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FirstAID > DIT notes > Flashcards

DIT notes Flashcards

1
Q

What hormone is increased or decreased in:

1) Cushing’s syndrome?
2) Conn’s syndrome?
3) Addison’s disease (aka primary adrenal insufficiency)?
4) Graves’ disease?

A

1) increased cortisol
2) increased aldosterone
3) decreased cortisol and decreased aldosterone
4) increased thyroid hormone

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2
Q

Function of MacConkey’s agar?

A

1) Select out gram (+), only gram (-) grow (crystal violet and bile salts inhibit gram (+) growth)
2) Distinguish lactose and non-lactose fermenters. Lactose is only carb that grows in agar; lactose fermenters form PINK colonies; non-lactose fermenters form other color or white colonies.

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3
Q

List 5 classes of drugs used to treat Glaucoma:

A

1) alpha-agonists
2) Beta-blockers
3) Diuretics (carbanic anhydrase inhibitors like acetazolamide, and mannitol)
4) Cholinergic agonists (cholinomimetics)
5) Prostaglandins (PGF-2alpha)

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4
Q

Symptoms:

  • facial angiofibroma
  • ash-leaf spots of skin depigmentation
  • history of seizures
  • mental retardation
A

Tuberous scelorosis

–> patients are at increased risk of developing these neoplasms: cardiac rhabdomyoma, astrocytoma, angiomyolipoma

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5
Q

What’s the cause of achalasia?

How is it diagnosed?

A

Achalasia = failure of relaxation of lower esophageal sphincter (LES) d/t loss of myenteric (Auerbach’s) plexus.
–> uncoordinated peristalsis –> progressive dysphagia to solids AND liquids.

DX by barium swallow: shows dilated esophagus with an area of distal stenosis. “Birds beak” on barium swallow.

Associated with increased risk of esophageal carcinoma.

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6
Q

Leading causes of death in 15-24 year olds:

A
  • injury
  • homicide
  • suicide
  • cancer
  • heart disease
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7
Q

Leading causes of death in 25-64 year olds:

A
  • cancer
  • heart disease
  • injuries
  • suicide
  • stroke
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8
Q

anti-GBM antibodies (Immunofluorescence)

A

Goodpasture’s syndrome

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9
Q

Kimmelstein-Wilson lesions (LM)

A

Diabetic nephropathy

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10
Q

“spike-and-dome” appearance (EM)

A

Membranous GN

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11
Q

“tram track” of subendothelial humps (EM):

A

membranoproliferative GN

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12
Q

subepithelial humps (EM)

A

Post-streptococcal GN

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13
Q

clinical uses for Metronidazole:

A 
GET GAP:
Giardia
Entamoeba
Trichomonas
Gardnerella vaginalis
Anaerobes (Bacteriodes, C. dificile)
H. Pylori (triple therapy = metronidazole + bismuth + amoxicillin or tetracycline)
  • note: pts must avoid alcohol while on this drug – has disulfiram-like reaction with alcohol
  • side effects = headache, metallic taste
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14
Q

2 most common post-MI complications?

A

1) Cardiac arrhythmias –> ventricular fib = most lethal/severe complication
2) LV failure –> leads to pulmonary edema and Right-sided heart failutre

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15
Q

What is Dressler’s syndrome?

A

autoimmune disease, occurs post-MI’s, results in fibrinous pericarditis

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16
Q

What is the WAGR complex?

A 
a mnemonic for Wilm's tumor (nephroblastoma) = a renal tumor; most common tumor of early childhood (spec 2-4 yo)
Wilms' tumor
Aniridia (lack of an iris)
Genitourinary malformation
Retardation - mental-motor
17
Q

What’s the cause of chronic granulomatous disease?

What are the consequences of chronic granulomatous disease?

A

Cause: Lack of NADPH oxidase activity
Results in: “impotent neutrophils or phagocytes”; lysosomes don’t work
Consequences = susceptible to opportunistic infections (because no neutrophils)

18
Q

4 main pharmacokinetics equations:

A

1) Vd = amount of drug given (by IV) / [drug in plasma]

2) Clearance:
CL = (0.7 X Vd) / t1/2
= k X Vd
( where k=elimination constant = 0.7/t1/2)

3) Loading Dose:
LD = Css X Vd
(where Css = concentration of steady state = desired concentration)

4) Maintenance Dose:
MD = Css X CL

19
Q

What’s the pKa?

A

pKa = acid dissociation constant = ph at which the amount of the non-protonated form = the amount of protonated form

20
Q

if pH < pKa:

A

this is an acidic environment; have more of hte protonated form; basic drugs gets trapped

21
Q

if pH > pKa:

A

this is a basic environment; there will be more of hte non-protonated form; acidic drugs get trapped

22
Q

How to treat an acidic drug OD (ie salicylates = aspirin)?

A

Give NaHCO3 –> traps the acidic drug in basic urine

23
Q

How to treat basic drug OD (ie amphetamines)?

A

Give NH4Cl (ammonium chloride) –> traps basic drug in the acidic urine

24
Q

What are the symptoms of excess parasympathetic activity?

A 
DUMBBELSS:
Diarrhea
Urination
Miosis
Bradycardia
Bronchospasm
Excitation of skeletal muscle and CNS
Lacrimation
Salivation
Sweating

*Parasympathetic drugs make you “leaky”!

25
Q

Ptosis or Diplopia that worsens throughout the day?

A

Myasthenia gravis

26
Q

Tensilon test = Endrophonium test:

A

Dx for myasthenia gravis; give endrophonium, if symptoms improve then dx as MG

27
Q

4 treatment options for myasthenia gravis:

A

1) acethylocholinesterase inhibitors (indirect cholinergic agonists) (b/c in MG have abs to ach receptor; so ach-ase inhibitors increase ach in synapse)
2) corticosteroids
3) thymectomy
4) plasmapheresis

28
Q

What drug regenerates acetylcholinesterases after organophosphate poisoning?

(organophosphates = anti-cholinesterases = parathion = insecticide)

A

Pralidoxime (regenerates active AchE); also can give atropine to treat symptoms

29
Q

What are symptoms of inhibiting parasympathetic activity? (ie from giving atropine)

A

Hot as a hare (increased body temp)
Dry as a bone (decreased sweating)
Red as a beet (flushed skin)
Blind as a bat (cycloplegia= ciliary body paralysis–> loss of accommodation = blurry, near vision)
Mad as a hatter (disorientaion, delirium)
Bloated as a toad (constipation, urinary retention)

30
Q

What anti-cholinergics are used to treat urge-type urinary incontinence?

A
  • oxybutinin
  • tolterodine
  • darifenacin and solifenacin
  • trospium
31
Q

What drugs inhibit parasympathetic activity?

A
  • atropine, homatropine, tropicamide (all muscarinic antagonists)
  • benztropine
  • scopolamine
  • ipratropium
  • oxybutynin
  • glycopyrrolate
  • methscopolamine
  • propatheline
32
Q

In what disease/s does one have increase Ach?

In what disease/s does one have decrease Ach?

A
  • increased Ach in: Parkinson’s disease (treat with muscarinic antagonists)
  • decreased Ach in Huntington’s disease and in Alzheimer’s disease (treat with cholinergic drugs)
33
Q

In what pt populations is atropine contraindicated?

A
  • Glaucoma
  • Prostatic hypertension or any urinary retention
  • GI obstruction (ie ileus)
  • Dementia, Delirium, Elderly
  • Infant with fever (because can cause hypoterhmia in infants)
34
Q

G-protein second messengers:

  • receptors and G-protein class
  • second messengers; what each class does
A 
qiss and qiq until you're siq of sqs
α1 --> Gq
α2 --> Gi
B1 --> Gs
B2 --> Gs
M1 --> Gq
M2 --> Gi
M3 --> Gq
D1 --> Gs
D2 --> Gi
H1 --> Gq
H2 --> Gs
V1 --> Gq
V2 --> Gs

Gq —> Phospholipase C —> converts lipids to PIP2 –> PIP2 forms DAG and IP3
-DAG (diacylglycerol) –> Protein kinase C
-IP3 (inositol triphosphase) –> increased incracellular Ca2+
(q-c = “cutesy”)

Gs–> stimulates adenylyl cyclases –> converts ATP to cAMP —> CAMP activates protein kinase A —> get increased intracellular Calcium (in heart) and inhibition of myosin light-chain kinase in smooth muscle.

Gi –> inhibits adenylyl cyclase

35
Q

Drugs that inhibit cytochrome P-450:

A 
PICK EGS:
Protease inhibitors
Isoniazid
Cimetidine
Ketoconazole
Erythromycin
Grapefruit juice
Sulfonamides
36
Q

Cholinomimetic Drugs:

  • Direct cholinergic agonists
  • Indirect cholinergic agonists
A

Direct agonists:

  • Bethanechol
  • Carbachol
  • Pilocarpine
  • Methacholine

Indirect Agonists = Anticholinesterases:

  • Neostigmine
  • Pyridostigmine
  • Edrophonium
  • Physostigmine
  • Echothiophate
  • Donepezil

FirstAID (24 decks)

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