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OMSITE > Medicine > Flashcards

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
Q

Thiazolidinediones

A

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
Q

Horner’s Syndrome symptoms

A

2/2 sympathetic nerve trunk damage.

Eyelid Ptosis,
miosis (constriction), anhidrosis (decreased sweating)

27
Q

Marfan Syndrome Cardiac abnormalities?

A

Prolapsed mitral or aortic valves due to cycstic media degeneration of the valves. Dilated aorta or aortic aneurysm.

28
Q

How do COX-2 inhibitors trigger asthma?

A

Increase luekotrienes.

29
Q

ACE Inhibitors cause angioedema most frequently in??

A

African Americans are more predisposed.

30
Q

Carbamazepine preop lab?

A

Obtain a CBC preop. Can cause aplastic anemia and agranulocytosis, loss of platelets may become life threatening.

31
Q

Dilantin preop lab?

A

CBC preop. Can cause megaloblastic anemia, agranulocuytosis, aplastic anemia, leukopenia.

32
Q

What is a non-selective beta blocker that has intrinsic sympathomimetic activity?

A

Pindolol, Penbutolol, Oxyprenolol, acebutolol
Carvedilol and labetalol are both also alpha blockers

33
Q

Hyperparathyroid signs/symptoms

A

Renal stones, bone lesions, Brown tumor is histogically the same as CGC
Groans/stones/psychic moans

34
Q

PTT measures?

A

Intrinsic pathway and common. Contact activation pathway

35
Q

What is the main role of the tissue factor/extrinsic pathway in clotting?

A

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
Q

What are the common hypercoagulable disorders?

A

Factor V Leiden - unresponsive to protein C.
Protein C deficiency, Protein S deficiency, Anti-thrombin 3 deficiency.

37
Q

What is the basic strategy of ventilating the ARDS patient?

A

Significant PEEP to recruit alveoli. PEEPs of 8+ but most commonly using APRV modes today.

38
Q

How does APRV work?

A

Allows for spontaneous ventilation while creating maximum recruitment.

39
Q

What are the diagnostic critfferia for HIT (Heparin Induced Thrombocytopenia)

A

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
Q

The formation of which clotting factor is the beginning of the common pathway?

A

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
Q

A patient with end stage renal disaes with potassium of 6.5- how to treat hyper kalemia preoperatively?

A

Insulin +D50, kayexelate. Calcium chloride or calcium gluconate to stabilize myocardium.

42
Q

Mitral stenosis smptoms?

A

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
Q

Antibiotic that crosses BBB?

A

Linezolid, penicillins, fluorquinolones, rifampin, flagyl, tetracyclines, Bactrim

44
Q

SIRS criteria

A

2 or more
Temp > 38 or <36 C
Tachycardic >90
Tachypneic >20 or PaCO2 <32
WBC >12 or greater than 10% bands

45
Q

Med to give someone with Wegner’s granulomatosis

A

Cyclophosphamide to down regulate immune system.

46
Q

Why can NSAIDS exacerbate/cause peptic ulcer?

A

COX1 stimulates prostaglandins= protective to stomach mucosa. Inhibition also inhibits protection.

47
Q

Young adult developing dyspnea ahs three relatives that are non-smokers athat have developed emphysema?

A

alpha 1-antitrypsin deficiency

48
Q

Marfan’s syndrom with what cardiac irregularity?

A

Mitral and aortic prolapse, dilated aorta, aneurysm.

49
Q

Calculating metabolic gap

A

Sodium - chlorid - bicarb

50
Q

Winter’s formula

A

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
Q

Wernickes vs Korsakoffs syndrome

A

Korsakoffs= memory loss. Both are caused by exhaustion of B vitamins esp B1/thiamine. Tx = thiamine supplementation.
Chronic alcoholics

52
Q

Marcus gunn pupil

A

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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