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Disease and Ther. Final > Midterm 2 > Flashcards

Midterm 2 Flashcards

1
Q

Which of the following cells are least prone to injury

Hematopoietic cells
Neurons
Hepatocytes
Testicular cells

A

Neurons

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2
Q

Highly active, injury prone cells

A

Hematopoietic cells
Hepatocytes
Testicular cells
Intestinal cells

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3
Q

Hypertrophy

A

Increased size of an organ or cell

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4
Q

Atrophy

A

Decreased size of organ or cell or cell count

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5
Q

Hyperplasia

A

Increased number of cells

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6
Q

Metaplasia

A

Replacement of one cell type with another

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7
Q

Dysplasia

A

Disordered, unregulated cell proliferation without maturation

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8
Q

Orderly cell death without inflammation

A

Apoptosis

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9
Q

Disorderly cell death with inflammation

A

Necrosis

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10
Q

Death of a body part

A

Gangrenous necrosis

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11
Q

Cell death occurring in a granuloma

A

Caseous necrosis

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12
Q

Left sided heart failure complications

A 
Hypertension
Ischemic heart disease
Pulmonary edema
Orthopnea - hypertension laying down
Reduced blood to kidneys
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13
Q

Right sided heart failure
caused by
effects

A

caused by lung disease/ left sided heart disease
causes hepatomegaly
hypertension

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14
Q

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

A

Typically precipitated by an atrial premature beat

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15
Q

Complications of MI

A

Arrhythmias (75-95%)
Pericarditis (50%)
Mural thrombus (40%)
Extension of infarct

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16
Q

Tachy-arrhythmias

A

cardiac contraction rates more than 100 bpm

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17
Q

Most common ineffective cardiac contraction

A

Atrial fibrillation

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18
Q

Essential/primary hypertension

A

don’t know what causes it
very common - 90-95% of hypertensive patients
narrowing of arterioles especially in kidneys

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19
Q

Secondary hypertension

A 
Caused by pheochromocytoma or other endocrine cause
and by congestive heart failure
5-10% of hypertensives
Drugs
Pregnancy
Renal failure
Sleep apnea
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20
Q

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

A reduction in cardiac stroke volume

Will want to increase stroke volume

Also will want to redistribute blood flow

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21
Q

Fixed (stable) stenosis/angina

A

Symptoms resolve after exerted effort

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22
Q

Variant angina

A

at rest, brief

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23
Q

Unstable angina

A

prolonged at rest

most dangerous

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24
Q

Risk of atrial fibrillation

A

Thrombus
25% of strokes
no MI danger

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25
Q

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

A

Atrial premature beats are usually very dangerous

Ventricular are dangerous

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26
Q

Thrombus

A

blood clot clogging an artery

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27
Q

Embolus

A

anything blocking a vessel

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28
Q

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

A

Procainamide is the first choice for ventricular arrhythmias

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29
Q

First choice for ventricular arrhythmias

A

Lidocaine

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30
Q

Treat atrial fibrillation

A

Amiodarone

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31
Q

Metoprolol

A

B1 blocker
treats heart failure, reduce heart rate and block sympathetic nervous system activity
treats heart failure

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32
Q

Dobutamine

A

Increases HR - B1 agonist
can cause arrhythmias
treats heart failure

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33
Q

Captopril

A

Decrease TPR
ACE inhibitor - angiotensin converting enzyme
Reduces salt and water retention
treats heart failure

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34
Q

Hydralazine

A

vasodilator
smooth muscle relaxer
treats heart disease

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35
Q

Digitalis

A

Increases Ca and contractility of heart

treats heart failure

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36
Q

Procainamide

A

Anti-arrhythmic
slows action potential conduction
Na channel blocker
not first choice

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37
Q

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
A

Clonidine is a alpha 2 agonist

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38
Q

Most likely to treat cholesterol and lipid condition

Fenobrate
Cholesteramine
Exetimibe
Lovastatin

A

Lovastatin - Inhibits synthesis of cholesterol

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39
Q

Fenobrate

A

Decreases LDL and VLDL
Increases HDL
Increases lipolysis in liver and muscles

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40
Q

Cholesteramine

A

Reduces bile reabsorption of lipid/cholesterol

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41
Q

Exetimibe

A

Decreases fat absorption

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42
Q

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

A

The main cause of COPD is not car emissions

it’s smoking

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43
Q

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
A

Fluticasone - steroid, thrush, ulcers

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44
Q

Theophylline

A

Add on controller
increased cyclic AMP
Phosphodiester inhibitor
combined with cortical steroids to treat asthma

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45
Q

Mentelukast

A

Leukotriene modifier

Prophylactic for serious/chronic asthma

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46
Q

Cromolyn

A

Inhibits release of histamine from mast cells

prophylactic before exercise

47
Q

Albuterol

A

beta 2 agonist

treats asthma

48
Q

Which of the following is responsible for the majority of renal/ureter stones

Magnesium ammonium phosphate
Calcium oxalate
Uric acid
Cystine

A

Calcium oxalate - 80% of stones, mostly men, alkalize, stop soda

49
Q

Struvite, 10% of stones

A

Magnesium ammonium phosphate
Infection
mostly women

50
Q

Acidify this stone to treat

A

Struvite/Magnesium ammonium phosphate

51
Q

Uric acid stone

A

Purines, men alkalize

52
Q

Cystine stones

A

alkalize

53
Q

Order of kidney stone commonality

A

Calcium oxalate - 80%
Struvite/Magnesium - 15%
Uric Acid - 5%
Cystine - 2-5%

54
Q

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

A

The most common cause is not kidney stones

Retrograde spread from cystitis

55
Q

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

A

the most frequent drug treatment for bacterial cystitis or urethritis is erythromycin

it is trimethoprim sulfamethoxazole

56
Q

Used to treat a heparin overdose

A

Protamine

57
Q

Platelet aggregate inhibitor

A

Clopidagrel

58
Q

Dissolves an established clot

A

streptokinase

59
Q

antagonized by vitamin K

A

Warfarin

60
Q

actions are similar to heparin

A

Enoxaparin

61
Q

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

A

Must alkalinize the urine pH to dissolve

Must acidify struvite

62
Q

Woman with enlarged thyroid, chronically nervous, weight loss, high thyroxine (T4), mostly likely has

DeQuervain thyroiditis
Graves disease
Hashimoto disease
Nodular goiter
Toxic nodule
A

Graves disease

63
Q

Graves disease

A

autoimmune

agonist of thyroid receptor

64
Q

DeQuervain thyroiditis

A

subacute granulomatous thyroiditis, viral, painful,

self limited

65
Q

Hashimoto disease

A 
auto-immune
causes hypothyroidism (with some hyper beforehand)
66
Q

Nodular goiter

A

low iodine levels

67
Q

Most appropriate treatment for hyperthyroidism lady, Graves disease

T3 supplements
T4 supplements
Antiserum for TSH
beta blocker and radioactive iodine

A

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

68
Q

Hours after thyoidectomy, the patient has severe muscle spasms, anxious, and depressed. Low calcium in blood, what happened

A

Inadvertent removal of parathyroid glands during thyroid surgery

69
Q

Man with hypercalcemia, constipation, anorexia, weakness and kidney stones

Pulmonary metastatic carcinoma
Multiple myeloma
Thyroid hyperplasia
Parathyroid adenoma

A

Parathyroid adenoma

70
Q

Acromegaly

Parathyroid adenoma
hypothalamus infarct
anterior pituitary adenoma
posterior pituitary insufficiency 
Cushing's disease
A

anterior pituitary adenoma

71
Q

Main effect of parathyroid adenoma

A

increased serum calcium

72
Q

effect of hypothalamus infarct

A

shuts down blood to hypothalamus and anterior pituitary

decreases hormone release

73
Q

effects of anterior pituitary adenoma

A

increase in TSH, LH, FSH, Prolactin, GH, ACTH

74
Q

Posterior pituitary insufficiency

A

less oxytocin and ADH

75
Q

Cushing’s disease

A 
Increase cortisol
increased ACTH 
caused by pituitary adenoma
moon face
buffalo hump
76
Q

Hypertension, headaches, flushing, nervousness, increased catecholamines, right adrenal mass.

A

Pheochromocytoma

77
Q

Neuroblastoma

A

Catecholamines possible

Usually in children

78
Q

Normal range of HbA1c

A

4-5.6%

79
Q

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

A

Infections of periodontal tissues
and Treatment can normalize HbA1c levels

He has diabetes, but don’t know which

80
Q

Addison’s disease

A

Adrenal gland does not produce as much cortical steroids

81
Q

Which favor type 2 diabetes over type 1

Age less than 15
Experiences polydipsia and polyphagia
Serum insulins is normal
Thin rather than obese

A

Serum insulin is normal

82
Q

Type I diabetes

A

Be cells don’t work
Ketoacidosis
need insulin to treat

83
Q

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

A

Promotes glucose uptake in kidney cells - nope

Every cell but kidney, RBC, Neurons, Retina and lens

84
Q

Insulin receptors are resistant to activation by insulin

A

type II diabetes

gestational

85
Q

Diuresis

A

all types of diabetes (including gestational and insipidus)

86
Q

Severe abnormal lipid metabolism

A

type I diabetes

87
Q

no insulin

A

type diabetes

88
Q

increased thirst

A

all diabetes

89
Q

Long-term increased risk of atherosclerosis and hypertension

A

Type I and II

90
Q

Increased risk of major periodontal disease

A

Type I
type II
Gestational diabetes

91
Q

Lispro

A

Rapid onset and early peak action insulin

92
Q

metformin

A

a biguanide that decreases glucose production in the liver

93
Q

acarbose

A

slows digestion and absorption of starch and disaccharides from intestines

94
Q

tolbutamide

A

a sulfonylurea that increases the release of insulin from beta cells

95
Q

orlistat

A

diminishes fat absorption in intestines

96
Q

rosiglitazone

A

reduces insulin resistance in muscle cells

97
Q

Which weight reduction drug is thought to suppress appetite by stimulating the 5HT2c receptors in they hypothalamus

Glucagon
Phentermine
Qsymia (topiramate)
Lorcaserin

A

Lorcaserin

98
Q

Glucagon

A

pancreas
increase gluconeogenesis
increase glycogenolysis
weight loss

99
Q

Phentermine

A

inhibits NE and DA uptake

weight loss

100
Q

Lorcaserin

A

Suppresses appetite in hypothalamus

weight loss

101
Q

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

A

All are right but - association with weight gain

associated with weight loss

102
Q

Which is a monoclonal antibody to treat excessive bone resorption

Alendronate
Denosumab
Thiazide diuretics
Calcitonin

A

Denosumab

103
Q

Alendronate

A

a bisphosphonate, inhibits osteoclasts

104
Q

Thiazide diuretics

A

decreased renal secretion of calcium

105
Q

Calcitonin

A

secreted by thyroid gland, C cells
gets Ca from blood to bone
not an antibody

106
Q

Legal limit of alcohol percent

A

0.08%

107
Q 
Sedation and slower reaction
Impaired motor and slurred speech
Emissis and stupor
Comma
Respiratory dysfunction and death
A 
.05 - .1
.1-.2
.2-.3
.3-.4
more than .4
108
Q

Alcohol metabolized to what order of kinetics

A

zero-order

fixed rate - usually saturated

109
Q

Alcohol can cause which concentration in low doses

A

can increase HDL

110
Q

abrupt withdrawal from alcoholics can cause

A

seizures

111
Q

Men or women more sensitive to alcohol

A

women

112
Q

Freak bone break accident, most important questions before appointment

A

What medications are you taking

Do you have a history of osteopororsis or Pagets disease

113
Q

Bisphosphonates and bone/implants

A

can’t do them when on bisphosphonates

114
Q

Alendronate

A

bisphosphonate

Disease and Ther. Final (7 decks)

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