Sudden onset of nausea/vomiting and epigastric abdominal pain. 

-Dilation of common bile duct may suggest gallstones

-May cause DIC

Decreased platelet count

Increased BT, PT, and PTT

1.Mebendazole/Thiabendazole(antihelminic)

2.Griseofulvan (antifungal)

3.Vincristine/vinblastine (anti-cancer-Hodgkin's/Non-Hodgkins)

4.Paclitaxel(anti-breast cancer)

5.Colchicine(anti-gout)

A BEAM=

Acebutolol (partial agonist), Betaxolol, Esmolol (short acting), Atenolol, Metoprolol

-These drugs are selective antagonists for B1 (which B1 stim. normally causes increased heart rate and contractility) but don't have an effect on B2 

What is mixed venous oxygen saturation?

What is the first line treatment for P. jiroveci pneumonia?

What is second line if patient has an allergy to the first line treatment?

First line: TMP-SMX

Second line if allergic to sulfa drugs: pentamidine

SNAP= Sulfa drugs treat Nocardia, Actionomyces use Penicillin

A. israelii causes oral and facial abscesses vs. n.asteroides which causes pneumonia in immunocompromised patients

β hemolytic, gram (+), cat (-), bacitracin sensitive

Strep. throat is B.S.

B.S.= beta hemolytic, Bacitracin Sensitive

What HIV drug should you give in HIV + pregnant women?

What are the S/S of HIV infection in a newborn?

Zidovudine(ZDV) is prescribed for prophylaxis during pregnancy to reduce risk of fetal transmission.ZDV is a reverse transcriptase inhibtor(toxicty:megaloblastic anemia)

-Oral thrush, interstitial pneumonia, severe lymphopenia in first year of life

What stain is used to detect crypto in bronchoalveolar fluid?

What about CSF?

Mucicarmine-will stain yeast red

You can do a latex agglutination test in the CSF, stained with india ink

What are the 4 T's of Type IV hypersensitivty reactions?

What is this?

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"walking pneumonia"-insidious onset, headache, non-productive cough, diffuse interstitial infiltrates, x-ray looks worse than patient. 

-affects people in enclosed spaces such as in prisons or military barracks (usually in patients <30)

-Rare sequelae: Cold-agglutin anemia(↑IgM), Stevens Johnson Syndrome (very rare), and joint pain

Gram + cocci in chains(in Strep family), catalase (-), gamma hemolytic (i.e.-no hemolysis), and grows in bile AND 6.5% NaCl (i.e. saline).

-Causes endocarditis after genitourinary procedures

G positive cocci, cat. - gamma hemolytic (i.e. no hemolysis), group D strep, growth in bile but NOT 6.5% NaCl (saline).

-Causes endocarditis asscoiated with colonic malignacy

Baroreceptors and responses:

The aortic arch transmits via what nerve and responds to what?

The carotid sinus transmits via what nerve and responds to what?

Aortic arch transmits via vagus nerve to medulla and responds only to ↑BP

Carotid sinus transmits via glossopharyngeal nerve to solitary nucleus of medulla and responds to ↑ or ↓ in BP

Dobutamine is used for acute heart failure associated with decreased myocardial contractility (e.g. cardiogenic shock).

-Increases contractility and CO, weakly increases HR and myocardial O2 consumption(don't really want these effects but they are weak), and also increases cardiac conduction velocity which can result in arthymias.

When should you screen for GBS in gestation?

-In women who culture positive or have had previous children infected with GBS in the past what is the treatment?

GBS should occur at 35-37 weeks of gestation(vaginal and rectal cultures)

-Treatment of choice remains Penicillin given intrapartum. Ampicillin is an acceptable alternative (while birthing) 

What organism is responsible for infective endocarditis in patients with indwelling catheters or previous valve replacement surgeries?

How is this infection treated?

S.epidermidis

Treated with vancomycin combined w/ rifampin or gentamicin or both (often resistant to methicllin)

What is one of the bacterial genetic mechanisms that the SHiN bugs use?

S. pneumo, H. influ., Neisseria (SHiN) have the ability to take up DNA (chromosomal fragments) from the environment→this is known as competence or transformation.

-This is one way for the bacteria that don't have a capsule and are not pathogenic to get DNA that codes for a capsule and thus gain virulence.

It uses dextrans which are polysaccarides made by using sucrose as a substrate.  Dextrans can facilitate adherence ONLY to previously damaged valves that have fibrin and platelet depositions.

-In contrast S. aureus can attach to healthy valves

Proximal part of pulmonary arteries and pulmonary to systemic shunt (ductus arteriosus-on left only).

Monic: just think of 6 looking like an upside down P so just flip it over make the P for Pulmonary arteries and Pul. to systemic shunt (ductus arteriosus).