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Classic Treatments Flashcards

1
Q

Kaposi sarcoma

A

Painless violaceous skin lesions that progress in size

Spindle cells and lymphocytic infiltrate in skin bx

Tx with IFN alpha

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2
Q

Ticlodipine

A

Anti platelet drug

Rare side effect- NEUTROPENIA dt agranulocytosis

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3
Q

Acute gout flare treatment

A

NSAIDS- reversible inhibit prostaglandin synthesis by inhibiting COX1 and COX2

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4
Q

Legionella pneumonia

A

Macrolides (ie azithromycin)

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5
Q

Left shift of Hb dissociation curve

A

Increased O2 affinity- want to hold onto O2

LOW pCO2
LOW body temp
LOW H+ (high pH)
LOW 2,3 BPG

POLYCYTHEMIA VERA

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6
Q

Warfarin reversal

A 
FFP (acute)
Vitamin K (non acute)
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7
Q

Granulomatosis with polyangiitis

A

Cyclophosphamide, steroids

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8
Q

Treponema pallidum

A

PCN G

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9
Q

Temporal arteritis

A

High dose steroids

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10
Q

tPA reversal

A

Aminocaproic acid
Tranexamic acid
Work by inhibiting activation of plasminogen

tPA increases thrombolysis by converting plasminogen to plasmin, which directly dissolved thrombus by degrading fibrin

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11
Q

Glomus tumor

A

Benign tumor arising from modified smooth muscle cells of the glomus body (involved in dermoregulation)

Small, solitary, PAINFUL, blue red papules/nodules on hand, foot, under nails of patients 20-40 yo

Pain is paroxysmal, severe, EXACERBATED BY COLD

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12
Q

Acute promyelocytic leukemia (M3)

A

All trans retinoic acid

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13
Q

Diabetes insipidus

A

Central- desmopressin

Nephrogenic- HCTZ, indomethacin, amiloride

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14
Q

Ethylene glycol/methanol intoxication

A

Fomepizole (alcohol dehydrogenase inhibitor)

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15
Q

First line treatment for Lyme disease in pregnant abs nursing women and kids under 8

A

Oral amoxicillin

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16
Q

ER+ breast cancer

A

Tamoxifen

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17
Q

Paradoxical embolism

A

Associated with ASD, PFO, VSD

Allows right sided emboli to enter left sided circulation bypassing pulmonary circulation

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18
Q

Bike acid sequestrants (cholestyramine, colestipol, colesevelam)

A

Lowers LDL, raises HDL and TGs

Reduce bile acid absorption abs decrease enterohepatic circulation of bile. To synthesize new bile, liver up regulates HDL production AND TG rich VLDL cholesterol- secreted directly into blood and cannot be taken up by liver, TGs increase

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19
Q

Streptococcus bovis

A

PCN prophylaxis

Eval for colon cancer if linked to endocarditis

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20
Q

Infertility

A

Leuprolide, GnRH (pulsatile), clomiphene

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21
Q

MSSA

A

Nafcillin
Oxaclin
Dicolxacillin

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22
Q

C tetani

A

Anti toxin

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23
Q

Carbamazepine

A

Antiepileptic
Used for trigeminal neuralgia

Inhibits voltage gated sodium channels in brain, which reduces excitability of neurons

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24
Q

Chronic hepatitis B and C

A

IFN alpha

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25
Q

Pneumocystis jirovecii

A

TMP SMX (prophylaxis and treatment in immunosuppressed pts CD4<200)

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26
Q

Cryptococcus neoformans

A

Induction with amphotericin B and flucytosine, maintain with fluconazole (in AIDS)

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27
Q

Arrhythmia in damaged cardiac tissue

A

Class IB anti arrhythmics

Lidocaine, mexilitine

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28
Q

Heparin reversal

A

Protamine sulfate

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29
Q

Glucagonoma

A

Tumor of pancreatic alpha cells

S/s:
Hyperglycemia 
Chronic diarrhea
Neuropsychiatric symptoms 
DVT
Normocytic anemia
NECROLYTIC MIGRATORY ERYTHEMA
30
Q

Candida albicans

A

Vaginal: topical azoles: nystatin, fluconazole, caspofungin

Oral/esophageal: systemic: fluconazole, caspofungin, amphotericin B

31
Q

Sporothrix schenkii

A

Itraconazole, oral potassium iodide

32
Q

Factor Xa inhibitors MOA

A

Blocks active site of factor Xa—> prevents Xa from converting prothrombin to thrombin

Rivaroxaban, apixaban

Oral, no monitoring, used in CVA prevention in a fib

33
Q

N meningiditis

A

PCN/ ceftriaxone

Rigampin for prophylaxis

34
Q

CML

35
Q

Beta catenin

A

Intracellular protein that acts as transcription factor for cell proliferation

Normally- Wnt signaling mediates destruction of beta catenin via tumor suppressor APC

Failure of this regulatory process implicated in CRC

36
Q

Anticoagulation in pregnancy and renal disease

37
Q

Medical abortion

A

Mifepristone

38
Q

Right shift of Hb o2 dissociation curve

A

Decreased O2 affinity- want to unload O2

HIGH pCO2
HIGH body temp
HIGH H+ (low pH)
HIGH 2,3 BPG

39
Q

Specific marker for monocyte-macrophage cell line

A

CD14

Caseating granulomas of TB are usually surrounded by large macrophages (CD14+)

40
Q

Sarcoidosis s/s

A 
Fatigue, dyspnea, hepatomegaly, erythema nodosum, 
Lupus pernio (erythematous/violaceous indurated lesions on face

Biopsy of NON CASEATING GRANULOMA shows asteroid bodies (eosinophilic inclusions in starry patter) or Schaumann bodies

RLD

Elevated ACE and high CD4:CD8 ratio

41
Q

Long term anti coagulation

A

Warfarin
Dabigitran
Rivaroxaban
Apixaban

42
Q

Cyclophosphamide hemorrhagic cystitis

43
Q

Pseudomonas aeroginosa

A

Piperacillin/tazobactam

Aminoglycosides

Carbapenems

44
Q

What is subacute sclerosing panencephalitis?

A

Rare complication of MEASLES that may develop years after infection

CSF analysis shows high levels of anti measles antibodies

Untreatable

45
Q

Toxoplasma gondii

A

Sulfadiazine and pyramethamine

46
Q

Cause of meckels diverticulum

A

Failed obliteration of vitelline (omphalomesenteric) duct

Presents with spontaneous painless lower GIB

Dx 99technecium scan- ectopic gastric mucosa, 99tech radioisotope has high affinity for PARIETAL CELLS

47
Q

Entacapone

A

Peripherally acting COMT inhibitor that reduces methylation of levodopa and dopamine—> more stable and long lasting plasma concentration of drug

48
Q

Immediate anti coagulation

49
Q

MRSA

A

Vancomycin
Daptomycin
Linezolid
Ceftaroline

50
Q

Fixed, wide splitting of S2

A

ASD

Caused by increased volume within pulmonary circulation

51
Q

Hyper IgM syndrome

A

Impaired interaction between Th cells and B cells resulting in B cell class switching defect

CD40 ligand deficiency MC—> CD40L deficiency in Th cells leads to abnormal interaction between B cells which express CD40 receptor—> disrupts B class switching—> depleted Igs

B cells produce IgM but cannot produce other Igs

LN bx shows absent germinal centers (where B cells proliferate and class switching occurs)

Recurrent infections with Pneumocystis jirovecii and Histoplasma, Cryptosporidium, CMV hepatitis

52
Q

Physostigmine and neostigmine

A

Acetylcholinesterase inhibitors

Used for myasthenia gravis and reversal of nondepolarizing neuromuscular blockers

Act peripherally, do not cross bbb

53
Q

Essential tremor

A

Primidone

Barbituate- primary active metabolite is phenobarbital

Also used as anticonvulsant for grand mail, psychomotor, focal seizures

54
Q

Malaria

A

Chloroquine, mefloquine, atovaquone/proguanil (for blood schizont)

Primaquine (for liver hypnozoite)

55
Q

Tiotropium, ipratropium

A

Competitive inhibition of muscarinic receptors,
—> prevents bronchoconstriction

COPD and asthma

56
Q

Breast cancer in post menopausal women

A

Aromatase inhibitor (anastrozole)

57
Q

Acute tubular necrosis

A

BUN/Cr < 20:1

Caused by ischemia- straight segment of PCT and thick ascending limb

  • hypotension (hypovolemia (dehydration, sepsis), shock
  • thromboembolism
  • thrombotic microangopathy

Caused by toxins- convoluted segment of PCT

  • contrast induced
  • aminoglycosides, cisplatin, amphotericin, lead, ethylene glycol, myoglobinuria, hemoglobinuria, uric acid

Diagnostics: azotemia, MUDDY BROWN CASTS, epithelial casts, free renal tubular epithelial cells

Spontaneous recovery

58
Q

C botulinum

59
Q

Lateral nucleus of hypothalamus

A

Regulates hunger

Damage to lateral nucleus causes anorexia, starvation, failure to thrive

Stimulated by ghrelin, inhibited by leptin

60
Q

HCV treatment

A

Ribavirin, simeprivir, sofosbuvir

61
Q

Chlamydia trachomatis

A

Doxycycline (with ceftriaxone for gonorrhea coinfection)

Erythromycin for chlamydial conjunctivitis in infants

62
Q

Buerger disease

A

Smoking cessation

63
Q

N gonorrhea

A

Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia trachomatis)

64
Q

Haemophilus influenzae B

A

Mucosal infections- Amoxicillin with clavulanate

Meningitis- ceftriaxone

Prophylaxis- rifampin

65
Q

Leydig and Sertoli cells in MALES

A

Leydig cells—> Testosterone

Sertoli cells- inhibin

66
Q

Hepatitis B 3 major facts

A
  1. Partially dsDNA
  2. Reverse transcriptase
  3. Envelope comes from ENDOPLASMIC RETICULUM
67
Q

MAOIs (transcyclomine, phenelzine, isocarboxazid)

A

Inhibit monoamine oxidase—> increased serotonin and NE in synaptic cleft

NO ANTIMUSCARINIC EFFECTS

Side effects- dizziness, weakness, fatigue, anxiety, HYPOTENSION

**if MAOIs patients ingest TYRAMINE, tyramine will not be broken down and will be absorbed and displace NE stores in peripheral neurons —> excess NE will not be broken down because of MAO inhibition—> HYPERTENSIVE CRISIS

68
Q

MHCI

A

Encoded by HLA A, B, C, etc

Bind to TCR and CD8 cells

1 long chain (alpha chain), 1 short chain (beta2 microglobulin)

Expressed on: ALL NUCLEATED CELLS, APCs, PLATELETS
NOT ON RBCS

Present ENDOGENOUS antigens (viral, cytosolic, cancer) to CD8 cytotoxic T cells

Ag PEPTIDE loaded onto MHCI in RER after delivery via TAP (transporter associated with antigen processing)

69
Q

MHCII

A

Encoded by HLA DP, DQ, DR

Binds TCR and CD4

2 alpha and 2 beta chains

Expressed ONLY on APCs- dendritic cells, B cells, macrophages

Present EXOGENOUS antigens (bacterial proteins) to CD4 Th cells

Ag loaded following release of INVARIANT CHAIN in ACIDIFIED LYSOSOME
- invariant chain blocks any binding in ag binding pocket before it merges with lysosome

70
Q

Cardiac arrest acid base disturbance

A

MIXED ACIDOSIS

  • high pCO2 dt ventilators standstill leading to respiratory acidosis
  • low bicarb and low pH dt lactic (metabolic) acidosis (poorly perfumed tissues)
  • high anion gap dt lactate accumulation
  • metabolic acidosis and respiratory acidosis

Rapid Review (5 decks)

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