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Medicine Flashcards

1
Q

Antihypertensive with disruption of fat and glucose metabolism?

A

Beta blocking antihypertensives

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2
Q

Name the lung volumes.

A

Inspiratory Reserve volume,
tidal volume,
expiratory reserve volume,
residual volume.

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3
Q

Name the Lung Capacities?

A

Inspiratory Capacity
Vital Capacity
Functional Residual Capacity
Total Lung Capacity.

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4
Q

What makes up Inspiratory Capacity?

A

IRV + TV

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5
Q

What makes up Vital Capacity?

A

IRV +TV +ERV

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6
Q

What makes up Functional Residual Capacity?

A

ERV + RV

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7
Q

What makes up Total Lung Capacity?

A

IRV +ERV+ Residual Volume+ Tidal volume.

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8
Q

What is restrictive lung disease?

A

Fibrotic process: Sarcoidosis, ARDS, etc.
FEV1/FVC is normal 80% or increased.
FRC, TLC, and RV are all decreased. Lung Volume is decreased- Lungs are smaller- less alveolar surface area .

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9
Q

What is obstructive Lung Disease?

A

Asthma, COPD, emphysema
FEV1 significantly reduced leading to a reduced FEV1/FVC <80%.
Volumes are unchanged but flow rates are impeded.

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10
Q

Non-selective Beta blockers?

A

Carvedilol, labetalol, Sotalol, pindolol, propranolol

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11
Q

Histotoxic hypoxia?

A

Inability of cells to take up O2 despite normal delivery. Usually results from alcohol, narcotics, cyanide.

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12
Q

Name the beta blockers with intrinsic sympathomimetic activity.

A

Oxyprenolol, penbutolol, pindolol, acebutolol

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13
Q

Which beta blockers also have alpha blocking activity?

A

Carvedilol, labetalol

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14
Q

Name the commonly used cardio (Beta-1) selective agents

A

atenolol, esmolol, metoprolol.

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15
Q

What are the firmer contraindications to beta blocker use?

A

asthma, hx of cocaine use.

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16
Q

What is treatment of beta blocker overdose

A

Glucagon- increases strength of heart contractions, increases intracellular cAMP, decreases renal vascular resistance. Cardiac pacing used if unresponsive to meds.
If experiencing bronchospasm - use anticholinergics like ipratropium.

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17
Q

What is parkinson’s disease

A

Degernerative CNS disorder resulting from death of dopamine generating cells in substantia nigra.

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18
Q

Why is Reglan contraindicated in Parkinson’s

A

Dopamine and 5HT3 blockers can cause extrapyrimida l effects (tardive dyskinesia, akathisia, dystonia, bradykinesia)

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19
Q

Digitalis toxicity abnd electrolytes

A

Hyperkalemia and subsequent severe arrhythmia. Antidote- Digoxin Immune Fab.

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20
Q

Sulfonylureas MOA

A

stimulate production of insuline. Ex: glyburide, glimepiride, glipizide.

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21
Q

Metformin

A

Biguanide- acts to reduce gluconeogeneiss in liver and decreases insulin resistance. Risk of lactic acidosis and vit B12 deficiency. Contraindicated in kidney disease and heart failure to o risk of acidosis.
Low risk of hypoglycemia.

22
Q

What is the concern of QT elongation?

A

Torsades
Tx is magnesium

23
Q

What antiemetics can cause QT prolongation/

A

Droperidol- dopamine and alpha blocker

Ondansetron- 5Ht3 inhibitor

24
Q

Alpha-glucosidase Inhibitors

A

Acarbose, voglibose
Reduce glucose absorbance in small intestine by decreasing enzymes needed to digest carbs.

25
Thiazolidinediones
Reduce insulin resistance by activating PPAR-gamma in fat and muscle. Ex: Pioglitazone and rosiglitazone. Risks include heart failure, edema, anemia, MI, bladder cancer, and hepatotoxicity. Requires frequent monitoring.
26
Horner's Syndrome symptoms
2/2 sympathetic nerve trunk damage. Eyelid Ptosis, miosis (constriction), anhidrosis (decreased sweating)
27
Marfan Syndrome Cardiac abnormalities?
Prolapsed mitral or aortic valves due to cycstic media degeneration of the valves. Dilated aorta or aortic aneurysm.
28
How do COX-2 inhibitors trigger asthma?
Increase luekotrienes.
29
ACE Inhibitors cause angioedema most frequently in??
African Americans are more predisposed.
30
Carbamazepine preop lab?
Obtain a CBC preop. Can cause aplastic anemia and agranulocytosis, loss of platelets may become life threatening.
31
Dilantin preop lab?
CBC preop. Can cause megaloblastic anemia, agranulocuytosis, aplastic anemia, leukopenia.
32
What is a non-selective beta blocker that has intrinsic sympathomimetic activity?
Pindolol, Penbutolol, Oxyprenolol, acebutolol Carvedilol and labetalol are both also alpha blockers
33
Hyperparathyroid signs/symptoms
Renal stones, bone lesions, Brown tumor is histogically the same as CGC Groans/stones/psychic moans
34
PTT measures?
Intrinsic pathway and common. Contact activation pathway
35
What is the main role of the tissue factor/extrinsic pathway in clotting?
Generate a thrombin burst. Once thrombin is generated it activates factors 11 8, and 5 and generating a large amount of thrombin will stabilize clot.
36
What are the common hypercoagulable disorders?
Factor V Leiden - unresponsive to protein C. Protein C deficiency, Protein S deficiency, Anti-thrombin 3 deficiency.
37
What is the basic strategy of ventilating the ARDS patient?
Significant PEEP to recruit alveoli. PEEPs of 8+ but most commonly using APRV modes today.
38
How does APRV work?
Allows for spontaneous ventilation while creating maximum recruitment.
39
What are the diagnostic critfferia for HIT (Heparin Induced Thrombocytopenia)
50% drop in PT on HIT +/- lesions at heparin injections ite, fever, dyspnea, chest pain. Presents 5-14 days after initiating Heparin. Prothrombotic state despite the thrmobocytopenia and is not associated with bleeding.
40
The formation of which clotting factor is the beginning of the common pathway?
10a. Combines with 5a to form the prothrombinase complex which converts prothrombin to thrombin. Thormbin converts fibtrinogen to fibrin and activactes factor 13. 13a is called fibrin stabilizing factor.
41
A patient with end stage renal disaes with potassium of 6.5- how to treat hyper kalemia preoperatively?
Insulin +D50, kayexelate. Calcium chloride or calcium gluconate to stabilize myocardium.
42
Mitral stenosis smptoms?
Heart failure symptoms, palpitations, chest pain, hemoptysis, VTE, ascites, and edema. In more advanced stenosis requires atrial kick for adequate filling leading to backup to lungs and pulmonary HTN.
43
Antibiotic that crosses BBB?
Linezolid, penicillins, fluorquinolones, rifampin, flagyl, tetracyclines, Bactrim
44
SIRS criteria
2 or more Temp > 38 or <36 C Tachycardic >90 Tachypneic >20 or PaCO2 <32 WBC >12 or greater than 10% bands
45
Med to give someone with Wegner's granulomatosis
Cyclophosphamide to down regulate immune system.
46
Why can NSAIDS exacerbate/cause peptic ulcer?
COX1 stimulates prostaglandins= protective to stomach mucosa. Inhibition also inhibits protection.
47
Young adult developing dyspnea ahs three relatives that are non-smokers athat have developed emphysema?
alpha 1-antitrypsin deficiency
48
Marfan's syndrom with what cardiac irregularity?
Mitral and aortic prolapse, dilated aorta, aneurysm.
49
Calculating metabolic gap
Sodium - chlorid - bicarb
50
Winter's formula
evaluates respiratory compensation of metabolic acidosis. Expected PCO2= (1.5x bicarb) + 8 =/-2. If PCO2 is higher = resp acidosis. If PCO2 is lower theire is also a primary respiratory alkalosis.
51
Wernickes vs Korsakoffs syndrome
Korsakoffs= memory loss. Both are caused by exhaustion of B vitamins esp B1/thiamine. Tx = thiamine supplementation. Chronic alcoholics
52
Marcus gunn pupil
Relative afferent pupillary defect. Light shined in affected eye causes less constriction in both eyes than light shined in unaffected eye. Efferent limb of the reflex is still intact.

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