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0. Step Ib > Jen's Last-Minute Review > Flashcards

Jen's Last-Minute Review Flashcards

1
Q

glucagon: effect on cAMP?

A

increases cAMP

Incr Protein Kinase A

–> gluconeogenesis

FASTING state

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2
Q

insulin: effect on cAMP?

A

decr cAMP

decr PKA

more glycolysis

FED state

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3
Q

drug for pt with HTN + BPH?

A

alpha1 blockers

(doxazosin, prazosin, terazosin)

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4
Q

drug for pt with HTN + coronary artery disease or CHF?

A

cardioselective beta-blockers

(metoprolol, atenolol)

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5
Q

drug for pt with HTN + DM?

A

ACE inhibitors (ramipril)

ARBs (Irbesartan)

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6
Q

drug NOT to use for pt with HTN + diabetes, hyperCa, or gout?

A

Thiazides

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7
Q

drug for pt with HTN + vasospasm?

(Raynauds, Prinzmetal angina)

A

Ca blockers

(cerapamil, amlodipine)

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8
Q

First line for essential hypertension?

A

HCTZ

(also first line for isolated systolic HTN)

(also first line for osteoporosis)

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9
Q

drug for pt with HTN + pregnancy?

A

alpha2 blocker

(methyldopa)

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10
Q

drugs that affect microtubules?

A

Microtubules Get Constructed Very Poorly

Mebendazole (anti-helminth)

Griseofulvin (anti-fungal)

Colchicine (anti-gout)

Vincristine (anti cancer)

Paxlitaxel (anti cancer)

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11
Q

drug that halts DNA in metaphase? use?

A

Colchicine

anti-gout

used to do karyotype analysis (need chromosomes in condensed/metaphase state)

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12
Q

Electron transport chain inhibitors?

(decr H+ gradient, block ATP sythesis)

A

R - A C CO

Rotenone (Complex I)

nothing (Complex II = succinate dehydrogenase)

Antimycin A (Complex III)

Cyanide, CO (Complex IV = Cytochrome C)

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13
Q

ATP synthase inhibitor?

A

Oligomycin (blocks Complex V = ATP synthase)

increases protin gradient

No ATP produced

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14
Q

uncoupling agents?

A

2,4 dinitrophenol (illicit weight loss)

aspirin (fever due to OD)

thermogenin (brown fat)

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15
Q

muscle tissue cannot do gluconeogenesis why?

A

lacks glucose-6-phosphatase

muscle can only break down glycogen stores for its own use

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16
Q

difference between odd chain FAs and even chain FAs?

A

odd chain can produce propionyl-CoA –> succinyl-CoA (source of glucose via TCA)

even chain can only produce acetyl-CoA equivalents - no new glucose.

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17
Q

tissues that use the HMP shunt? (4)

A

RBCs

lactating mammary glands

liver

adrenal cortex (to synth FAs or steroids)

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18
Q

isolated elevated alkaline phosphatase level indicates what disease?

A

Paget disease of bone

localized imbalance between clast and blast activity

mosaic pattern of lamellar bone

incr hat size

alk phos elevation due to incr blast activity (alk phos creates alkaline env’t for osteoid to be mineralized with Ca)

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19
Q

treatment for Paget disease of bone?

A

calcitonin - inhibits osteoclast function, anti-PTH

bisphosphonates - induce osteoclast apoptosis

20
Q

complications of Paget disease of bone?

A

high output cardiac failure (AV shunts through bone!!)

osteosarcoma (incr cellular activity overall)

21
Q

most common cause of osteomyelitis overall?

A

staph aureus

invasive: alpha toxin can lyse host cell membranes, has superantigens

22
Q

most common cause of osteomyelitis in SA young adults?

A

N gonorrhea

23
Q

most common cause of osteomyelitis in sickle cell pts?

A

Salmonella

24
Q

most common cause of osteomyelitis in diabetics?

A

Pseudomonas

25
Q

most common cause of osteomyelitis in IVDU?

A

Pseudomonas

26
Q

most common cause of osteomyelitis in pts with a dog/cat bite?

A

Pasteurella

27
Q

most common cause of osteomyelitis in vertebrae?

A

Mycobacterium tuberculosis

(pott disease)

28
Q

complications of Rheumatoid arthr?

A
  • pleural effusions
  • tophi (rheumatoid nodules)
  • anemia of chronic disease (chronic inf, production of acute phase reactants incl hepcidin, sequesters iron in RBCs)
  • secondary amyloidosis
29
Q

Reiter syndrome triad

A

arthritis (seroneg spond), urethritis, conjunctivitis

(cant see cant pee cant climb a tree)

usually after a GI of chlamydia inf

30
Q

extra-articular complications of seroneg spond?

A

uveitis

aortitis

(think axial skeleton and what allows you to move it/see where you’re going?)

31
Q

Myasthenia Gravis associated with what other finding?

A

thymic hyperplasia or thymoma

removal of thymus improves symptoms!

32
Q

Acronym for defects of Mesodermal derivatives?

A

VACTERL

Vertebral

Anal atresia

Cardiac

Tracheo-Esophageal fistula

Renal

Limb (bone and muscle)

33
Q

Enalapril

A

ACE inhibitor

CHF, diabetic nephropathy, pulmonary HTN

34
Q

Clopidogrel

A

inhibits platelet aggregation

tx for atherosclerotic ischemia, to prevent stent thrombosis

35
Q

Indomethacin

A

COX 1 and COX 2 inhibitor

decreases prostaglandin synthesis

anti-inflammatory, pain relief

36
Q

etanercept

A

monoclonal antibody

binds TNF

anti-inflammatory for RA, psoriasis, psoriatic arthritis

37
Q

bosentan

A

endothelin receptor antagonist

primary pulmonary arterial hypertension

38
Q

endothelin

A

vasoconstrictor

stimulates proliferation of endothelium

39
Q

metformin SE?

A

lactic acidosis

GI upset

renal failure (monitor serum creatinine)

40
Q

Cardio vs vascular selectivity of

Verapamil

Diltiazem

Nifedepine

A

(all are calcium channel blockers)

Most cardioselective: Verapamil

Most selective for peripheral vasculature: Nifedepin

Diltiazem = in the middle

41
Q

drugs with high hepatic clearance have what other qualities?

A

tend to be lipophilic (because these drugs are filtered in kidney but then re-enter circulation via prox tubule - ie, not excreted)

tend to have high volume of distribution (if low distribution, don’t make it to the liver)

42
Q

captopril v losartan

A

Captopril: ACE inhibitor. can cause dry cough due to increased levels of bradykinin

Losartan: ARB. good for HTN & diabetes

43
Q

asthma due to atopy - treatment?

A

anti-leukotriene

acetylcholine

44
Q

possible side effect with first dose of ACE inhibitor?

A

first-dose hypotension

make sure patient is not on thiazide diuretics

45
Q

Thiazide diuretics: HYPER and HYPO?

A

HYPER:

calcium

uricemia (gout)

glycemia

lipidemia (cholesterol)

HYPO:

kalemia (common to all diuretics except K sparing)

tension

0. Step Ib (19 decks)

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