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Step 1 Crush 250! - Hans > GI 375 - 380 > Flashcards

GI 375 - 380 Flashcards

1
Q

name of the drug that blocks gastric/pancreatic lipase

A

orlistat

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2
Q

what is the clinical app of orlistat?

A

weight loss (dec breakdown and absorption of dietary fats)

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3
Q

side effects of orlistat?

A

steatorrhea, dec absorption of fat-soluble vitamins

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4
Q

side effects of ondansetron?

A

QT polongation, headache, constipation

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5
Q

what type of antibiotic also causes QT prolongation?

A

macrolides

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6
Q

what is the target of ondansetron?

A

5HT3

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7
Q

2 functions of ondansetron?

A
  1. dec vagal stimulation

2. powerful central acting antiemetic

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8
Q

what is metoclopramide?

A

D2 receptor antagonist

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9
Q

what is the clinical app for metoclopramide?

A

diabetic and postsurgery gastroparesis, antiemetic

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10
Q

2 conditions that are contraindicated to metoclopramide?

A

small bowel obstruction, parkinson dz

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11
Q

metoclopramide can interact with what kinds of drugs?

A

digoxin, diabetic agents

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12
Q

side effects of metoclopramide?

A

inc parkinsonian effects, tardive dyskinesia, restlessness, drowsiness, diarrhea

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13
Q

does metoclopramide affect the colon transportation time?

A

no

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14
Q

name 4 H2 blockers

A

cimetidine, ranitidine, famotidine, nizatidine

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15
Q

what is the mech of H2 blockers?

A

reversible block of histamine H2 receptors –> dec proton secretion by parietal cells

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16
Q

among H2 blockers, what is unique about cimetidine?

A

inhibitor of P450 and also has antiandrogenic effects (prolactin release, gynecomastia, impotence, dec libido in males)

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17
Q

what 2 H2 blockers dec renal excretion of creatinine?

A

cimetidine, ranitidine

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18
Q

4 clinical applications for octreotide

A
  1. variceal bleeds
  2. acromegaly
  3. VIPoma
  4. carcinoid tumors
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19
Q

what is the common side effect of all antacid?

A

hypokalemia

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20
Q

name 4 osmotic laxatives

A
  1. magnesium hydroxide
  2. magnesium citrate
  3. polyethylene glycol (prep for colonoscopy)
  4. lactulose
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21
Q

the mech of osmotic laxatives?

A

provide osmotic load to draw water into the GI lumen

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22
Q

what is sulfasalazine?

A

combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory)

23
Q

sulfasalazine need to be activated by

A

colonic bacteria

24
Q

3 clinical usage for sulfasalazine?

A
  1. UC
  2. Crohn (colitis component)
  3. rheumatoid arthritis
25
Q

name 3 antacids

A
  1. aluminum hydroxide
  2. calcium carbonate
  3. magnesium hydroxide
26
Q

which antacid can chelate and dec the effectiveness of drugs such as tetracycline, fluoroquinolones

A

calcium carbonate

27
Q

what is the drug that ripens cervix?

A

misoprostol (PGE1 analog)

28
Q

name two H2 blockers that reduce renal excretion of creatinine?

A

cimetidine, ranitidine

29
Q

mech of proton pump inhibitor?

A

irreversible inhibition of Na+/K+ ATPase

30
Q

3 side effects of PPI?

A
  1. inc risk of C. difficle infection
  2. pneumonia
  3. dec serum Mg2+ with long term use
31
Q

does PPI inhibit or induce P450?

A

inhibit

32
Q

mech of bismuth, sucralfate?

A

bind to ulcer base providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer

33
Q

which drug is a prodrug that requires acid to be activated?

A

sucralfate

34
Q

bismuth is also used is what other path?

A

H. pylori (Quadruple tx: PPI, bismuth, metronidazole, tetracycline)

35
Q

4 clinical applications for octreotide?

A
  1. variceal bleeds
  2. acromegaly
  3. VIPoma
  4. carcinoid tumors
36
Q

what path is associated with “disorganized glandular structure with cellular infiltration?”

A

pancreatic adenocarcinoma

37
Q

where does pancreatic adenocarcinoma usually arise from?

A

pancreatic duct

38
Q

what is the most common location of pancreatic adenocarcinoma?

A

pancreatic head

39
Q

what are the clinical symptoms from obstructive jaundice due to pancreatic adenocarcinoma?

A
  1. painless jaundice
  2. puritis
  3. dark urine
  4. pale stool
40
Q

what are the 2 tumor markers for pancreatic adenocarcinoma?

A

CA 19-9, CEA

41
Q

name 5 risk factors for pancreatic adenocarcinoma

A
  1. tobacco use
  2. chronic pancreatitis
  3. diabetes
  4. age > 50 yrs
  5. Jewish and African American males
42
Q

name 4 unique presentations of pancreatic adenocarcinoma

A
  1. abdominal pain radiating to back
  2. weight loss (due to malabsorption and anorexia)
  3. migratory thrombophlebitis
  4. obstructive jaundice with palpable nontender gallbladder
43
Q

explain the pathophysio of the migratory thrombophlebitis?

A

precoabulant effect of the circulating “mucin” released by tumor cells –> inc coagulation factors

44
Q

what is another name for migratory thrombophlebitis?

A

Trousseau syndrome

45
Q

what is Courvoisier sign?

A

obstructive jaundice with palpable nontender gallbladder

46
Q

what path is associated with inc risk of gallbladder carcinoma?

A

porcelain gallbladder

47
Q

what infectious agent is associated with cholangiocarcinoma?

A

clonorchis sinensis (Chinese liver fluke)

48
Q

what is the treatment for porcelain gallbladder?

A

prophylactic cholecystectomy due to high rates of gallblader carcinoma

49
Q

define porcelain gallbladder

A

calcified gallbladder due to chronic cholecystitis

50
Q

what is the complication of acute pancreatitis?

A

pancreatic pseudocyst (lined by granulation tissue, not epithelium can rupture and hemorrhage)

51
Q

3 clinical presentations for acute pancreatitis?

A
  1. epigastric abdominal pain radiating to back
  2. anorexia
  3. nausea
52
Q

what are the consequences of acute pancreatitis other than pseudocysts?

A
  1. DIC
  2. ARDS
  3. diffuse fat necrosis
  4. hypocalcemia (Ca2+ collects in pancreatic Ca2+ soap deposits)
  5. infection
  6. multiorgan failure
53
Q

is amylase and lipase a good marker for confirming chronic pancreatitis?

A

no (amylase and lipase may or my not be elevated in chronic pancreatitis)

54
Q

is amylase/lipase good makers for acute pancreatitis?

A

yes (amylase and lipase always elevate in acute pancreatitis)

Step 1 Crush 250! - Hans (41 decks)

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