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Capstone Test 2 > Failure to Thrive > Flashcards

Failure to Thrive Flashcards

1
Q

on gel electrophoresis, M spike represent overproduction of […]

A

Monoclonal Ig

Starr: “monoclonal spike = monoclonal protein when talking about SPEP”

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2
Q

what would you expect to see on bone marrow biopsy in multiple myeloma?

A

clusters of plasma cells with clock face chromatin
intracytoplasmic Ig inclusions

Starr: “Recognize eccentric nucleus of a plasma cell.”

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3
Q

You will get a vignette of multiple myeloma with two clonal spikes: recognize that […] could occur within a clonal line, causing this phenomenon

A

switching

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4
Q

Would the rough Endoplasmic reticulum be active in Multiple Myeloma?

A

Yes - extensive synthesis of monoclonal proteins

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5
Q

what is the role of NF-kB?

A

transcription of pro-inflammatory mediatiors

TNF, IL-1, IL-6

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6
Q

what drugs inhibit NF-kB?

A

glucocorticoids

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7
Q

CRAB criteria for multiple myeloma

A

hyperCalcemia
Renal insufficiency
Anemia
Bone lytic lesions

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8
Q

Osteolytic lesions will have less bone appearing […] on x-ray or CT in multiple myeloma.

A

darker

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9
Q

MOA: Reversibly inhibits cyclooxygenase, mainly in the CNS

A

acetaminophen

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10
Q

MOA of hydrochlorothiazide

A

inhibit NaCl reabsorption in the early DCT

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11
Q

adverse effects of thiazide diuretics

A

hyperGLUC

hyperglycemia
hyperlipidemia
hyperuricemia –> uric acid stones
hypercalcemia

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12
Q

MOA of furosemide

A

loop diuretic
inhibit NKCC channels of thick ascending loop of Henle

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13
Q

MOA of fluoxetine

A

SSRI
inhibit serotonin reuptake at the 5-HT receptors

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14
Q

the more common use for this drug is peripheral neuropathy, although it is an effective anti-epileptic, and is used in alcohol withdrawal and abstinence therapy

A

Gabapentin

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15
Q

Gabapentin blocks […] channels

A

Ca2+

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16
Q

What would DKA look like on an arrow pushing table

pH:
PCO2:
HC03-:

A

pH: low
pCO2: low
HCO3-: low

(MUDPILES: anion gap acidosis)
(respiratory compensation occurs very quickly)

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17
Q

MOA: irreversibly blocks COX, downregulating TXA2 release

A

aspirin

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18
Q

MOA: Inhibition of P2Y12 receptor on platelets (ADP receptor) → ↓ expression of Gp IIb/IIIa receptors on platelets → inhibition of platelet aggregation

A

Clopidogrel

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19
Q

MOA of losartan

A

ARB

angiotensin receptor blocker

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20
Q

MOA of atorvastatin

A

HMG coA reductase inhibitor

unable to convert HMG-CoA to mevalonate (the rate-limiting step of cholesterol synthesis) → reduced intrahepatic cholesterol biosynthesis → upregulation of expression of LDL receptor gene via sterol regulatory element-binding protein (SREBP) → increased LDL recycling

21
Q

MOA of omeprazole

A

Irreversible inhibition of H+/K+ATPase in parietal cells → increases stomach pH

22
Q

Do not treat […] with verapamil or clonidine as first line therapy

A

hypertension

23
Q

the buzzword when looking at a biopsy of hemochromatosis is […]

A

Prussian blue

24
Q

dietary iron is absorbed in the […]

A

duodenum

25
Q

[…] transports iron in the blood

A

transferrin

26
Q

[…] is the primary iron storage protein of the body

A

ferritin

27
Q

The enzyme […] decreases intestinal absorption of iron by inhibiting ferroportin

A

hepcidin

(upregulated in inflammatory states –> anemia of chronic disease)

28
Q

[…] transports ferrous iron (Fe 2+) from the enterocytes to the bloodstream.

A

Ferroportin

29
Q

describe the absoprtion of non-heme iron

A
  1. ascorbate ferrireductase reduces non-heme iron Fe3+ to Fe2+
  2. DMT cotransports Fe2+ with H+
  3. Fe2+ transfers to mobilferrin
  4. Fe2+ leaves cell via ferroportin and hephaestin oxidizes it to Fe3+
  5. iron binds to transferrin in plasma
30
Q

why does hephaestin oxidize Fe2+ to Fe3+ ?

A

keeps it in interstitial space allowing it to bind to transferrin

31
Q

describe the absoprtion of heme iron in the duodenum

A
  1. Heme Fe2+ enters cell (unknown mechanism)
  2. Fe2+ transfers to mobilferrin
  3. Fe2+ leaves cell via ferroportin and hephaestin oxidizes it to Fe3+
  4. iron binds to transferrin in plasma
32
Q

[…] transports non-heme iron into the enterocyte

A

DMT-1

33
Q

patients with hemochromatosis are at an increased risk for developing

A

cirrhosis
HCC
restrictive cardiomyopathy

34
Q

Plasma […] is a marker of total body iron stores

A

ferritin

35
Q

A liver biopsy showing macrophages with cytoplasmic granules that stain golden-yellow with hematoxylin describes […] deposits.

A

hemosiderin

(due to chronic iron overload)

36
Q

In […], the HFE gene is mutated; this leads to defective binding of transferrin to its receptor, which signals decreased iron stores

A

hemochromatosis

(liver stops producing hepcidin)

37
Q

seen on peripheral blood smear in MM

A

rouleux formation

38
Q

MM can cause foamy urine due to […] proteinuria

A

light chain (Bence Jones proteins)

39
Q

plasma cell dyscrasia characterized by abnormal proliferation of terminally differentiated B cells that produce monoclonal IgM antibodies

A

Waldenstrom macroglobulinemia

40
Q

[…] acting insulins do not produce an observable peak in serum insulin concentration

A

long

(glargine)

41
Q

high doses of […] especially in patients with underlying renal insufficiency, carry a risk of sensorineural hearing loss

A

loop diuretics

42
Q

what HTN med can be used in the setting of osteoporosis to increase Ca reabsorption?

A

thiazide diuretic

43
Q

enhances bicarbonate elimination in the proximal convoluted tubule

A

acetazolamide

(used to treat altitude sickness)

44
Q

what HTN medication can cause gynecomastia?

A

spironolactone

45
Q

ACE inhibitors inhibit […] arteriole constriction

A

efferent

(decrease GFR)

46
Q

used for the treatment of stable angina pectoris in patients with aspirin allergy as well as adjunctive therapy in acute coronary syndromes

A

clopidogrel

(patient develops signs of acute asthmatic attack (wheezing, dyspnea) shortly after initiating therapy with aspirin)

47
Q

most common adverse effect of aspirin

A

GI bleed

48
Q

oral ulcers, sore throat, fever, and a low neutrophil count following initiation of a new medication

A

drug induced neutropenia

49
Q

key mediator of platelet-induced coronary artery stenosis and thrombosis

A

TXA2

Capstone Test 2 (5 decks)

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