April 4 Flashcards
Aortic dissection presentation
Classic presenting symptom is tearing chest pain radiating to back and widened mediastinum on chest pain. There can be BP differential between arms and BP can be high or low.
If involves aortic root, can see aortic regurg or pericardial effusion/tamponade.
If involves aortic arch, can see stroke, Horner syndrome, vocal cord paralysis due to compression of recurrent laryngeal nerve, which runs under the aorta
Ibutilide
Class III antiarrhythmic
Actinic keratosis gross pathology
Scaly plaque
SCC gross pathology and risk factors
Gross: Ulcerated, nodular mass, classically involving lower lip
Risk factors: immunosuppression, arsenic poisoning, chronic inflammation
BCC gross and micro
Gross: elevated nodule with central ulcerated crater. Surrounded by dilated vessesl (telangiectasias). Classically on upper lip.
Micro: Nodules of basal cells with peripheral palisading
Seborrheic keratosis micro
Circular spaces with abundant pink keratin, proliferation of keratinocytes
Herniation: which nerve root
Posterolateral disc herniation most common: affects nerve root below (L4-L5 herniation affects L5 nerve root)
Foraminal herniation affects nerve root above (L4-L5 herniation affects L4 nerve root)
Precontemplation vs contemplation
Precontemplation: not yet acknowledging that there is a problem behavior
Contemplation: acknowledging a problem but not yet ready to make a change
Theophylline
Phosphodiesterase inhibitor that increases cAMP leading to bronchodilation to treat asthma.
Narrow therapeutic index drug thtat is cardiotoxic and neurotoxic. OD treated with cardioselective beta blocker
Ipratropium
Competitive muscarinic antagonist. Prevents bronchoconstriction in asthma and COPD.
Montelukast
Blocks leukotriene receptors. Good for aspirin-induced asthma
Zafirlukast
Blocks leukotriene receptors. Good for aspirin-induced asthma
Zileuton
Blocks 5-lipoxygenase, preventing formation of leukotrienes. Used for asthma
Digitalis/anti-arrhythmic interaction
Quinidine blocks digitalis clearance and displaces digitalis from binding sites
Anti-psuedomonal cephalosporin
Ceftazidime
Isoproterenol
Agonist at beta1 and beta2 receptors
Dobutamine
Beta1 agonist
Norepinephrine
Dominantly alpha agonist
Phenylephrine
Alpha agonist
Pseudoephedrine
Alpha agonist
Terbutaline
beta agonist used in obstetrics to decrease contractions
Ritodrine
beta agonist used in obstetrics to decrease contractions
Clonidine
Alpha2 agonist, decreases sympathetic tone
Methyldopa
Alpha2 agonist, decreases sympathetic tone
Amphetamine
Blocks reuptake and promotes release of norepi
Ephedrine
Promotes release of NE
Treatment of cocaine intoxication
Benzos, no beta blockers
Phentolamine
Blocks alpha1 and alpha2 receptors. USed for MAOi tyramine reaction
Musc agonist effect on BP
Indirect effect: activate guanylate cyclase, decreasing Ca++ leading to vasodilation
Bethanechol
Muscarinic agonist.
Methacholine
M agonist, used to cause bronchoconstriction and test for asthma
Pilocarpine
M agonist, used to decrease IOP
Carbachol
M agonist, used to decrease IOP
Myasthenia gravis exacerbation
Two causes
1) insufficient AChE dose
2) cholinergic crisis: too much AChE making NMJ refractory
Give edrophonium to distinguish
M receptor effect on sweating
Agonists increase sweating
Antagonists decrease sweating, increasing temp leading to reflexive flushing of skin
Pralidoxime
Regenerates AChEI
Benztropine
Anti-M for PD
Scopolamine
Anti-M for motion sickness
Oxybutynin
Anti-M for overacitive bladder
TRAP
Marker of B cell neoplasms
Cluster hedache
Severe headache, lacrimation, conjunctival injection, ptosis, congestion, abortive O2 therapy
I cell disease
Defective phosphotransferase - can’t phosphorylate mannose so golgi doesn’t recognize mannose-6-phosphate on hydrolase enzyme and traffic it to lysosome and it instead gets secretd. Without hydrolase, lysosomes fill up with stuff that can’t be degraded
Presents iwth dev delay, club foot, joint contractures, hernias, coarse facial features, gingival hypertrophy, hoarse voice
Diffuse vs perfusion limited gases
CO: diffusion limited
NO: perfusion limited
O2: normally perfusion limited; becomes diffusion limited during excercise
