is the main cause of Pituitary Pars Intermedia Dysfunction (PPID)?

<p>Loss of dopaminergic inhibition (B)</p> Signup and view all the answers

Which of the following is a common clinical sign of PPID in horses?

<p>Excessive shedding (B)</p> Signup and view all the answers

What provides the mechanism of action for aminoglycosides?

<p>Binding to ribosomal subunits (B)</p> Signup and view all the answers

What is the treatment method for periocular sarcoids?

<p>Excision, laser, and chemotherapy (A)</p> Signup and view all the answers

What is a key component of the ACTH production process in the normal pars intermedia?

<p>PC2 cleaving pro-opiomelanocortin (B)</p> Signup and view all the answers

Which testing method is NOT recommended for diagnosing PPID?

<p>Urine test for toxins (A)</p> Signup and view all the answers

Which of the following is NOT a consideration when choosing antibiotics?

<p>Comprehensive chemistry analysis of the drug (A)</p> Signup and view all the answers

What would be an appropriate step to take before conducting a TRH stimulation test?

<p>Ensure the horse has not eaten grain within the last 12 hours (D)</p> Signup and view all the answers

What process does surgical excision aim to avoid during the treatment of sarcoids?

<p>Granulation tissue formation (A)</p> Signup and view all the answers

Which of the following conditions is most commonly associated with older horses?

<p>Pituitary Pars Intermedia Dysfunction (B)</p> Signup and view all the answers

Radiation therapy is considered for which of the following conditions?

<p>Sarcoids (C)</p> Signup and view all the answers

Which method is part of the basic procedure for baseline ACTH testing?

<p>Centrifuge to separate plasma after collection (C)</p> Signup and view all the answers

What is the primary role of dopamine in the normal functioning of the pars intermedia?

<p>To inhibit secretion of hormones from the pars intermedia (A)</p> Signup and view all the answers

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Flashcards

Atrial Fibrillation (A-fib)

A condition where the atria of the heart beat irregularly and rapidly, often due to random re-entry of electrical impulses.

Systolic Murmur

A heart sound or murmur caused by turbulent blood flow across heart valves during the contraction of the heart (systole).

Diastolic Murmur'

A heart sound or murmur caused by turbulent blood flow across heart valves during the relaxation of the heart (diastole).

Quinidine Sulfate

A medication used for cardioversion of atrial fibrillation (A-fib) in horses.

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Cardiac Output

The ability of the heart to pump blood throughout the body, measured by the amount of blood ejected from the heart per minute.

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Re-entry (in the context of heart arrhythmia)

A process where a faulty electrical impulse takes a longer pathway through the heart and re-enters the heart muscle before it has fully repolarized, leading to irregular rhythm.

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Cardioversion

A procedure to restore a normal heart rhythm by delivering a controlled electrical shock to the heart, often used for atrial fibrillation.

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Equine Pastern Dermatitis

A skin condition that affects the pastern of horses, characterized by inflammation, scaling, and hair loss. It can be caused by a variety of factors, including genetics, environment, and infections.

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Perpetuating Factors of Equine Pastern Dermatitis

Factors that contribute to the development and worsening of Equine Pastern Dermatitis. These might include secondary infections, environmental factors, and skin changes.

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Chronic Progressive Lymphedema

A severe condition affecting draft horses where lymphatic vessels and connective tissue are abnormally formed, leading to excessive swelling and skin changes in the legs.

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Photosensitivities

A condition caused by an abnormal reaction to sunlight, leading to skin damage and inflammation.

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Phototoxicity

A type of photosensitivity where the skin reacts to sunlight in a dose-dependent manner, like a sunburn.

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UVA Wavelength

The type of ultraviolet radiation that is most commonly associated with photosensitivities.

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Photodynamic Agent

One of the three basic features of photosensitivities and refers to a substance that can absorb light and cause damage to the skin.

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Mild Equine Pastern Dermatitis

The mild form of Equine Pastern Dermatitis, characterized by hair loss, scaling, and crusting, affecting large areas of the pastern.

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Chronic Proliferative Equine Pastern Dermatitis

The most severe form of Equine Pastern Dermatitis, characterized by thick, raised nodules, deep fissures, and painful lameness.

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Equine Pituitary Pars Intermedia Dysfunction (PPID)

A condition in horses where the pituitary gland (specifically the pars intermedia) produces excess ACTH, leading to a range of clinical signs including hirsutism, weight loss, laminitis, and hyperadrenocorticism.

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What causes PPID?

The main cause of PPID in horses is a loss of dopaminergic inhibition of the pars intermedia in the pituitary gland.

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How does the pars intermedia normally function?

In a normal horse, dopamine from the hypothalamus inhibits cells in the pituitary pars intermedia, limiting the release of ACTH into the bloodstream.

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Explain the pathogenesis of PPID.

Hypothalamic dopaminergic neurons undergo oxidative stress leading to a loss of inhibition of the pars intermedia. This results in hyperplasia of the pars intermedia and an increased release of ACTH.

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What is the primary product produced by melanocytes of the pars intermedia?

Pro-opiomelanocortin, which can be cleaved into ACTH, beta-endorphin, alpha-melanocyte stimulating hormone (MSH), and corticotropin-like intermediate peptide (CLIP).

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What is the enzyme involved in ACTH processing in the pars intermedia?

Prohormone convertase 2 (PC2) is responsible for cleaving most ACTH in the normal pars intermedia.

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What is the epidemiology of PPID?

PPID is most common in older horses of any breed and also affects donkeys.

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What are some clinical signs of PPID?

Common clinical signs of PPID in horses include: abnormal hair coat/shedding, muscle wasting/weight loss, increased water consumption and urination, chronic laminitis, excessive sweating, immunosuppression, behavioral changes, infertility, blindness, adiposity, and insulin resistance.

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What tests are used to diagnose PPID?

Recommended tests for diagnosing PPID include baseline ACTH concentration, TRH stimulation test, dexamethasone suppression test, and MRI.

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What is the basic procedure for baseline ACTH testing?

Collect blood into an EDTA purple top tube, keep it cool, centrifuge, and freeze the plasma (avoid freeze-thaw cycles).

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Excisional biopsy

Surgical removal of tissue for microscopic examination to diagnose a disease or condition.

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Sarcoids

A chronic inflammatory disease that affects the skin of horses, characterized by raised, granulomatous lesions.

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Cryotherapy

A method of destroying tissue using extremely cold temperatures.

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Cisplatin

A type of chemotherapy drug used to treat sarcoids in horses, administered as injections or beads.

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Fluorouracil

A type of chemotherapy drug used to treat sarcoids, applied topically to the affected area.

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Penicillin

A type of antibiotic that inhibits bacterial cell wall synthesis.

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Aminoglycosides

A group of antibiotics that work by interfering with bacterial protein synthesis.

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Minimum inhibitory concentration (MIC)

The minimum concentration of a drug required to inhibit the growth of a particular bacteria.

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Time dependent antibiotics

Antibiotics whose effectiveness is related to the time they remain above the MIC.

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Concentration dependent antibiotics

Antibiotics whose effectiveness is related to the peak concentration of drug in the blood.

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Cephalosporins

A class of antibiotics that inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins. They are divided into generations, with higher generations showing greater resistance to beta-lactamases.

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Imipenem

A carbapenem antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins. It is known for a broad spectrum of activity against many bacteria.

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Potentiated Sulfas

A group of antibiotics that work by inhibiting the synthesis of folic acid, a vital nutrient for bacterial survival. This happens through two mechanisms: trimethoprim inhibits the enzyme dihydrofolate reductase, while sulfadiazine is mistaken for PABA, a precursor for folic acid synthesis.

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Fluoroquinolones

A class of antibiotics that inhibit the activity of DNA gyrase, an enzyme crucial for DNA replication and coiling in bacteria. This prevents the bacterial DNA from coiling properly, disrupting their ability to divide and survive.

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Tetracyclines

A group of antibiotics that inhibit protein synthesis by binding to the 30S subunit of bacterial ribosomes. This disrupts the bacterial translation process, stopping the production of essential proteins for their survival.

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Study Notes

Horse Ophthalmology

  • Horse's field of vision is large, 350 degrees, with narrow blind spots. Rod cells (light/motion) make up 90% of the retina, and cone cells (color) make up 10%
  • Epiphora is tearing.
  • Blepharospasm is squinting.
  • Common ocular problems in horses include epiphora, blepharospasm, vision loss, behavioral changes, conjunctivitis, and discharge.
  • Important aspects of an ophthalmic exam include assessing vision (ambient and dim light), menace response, obstacle course (with one eye blindfolded), and cranial nerve function (CN 2, 3, 5, 7).
  • The menace response in foals is learned and not evident until after 2-3 weeks of age.
  • Cranial nerves checked during an exam include 2, 3, 5, and 7. Specifically, the ophthalmic exam checks the following cranial nerves: CN2 (optic nerve), CN3 (oculomotor nerve), CN5 (trigeminal nerve), and CN7 (facial nerve).
  • An equine ophthalmic exam involves evaluation of the orbit, eyelids, nictitating membrane, conjunctiva, anterior segment (tears, cornea, iris, lens, ciliary body), and posterior segment (vitreous, retina, choroid, optic nerve).
  • Typical sedation/blocking protocol for equine ophthalmic exams include xylazine (150-250 mg for a 1,000 pound horse) for 10 minutes, followed by an auriculopalpebral block for motor and supraorbital block for sensory.
  • Fluorescein stain is a diagnostic test for all horses.
  • Schirmer tear test measures tear production. A value of less than 10 mm/minute is considered abnormal. Alpha 2 agonists can cause increased lacrimation, so it's important to perform the test prior to any medications and sedation.
  • Intraocular pressure (IOP) is normal in horses at 16-30 mmHg. Normal IOP is 16-28 mmHg. High IOP indicates glaucoma, and low IOP indicates inflammation or uveitis.
  • Rose Bengal staining helps visualize tear film deficiencies, and is especially useful for chronically affected horses.
  • A Nasolacrimal flush can be used to treat blockages of the tear duct.
  • Tropicamide is a mydriatic (pupil dilating) drug, commonly used for thorough retinal examination.
  • Corneal ulcers are a common condition in horses, and are diagnosed using corneal cultures and scrapes prior to medication.
  • Ultrasounds are used to view the different structures in the eye such as cornea, lens, retina, iris, ciliary body, optic nerve and vitreous.

Other Horse Eye Conditions

  • Corneal ulcers, keratitis, and stromal abscesses are common eye problems in horses.
  • Corneal ulcerations necessitate aggressive treatment to prevent complications like globe rupture and blindness.
  • Uncomplicated corneal ulcer healing time is typically 7-10 days.
  • Blood vessel formation in corneal ulcers takes approximately 3-5 days.

Additional treatments for eye problems

  • Topical and systemic medications are used to reduce inflammation and treat infections.
  • Fungal corneal ulcers require specific antifungal medications.
  • Corneal lacerations/perforations may require surgical intervention or plugs.
  • Viral keratitis treatment usually involves topical NSAIDs and antivirals.
  • Eosinophilic keratoconjunctivitis is treated with topical steroids and cetirizine.
  • Immune-mediated keratitis (IMMK) is managed with cyclosporine and topical NSAIDs.
  • Treatments for stromal abscesses include aggressive medical/surgical therapy.

Other Equine Eye Conditions

  • Equine recurrent uveitis (ERU), is a common inflammatory condition, and is managed with corticosteroids, NSAIDs, and cyclosporine.
  • Cataracts are lens opacities that may be congenital or secondary to other conditions, including uveitis.
  • Glaucoma is an elevated Intraocular blood pressure, it is treated with topical carbonic anhydrase inhibitors, miotics, and beta blockers.
  • Exophthalmos is a forward displacement of the eye. Buphthalmos is a bulging of both eyes,
  • Chorioretinitis is an inflammation of the choroid/retina, and can be caused by infection, immune-mediated diseases, or trauma.
  • Corneal ulcers and abrasions/perforations frequently require aggressive treatment.
  • Alopecia areata, is an immune-mediated inflammatory skin disease.
  • Dermatophilosis, causes a scaling/crusting dermatitis due to a facultative anaerobic, gram-positive bacterium.
  • Pemphigus foliaceus: is an autoimmune skin disease characterized by scaling, crusting lesions.

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