Chest Pain Flashcards
treat esophageal candidiasis with
fluconazole
MOA of fluconazole
inhibit fungal sterol (ergosterol) synthesis via inhibition of cyp450
fluconazole inhibits cyp[…] in fungal sterol synthesis
450
(can cause liver dysfunction)
fluconazole can cause […] prolongation
QT
gynecomastia can be an adverse effect of […] due to testosterone synthesis inhibition
-azoles (esp ketoconazole)
MOA of zidovudine (formerly AZT)
inhibit nucleotide binding to reverse transcriptase
[…] is a nucleoside analog
zidovudine (formerly AZT)
[…] can be used for both general ART and during pregnancy to decrease risk of fetal transmission
zidovudine (formerly AZT)
[…] is a common adverse effect of zidovudine (formerly AZT) that can be reversed with G-CSF
myelosuppresion
renal toxicity is a adverse effect of what ART?
zidovudine (formerly AZT)
[herpes esophagitis vs. esophageal candidiasis]
white/yellow adherent plaques
esophageal candidiasis
[herpes esophagitis vs. esophageal candidiasis]
pseudohyphae accompanied by visible spores
esophageal candidiasis
[herpes esophagitis vs. esophageal candidiasis]
superficial, punched out ulcers in the distal esophagus
herpes esophagitis
[herpes esophagitis vs. esophageal candidiasis]
multi-nucleated giant cells with cowdry bodies
herpes esophagitis
[herpes esophagitis vs. esophageal candidiasis]
esophageal candidiasis
[herpes esophagitis vs. esophageal candidiasis]
herpes esophagitis
in pericarditis, the pain improves with
sitting up and learning forward
pericarditis typically presents with sharp retrosternal chest pain on […]
inspiration
describe ECG changes in pericaditis
diffuse ST elevation
and/or PR depression
pericarditis is often complicated by
pericardial effusion
a complication of chronic kidney disease that causes fibrinous pericarditis
uremic pericarditis
viruses that cause acute pericarditis
coxsackie virus
echovirus
adenovirus
HIV
HSV
EBV
CMV
treatment for uremic pericarditis is
dialysis
treatment for viral pericarditis is
NSAIDs
colchicine
glucocorticoids
treatment for acute DVT [2]
heparin
enoxaparin
activates anti-thrombin III
decreases activity and IIa and Xa
heparin
directly inhibit Xa
-axabans
inhibits vitamin K epoxide reductase
results in inhibition of factors II, VII, IX, and X
and protein C and S
warfarin
directly inhibit thrombin (IIa) [3]
bivalirudin
argatroban
dabigatran
BAD
signs/symptoms of PE
sudden onset dyspnea
pleuritic chest pain
tachypnea
tachycardia
hypoxemia
respiratory alkalosis
during PE, affected alveoli are […] but not […]
during PE, affected alveoli are [ventilated] but not [perfused]
(VQ mismatch –> hyperventilation —> respiratory alkalosis)
a D-dimer has high […] value
negative predictive
(if negative, rules out PE)
D-dimer has high […] and low […]
D-dimer has high [sensitivity] and low [specificity]
what do you expect to see on CT in PE?
intraluminal filling defect
(this is saddle PE)
describe what this image is telling us
the ventilation image (A) shows uniform distribution of gas throughout the lungs
the perfusion image (B) shows bilateral wedge-shaped infarcts characteristic of PE
[…] is a dimorphic fungus that appears as budding yeast cells with pseudohyphae at 20–25°C
candida albicans
chronic local immunosuppression from prolonged use of inhaled steroids (e.g., fluticasone) can cause
oropharyngeal candidiasis.
Dysphagia and heartburn refractory to proton pump inhibitors in an individual with a history of atopy are indicative of […] esophagitis
eosinophilic
trachealization of the esophagus, longitudinal furrows, friable mucosa on endoscopy
eosinophilic esophagitis
what is the difference between NRTIs and NNRTIs?
NRTIs require phosphorylation
NNRTIs do not
nucleoside reverse transcriptase inhibitor that significantly decreases the vertical virus transmission rate
zidovudine
Antifibrinolytics such as […] and […] can reverse the effects of tPA by inhibiting the activation of plasminogen
aminocaproic
TXA
protamine sulfate reverses […] overdose
heparin
treatment of PE with heparin or Xa inhibitors are used for patients who are [….] stable
hemodynamically
(if unstable –> altepase)
most common cardiac manifestation of SLE, occurring in ∼ 25% of patients
acute pericarditis
hypotension, distended neck veins, and muffled heart sounds (i.e., Beck triad) with low-voltage QRS complexes
cardiac tamponade
(can be secondary to pericarditis)
visceral innervation above the pectinate line comes from
lumbar splanchnics via inferior hypogastric plexus
pelvic splanchnics arise from what spinal levels?
S2-4
above the pelvic pain line, pain travels with [parasympathetics/sympathetics]
sympathetics
[parasympathetics/sympathetics]
travel in lumbar splanchnics
sympathetics
[parasympathetics/sympathetics]
travel in pelvic splanchnics
parasympathetics
[…] splanchnic nerves carry visceral pain fibers from pelvic organs above the pelvic pain line
lumbar
[…] splanchnic nerves carry visceral pain fibers from pelvic organs below the pelvic pain line
pelvic
most common side effect of nitrates
headache
