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Questions and Answers
A patient presents with a suspected Streptococcus pyogenes infection. Which penicillin would be the MOST appropriate choice for initial treatment?
A patient presents with a suspected Streptococcus pyogenes infection. Which penicillin would be the MOST appropriate choice for initial treatment?
- Dicloxacillin
- Nafcillin
- Amoxicillin
- Penicillin V (correct)
Why are penicillinase-resistant penicillins like oxacillin primarily used to treat methicillin-sensitive Staphylococcus aureus (MSSA) infections?
Why are penicillinase-resistant penicillins like oxacillin primarily used to treat methicillin-sensitive Staphylococcus aureus (MSSA) infections?
- They exhibit enhanced activity against streptococcal species.
- They have a broader spectrum of activity compared to natural penicillins.
- They are not susceptible to breakdown by the bacterial enzyme penicillinase. (correct)
- They are effective against Gram-negative bacteria.
A patient is diagnosed with a Helicobacter pylori infection. Which penicillin-class antibiotic would be the MOST appropriate to prescribe, considering its enhanced activity against Gram-negative bacteria?
A patient is diagnosed with a Helicobacter pylori infection. Which penicillin-class antibiotic would be the MOST appropriate to prescribe, considering its enhanced activity against Gram-negative bacteria?
- Oxacillin
- Nafcillin
- Penicillin G
- Amoxicillin (correct)
Why are aminopenicillins like ampicillin and amoxicillin preferred over natural penicillins when treating infections caused by Haemophilus influenzae?
Why are aminopenicillins like ampicillin and amoxicillin preferred over natural penicillins when treating infections caused by Haemophilus influenzae?
A patient who is allergic to penicillin requires treatment for methicillin-sensitive Staphylococcus aureus (MSSA). Which of the following penicillins would be the LEAST appropriate to administer?
A patient who is allergic to penicillin requires treatment for methicillin-sensitive Staphylococcus aureus (MSSA). Which of the following penicillins would be the LEAST appropriate to administer?
A patient presents with complete ipsilateral facial paralysis, hyperacusis, and reports experiencing dry eyes. Based on this information, where is the most likely location of the facial nerve lesion?
A patient presents with complete ipsilateral facial paralysis, hyperacusis, and reports experiencing dry eyes. Based on this information, where is the most likely location of the facial nerve lesion?
A lesion in the facial canal after the branch of the greater petrosal nerve will cause which of the following symptoms?
A lesion in the facial canal after the branch of the greater petrosal nerve will cause which of the following symptoms?
Damage to the zygomatic branch of the facial nerve would most likely result in the inability to perform which action?
Damage to the zygomatic branch of the facial nerve would most likely result in the inability to perform which action?
If a patient can wrinkle their forehead but cannot smile on one side of their face, where might the lesion of the facial nerve be located?
If a patient can wrinkle their forehead but cannot smile on one side of their face, where might the lesion of the facial nerve be located?
Which branch of the facial nerve is responsible for innervating the orbicularis oris muscle?
Which branch of the facial nerve is responsible for innervating the orbicularis oris muscle?
Why does a lesion prior to the internal auditory meatus result in eye dryness?
Why does a lesion prior to the internal auditory meatus result in eye dryness?
What is hyperacusis, and which branch of the facial nerve is damaged when it occurs with facial paralysis due to lesion?
What is hyperacusis, and which branch of the facial nerve is damaged when it occurs with facial paralysis due to lesion?
Which muscles are innervated by the cervical branch?
Which muscles are innervated by the cervical branch?
The greater petrosal nerve eventually utilizes which two cranial nerve branches to reach its target innervation?
The greater petrosal nerve eventually utilizes which two cranial nerve branches to reach its target innervation?
If a patient reports a loss of taste sensation on the anterior two-thirds of their tongue following damage to a nerve outside of the Cranial vault, which nerve is most likely affected?
If a patient reports a loss of taste sensation on the anterior two-thirds of their tongue following damage to a nerve outside of the Cranial vault, which nerve is most likely affected?
A lesion at the stylomastoid foramen would most likely impact which function of the facial nerve?
A lesion at the stylomastoid foramen would most likely impact which function of the facial nerve?
What is the correct sequence that the facial nerve passes through?
What is the correct sequence that the facial nerve passes through?
Which of the following is/are a pre-ganglionic nerve(s) of the facial nerve (VII)?
Which of the following is/are a pre-ganglionic nerve(s) of the facial nerve (VII)?
A patient presents with dry eyes and a dry mouth following damage to a nerve. Which nerve is most likely damaged?
A patient presents with dry eyes and a dry mouth following damage to a nerve. Which nerve is most likely damaged?
The nerve of the pterygoid canal is formed by the combination of which two nerves?
The nerve of the pterygoid canal is formed by the combination of which two nerves?
Which ganglion does NOT contain a synapse of the Facial Nerve (VII)?
Which ganglion does NOT contain a synapse of the Facial Nerve (VII)?
Chloramphenicol resistance is often acquired through which mechanism?
Chloramphenicol resistance is often acquired through which mechanism?
Which of the following best describes a mechanism of action of oxazolidinones?
Which of the following best describes a mechanism of action of oxazolidinones?
A patient has a severe infection caused by a Gram-positive bacterium resistant to multiple antibiotics. Which of the following medications would target the 50S ribosomal subunit?
A patient has a severe infection caused by a Gram-positive bacterium resistant to multiple antibiotics. Which of the following medications would target the 50S ribosomal subunit?
What is the primary target of pleuromutilins, such as lefamulin, in bacterial cells?
What is the primary target of pleuromutilins, such as lefamulin, in bacterial cells?
Which mechanism is least likely to contribute to bacterial resistance against linezolid?
Which mechanism is least likely to contribute to bacterial resistance against linezolid?
A hospital pharmacist is reviewing a patient's medication list and notices they are prescribed linezolid. What potential drug interaction should the pharmacist be most concerned about?
A hospital pharmacist is reviewing a patient's medication list and notices they are prescribed linezolid. What potential drug interaction should the pharmacist be most concerned about?
A research team is investigating new antibacterial agents. They discover a compound that binds to the 50S ribosomal subunit, but it loses effectiveness in bacteria that produce a specific enzyme. This enzyme most likely:
A research team is investigating new antibacterial agents. They discover a compound that binds to the 50S ribosomal subunit, but it loses effectiveness in bacteria that produce a specific enzyme. This enzyme most likely:
Which antibiotic's mechanism of action involves preventing the formation of the initiation complex during protein synthesis, specifically targeting the 50S ribosomal subunit?
Which antibiotic's mechanism of action involves preventing the formation of the initiation complex during protein synthesis, specifically targeting the 50S ribosomal subunit?
Which antiviral drug would be most appropriate for treating a patient with Herpes Simplex Virus (HSV) who has developed resistance to acyclovir?
Which antiviral drug would be most appropriate for treating a patient with Herpes Simplex Virus (HSV) who has developed resistance to acyclovir?
A patient diagnosed with Cytomegalovirus (HCMV) retinitis, who is also HIV positive may be prescribed which of the following antiviral medications?
A patient diagnosed with Cytomegalovirus (HCMV) retinitis, who is also HIV positive may be prescribed which of the following antiviral medications?
What is the mechanism of action of amantadine and rimantadine in treating influenza A?
What is the mechanism of action of amantadine and rimantadine in treating influenza A?
Oseltamivir inhibits influenza virus by targeting which of the following?
Oseltamivir inhibits influenza virus by targeting which of the following?
Which of the following antiviral medications is a non-nucleoside DNA polymerase inhibitor?
Which of the following antiviral medications is a non-nucleoside DNA polymerase inhibitor?
Why is the timing of Oseltamivir administration crucial for its effectiveness?
Why is the timing of Oseltamivir administration crucial for its effectiveness?
What is the primary mechanism by which neuraminidase normally facilitates the spread of the influenza virus?
What is the primary mechanism by which neuraminidase normally facilitates the spread of the influenza virus?
Acyclovir and Valacyclovir are effective treatments against which viruses?
Acyclovir and Valacyclovir are effective treatments against which viruses?
A patient tests positive for influenza A and is experiencing symptoms. When should Oseltamivir be administered for maximum effectiveness?
A patient tests positive for influenza A and is experiencing symptoms. When should Oseltamivir be administered for maximum effectiveness?
What is the primary mechanism of action (MOA) of Foscarnet?
What is the primary mechanism of action (MOA) of Foscarnet?
How does Oseltamivir's mechanism of action directly contribute to reducing the duration of flu symptoms?
How does Oseltamivir's mechanism of action directly contribute to reducing the duration of flu symptoms?
Which medication listed is classified as a nucleotide analog rather than a nucleoside analog?
Which medication listed is classified as a nucleotide analog rather than a nucleoside analog?
If Oseltamivir is administered 5 days after the onset of influenza symptoms, what is the likely outcome?
If Oseltamivir is administered 5 days after the onset of influenza symptoms, what is the likely outcome?
A clinician is considering an antiviral treatment for a patient presenting with shingles. Which of the following would be an appropriate choice?
A clinician is considering an antiviral treatment for a patient presenting with shingles. Which of the following would be an appropriate choice?
Which of the following drugs selectively targets and inhibits viral release?
Which of the following drugs selectively targets and inhibits viral release?
Which aspect of the influenza virus's life cycle is directly targeted by neuraminidase inhibitors like Oseltamivir?
Which aspect of the influenza virus's life cycle is directly targeted by neuraminidase inhibitors like Oseltamivir?
A researcher is investigating new antiviral drugs for influenza. Which of the following targets would have a similar mechanism of action to Oseltamivir?
A researcher is investigating new antiviral drugs for influenza. Which of the following targets would have a similar mechanism of action to Oseltamivir?
A patient presents with an influenza A infection. Considering the information, which medication could be used in treatment?
A patient presents with an influenza A infection. Considering the information, which medication could be used in treatment?
Flashcards
Prototype Penicillins (G and V)
Prototype Penicillins (G and V)
Natural penicillins active against Streptococci and some Gram-negative bacteria.
Penicillinase-Resistant Penicillins
Penicillinase-Resistant Penicillins
Penicillins developed to combat penicillin-resistant staphylococci, effective against methicillin-sensitive S. aureus (MSSA).
Amino-Penicillins
Amino-Penicillins
Penicillins with enhanced Gram-negative activity, effective against H. influenzae and H. pylori.
MSSA Activity
MSSA Activity
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Amino-penicillins spectrum
Amino-penicillins spectrum
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Motor (Branchiomotor)
Motor (Branchiomotor)
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Temporal Branch
Temporal Branch
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Zygomatic Branch
Zygomatic Branch
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Buccal Branch
Buccal Branch
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Mandibular Branch
Mandibular Branch
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Cervical Branch
Cervical Branch
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Lesion Prior to Internal Auditory Meatus
Lesion Prior to Internal Auditory Meatus
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Hyperacusis
Hyperacusis
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Facial Nerve (CN VII)
Facial Nerve (CN VII)
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Internal Acoustic Meatus
Internal Acoustic Meatus
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Facial Canal
Facial Canal
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Geniculate Ganglion
Geniculate Ganglion
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Greater Petrosal Nerve
Greater Petrosal Nerve
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Nerve of the Pterygoid Canal
Nerve of the Pterygoid Canal
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Chorda Tympani
Chorda Tympani
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Submandibular Ganglion
Submandibular Ganglion
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50S Subunit Binding
50S Subunit Binding
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Low-Level Resistance (C)
Low-Level Resistance (C)
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Chloramphenicol Acetyltransferase
Chloramphenicol Acetyltransferase
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Oxazolidinones Spectrum
Oxazolidinones Spectrum
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Oxazolidinones MOA (1)
Oxazolidinones MOA (1)
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Oxazolidinones MOA (2)
Oxazolidinones MOA (2)
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Oxazolidinones Resistance
Oxazolidinones Resistance
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Lefamulin Use
Lefamulin Use
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Acyclovir/Valacyclovir
Acyclovir/Valacyclovir
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Penciclovir/Famciclovir
Penciclovir/Famciclovir
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Ganciclovir/Valganciclovir
Ganciclovir/Valganciclovir
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Cidofovir
Cidofovir
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Foscarnet MOA
Foscarnet MOA
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Foscarnet Use
Foscarnet Use
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Amantadine/Rimantadine MOA
Amantadine/Rimantadine MOA
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Amantadine/Rimantadine usage
Amantadine/Rimantadine usage
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Amantadine target
Amantadine target
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Influenza A and B
Influenza A and B
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Oseltamivir
Oseltamivir
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Neuraminidase
Neuraminidase
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48 hours
48 hours
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Virions remain attached to host cell
Virions remain attached to host cell
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Neuraminidase inhibitors
Neuraminidase inhibitors
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Neuraminidase function
Neuraminidase function
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Reduce duration of flu symptoms
Reduce duration of flu symptoms
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Study Notes
External Surface of the Skull
- Features of the external surface of the skull and the structures/nerves/vessels/muscles related to each feature are important.
- The individual bones of the skull and sutures need to be identified.
- The external features of each bone, structures that pass through, and what attaches/articulates to each bone need to be identified.
Cranial Fossae
- Foramina/apertures of cranial fossae and their contents are important.
Trigeminal and Facial Nerves
- Knowledge of key external landmarks is helpful before learning about landmarks of the skull.
- Orbit, middle superior orbital fissure, and foramen rotundum are landmarks for the CN V (Trigeminal).
- Temporal bone features, including internal acoustic meatus and facial canal landmarks, are important for the CN VII (Facial).
- The trigeminal nerve (CN V) is the 5th paired cranial nerve, emerging from the lateral aspect of the pons.
- It is the principal general sensory nerve for the head (face, teeth, mouth, nasal cavity, and dura of the cranial cavity).
- The trigeminal ganglion contains the cell bodies of the sensory nerves.
Trigeminal Nerve Divisions:
- Ophthalmic: Exits the cranial cavity via the superior orbital fissure to the upper orbit of the eye, then innervates parts of the forehead and nose.
- Maxillary: Passes through the foramen rotundum into the pterygopalatine fossa and innervates the mid-face, lower orbit, nasal cavity, palate, and upper jaw.
- Mandibular: Leaves the skull via the foramen ovale to the infratemporal fossa, then innervates the lower jaw, lower face, anterior 2/3 of the tongue, and dura mater; also provides motor innervation to muscles of mastication, anterior digastric, and mylohyoid muscles.
- An auxiliary function of the trigeminal nerve is to "shuttle" the parasympathetic fibers to a target the salivary glands.
- The facial nerve (CN VII) exits the facial canal via the stylomastoid foramen.
Facial Nerve Branches:
- Greater Petrosal Nerve: Has preganglionic parasympathetic fibers that combine with the deep petrosal nerve to form the nerve of the pterygoid canal; fibers join zygomatic (CN V2) & lacrimal (CN V1) nerves to paraysympathetically innervate the lacrimal gland.
- Chorda Tympani: Carries parasympathetic and sensory (taste) fibers, joins the lingual nerve (CN V3).
- Nerve to Stapedius: Motor innervation to the stapedius muscle.
- Posterior Auricular Nerve: Supplies sensory innervation around the outer ear.
- Terminal Motor branches (Temporal, Zygomatic, Buccal, Mandibular, Cervical): Supply motor innervation to muscles of facial expression.
Lesions of the Facial Nerve
- Lesions of the facial nerve affect the structures of the eye, nerves, etc.
- Lesion before the internal auditory meatus causes no lacrimation, hyperacusis, and complete ipsilateral facial paralysis.
- Lesion in the facial canal causes preserved lacrimation, hyperacusis, and facial paralysis.
- Lesion distal to the stylomastoid foramen causes preserved lacrimation, no hyperacusis, and facial paralysis.
- Lesion along the greater petrosal pathway causes no lacrimation, no hyperacusis, and no facial paralysis.
Muscles of Face
- Peripheral motor lesions of the facial nerve (LMN) result in an inability to move muscles on the ipsilateral side (e.g., Bell's Palsy), often reversible.
- A central motor lesion (UMN) of the facial nerve only results in paralysis of the lower face muscles on the contralateral side because the upper face has bilateral innervation.
- All muscles of the face are innervated by the facial nerve (CN VII), and their actions include elevating eyebrows, retracting scalp, closing eyelids, depressing the medial end of the eyebrow, closing the oral fissure, etc.
Divisions of the Ear
- The external ear and middle ear transfer sound to the internal ear, while the internal ear transduces sound to the brain.
External Ear Components:
- Shell-like auricle (pinna) collects sound.
- External acoustic meatus (ear canal) conducts sound to the tympanic membrane.
- The auricle consists of the helix, antihelix, tragus, concha, and lobule.
- The external acoustic meatus leads inward through the tympanic part of the temporal bone.
- The tympanic membrane separates the external and middle ear.
- The skin of the superoanterior external acoustic meatus is mainly supplied by the auriculotemporal nerve (CN V3).
- The skin of the posteroinferior walls of the meatus is supplied by the auricular branch of the vagus (CN X).
Middle Ear Contents:
- Auditory ossicles (malleus, incus, and stapes).
- Stapedius and tensor tympani muscles.
- Chorda tympani nerve (branch of CN VII).
- Tympanic plexus of nerves.
- Equalizes gas pressure.
- Auditory ossicles form a mobile chain across the tympanic cavity from Tympanic membrane.
- Malleus for vibrations
- Incus between Malleus & Stapes
- Stapes sends to inner ear
- Muscles reduce amp vibrations
Internal Ear Contents:
- Vestibulocochlear organ for hearing, balance
- Consists of sacs and ducts of the membranous labyrinth with fluids involved in end-organ stimulation.
- The bony labyrinth consists of The Cochlea (hearing), the vestibule (balance, head movement, etc.) and semicircular canals.
- Membranous labyrinth contains sacs and ducts, has endolympth
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Description
Explore penicillin antibiotic choices for common bacterial infections, including Streptococcus pyogenes, Helicobacter pylori, and Staphylococcus aureus. Learn about penicillinase-resistant options and considerations for penicillin allergies. Review guidelines to manage bacterial infections effectively.
