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Firecracker 1 Flashcards

1
Q

Dantrolene is used to treat which medical emergencies?

A

1) Malignant Hyperthermia

2) Neuroleptic Malignant Syndrome:

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2
Q

: a genetically predisposed hypermetabolic syndrome caused by exposure to inhalation anesthetics or succinylcholine

A

Malignant Hyperthermia

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3
Q

a toxic hypermetabolic side effect in patients using combination antipsychotic drugs or associated with withdrawal of L-Dopa medication. Such side effects include rigidity, autonomic instability, fever, and coma. Unlike malignant hyperthermia, there is no genetic predisposition.

A

Neuroleptic Malignant Syndrome:

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4
Q

How do sulfonylurea drugs (eg, tolbutamide, glyburide) work?

A

stimulate insulin secretion by causing the closure of the ATP-sensitive K+ channels in β cells.

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5
Q

Name two sulfonylurea drugs

A

tolbutamide, glyburide

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6
Q

Name 3 long acting insulins.

A

Ultralente (Insulin glargine, insulin detemir, Protamine-zinc)

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7
Q

What is their onset and duration of action of long-acting insulins?

A

Onset: 4 hr
Duration: 36 hr
Note: insulin glargine has no peak

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8
Q

Acetaminophen pathways of actions

A

Acetaminophen reduces the oxidized form of the COX enzyme, preventing it from forming pro-inflammatory chemicals; it also also modulates the endogenous cannabinoid system. It is metabolized to AM404, which inhibits the reuptake of anandamide (an endogenous cannabinoid/ vanilloid) by neurons and inhibits sodium channels, similarly to the anesthetics lidocaine and procaine

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9
Q

These drugs act to halt bone remodeling. Due to their negative charge, they bind to calcium in bones, then are engulfed by osteoclasts (which are specialized macrophages) and effectively kill them.

A

Bisphosphonates

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10
Q 
Alendronate,
Etidronate,
ibandronate, 
risedronate, 
zoledronic acid
A

bisphosphonates

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11
Q

Important side effects of bisphosphonates →

A

pill esophagitis, osteonecrosis of the jaw

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12
Q
  • High fever (hyperpyrexia)
  • Tachycardia out of proportion to fever
  • Tachyarrhythmias
  • Shock due to heart failure and/or vomiting
  • Coma
A

Symptoms of thyroid storm

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13
Q

What artery supplies the bladder?

A

Internal iliac

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14
Q

Valproic acid side effect

A

hepatotoxicity

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15
Q

Topiramate side effect

A

kidney stones

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16
Q

carbamazepine side effects

A

agranulocytosis, aplastic anemia

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17
Q

phenytoin side effect

A

megaloblastic anemia

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18
Q

Acts to inhibit sodium channels, T-type calcium channels, and GABA transaminase, the latter resulting in increased synaptic GABA concentrations. It is indicated as a first line therapy for generalized tonic-clonic seizures.

A

Valproic acid

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19
Q

Clinical manifestations include increasing fever, tachycardia, tachypnea, rhabdomyolysis (brown color urine), electrolyte disturbances, and eventual circulatory collapse.

A

MH, caused by exposure to certain drugs used during general anesthesia (volatile agents, succinylcholine)

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20
Q

Name 2 clinical conditions in which serum amylase is elevated.

A

↑ in pancreatitis and mumps

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21
Q

what does amylase do?

A

breaks down starch

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22
Q

Patients do not develop tolerance to which two side effects of opioids?

A

constipation and miosis.

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23
Q

Wilms tumor chromosome

A

11

24
Q

blocks voltage gated sodium channels by prolonging their inactivated state. It is indicated in the treatment of partial seizures, generalized tonic-clonic seizures, and as a first line prophylaxis of status epilepticus.

A

Phenytoin

25
Q

Along with BLANK and BLANK, phenytoin exhibits zero order kinetics, meaning it has a constant rate of elimination.

A

ethanol and aspirin

26
Q

the following are side effects of what med?

  • Neurologic signs such as nystagmus, diplopia, ataxia, and peripheral neuropathy
  • Sedation
  • Megaloblastic anemia
  • Gingival hyperplasia
  • Drug-induced SLE
  • Stevens-Johnson syndrome
  • P-450 induction
  • Teratogenic
A

phenytoin

27
Q

Medullary thyroid carcinoma
multiple Mucosal neuromas
Marfanoid habitus
Pheochromocytoma

A

MEN2b

28
Q

Because first generation antihistamines are WHAT they can easily cross the blood-brain barrier and thus cause significant sedation. Also has mild anticholinergic effects.

A

lipophilic

29
Q

diphenhydramine, chlorpheniramine, hydroxyzine, and brompheniramine.

A

first generation antihistamines

30
Q

first generation antihistamines MOA

A

H1-receptor antagonists – prevent the action of histamine, thus reducing itching, rhinorrhea and sneezing.

31
Q

Can you describe how/why C-peptide is useful?

A

C-peptide is essential for proper folding of insulin. Also, because of its longer half-life, C-peptide is a good indicator of insulin production and secretion in early diabetes.

32
Q

What type of cell does excessive NAPQI interact with?

A

NAPQI binds to, and interacts with vital cellular proteins and the lipid bilayer of hepatocyte membranes

33
Q

Potentiates the effect of GABA by increasing the frequency of chloride channel opening. Thus, these drugs are ineffective in the absence of GABA.

A

Benzodiazepines

34
Q

activates AMPK→ ↑ expression of orphan nuclear receptor SHP→ inhibits expression of liver PEPCK and glucose-6-phosphatase, thus repressing hepatic gluconeogenesis. It also increases peripheral insulin sensitivity and utilization of glucose.

A

Metformin

35
Q

Metformin side effects (3)

A
  • GI distress (eg, diarrhea)
  • Weight loss
  • Lactic acidosis (rare, but 50% mortality when it occurs), especially in patients with underlying renal disease.
36
Q

what is a biguanide?

A

METFORMIN

37
Q

What is the mechanism of action of sumatriptan?

A

5HT serotonin agonist that causes vasoconstriction

38
Q

sumatriptan utility

A

acute migraines and cluster headaches

39
Q

sumatriptan toxicity

A

coronary vasospasm (contraindicated in patients with Prinzmetal’s angina)

40
Q

Plasma cell disorders such as multiple myeloma are associated with which type of amyloidosis?

A

Primary amyloidosis of the amyloid light chain (AL) type

41
Q

What drug can be administered to try to reverse the effects of serotonin syndrome?

A

cyproheptadine (a 5HT2 receptor antagonist)

42
Q

What is the antidote for acetaminophen poisoning?

A

N-acetylcysteine (NAC), a precursor of glutathione and increases the available glutathione to conjugate NAPQI

43
Q

What are some examples of systemic non-volatile anesthetics?

A

ketamine, propofol, droperidol, and etomidate, benzodiazepines, barbiturates, and opiates

44
Q

What are common causes of nephrogenic diabetes insipidus?

A
  • lithium
  • demeclocycline
  • hypercalcemia
  • sickle cell disease
45
Q

nuclei with uniform staining, which appear empty

A

orphan annie eye inclusions (papillary thyroid cancer)

46
Q

round concentric collection of calcium

A

psammoma bodies (papillary thyroid cancer)

47
Q

GnRH, Oxytocin, ADH (V1 receptor), and TRH use what kind of signaling mechanism?

A

IP3-Ca2+

48
Q

acts by enhancing the inhibitory effects of GABA neurons. In the context of epilepsy, it is indicated in the treatment of all seizure types except absence, as well as in the second line treatment of status epilepticus.

A

phenobarbital

49
Q

loratadine, fexofenadine and cetirizine

A

2nd gen antihistamines

50
Q

why are second generation antihistamines less sedating?

A

lipophobic

51
Q

adverse effects of second gen antihistamines

A

mild anticholinergic effects such as dry eyes or dry mouth

52
Q

approved for adjuvant therapy of partial onset seizures, myoclonic seizures, and primary generalized tonic-clonic seizures. It has an unknown mechanism of action.

A

Levetiracem

53
Q

Sides effects associated with levetiracetam include

A

dizziness, sleep disturbances, headache, and weakness.

54
Q

A diabetic patient with long term analgesic use presents with hematuria and colicky flank pain. What might an IVP show to lend evidence to your suspicions?

A

Sloughing of papilla can be seen as a “ring defect” on intravenous pyelogram (IVP): dark lesion surrounded by bright rings of excreted contrast material.

55
Q
  • Platelets: Reversibly inhibit platelet activity → ↑ risk for bleeding.
  • Stomach: Inhibition of prostaglandin synthesis → inhibition of synthesis of protective barrier (e.g. mucus) in stomach → ↑ risk for ulcer.
  • Kidneys: ↑ risk for interstitial nephritis and ATN.
A

NSAID side effects

56
Q

Describe the relationship between free serum Ca2+ levels and PTH secretion.

A

↓ Free serum Ca2+ causes ↑ PTH secretion

57
Q

what mediates PTH release in response to low calcium

A

Ca2+-sensing receptors on chief cells

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