1 Giant Exam 2 SG Pathopharm PDF

1. **[exotoxin]** **[endotoxin]** ----------------------------------------------------------------------------------------------------------------------------- ---------------------------...

1. **[exotoxin]** **[endotoxin]** ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- Toxins secreted by bacteria that can cause damage to the host by destroying cells or disrupting normal cellular metabolism. Toxins secreted by bacteria that can cause damage to the host by destroying cells or disrupting normal cellular metabolism. 2. **[infectivity]** **[communicability]** **[virulence]** --------------------------------------------------------------- --------------------------------------------------------------- ----------------------------------------------------------------------------- The ability of a pathogen to invade and multiply in the host. The ability of a pathogen to invade and multiply in the host. The ability of a microorganism to cause severe disease or harm to the host. 3. **[Narrow spectrum Penicillin and Cephalosporin]** **[narrow spectrum Aminoglycoside]** ---------------------------------------------------------------- -------------------------------------------------- treat gram-positive treat gram negative 4. **[Cephalosporin first generation]** **[higher generation]** ------------------------------------------------------ ------------------------------------------------------------- treat gram positive and has more bacterial resistant treat gram positive, negative, and less bacterial resistant 5. **[Antibiotics that treat MRSA infection]** --------------------------------------------------------- -------------------------------------------- Vancomycin Inhibits cell wall synthesis used for severe infections including MRSA. Fifth generation cephalosporin (Ceftaroline) Used for infections associated with MRSA. 6. **[Antibiotics that treat Pseudomonas infection]** ---------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- **Fourth generation cephalosporin (Cefepime)**: Used to treat health care- and hospital-associated pneumonias, including those caused by Pseudomonas. 7. **[Inhibit cell wall of bacteria:]** -------------------------------------------------- --------------------------------------------------------------------------------- Penicillin Weakens the cell wall, causing bacteria to take up excessive water and rupture. Cephalosporin Similar mechanism of action, inhibits cell wall synthesis. Vancomycin Inhibits cell wall synthesis, effective against Gram-positive bacteria. 8. **[Protein inhibitors:]** --------------------------------------- ---------------------------------------------------------------------------------- Macrolides Inhibit protein synthesis. Aminoglycosides Inhibit protein synthesis, bactericidal, used for aerobic Gram-negative bacilli. Tetracyclines Inhibit protein synthesis, broad-spectrum antibiotics. 9. **[DNA and folic acid inhibitor:]** ------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------- Sulfa and Trimethoprim **Sulfonamides and Trimethoprim**: Suppress bacterial growth by inhibiting tetrahydrofolic acid, a derivative of folic acid or folate. 10. **[allergic reactions]** ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ Penicillin and cephalosporins with Penicillin allergies as more common, with anaphylaxis being the most severe reaction characterized by bronchospasm, laryngeal edema, and hypotension. Sulfa Antibiotics: Common mild reactions include rash, drug fever, and photosensitivity. 11. **[Aminoglycosides SE:]** --------------------------------------- Ototoxicity nephrotoxicity 12. -------------------------- ----------------- Grape fruit juices **=** P-450 inhibitor -------------------------- ----------------- 13. **[Opioid SE]** ----------------------------- constipation decrease RR sedation euphoria hypotension 14. Cyclosporine SE: nephrotoxicity, hepatotoxicity, and increase chance of infection 15. **[NSAID SE]** ---------------------------- ---------------- GI side effect nausea vomiting abdominal pain GI bleeding nephrotoxicity 16. Glucocorticoids SE: Hypertension, increase chance of infection, Hyperglycemia, breakdown of skin, muscle, and bones, and GI side effect (nausea, vomiting, abdominal pain), GI bleeding. 17. **[Hypersensitivity type IV:]** --------------------------------------------- ----------------------------- delayed response only T lymphocytes involved no antibody present Ex: PPD test and contact dermatitis 18. **[Autoimmune disorders:]** ----------------------------------------- Lupus RA Graves Type 1 DM 19. Hypersensitivity type I: Mast cells, IgE, genetic link, prompt reaction 20 mins, mild hives and rash, life-threatening Anaphylaxis 20. Hypersensitivity type II and III: IgG, and IgM, causing autoimmune disorders, transfusion reaction and Rh disease of fetus 21. **[C-pain fibers]** --------------------------------- unmyelinated slow poor localized 22. **[delta pain fibers]** ------------------------------------- located in skin fast highly localized 23. Threshold and tolerance pain 24. Why we have referred pain? **Pain perceived at a location other than the site of the painful stimulus. Often occurs due to the sharing of sensory pathways between the site of injury and the referred area.** 25. **[Benefits of low grade fever]** -------------------------------------------------------------------- Kills invading microorganisms Promotes lysosomal breakdown and autodestruction of infected cells Increases lymphocytic transformation and phagocytic motility Augments antiviral interferon production Augments phagocytosis 26. **[Danger of hyperthermia]** ---------------------------------------------------------------------- Heat cramps, exhaustion, heatstroke Nerve damage at temperatures ≥ 41°C (105.8°F) leading to convulsions Death at temperatures ≥ 43°C (109.4°F) 27. **[Active Immunity:]** **[Passive Immunity:]** --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ This occurs when an individual\'s immune system responds to a foreign substance (antigen) and produces antibodies. This can happen through natural exposure to a pathogen or through vaccination. This occurs when a person is given antibodies to a disease rather than producing them through their immune system. This can happen naturally, such as antibodies passed from mother to baby through breast milk, or artificially through antibody-containing blood products. Example: Getting vaccinated against measles. Example: Receiving antibodies for rabies after exposure to the virus. 28. What is Superinfection? **A superinfection is an infection that occurs on top of an existing infection, usually due to the disruption of normal microbial flora by antibiotics, allowing opportunistic pathogens to overgrow.** 29. **[COPD]** ------------------------ ----------------------------------------------------------------------------------------------------------------------------------------------- Barrel Chest A physical characteristic often seen in advanced COPD where the chest becomes rounded and enlarged due to chronic overinflation of the lungs. 30. ----------------------------- ---------------------------------------------- Glucorticoid inhalers **=** use daily regardless of having asthma or not ----------------------------- ---------------------------------------------- 31. -------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------- Main pathogenesis in emphysema **=** The destruction of the alveoli (air sacs) in the lungs, leading to decreased surface area for gas exchange and difficulty in breathing -------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------- 32. ----------------------------------------------- ---------------------------------------------------------------------------------------------------------------- Main pathogenesis in chronic bronchitis **=** increase in mucus production and inflammation in the airways, leading to coughing and difficulty in breathing. ----------------------------------------------- ---------------------------------------------------------------------------------------------------------------- 33. ----------------- ---------------------------------------------------------------------- Albuterol **=** beta 2 agonist treats asthma by opening the airways (bronchodilator) ----------------- ---------------------------------------------------------------------- 34. Different types of **pleural effusions** ----------------------- -------------------------------------------------------------------------------------------------------------------------------------------- Transudative Caused by fluid leaking into the pleural space due to increased pressure or low protein content, often seen in heart failure or cirrhosis. Exudative Caused by inflammation, infection, or malignancy, leading to fluid with high protein content and cellular debris. Hemorrhagic Contains blood, often due to trauma or malignancy. Chylous Contains lymph fluid, often due to injury or obstruction of the thoracic duct. 35. **Signs and symptoms of acute asthma** ---------------------------------------- SOB Wheezing Chest tightness Coughing 36. **Pathogenesis of asthma** ------------------------------------- chronic inflammation of the airways leading to hyperresponsiveness bronchoconstriction airflow obstruction Allergens, infections...etc. 37. **Temperature Benefit of fever** -------------------------------------------------------------------- Kills invading microorganisms Promotes lysosomal breakdown and autodestruction of infected cells Increases lymphocytic transformation and phagocytic motility Augments antiviral interferon production Augments phagocytosis 38. and their stages: what is the s/s or consequence of different stages of hyperthermia? **Hyperthermia** ------------------ ---------------------------------------------------------------------------------------------------------------------- Heat Cramps: Painful muscle contractions due to loss of fluids and electrolytes. Heat Exhaustion Symptoms include heavy sweating, weakness, dizziness, nausea, and headache. Heatstroke A medical emergency where body temperature exceeds 41°C (105.8°F), causing confusion, seizures, and potential death. 39. Bacterial Infection a. Identify the factors of infection: including chain of transmission: **[pathogenicity ]** **[communicability ]** **[virulence]** ------------------------------------------------------------------ ------------------------------------------------------------------- ----------------------------------------------------------------------------- Microorganism's ability to infect and cause disease in the host. The ability to spread the disease from one individual to another. The ability of a microorganism to cause severe disease or harm to the host. b. What factors in an individual increase the risk of infection? **Malnutrition, age, chronic illness, stress, immunosuppression, recent antibiotic use.** c. For bacterial infection describe the following: **[Exotoxins]** **[Endotoxins]** ------------------------------ ------------------------------------------------------------------------------------------------- Toxins secreted by bacteria. Components of the outer membrane of Gram-negative bacteria, released upon bacterial cell death. d. ---------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **endospores** role and mechanism: Endospores are a form of bacterial resistance; they can withstand extreme conditions and germinate when conditions are favorable, thus ensuring the survival of the bacterium. ---------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- e. Limitations/complications of antibiotic use (i.e., antimicrobial resistance-understand thoroughly) 40. Antimicrobials -------------------------- ----------------- Grape fruit juices **=** P-450 inhibitor -------------------------- ----------------- i. f. **Aminoglycosides: narrow-spectrum** -------------------------------------- Treat gram negative protein inhibitor SE: Ototoxicity, and nephrotoxicity 41. --------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **Nosocomial infections** known as hospital-acquired infections, are infections that patients acquire during their stay in a healthcare facility. These infections can be caused by bacteria, viruses, fungi, or parasites and are often associated with medical procedures or devices like catheters and ventilators. --------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 42. -------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **Superinfection** A superinfection is an infection that occurs on top of an existing infection, usually due to the disruption of normal microbial flora by antibiotics, allowing opportunistic pathogens to overgrow. -------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 43. **Bactericidal** **Bacteriostatic** -------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- Bactericidal: Antibiotics that kill bacteria directly. Antibiotics that inhibit the growth and reproduction of bacteria, allowing the immune system to eliminate the infection. Example: Penicillin. Example: Tetracyclines. 44. **Gram Positive** **Gram Negative** ------------------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Gram Positive Bacteria: Have a thick peptidoglycan cell wall that retains the crystal violet stain, appearing purple under a microscope. Gram Negative Bacteria: Have a thin peptidoglycan cell wall and an outer membrane, which does not retain the crystal violet stain, appearing pink under a microscope. Example: Staphylococcus aureus. Example: Escherichia coli. 45. **MRSA** **Pseudomonas** --------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------- Treated with antibiotics like Vancomycin and Fifth-generation cephalosporins (Ceftaroline). Treated with Fourth-generation cephalosporins (Cefepime) and other antibiotics like Piperacillin-tazobactam. 46. **antimicrobial class:** -------------------------- ------------------------------------------------------------------------------------------------------------------ Penicillin Inhibits cell wall synthesis. Side effects: Allergic reactions, gastrointestinal issues. Cephalosporins Inhibit cell wall synthesis. Side effects: Allergic reactions, gastrointestinal issues. Vancomycin Inhibits cell wall synthesis. Side effects: Nephrotoxicity, ototoxicity. Macrolides Inhibit protein synthesis. Side effects: Gastrointestinal issues, hepatotoxicity. Aminoglycosides Inhibit protein synthesis. Side effects: Ototoxicity, nephrotoxicity. Tetracyclines Inhibit protein synthesis and DNA/folic acid synthesis. Side effects: Photosensitivity, gastrointestinal issues. Sulfa antibiotics: Inhibit DNA/folic acid synthesis. Side effects: Allergic reactions, kidney issues. 47. [**Gentamicin Cephalosporin**:] ------------------------------------------------------------------------------------------------------------------------------------------------------- Inhibit cell wall of bacteria: Cephalosporins inhibit cell wall synthesis. first generation treat gram positive and has more bacterial resistant, higher generation treat gram positive, negative, and less bacterial resistant: 48. including Vancomycin: inhibit cell wall of bacteria **[Penicillin group (B-lactam):]** ------------------------------------------------ ------------------------------- Penicillin (B-lactam): Inhibits cell wall synthesis. Vancomycin Inhibits cell wall synthesis. 49. ------------------ ------------------------------------------------ ----------------------- **Tetracycline** protein inhibitor and DNA/folic acid inhibitor broad-spectrum action ------------------ ------------------------------------------------ ----------------------- 50. ------------ --------------------------- **Sulfa**: DNA/ folic acid inhibitor ------------ --------------------------- 51. ---------------- ------------------- **Macrolides** protein inhibitor ---------------- ------------------- 52. Immune Dysfunction 53. **[Active Immunity:]** **[Passive Immunity:]** --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ This occurs when an individual\'s immune system responds to a foreign substance (antigen) and produces antibodies. This can happen through natural exposure to a pathogen or through vaccination. This occurs when a person is given antibodies to a disease rather than producing them through their immune system. This can happen naturally, such as antibodies passed from mother to baby through breast milk, or artificially through antibody-containing blood products. Example: Getting vaccinated against measles. Example: Receiving antibodies for rabies after exposure to the virus. 54. Describe autoimmune disorders **Autoimmune disorders occur when the immune system mistakenly attacks the body\'s own tissues, recognizing them as foreign. This leads to inflammation and damage to various organs and tissues.** 55. **[Autoimmune disorders:]** ----------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Lupus systemic lupus erythematosus (SLE), is a chronic autoimmune disease where the body\'s immune system mistakenly attacks its own healthy tissues and organs RA a chronic autoimmune disease that primarily affects the joints. It causes inflammation, pain, and stiffness in the joints, which can lead to damage and disability over time Graves an autoimmune disorder that causes the thyroid gland to produce too much thyroid hormone. Type 1 DM an autoimmune disease that occurs when the body\'s immune system destroys the pancreas\' insulin-producing cells. 56. Differentiate among the four hypersensitivity reactions and what immunoglobulins are involved in the hypersensitivities ii. +-----------------------------------+-----------------------------------+ | **Hypersensitivity** | | +===================================+===================================+ | 1 | Mast cells & basophils, IgE, | | | genetic link, prompt reaction 20 | | | mins, mild hives and rash, | | | life-threatening Anaphylaxis | | | (Allergens) | +-----------------------------------+-----------------------------------+ | 2 | Immediate, specific antibodies | | | attacking specific antigens Ex: | | | Graves disease and myasthenia | | | gravis | | | | | | -Transfusion Reaction | | | | | | \- Rh disease of fetus | +-----------------------------------+-----------------------------------+ | 3 | Non-tissue specific, system | | | unable to remove antigen-antibody | | | immune complexes | | | | | | Ex: Lupus | +-----------------------------------+-----------------------------------+ | 4 | delayed response, and only T | | | lymphocytes involved, no antibody | | | present. PPD test and contact | | | dermatitis (Mediated by T cells | | | only and no antibodies) | +-----------------------------------+-----------------------------------+ 57. Allergies (include anaphylaxis) iii. Describe the --------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- role of histamine in the allergic response. Histamine is released by mast cells during an allergic reaction, causing symptoms like vasodilation, increased vascular permeability, and bronchoconstriction. --------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- iv. can cause allergic reactions -------------------------------------------------- ------------------------------------------------------------------------------------ Penicillin, Cephalosporin, and sulfa antibiotics These can cause allergic reactions ranging from mild rashes to severe anaphylaxis. -------------------------------------------------- ------------------------------------------------------------------------------------ 58. **Immune System Medications** -------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **Glucocorticoid drugs**: Reduce inflammation and suppress the immune system. Side effects: Hypertension, increased risk of infection, hyperglycemia, breakdown of skin, muscle, and bones, GI side effects, GI bleeding. **Cyclooxygenase inhibitors**: Reduce inflammation and pain. Side effects: GI issues, increased risk of bleeding. Cyclosporine An immunosuppressant used to prevent organ rejection. Side effects: Nephrotoxicity, hepatotoxicity, increased risk of infection. 59. glucocorticoid drugs cyclooxygenase inhibitors, Knows the: v. Cyclosporine: Side effects: nephrotoxicity, hepatotoxicity, and increase chance 1. of infection **Mechanism of actions and side effects of :** ------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **Glucocorticoid drugs**: Reduce inflammation and suppress the immune system. Side effects: Hypertension, increased risk of infection, hyperglycemia, breakdown of skin, muscle, and bones, GI side effects, GI bleeding. **Cyclooxygenase inhibitors**: Inhibit the COX enzyme, immunosuppressant, Reduce inflammation and pain. Side effects: GI issues, increased risk of bleeding. Cyclosporine An immunosuppressant used to prevent organ rejection. Side effects: Nephrotoxicity, hepatotoxicity, increased risk of infection. 60. Inflammation 61. **Types of Exudate** ---------------------- ---------------------------------------------------- Serous Clear, watery fluid. Fibrinous Thick, sticky, and contains high levels of fibrin. Purulent Contains pus, indicating infection. Hemorrhagic Contains blood, indicating bleeding. 62. Complement Cascade function: Opsonization **Opsonization is a process where pathogens are marked for destruction by the immune system. The complement cascade enhances the ability of antibodies and phagocytic cells to clear microbes and damaged cells.** 63. **inflammation** ------------------ -------------------------------------------------------------- Localized Inflammation that occurs at the site of injury or infection. General Systemic inflammation affecting the entire body. 64. ------------- ----------------------------------------------------------------------------------- Macrophages Phagocytose pathogens and release cytokines to mediate the inflammatory response. Neutrophils Phagocytose pathogens and release free radicals to kill microbes. ------------- ----------------------------------------------------------------------------------- 65. **Pain and Pain medication** ------------------------------ --------------------------------------------------------------------------------- Pain Process Involves the transmission of pain signals from the site of injury to the brain. **Pain Pathway**: Nerve fibers transmit pain signals to the central nervous system. **Types of Pain**: Acute, chronic, referred pain. **Referred Pain**: Pain perceived at a location other than the site of the painful stimulus **Threshold** Pain threshold is the minimum intensity at which a person perceives pain. **Tolerance** Pain tolerance is the maximum level of pain a person can endure. vi. **characteristics of pain fibers?** ------------------------------------- -------------------------------------------------- Delta Pain Fibers Fast-paced, highly localized, found in the skin. C Pain Fibers Unmyelinated, slow, poorly localized. vii. ------------------------------------------------------------------------------ --------------------------------------------------------------------------------- ------------------ ---------------------------------------------------------------------------- **Mechanism of action and side effects of opioid medications like Morphine** Like morphine, work by binding to opioid receptors in the brain to reduce pain. **Side effects** constipation, decreased respiratory rate, sedation, euphoria, hypotension. ------------------------------------------------------------------------------ --------------------------------------------------------------------------------- ------------------ ---------------------------------------------------------------------------- viii. Narcan **Reverses the effects of opioids.** ix. Buprenorphine **A partial opioid agonist used for pain and opioid dependence.** x. Clonidine xi. Ultram xii. NSAID: what are they? How do they work? xiii. side effects: GI side effects (nausea, vomiting, abdominal pain), GI bleeding, and nephrotoxicity. 66. Antiviral and antifungal: Understanding mechanism of action and side effects g. Acyclovir h. Flu Vaccines i. Protease Inhibitors (as a group) j. Tamiflu k. Efavirenz l. Nelfinavir m. Zidovudine n. Voriconazole o. Amphotericin B p. Azoles as a group q. HIV: Modes of transmission, expected lab findings, dx of AIDS. r. Fungal Infections: superficial, mucocutaneous, and Primary or deep. 67. **Additonal Information** 68. Efavirenz: Can it be taken with meals? 69. Nelfinavir: Common side effects 70. 9\. Pulmonary diseases and treatments s. T.B. medications: As stated in class know these very well: Rifmapin, Isonaizid, xiv. Pyrazinamide, Ethambutol. 71. [Pathophysiology:] 72. TB: Testing results, Adherence, Drug resistance, Latent Vs Active, Transmission, Pulmonary: 73. Pulmonary Embolism: Causes, clinical manifestations, Composition, prevention t. Pulmonary Edema: Clinical manifestations, primary cause u. Pneumonia: Clinical manifestations, pathogenesis (know slide well) v. Virchow\'s triad 74. 9\. Pulmonary disorders 75. Hypoxemia, Hypoxia, and ventilation/perfusion 76. Asthma Extrinsic: xv. Pathogenesis and clinical manifestations xvi. Status Asthmatics 77. COPD and barrel chest: 78. Types: Chronic Bronchitis xvii. Clinical Manifestations xviii. Pathogenesis : increase mucus production 79. Emphysema: xix. clincial manifestation: xx. pathogenesis: destruction of alveoli 80. Pneumothorax and pleural effusion different types of pleural effusion 81. 10\. Pulmonary medications 82. Albuterol SABA: beta 2 agonist treats asthma by opening the airways Glucocorticoids how it works and its side effects: 83. need to be used daily whether having asthma or not 84. Hypertension, increased chance of infection, Hyperglycemia, breakdown of skin, muscle, and bones, GI side effects (nausea, vomiting, abdominal pain), and GI bleeding. 85. Long-acting B agonists LABA indication 86. Singulair 87. Corticosteroids how it work in treating Asthma, their side effects, and patient teaching