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7 Flashcards

1
Q

How many half-lives does it take for a drug infused at a constant rate to reach 94% of steady state? What variables determine the half-life of a drug? (FA15 p243) (FA16 p237)

A

about 3.3 half-lives (90%, 4-5 to reach steady state)
2 half lives: 75%
3: 87.5%
4: 93.75%

half life (t1/2) = (0.7 x Vd)/CL
-volume distribution and clearance
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2
Q

Describe the anatomical layers of the penis

A 
outer dermis
dartos fascia
deep (Buck's) fascia
tunica albuginea
2 corpora cavernosa (dorsal/top)
1 corpus spongiosum (ventral/bottom) -urethra inside
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3
Q

What is the mechanism of action of penicillin? Is it a bacteriostatic or bactericidal antibiotic? (FA15 p180) (FA16 p170)

A

bacteriocidal, binds PBPs (PCN binding proteins) and blocks cell wall synthesis via inhibiting PTG cross-linking

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4
Q 
What is the adult remnant of each of the following fetal structures? (FA15 p271, 569) (FA16 p264, 573)
Gubernaculum (female)
Processus vaginalis (male)
Foramen ovale
Notochord
A

Gubernaculum (female): round ligament of uterus + ovarian ligament
Processus vaginalis (male): tunica vaginalis
Foramen ovale: fossa ovalis
Notochord: Nucleus pulposus

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5
Q

A 37-year-old patient with refractory peptic ulcer disease undergoes an esophagogastric duodenoscopy (EGD). Biopsies of the duodenum reveal hypertrophied submucosal glands. What are these glands? What are Peyer’s patches? How can these structures help you identify the location from which a histological specimen was taken? (FA15 p345, 360, 356) (FA16 p341, 357, 352)

A

Brunner glands (HCO3−-secreting cells of submucosa) (duodenum) :hypertrophy implies PUD, etc.

Peyer patches (lymphoid aggregates in lamina propria, submucosa) (ileum), MALT

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6
Q

A person eating fugu sashimi in Japan is at risk for what toxicity? What is the mechanism of this toxicity? (FA15 p252) (FA16 p250)

A

Tetrodotoxin
Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing depolarization (blocks action potential without changing resting potential).
Causes nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes. severe: coma, respiratory arrest, CV collapse
tx: supportive

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7
Q

You are performing a well-child examination on a 4-year-old girl. The patient was recently adopted after being removed from the biological mother for abandonment. What changes might you see in your evaluation? What are the effects seen in an infant when there is long-term deprivation of affection? (FA15 p506) (FA16 p510)

A

Long-term deprivation of affection results in: 􏰂 Failure to thrive, Poor language/socialization skills, Lack of basic trust, Anaclitic depression (infant withdrawn/ unresponsive)
The 4 W’s: Weak, Wordless, Wanting (socially), Wary.
Deprivation for more than 6 months can lead to irreversible changes.
Severe deprivation can result in infant death.
-malnutrition and hygiene/dental issues

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8
Q

Which antifungal drugs cause gynecomastia and by what mechanism? Which diuretic drug causes gynecomastia and by what mechanism? (FA15 p191, 554) (FA16 p182, 558)

A

ketoconazole: inhibition of testosterone synthesis via inhibiting desmolase (cholesterol–>pregnenolone), also weak testosterone receptor antagonist
spironolactone: antiandrogen, ^conversion of testosterone–>estradiol (causing gynecomastia) and blocks testosterone synthesis; testosterone receptor antagonist

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9
Q

A 25-year-old woman presents to the clinic with severe pelvic pain that is always associated with menses. What diagnosis is characteristic of this type of pain and often results in infertility? What is the classic finding on the ovary that is associated with this diagnosis? (FA15 p588) (FA16 p594)

A

endometriosis

“chocolate cyst” ovary (endometrioma); normal-sized uterus

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10
Q

What are the early cyanotic heart diseases? What are the late cyanotic heart diseases? (FA15 p288- 289) (FA16 p282-283)

A

early: R–>L shunts; “blue babies”
5 T’s: Truncus arteriosus (1 vessel), Transposition (2 switched vessels), Tricuspid atresia (3=Tri), Tetralogy of Fallot (4=tetra), TAPVR (5 letters)

late: L–>R shunts; “blue kids”
VSD>ASD>PDA; also Eisenmenger syndrome

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11
Q

causes K+ to shift OUT of cell (inducing hyperkalemia)

A 
Digitalis (blocks Na+/K+ ATPase)
HyperOsmolarity
Lysis of cells (e.g., crush injury, rhabdomyolysis, cancer)
Acidosis
β-blocker
High blood Sugar (insulin deficiency)
Patient with hyperkalemia? *DO LAβS*
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12
Q

causes K+ to shift into cells (inducing hypokalemia)

A 
Hypo-osmolarity
Alkalosis
β-adrenergic agonist (􏰄Na+/K+ ATPase) Insulin (􏰄Na+/K+ ATPase)
Insulin shifts K+ into cells

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13
Q

e-lyte disturbance: Nausea and malaise, stupor, coma, seizures

A

hyponatremia

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14
Q

e-lyte disturbance: U waves on ECG, flattened T waves, arrhythmias, muscle spasm

A

hypokalemia

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15
Q

e-lyte disturbance: Tetany, seizures, QT prolongation

A

hypocalcemia

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16
Q

e-lyte disturbance: Tetany, torsades de pointes, hypokalemia

A

hypomagnesia?

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17
Q

e-lyte disturbance: Bone loss, osteomalacia (adults), rickets (children)

A

hypophosphatemia

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18
Q

e-lyte disturbance: Renal stones, metastatic calcifications, hypocalcemia

A

hyperphosphatemia

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19
Q

e-lyte disturbance: decreased DTRs, lethargy, bradycardia, hypotension, cardiac arrest, hypocalcemia

A

hypermagnesia

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20
Q

e-lyte disturbance: Stones (renal), bones (pain), groans (abdominal pain), thrones (􏰄urinary frequency), psychiatric overtones (anxiety, altered mental status), but not necessarily calciuria

A

hypercalcemia

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21
Q

e-lyte disturbance: Wide QRS and peaked T waves on ECG, arrhythmias, muscle weakness

A

hyperkalemia

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22
Q

e-lyte disturbance: Irritability, stupor, coma

A

hypernatremia

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23
Q

consequences of renal failure

A

“MAD HUNGER”
Metabolic Acidosis
Dyslipidemia (especially 􏰄 triglycerides)
Hyperkalemia
Uremia—clinical syndrome marked by ^ 􏰄BUN: Nausea and anorexia, Pericarditis, Asterixis, Encephalopathy, Platelet dysfunction
Na+/H2O retention (HF, pulmonary edema, hypertension)
Growth retardation and developmental delay
􏰂Erythropoietin failure (anemia)
􏰂Renal osteodystrophy

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24
Q

ACE inhibitor SEs

A

Captopril’s CATCHH.
Cough, Angioedema (contraindicated in C1 esterase inhibitor deficiency), Teratogen (fetal renal malformations), ^Creatinine (decreased 􏰃GFR), Hyperkalemia, and Hypotension. Avoid in bilateral renal artery stenosis, because ACE inhibitors will further􏰃 decrease GFR–>􏰅renal failure.

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25
Q

drugs that cause gynecomastia

A 
"Some Drugs Cause Awesome Knockers"
Spironolactone
Digitalis
Cimetidine
Alcohol
Ketoconazole
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26
Q

For what conditions is hyperbaric oxygen therapy particularly helpful?

A 
CO poisoning-->carboxyhemoglobin (binds Hgb w. 200x more affinity than O2)
the bends (decompression sickness)
arterial gas emboli
gas gangrene (C. perfringens)
osteomyelitis
acute MI
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27
Q

What is the pressure in the potential spaces of the body including the pleural cavity, the joint spaces, and the pericardial cavity?

A

negative, facilitates diffusion of fluids in
pleural cavity: -7 to -8 cm H2O
joint spaces: -3 to -5 cm H2O
pericardial cavity: -5 to -6 mmHg

28
Q

If stroke volume determines cardiac output, and contractility determines stroke volume, what determines contractility? (FA15 p273) (FA16 p267)

A

increases with:
Catecholamines (^􏰄activity of Ca2+ pump in
sarcoplasmic reticulum)􏰂/sympathethic stimuation
^􏰄intracellular Ca2+
^􏰃extracellular Na+ (dec. 􏰃activity of Na+/Ca2+ exchanger)
􏰂Digitalis (blocks Na+/K+ pump–>􏰅􏰄intracellular Na+–>dec. 􏰅􏰃Na+/Ca2+ exchanger activity–>^􏰅􏰄intracellular Ca2+)

decreases with:
β1-blockade (dec.􏰃 cAMP) HF with systolic dysfunction 􏰂
Acidosis
􏰂Hypoxia/hypercapnia (􏰃dec. Po2/^Pco2)
Non-dihydropyridine Ca2+ channel blockers (verapamil, diltiazem)
decreased IC Ca2+, ^EC Na+ (opposite digoxin/digitalis)

29
Q

A 48-year-old man presents to your office with a persistent cough that has become bloody. Chest x- ray reveals a coin lesion within the lung parenchyma. Further workup reveals that the patient has the most common type of lung cancer in nonsmokers. Which cancer is this? What other lung cancers are not associated with smoking? Which lung cancers are associated with smoking, and where are they located, centrally or peripherally? (FA15 p619) (FA16 p626)

A

bronchial adenocarcinoma
other non-smoking cancers: bronchioloalveolar adenocarcinoma, malignant mesothelioma (pleural)

others: small cell (oat cell), squamous, large cell, non-small cell, bronchial carcinoid tumor
smokers: small cell, squamous; “sentrally” located

30
Q

How does standard deviation differ from standard error of the mean? (FA15 p53) (FA16 p37) Which one is used in calculating confidence intervals? (FA15 p54) (FA16 p38)

A

Standard deviation = how much variability exists from the mean in a set of values.
Standard error of the mean = an estimate of how much variability exists between the sample mean and the true population mean.
= standard deviation/ square root of #number of subjects (larger population, lower SEM)
CI= confidence interval= range from [mean-Z(SEM)] to [mean+Z(SEM)]
95% CI, Z=1.96
99% CI, Z=2.58

31
Q

Diagram the pathway by which the cochlea communicates a signal to the primary auditory cortex.

A

cell bodies of spiral ganglion–>cochlear nuclei–>contralateral superior olivary nucleus–>lateral lemniscus–>inferior colliculus–>medial geniculate body (thalamus)–>primary auditory cortex

32
Q

Homocystinuria is one of the few diseases that can result in subluxation of the lens. What are the different causes of homocystinuria? How does the treatment differ for each? (FA15 p108) (FA16 p96)

A

-Homocysteine methyltransferase
(methionine synthase) deficiency (treatment: ^􏰄methionine in diet)
-Cystathionine synthase deficiency
(treatment: dec. 􏰃methionine ,^􏰄cysteine, ^􏰄B12 and ^folate in diet)
-decreased affinity of cystathionine synthase for pyridoxal phosphate (treatment: ^^􏰄􏰄B6 and
^􏰄cysteine in diet)
i.e. give end product of deficient enzyme pathway and supplement cofactors

keep in mind, Marfan’s also presents with subluxation of the lens

33
Q

A 34-year-old obese white woman develops urinary retention after undergoing a laparoscopic cholecystectomy. Which cholinergic agonist can be used to treat post-op ileus and urinary retention? What conditions can be made worse by using cholinomimetic agents? (FA15 p250) (FA16 p244)

A

benthacol (direct cholinergic agonist)
neostigmine (indirect: cholinesterase inhibitor)

bronchoconstriction; so exacerbates asthma, COPD
increases acid secretion; exacerbates PUD

34
Q

A 20-year-old Italian woman complains of weakness and fatigue. A CBC reveals a microcytic, hypochromic anemia with a normal iron panel. Which type of thalassemia does this patient most likely have? What is the structure of HbH? What disease results in HbH production? What is the structure of Hb Bart’s? What disease results in Hb Bart’s production? (FA15 p390-391) (FA16 p388-389

A

β-thalassemia

α-thalassemia
3 allele deletion: HbH disease. Very little α-globin. Excess β-globin forms β4 (HbH).

4 allele deletion: No α-globin, no HbF Excess γ-globin forms γ4 (Hb Barts). Incompatible with life (causes hydrops fettles)

35
Q

A 23-year-old man undergoes a splenectomy due to splenic rupture from blunt abdominal trauma. What would you expect to find on this patient’s peripheral RBC smear after the splenectomy? (FA15 p389) (FA16 p387) (SU p257) Asplenic patients are susceptible to which encapsulated organisms? (FA15 p199) (FA16 p191) (SU p367) What vaccines for these encapsulated organisms should be given to asplenic patients? (FA15 p122) (FA16 p112)

A

Howell-Jolly bodies: basophilic nuclear inclusions in RBCs normally removed from spleen
also target RBCs

SHiNE SKiS.
Strep pneumo, Hib, N. meningitis, E. coli, Salmonella, Kleb pneumo, group B Strep (GAS?)

vaccines:
S. pneumo (pneumovar)
Hib
N.meningitis

36
Q

The parents of a 5-year-old girl are concerned because their daughter has night terrors, sleepwalking, and enuresis (bedwetting). In which stage of sleep do these occur? What medications shorten this stage of sleep and thus are useful in treating night terrors, sleepwalking, and enuresis? (FA15 p455) (FA16 p457)

A 
Stage N3 (non-REM)
benzos (clonazepam)
37
Q

What medications are known for causing erectile dysfunction?

A

antihypertensives (sympathetic blockers: clonidine, methyldopa, guanethidine) neuroleptics, SSRIs, ethanol, antipsychotics, spironolactone, ketoconazole, cimetidine (H2 blocker)
thiazide diuretics
B-blockers (minimally)

38
Q

A 48-year-old woman who has taken oral contraceptive pills for the past 15 years is concerned because she is not experiencing menopausal symptoms like the rest of her friends her age. What is the primary reason why menopausal women experience symptoms? Why might this patient not be experiencing menopausal symptoms? What symptoms/conditions are attributed to the changes that take place in menopause? (FA15p576,596)(FA16p582,601)

A

menopause symptoms caused by lack of estrogen
this pt. getting estrogen in OCPs, so no symptoms
Hormonal changes: dec. 􏰃estrogen ^^,􏰄􏰄FSH, ^􏰄LH (no surge), ^􏰄GnRH.
Menopause (lack of estrogen) causes HAVOCS: Hot flashes, Vaginal atrophy/dryness, Osteoporosis, Coronary arterial disease, Sleep disturbances.

39
Q

What is the rule of 2’s associated with a Meckel diverticulum? (FA15 p364) (FA16 p361)

A 
2 inches long
2 ft from ileocecal valve
2% of the population
usually present in first 2 yrs of life
May have 2 types of epithelia (gastric/
pancreatic)
40
Q

A newly married couple is enjoying a honeymoon on a Caribbean beach in Mexico. A few days into the trip, the two begin complaining of abdominal cramps and watery diarrhea. They do not have fevers. Which type of Escherichia coli causes the very common “travelers’ diarrhea”? (FA15 p138) (FA16 p128)

A

ETEC (Enterotoxigenic)

41
Q

A patient comes to your clinic because he has not been able to extend his wrist for the last three days. Upon further questioning, you discover that four days ago the patient passed out drunk for an entire night while his arm was draped over a chair. What is this patient’s condition? (FA15 p418) (FA16 p419) Does the regeneration of neurons occur in both the CNS and the PNS? What is the rate of growth of a new axon in the PNS?

A

radial nerve neuropathy (“Saturday night palsy”) (C5-T1) (posterior cord)

PNS neurons may regenerate, not CNS

  • Schwann cells secrete hemotropic GF that enables regeneration (myelination)
  • oligodendrogliomas secrete factors that inhibit growth

-grow at 1-2 mm/day

42
Q

Women with polycystic ovarian syndrome can have decreased levels of sex hormone-binding globulin (SHBG) which contribute to the development of hirsutism. What can an elevated SHBG produce in men? What is the general mechanism of action of the steroid/thyroid hormones?

A

^SHBG can decrease free testosterone–>gynecomastia

in women, decreased SHBG increases free testosterone–>hirsutism

basically, the more SHBG, the more male hormone is bound up (less manly features)

lipophilic, enter nucleus and affect gene expression, work slowly

43
Q

What is the equation for determining a drug’s volume of distribution? Which types of disease would alter the volume of distribution of a highly protein-bound drug such as ceftriaxone? (FA15 p243) (FA16 p237)

A

Vd = amount of drug in the body/plasma drug concentration
(i.e. how much total (distributed throughout) as a fraction of how much in blood)

diseases that alter Vd of protein bound drugs:
liver disease: decreased binding proteins–>^tissue distribution, less in blood
kidney disease: impaired plasma protein binding, larger apparent Vd (more in tissues)

44
Q

A 36-year-old malnourished woman comes to the ER with abdominal pain. She has a fever, abdominal tenderness (without rebound tenderness), and anorexia. Her WBC count is markedly elevated, and her RDW is high. The patient reports having had a bowel movement this morning and is not nauseated. A small bowel follow-through reveals skip lesions (discontinuous areas of focal narrowing) and a “string sign” (significant narrowing) in the terminal ileum. What disease does this patient likely have? What drugs can be used to treat it? (FA15 p362) (FA16 p359)

A

Crohn’s disease
5-ASA, corticosteroids
more severe: immunosuppressants: azathioprine, 6-MP
anti-TNF-a: infliximab, adalimumab
antibiotics (e.g., ciprofloxacin, metronidazole)

vs UC: 5-aminosalicylic preparations (e.g., mesalamine), 6-mercaptopurine, infliximab, colectomy.

45
Q

A 30-year-old man begins to develop shortness of breath and cyanosis even at rest. Exam reveals clubbing and a systolic murmur. He mentions that he has had a murmur since childhood. Further workup reveals a large ventricular septal defect and pulmonary hypertension. The patient is diagnosed with Eisenmenger syndrome. Describe how this syndrome develops. (FA15 p289) (FA16 p283)

A

begins as L–>R shunt (VSD, ASD, PDA)–>^pulmonary blood flow–>remodeling of vasculature–>pulm. arterial HTN–>RVH to compensate–>R–>L shunt
Causes late cyanosis, clubbing, and polycythemia

46
Q

What ratio indicates fetal lung maturity? What is the proper name for the main component of pulmonary surfactant? (FA15 p600) (FA16 p607)

A

lecithin: sphingomyelin ratio >2:1

dipalmatolyphosphotidylcholine

47
Q

Which nutrient deficiency is associated with spooning of the nails (koilonychia)?

A

iron deficiency (koilonychia)

48
Q

You start a patient on a drug that has been on the market for five years. It has excellent efficacy. However, your patient begins to have an annoying side effect one month after initiation of this drug. She contacts the manufacturer about it, and they, in turn, contact you to gather data on her course while on the drug. In which phase of the clinical trial would this example fall? (FA15 p48) (FA16 p32)

A

phase IV:
Postmarketing surveillance of patients after treatment is approved.
“can it stay?”
Detects rare or long-term adverse effects. Can result in treatment being withdrawn from market.

I: is it safe?
II: does it work?
III: is it as good or better?

49
Q

Which bacteria are known for being obligate intracellular bacteria? (FA15 p122) (FA16 p112)

A

Rickettsia, CHlamydia, COxiella. Rely on host ATP.
“Stay inside (cells) when it is Really CHilly and Cold.”

vs facultative IC: Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia pestis.
“Some Nasty Bugs May Live FacultativeLY.”

50
Q

What is the equation for determining a drug’s clearance? (FA15 p243) (FA16 p237)

A

CL=rate of elimination of drug/plasma drug concentration = Vd × Ke (elimination constant)
CL = (0.7xVd) / t1/2

51
Q

The protein derived from what gene serves as a transcription factor for the development and function of regulatory T cells?

A

FOXP3 found on X chromosome
(codes for Forkhead Box Protein P3)
important for self-tolerance
-absence implicated in autoimmune diseases: mutation: immune dysregulation, polyendocrinopathy, interopathy, X-linked IPEX syndrome (?? not in FA)

52
Q

Where would you expect to find B cells in a lymph node? Where would you find T cells, plasma cells, and macrophages? (FA15 p198) (FA16 p190) (SU p367, 369)

A

B cells: follicles in the cortex
T cells: paracortex
plasma cells and lymphocytes: medullary cords
medullary sinuses: macrophages and reticular cells

53
Q

What important intracellular proteins are common to both the extrinsic and intrinsic apoptotic pathways? (FA15 p222) (FA16 p216)

A

both pathways–>􏰅activation of cytosolic caspases that mediate cellular breakdown.

54
Q 
What is the female homolog to each of the following male structures? (FA15 p568) (FA16 p572)
Corpus spongiosum
Cowper’s glands (bulbourethral glands)
Prostate
Glans penis
Ventral penile shaft
Scrotum

A

Corpus spongiosum/cavernosum: vestibular bulbs
Cowper’s glands (bulbourethral glands): Bartholin glands (greater vestibular glands)
Prostate: Skene’s glands (Urethral and paraurethral glands)
Glans penis: Glans clitoris
Ventral penile shaft: labia minora
Scrotum: labia majora


55
Q

Which amino acids are necessary for purine synthesis? (FA15 p63) (FA16 p49)

A

glycine, aspartate, glutamine (“GAG” me she’s so pure)

56
Q

Your 46-year-old male patient is asking your advice on whether to take a daily aspirin. How does taking an aspirin a day prevent platelet aggregation and myocardial infarction? Which two arachidonic acid products affect platelet aggregation? (FA15 p444) (FA16 p446)

A

anti-platelet agent
permanently inhibits COX-1 (on platelets) and COX-2 via acetylation, decreases synthesis of TXA2
PGI2 (prostacyclin) inhibits platelet aggregation, TXA2 causes platelet aggregation (actions blocked by ASA)
increases bleeding time, no effect on PT, PTT

57
Q

What is compartment syndrome, and how is it treated? (SU p242) (COA p540)

A

increase pressure in fascial compartments, can be caused by caused by trauma, intense exercise
tx w. fasciotomy

58
Q

Thiazolidinediones (TZDs) increase expression of one type of GLUT receptors—those in adipose tissue—as one of their antidiabetic actions. Which GLUT receptors would you expect to find on skeletal muscle and fat? (FA15 p314) (FA16 p308)

A

GLUT-4 (insulin-dependent)

59
Q

Which GI ligaments match the following descriptions? (FA15 p344) (FA16 p340)
Separates the greater and lesser sacs
May be cut during surgery to access the lesser sac
2 ligaments that connect the spleen to other structures
Contains the portal triad
Connects liver to the anterior abdominal wall

A

Separates the greater and lesser sacs: gastrohepatic, gastrosplenic

May be cut during surgery to access the lesser sac: gastrohepatic

2 ligaments that connect the spleen to other structures: gastrosplenic, splenorenal

Contains the portal triad: hepatoduodenal

Connects liver to the anterior abdominal wall: falciform

60
Q

An 18-year-old woman has seasonal allergies. She complains that her eyes water and her nose runs constantly during the spring. Which cell type is responsible for her symptoms, and what drug inhibits these cells’ actions? What WBCs descend from the myeloblast (granulocyte) lineage? (FA15 p382-383) (FA16 p378-379)

A

mast cells
Cromolyn sodium prevents mast cell degranulation
(antihistamines block downstream effects of histamine)

neutrophils, basophils, eosinophils
mast cells come from a different cell line (but similar to basophils)

61
Q

In the lower extremity, what are some of the clinical differences between peripheral vascular disease (PVD, also known as peripheral artery disease (PAD)) and deep venous thrombosis (DVT)?

A

PVD/PAD: ischemia of muscles during exercise (claudication), decreased/absent peripheral pulses, white, gangrene, cold, decreased hair

DVT: swollen, hyperchromatic, dimpling, leg is warm (not cool), Moses sign (calf tenderness w. compression), Homan sign (calf pain w. dorsiflexion of ankle)

62
Q

You have a patient who is experiencing progressive difficulty with swallowing liquids and solid food. Subsequently, the patient undergoes a barium swallow that reveals stenosis of the lower esophageal sphincter. What is the diagnosis associated with this barium swallow finding? What are some common causes of this diagnosis? (FA15 p357) (FA16 p354)

A

achalasia

  • loss of myenteric (Auerbach) plexus
  • idiopathic, inflammatory destruction
  • 2° achalasia may arise from Chagas disease (T. cruzi infection) or malignancies (mass effect or paraneoplastic), amyloidosis, sarcoidosis

^ 􏰄risk of esophageal squamous cell carcinoma

63
Q

A 66-year-old man currently taking warfarin for atrial fibrillation is instructed to avoid food products that contain vitamin K in order to optimize anticoagulation. For what coagulation factors is vitamin K necessary? (FA15 p94) (FA16 p82)

A

Factors II, V, IX, X (2, 7, 9, 10) and
Proteins C and S
“DiSCo started in 1972”

64
Q

A 22-year-old man suffers a stabbing injury to the chest. He has lost a lot of blood, and you are concerned that his cardiac output is low. What are the two equations for cardiac output?
(FA15 p272) (FA16 p266)

A

CO=SVxHR

CO=rate of O2 consumption/(arterial O2 content − venous O2 content)

65
Q

A 5-year-old boy is treated with mebendazole for a pinworm infection. Mebendazole acts on microtubules to inhibit the pinworms. What other medications act on microtubules? What syndrome demonstrates a defect in microtubule polymerization? (FA15 p74, 215) (FA16 p60, 209)

A 
Drugs that act on microtubules (Microtubules Get Constructed Very Poorly):
􏰃 Mebendazole (antihelminthic)
􏰃 Griseofulvin (antifungal)
􏰃 Colchicine (antigout)
􏰃Vincristine/Vinblastine (anticancer) 􏰃
 Paclitaxel (anticancer)

Chédiak-Higashi syndrome:
Defect in lysosomal trafficking regulator gene (LYST).
Microtubule dysfunction in phagosome-lysosome fusion; AR
Recurrent pyogenic infections by staph and strep, partial albinism, peripheral neuropathy, progressive neurodegeneration, infiltrative lymphohistiocytosis.

DIT (8 decks)

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