Mix14 Flashcards
What are common side effects of nondihydropyridine CCB?
Diltiazem and verapamil. Side effects include constipation, bradycardia, AV conduction block (neg chronotropic effect) and worsening of HF in patients with reduced LV function (neg inotropic effect).
How does acyclovir express some selectivity for virally infected cells?
Acyclovir is used to treat HSV. It goes into the cell and is monophosphorylated by the viral thymidine kinase. Cellular enzymes then convert the monophosphate product into acyclovir triphophosphate, which competes with deoxyguanosine triphosphate for viral DNA polymerase. DNA chain gets terminated when it gets incorporated.
Why do you always try to go below the inguinal ligament when obtaining venous access in the lower extremity during cardiac catheterization?
Want to avoid arterial puncture above the inguinal ligament because this can cause retroperitoneal hemorrhage.
This bleeding can’t be controlled and usually presents as hemodynamic instability with significant drop in BP, drop in Hb, and ipsilateral flank pain.
If giant cell (temporal) arteritis is suspected in a Pt, how would you test it?
Check C-reactive protein and ESR immediately. Although nonspecific, they are almost always elevated in GCA. Pt with characteristic symptoms and elevated ESR and CRP should undergo temporal artery biopsy for definitive Dx.
Rx = high dose corticosteroids prior to biopsy
What vessel does horseshoe kidney get caught on during its ascent?
IMA. Normally kidneys ascend to level of T12-L3 in adult.
For reference, SMA leaves the aorta around L1.
What part of the intestine is the primary site of Fe absorption?
Duodenum and proximal jejunum.
Growth hormone is secreted by the anterior pituitary and acts to promote bone, cartilage, and soft tissue growth by stimulating release of ___ from the liver.
IGF-1 (via a Jak-STAT pathway). Hypersecretion of GH before the fusion of the epiphyseal growth plates close»_space; gigantism.
What part of fetal circulation has the highest O2 content?
Most highly oxygenated blood in fetal circulation is the umbilical vein (directly from placenta), which empties directly into the IVC via the ductus venosus in order to bypass the hepatic circulation.
What’s Fick’s eq for calculating CO?
CO = Rate of O2 consumption/arteriovenous O2 diff.
Why would you see delayed rather than immediate bleeding after procedures in Pt with Hemophilia?
In hemophilia patients, they have normal platelet function and can form an initial platelet plug. This accounts for the delayed bleeding. Pt with platelet deficiencies on the other hand show immediate bleeding after trauma/surgery.
LPS (lipid A) in bacterial infections can cause macrophage activation and release of what inflammatory mediators?
Mac activation»_space; release of IL1, IL6, and TNFa.
This is the virulence factor responsible for bacteremia and septic shock.
Molluscum contagiousum is caused by what pathogen?
DNA Pox virus. Presents as smooth, whitish or skin colored, firm, somewhat pearly papule with an area of central umbilication.
If a Pt presents with a chancroid with a deep, painful ulcer with ragged borders that are assoc with a grey exudate and inguinal lymphadenopathy, then what bug should you consider?
Haemophilus ducreyi
Why should nonselective B-blockers be avoided in DM patients?
nonselective B blockers like propanlol, timolol, and nadalol can all inhibit NE/Epi mediated compensatory rxns to hypoglycemia. Blockade of B2 AR inhibits hepatic gluconeogenesis and peripheral glycogenolysis and lipolysis.
Selective B1 blockers and B blockers with intrinsic sympathomimetic activity (pindolol and acebutolol) are preferred in diabetics because they have minimal effect on glucose metabolism.
What is a potential life threatening toxicity of zidovudine?
Zidovudine = NRTI for treating HIV. Can cause BM suppression.
