Cytokines And Their Responses to Injury Cytokines and their Responses to Injury Among earliest responders after injury Tumor Necrosis Factor Induces muscle breakdown and Alpha (TNF- ) cachexia through increased catabolism Induces fever through prostaglandin activity in anterior Interleukin 1 (IL-1) hypothalamus Promotes -endorphin release from pituitary Promotes lymphocyte proliferation, immunoglobulin production, gut barrier integrity Interleukin 2 (IL-2) Attenuated production after major blood loss leads to immunocompromise Elicited by all immunogenic cells as mediator of acute phase Interleukin 6 (IL-6) response Prolongs activated neutrophil survival Chemoattractant for neutrophils, Interleukin 8 (IL-8) basophils, eosinophils, lymphocytes Activates macrophages via TH1 cells that demonstrate enhanced phagocytosis and microbial killing Interferon (IFN- ) Found in wounds 5-7 days after injury Mediators of Inflammation Central Nervous System Regulation of Inflammation Hormonal Response to Injury Surgical Metabolism Nutrition in the Surgical Patient PART I: BASIC PRINCIPLES IN SURGERY SYSTEMIC RESPONSE TO INJURY AND METABOLIC SUPPORT A. Liver, Portal Venous System & Gallbladder Hemostasis, Surgical bleeding and transfusion d. Fluid and Electrolyte management of the Surgical Patient c. Systemic Response to Injury and Metabolic support b. Master topics written in our quick review, subject cross overs and end of review question boxes because they provide high yield information, not just for surgery but for the rest of the other subjects as well! Pay close attention to those in bold, italicized, underlines as these are very important facts to remember for the subject. Any statements, tables, figures marked with a means that the information highlighted was previously tested in previous board exams. Ophthalmology, ENT, Orthopedics, and Gynecology topics are not included in this surgery handout. Integration with other basic subjects as well as review questions per section are also included to facilitate mastery of the course. SURGERY REVIEW This review material is a synthesis of the first few chapters of Schwartz’s Principles of Surgery, 9th edition, Absite and Board Review of Schwartz’s Principles of Surgery, 9th edition, 2009 Absite Clinical Review of Surgery and RUSH integrated review of surgery.
TOPNOTCH MEDICAL BOARD PREP SURGERY SUPPLEMENT HANDOUT - Jules Lopez,MD-MBA,Teddy Carpio,MD-MBA For inquiries visit or email us at
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