Midterm 2 Flashcards
Which of the following cells are least prone to injury
Hematopoietic cells
Neurons
Hepatocytes
Testicular cells
Neurons
Highly active, injury prone cells
Hematopoietic cells
Hepatocytes
Testicular cells
Intestinal cells
Hypertrophy
Increased size of an organ or cell
Atrophy
Decreased size of organ or cell or cell count
Hyperplasia
Increased number of cells
Metaplasia
Replacement of one cell type with another
Dysplasia
Disordered, unregulated cell proliferation without maturation
Orderly cell death without inflammation
Apoptosis
Disorderly cell death with inflammation
Necrosis
Death of a body part
Gangrenous necrosis
Cell death occurring in a granuloma
Caseous necrosis
Left sided heart failure complications
Hypertension Ischemic heart disease Pulmonary edema Orthopnea - hypertension laying down Reduced blood to kidneys
Right sided heart failure
caused by
effects
caused by lung disease/ left sided heart disease
causes hepatomegaly
hypertension
Select incorrect statement concerning myocardial infarction
as many as 10-20% of these patients experience no pain
The majority of these patients experience pulmonary edema
These are often associated with a mural thrombus (40%)
Typically precipitated by an atrial premature beat
Typically precipitated by an atrial premature beat
Complications of MI
Arrhythmias (75-95%)
Pericarditis (50%)
Mural thrombus (40%)
Extension of infarct
Tachy-arrhythmias
cardiac contraction rates more than 100 bpm
Most common ineffective cardiac contraction
Atrial fibrillation
Essential/primary hypertension
don’t know what causes it
very common - 90-95% of hypertensive patients
narrowing of arterioles especially in kidneys
Secondary hypertension
Caused by pheochromocytoma or other endocrine cause and by congestive heart failure 5-10% of hypertensives Drugs Pregnancy Renal failure Sleep apnea
Which of the following is least likely to be a compensation for congestive heart failure
Cardiohypertrophy
A reduction in cardiac stroke volume
Increased catecholamine (sympathetic) activity
Tachycardia
A reduction in cardiac stroke volume
Will want to increase stroke volume
Also will want to redistribute blood flow
Fixed (stable) stenosis/angina
Symptoms resolve after exerted effort
Variant angina
at rest, brief
Unstable angina
prolonged at rest
most dangerous
Risk of atrial fibrillation
Thrombus
25% of strokes
no MI danger
Select the incorrect statement
Valvular heart disease can be caused by streptococcal infections
Endocarditis can cause fatal thromboemboli
Atrial premature beats are usually very dangerous
Bradycardia is defined as fewer than 60 bpm and can be caused by cardiac conduction blocks
Atrial premature beats are usually very dangerous
Ventricular are dangerous
Thrombus
blood clot clogging an artery
Embolus
anything blocking a vessel
Select the incorrect statement concerning cardiac arrhythmias
Tachy-arrhythmias can be caused by multiple ectopic foci
A risk of atrial fibrillation is stroke-causing emboli
Often are associated with congestive heart failure
Procainamide is the first choice for ventricular arrhythmias
Procainamide is the first choice for ventricular arrhythmias
First choice for ventricular arrhythmias
Lidocaine
Treat atrial fibrillation
Amiodarone
Metoprolol
B1 blocker
treats heart failure, reduce heart rate and block sympathetic nervous system activity
treats heart failure
Dobutamine
Increases HR - B1 agonist
can cause arrhythmias
treats heart failure
Captopril
Decrease TPR
ACE inhibitor - angiotensin converting enzyme
Reduces salt and water retention
treats heart failure
Hydralazine
vasodilator
smooth muscle relaxer
treats heart disease
Digitalis
Increases Ca and contractility of heart
treats heart failure
Procainamide
Anti-arrhythmic
slows action potential conduction
Na channel blocker
not first choice
Select the incorrect statement concerning the following antihypertensive drugs
Furosemide is a loop diuretic more potent than hydrochlorthiazide Mannitol is an osmotic diuretic Clonidine is an alpha 1 antagonist Diltiazem is a calcium channel blocker Captopril is an ACE inhibitor
Clonidine is a alpha 2 agonist
Most likely to treat cholesterol and lipid condition
Fenobrate
Cholesteramine
Exetimibe
Lovastatin
Lovastatin - Inhibits synthesis of cholesterol
Fenobrate
Decreases LDL and VLDL
Increases HDL
Increases lipolysis in liver and muscles
Cholesteramine
Reduces bile reabsorption of lipid/cholesterol
Exetimibe
Decreases fat absorption
Select the incorrect statement concerning pulmonary pathology
Asthma is associated with smooth muscle hypertrophy and hyper-inflated lungs
Fibrosing lung diseases are often associated with rheumatoid arthritis
The main cause of COPD (congestive obstructive pulmonary disease) is car emissions
Cystic fibrosis is associated with destruction of elastin and muscle in the pulmonary bronchial walls
The main cause of COPD is not car emissions
it’s smoking
Which is described as a ‘controller’ agent and is most likely to be prescribed as the primary drug for regular use to treat long-term stable moderate to severe asthma
Theophylline Mentelukast Cromolyn Albuterol Fluticasone
Fluticasone - steroid, thrush, ulcers
Theophylline
Add on controller
increased cyclic AMP
Phosphodiester inhibitor
combined with cortical steroids to treat asthma
Mentelukast
Leukotriene modifier
Prophylactic for serious/chronic asthma
Cromolyn
Inhibits release of histamine from mast cells
prophylactic before exercise
Albuterol
beta 2 agonist
treats asthma
Which of the following is responsible for the majority of renal/ureter stones
Magnesium ammonium phosphate
Calcium oxalate
Uric acid
Cystine
Calcium oxalate - 80% of stones, mostly men, alkalize, stop soda
Struvite, 10% of stones
Magnesium ammonium phosphate
Infection
mostly women
Acidify this stone to treat
Struvite/Magnesium ammonium phosphate
Uric acid stone
Purines, men alkalize
Cystine stones
alkalize
Order of kidney stone commonality
Calcium oxalate - 80%
Struvite/Magnesium - 15%
Uric Acid - 5%
Cystine - 2-5%
Select the incorrect statement concerning pyelonephritis
The most common cause is kidney stones
Often associated with flank pain
10-20% result in kidney failure
Often causes kidney scarring
The most common cause is not kidney stones
Retrograde spread from cystitis
Select the incorrect statement concerning urogenital diseases
The majority of renal cancers are renal cell carcinomas
3 weeks of complete urinary tract obstruction by a stone typically causes permanent kidney damage (partial blockage- 3 months)
Females tend to have more bladder infections (cystitis) than males
The most frequent drug treatment for bacterial cystitis or urethritis is erythromycin
the most frequent drug treatment for bacterial cystitis or urethritis is erythromycin
it is trimethoprim sulfamethoxazole
Used to treat a heparin overdose
Protamine
Platelet aggregate inhibitor
Clopidagrel
Dissolves an established clot
streptokinase
antagonized by vitamin K
Warfarin
actions are similar to heparin
Enoxaparin
Which of the following is incorrect about struvite (magnesium ammonium phosphate) kidney stones and their treatment
They are the second most common type of kidney stone (10-15%)
Must alkalinize the urine pH to dissolve
Trimethoprim-sulfamethoxazole is often give to prevent or control the underlying urinary tract infection in these patients
More common in females than males
Must alkalinize the urine pH to dissolve
Must acidify struvite
Woman with enlarged thyroid, chronically nervous, weight loss, high thyroxine (T4), mostly likely has
DeQuervain thyroiditis Graves disease Hashimoto disease Nodular goiter Toxic nodule
Graves disease
Graves disease
autoimmune
agonist of thyroid receptor
DeQuervain thyroiditis
subacute granulomatous thyroiditis, viral, painful,
self limited
Hashimoto disease
auto-immune causes hypothyroidism (with some hyper beforehand)
Nodular goiter
low iodine levels
Most appropriate treatment for hyperthyroidism lady, Graves disease
T3 supplements
T4 supplements
Antiserum for TSH
beta blocker and radioactive iodine
beta blocker and radioactive iodine
beta blocker for symptoms
T3 and T4 would be for Hashimoto disease
Antiserum for TSH is not effective, TSH levels are already low in Graves
Hours after thyoidectomy, the patient has severe muscle spasms, anxious, and depressed. Low calcium in blood, what happened
Inadvertent removal of parathyroid glands during thyroid surgery
Man with hypercalcemia, constipation, anorexia, weakness and kidney stones
Pulmonary metastatic carcinoma
Multiple myeloma
Thyroid hyperplasia
Parathyroid adenoma
Parathyroid adenoma
Acromegaly
Parathyroid adenoma hypothalamus infarct anterior pituitary adenoma posterior pituitary insufficiency Cushing's disease
anterior pituitary adenoma
Main effect of parathyroid adenoma
increased serum calcium
effect of hypothalamus infarct
shuts down blood to hypothalamus and anterior pituitary
decreases hormone release
effects of anterior pituitary adenoma
increase in TSH, LH, FSH, Prolactin, GH, ACTH
Posterior pituitary insufficiency
less oxytocin and ADH
Cushing’s disease
Increase cortisol increased ACTH caused by pituitary adenoma moon face buffalo hump
Hypertension, headaches, flushing, nervousness, increased catecholamines, right adrenal mass.
Pheochromocytoma
Neuroblastoma
Catecholamines possible
Usually in children
Normal range of HbA1c
4-5.6%
a 54 year old male informs you he has HbA1c value at 9.0%. Without any additional info, which are correct statements
Patient has type 1 diabetes
Patient has Addison’s disease
Infections of the periodontal tissues may be a particular problem
With proper treatment, the HbA1c value can be returned to normal range
Daily insulin treatments are required for this patient
Infections of periodontal tissues
and Treatment can normalize HbA1c levels
He has diabetes, but don’t know which
Addison’s disease
Adrenal gland does not produce as much cortical steroids
Which favor type 2 diabetes over type 1
Age less than 15
Experiences polydipsia and polyphagia
Serum insulins is normal
Thin rather than obese
Serum insulin is normal
Type I diabetes
Be cells don’t work
Ketoacidosis
need insulin to treat
Which is not associated with insulin activity
Reduces HbA1c
Promotes glucose uptake in kidney cells
connected with a C-peptide in its precursor form
Prevents glucosuria
Promotes glucose uptake in kidney cells - nope
Every cell but kidney, RBC, Neurons, Retina and lens
Insulin receptors are resistant to activation by insulin
type II diabetes
gestational
Diuresis
all types of diabetes (including gestational and insipidus)
Severe abnormal lipid metabolism
type I diabetes
no insulin
type diabetes
increased thirst
all diabetes
Long-term increased risk of atherosclerosis and hypertension
Type I and II
Increased risk of major periodontal disease
Type I
type II
Gestational diabetes
Lispro
Rapid onset and early peak action insulin
metformin
a biguanide that decreases glucose production in the liver
acarbose
slows digestion and absorption of starch and disaccharides from intestines
tolbutamide
a sulfonylurea that increases the release of insulin from beta cells
orlistat
diminishes fat absorption in intestines
rosiglitazone
reduces insulin resistance in muscle cells
Which weight reduction drug is thought to suppress appetite by stimulating the 5HT2c receptors in they hypothalamus
Glucagon
Phentermine
Qsymia (topiramate)
Lorcaserin
Lorcaserin
Glucagon
pancreas
increase gluconeogenesis
increase glycogenolysis
weight loss
Phentermine
inhibits NE and DA uptake
weight loss
Lorcaserin
Suppresses appetite in hypothalamus
weight loss
Correct statements concerning Addison’s disease
Often associated with hyperpigmentation in skin
Typically associated with weight gain
Often associated with a deficiency of aldosterone
Frequently treated with prednisone
Administration of mifepristone worsens the symptoms
All are right but - association with weight gain
associated with weight loss
Which is a monoclonal antibody to treat excessive bone resorption
Alendronate
Denosumab
Thiazide diuretics
Calcitonin
Denosumab
Alendronate
a bisphosphonate, inhibits osteoclasts
Thiazide diuretics
decreased renal secretion of calcium
Calcitonin
secreted by thyroid gland, C cells
gets Ca from blood to bone
not an antibody
Legal limit of alcohol percent
0.08%
Sedation and slower reaction Impaired motor and slurred speech Emissis and stupor Comma Respiratory dysfunction and death
.05 - .1 .1-.2 .2-.3 .3-.4 more than .4
Alcohol metabolized to what order of kinetics
zero-order
fixed rate - usually saturated
Alcohol can cause which concentration in low doses
can increase HDL
abrupt withdrawal from alcoholics can cause
seizures
Men or women more sensitive to alcohol
women
Freak bone break accident, most important questions before appointment
What medications are you taking
Do you have a history of osteopororsis or Pagets disease
Bisphosphonates and bone/implants
can’t do them when on bisphosphonates
Alendronate
bisphosphonate
