15 April wk6-E

Question 1

Why are ACEI’s especially useful in HTN in DM?

Answer 1

DM causes arteriosclerosis of the efferent vessels of the kidney leading to increased GFR and microalbuminuria
ACEI’s are helpful because ANGII affects the efferent arterioles preferentially

Question 2

Why are ACEI’s CI in bilateral renal artery stenosis?

Answer 2

Stenosis causes decreased GFR, to compensate kidney constricts efferent arteriole
Blocking formation of ANG II prevents this compensatory restriction and leads to renal failure leading to hyper renin release further constricting the renal vasculature causing severe HTN leading to LV failure and flash pulmonary edema

Question 3

What is the difference between peripheral and central vertigo?

Answer 3

Peripheral caused by vestibule or the nerve, Sx more severe and may be caused by positions and can come and go
Central caused by vestibular nuclei or other structure more central in the brainstem or brain, less common, not associated with position, and less severe Sx, assoc. with stroke and other central lesions

Question 4

What drug causes orange-colored urine and what is it used to treat?

Answer 4

Rifampin

TB

Question 5

What are the 4 first-line drugs for TB?

Answer 5

Isoniazid, Rifampin, Ethambutol, Pyrazinamide

Question 6

What are some common P450 inducers?

Answer 6

Rifampin
Phenobarbitol
Carbamazepine
Phenytoin
St. John's wart
Corticosteroids
Efavirenz

Question 7

Common inhibitors of P450

Answer 7

Isoniazid
Cimetidine
Azole antifungals
Erythromycin
Grapefruit juice
SSRI's

Question 8

What GI disorder is more common in down syndrome?

Answer 8

Hirschsprung’s disease

Question 9

What lab values will be different in utero for a fetus with down syndrome?

Answer 9

First trimester: increased beta-HCG

Second trimester: increased beta-HCG, decreased alpha-fetoprotein