Herbs

Question 1

Ephedra

Answer 1

Alpha adrenergic stimulant alkaloid (evergreen) that produce HTN and radiolucent stones

Question 2

Synephrine

Answer 2

Bitter orange, like ephedra but not banned bc different name

Question 3

Glycyrrhiza Glabra

Answer 3

Sweetener that blocks 11Beta-hydroxysteroid dehydorgenase, which usually degrades cortisol in cell, so cortisol activates Aldo R all the time and causes constant pseudohyperaldosteronism (hypokal, HTN, metabolic alk, low renin, low aldosterone)

Question 4

St. John’s Wort

Answer 4

Increase P450 and P-glycoprot so metabolize faster and inactivate meds

Question 5

Chronic Lead Toxicity Triad (& two other findings)

Answer 5

HTN, CKD, Gout

Interstitial fibrosis and “myeloid-like bodies” (PT nuclear inclusions)

Question 6

Lead Therapy

Answer 6

Chelation therapy w/ EDTA/DMSA, otherwise stays in body forever

Question 7

Cadmium 3 Risks

Answer 7

HTN, CKD (CIN), and Malignancy (lifelong)

Question 8

Aristolochia

Answer 8

Chinese herbs that increase risk of uroepithelial cancers (high grade transitional cell, so bladder/ureter/renal pelvis) (lifelong)

Question 9

Star Fruit: Carambola (Oxalidacaceua)

Answer 9

Acute Oxalate Nephropathy, like ethylene glycol or short bowel syndrome