Deck 5

Question 1

Why is it dangerous to give fibrates with statins?

Answer 1

Fibrates inhibit P-450 needed to metabolize statins. Excaberate myopathy. If statins aren’t good enough add niacin before fibrates

Question 2

What drug causes folate deficiency? What is it used for?

Answer 2

TMP-SMX. First line for UTI’s

Question 3

What is Berger dz?

Answer 3

IgA nephropathy. Nephritic syndrome with mesangial deposits of IgA. Different from PSGN because 2-3 days after and not 2 weeks

Question 4

Fractional excretion of Na with intrarenal problems?

Answer 4

Between 2-4%

Question 5

How do you know its prerenal?

Answer 5

BUN:Cr greater than 15, Fractional excretion of sodium <1%

Question 6

Post renal failure?

Answer 6

Fractional excretion of sodium >4%

Question 7

What would cause interstial nephritis?

Answer 7

Allergic reaction to penicillins, cephalosporins, sulfonamides

Question 8

Muddy brown casts are pathognomonic for what?

Answer 8

ATN. From Rhabdo, chemo agents, aminoglycosides

Question 9

White blood cell casts?

Answer 9

Intrarenal- pyelonephritis

Question 10

What effect does ATII have on bicarb and H+?

Answer 10

Increase bicarb, unchanged H. exchanges more H in distal that then can help reabsorb more bicarb in collecting duct (as H20 and CO2 by carbonic anhydrase)

Question 11

What is Conn syndrome?

Answer 11

aldosterone secreting tumor of adrenal cortex- hyperaldosteronism. Hypokalemia, alkalosis, low renin

Question 12

Signs of hyperkalemia? Like from spironolactone for example

Answer 12

nausea, vomiting, diarrhea, areflexia, weakness, parasthesias, flaccid paralysis, arrythmias, tall peaked T waves

Question 13

What HLA alleles make a person more susceptible to DM type 1

Answer 13

HLA3/HLA4

Question 14

What effects do iodine insufficiency have?

Answer 14

Neurologic impairment and growth delay. In SE asia and Africa

Question 15

What is NADPH derived from?

Answer 15

Niacin (Vit B3)

Question 16

What do you give for hyperthyroid in pregnant women?

Answer 16

PTU- methimizole is contraindicated. However, PTU can cause hepatotoxicity

Question 17

What is octreotide/ what is it used for?

Answer 17

Somatostatin analog for carcinoid, acromegaly, VIPoma, acute esophageal variceal bleed

Question 18

What is side effect of metformin in person with renal insufficiency?

Answer 18

Lactic acidosis (anion gap). It promotes conversion of glucose to lactic acid. Probably inhibits gluconeogenesis

Question 19

What hormones do neurophysis 1/2 transport?

Answer 19

1= oxytocin 2= ADH

Question 20

Why does exercise help with diabetes?

Answer 20

Increase translocation of GLUT4 to cell surface. = insulin dependent receptor

Question 21

Histology of diabetic nephropathy?

Answer 21

Nodular glomerulosclerosis (Kimmelstiel-Wilson nodules) and thickened basement membrane

Question 22

What does GH do to fasting glucose?

Answer 22

Increase. Acts like anti-insulin agent

Question 23

What is renal osteodystrophy and causes?

Answer 23

HyperPTH secondary to renal dz. Less P excretion, less 1,25OHD3 made from kidneys. PTH rises in response

Question 24

What does VIP do?

Answer 24

Acts on gut mucosa to promotes sodium secretion causing secretory diarrhea. Also incr. potassium secretion in colon . Also inhibits gastric acid secretion. WDHA SYNDROME= Water Diarrhea, Hypokalemia, Achlorhydria

Question 25

Different presentations of 21 and 11-hydroxylase deficiency?

Answer 25

Both = virilization. But 21 = hypotension and 11 = HYPERtension (11 deoxycorticosterone is released and leads to hypertension)

Question 26

Medication for primary hyperaldosteronism (Conn syndrome)?

Answer 26

Spirinolactone. SE = gynecomastia

Question 27

What effect does somatostatin have on body?

Answer 27

AKA Octreotide (analog) blocks GHRH at hypo to reduce GH. In GI, SST is released from mucosal D cells to decr gastric secretion/motility. In pancreas reduces glucagon/insulin secretion

Question 28

What is the active form of Vit D, where is it made? And what enzyme?

Answer 28

1,25-dihydroxycholecalcetriol (calcetriol) is made in kidney by 1alpha-hydroxylase

Question 29

What's first line, second line treatment of BPH?

Answer 29

1 = alpha1 antagonists (tamsulosin) but can cause hypotension. 2= 5a reductase inhibitors (finasteride) but take 6-12 months to work and can decrease libido

Question 30

What happens with K with DKA?

Answer 30

Acidosis shifts K out of cells and makes it look like hyperkalemia. Add K when giving insulin, because insulin makes it go into cells and can cause hypokalemia

Question 31

Hormones that use Gs receptors?

Answer 31

TSH, LH, FSH, ACTH, ADH, PTH, glucagon, GHRH

Question 32

Hormones that use Gi receptors?

Answer 32

Somatostatin

Question 33

Hormones that use Gq receptors?

Answer 33

TRH, GRH, oxytocin, Ang II, bradykinin. Use phospholipase C and IP3/DAG pathway

Question 34

Hormones that use tyrosine kinase?

Answer 34

IGF-1, insulin

Question 35

Hormones that use non-tyrosine kinase?

Answer 35

Prolactin, GH, G-CSF, EPO

Question 36

What diseases cause granuloma formation?

Answer 36

Tuberculosis, histoplasmosis, sarcoidosis

Question 37

Treatment of C diff?

Answer 37

Oral vancomycin, metronidazole

Question 38

Treatment of UC? Hint: Purine synthesis

Answer 38

Azathioprine: Inhibits purine synthesis. Can affect WBCs and can cause leukopenia

Question 39

What can be complications of celiac's?

Answer 39

Iron deficiency, autoimmune thyroiditis, type 1 diabetes, T cell lymphoma