Mix17 Flashcards
The portal triad runs through the hepatoduodenal ligament and is composed of:
hepatic artery, portal vein, common bile duct. The hepatoduodenal ligament is compressed in the Pringle maneuver during repair of traumatic liver injury with heavy bleeding.
Why could bosentan be used to help treat pulmonary artery hypertension?
Bosentan is an endothelin R antagonist that blocks the effects of endothelin (vasoconstrictor that stimulates endothelial proliferation)
What’s the drug of choice for paroxysmal supraventricular tachycardia?
Adenosine. Slows conduction through AV node by hyperpolarizing the nodal pacemaker.
Can cause flushing, chest burning, hypotension and AV block
What are 3 diff ways to treat cyanide toxicity (as from overuse of nitroprusside)?
- Direct binding of intracellular cyanide ions (hydroxycobalamin)
- Induction of methemeglobinemia (sodium nitrate)
- Detoxifying sulfur donors (sodium thiosulfate)
___ is a disease characterized by calcification of the rim of the hilar nodes (eggshell calcification) and also ^ susceptibility to TB infection:
silicosis. (Impairs Macs by preventing phagolysosome fusion)
Hindgut derivatives include the distal 1/3 of the transverse colon, descending colon, sigmoid colon, and the rectum. These structures receive their blood supply from the ___
IMA.
What’s the reason for the urge incontinence in normal pressure hydrocephalus?
Bladder control is achieved by the descending cortical fibers that run in the distended paraventricular area and project to the sacral micturition center. Loss of cortical inhibition (because periventricular white matter is distorted and pulls on the cortical fibers)»_space; development of urge incontinence.
Inheritance pattern of osteogenesis imperfecta:
AD. Defective collagen type I
Why is potassium citrate prescribed to prevent recurrent Ca2+ stones from forming?
A high urine citrate [ ] has stone preventing effects because citrate binds to free (ionized) Ca2+ , preventing precipitation and facilitating its excretion.
Inheritance pattern of sickle cell
AR
peau de orange rash is assoc with what type of cancer?
inflammatory breast cancer
What would you give to treat adrenal crisis/adrenal insufficiency?
Dexamethasone, along with aggressive fluid resuscitation.
People with adrenal insufficiency can’t produce glucocorticoids in response to acute stress.
Anemia in lead poisoning is due to inhibition of what 2 enzymes in the heme synth pathway?
ALA synthase and ferrocheletase
What could you give to someone to dissolve cholesterol gallstones in a Pt who doesn’t want surgery?
Hydrophilic bile acids (ursodeoxycholic acid) can be given to improve cholesterol solubility, reduce the amount of cholesterol secreted into bile, and ^^ biliary bile acid [ ]
What are the effects of estrogen and progesterone on bile acid secretion?
Estrogen ^ cholesterol secretion while progesterone decreases bile acid secretion»_space; bile to become supersaturated with cholesterol. Progesterone also slows gallbladder emptying»_space; bile stasis/gallstone formation.
What are the extrarenal manifestations of autosomal dominant polycystic kidney disease?
Formation of liver cysts and cerebral aneurysms.
What role does the “Vi” antigen play in Salmonella infection?
Vi antigen = capsule that prevents opsonization and phagocytosis of the bacteria
How does niacin improve hyperlipidemia?
Improves hyperlipidemia by decreasing hepatic synth of VLDL and triglycerides, and increasing synth of HDL.
BUT, it can cause flushing, hyperglycemia, and hepatotoxicity. Niacin can also decrease renal excretion of uric acid»_space; elevated uric acid blood levels and promotion of acute gouty arthritis.
Function of ezetimibe in cholesterol mgmt.:
selectively inhibits cholesterol reabsorption at small intestine brush border
Does DLCO increase or decrease in emphysema?
DLCO = diffusing lung capacity for carbon monoxide.
Decreases because there is a decrease in alveolar-capillary surface area due to the interalveolar wall destruction.
What’s the function of haptoglobin?
serum protein that binds free Hb and causes its uptake by the reticuloendothelial system (RES). Haptoglobin levels decrease when significant quantities of Hb are released into circulation (i.e. intravascular hemolysis)
Why is there a “nitrate free period” of the day in Pt taking long term daily acting nitrates?
Want to avoid tolerance. generally scheduled at night when cardiac work is lowest.
Why should Pt with G6PD avoid NSAID use?
NSAIDS uncouple Ox-phos and can cause glutathione depletion with subsequent lipid peroxidation»_space; damage in tubular and vascular endothelial cells. Chronic use can cause chronic interstitial nephritis as they concentrate in the renal medulla.
Note: NSAIDS can also prevent prostaglandin synth»_space; constriction of medullary vasa recta»_space; ischemic papillary necrosis
Superior sulcus (Pancoast) tumors can cause shoulder pain due to compression of the ___ and Horner’s syndrome (ptosis, miosis, anhydrosis) due to compression of ____
brachial plexus and cervical sympathetic ganglia
What would you see on histology of Hashimoto’s?
Intense mononuclear infiltrate consisting of lymphocytes and plasma cells, often with germinal centers. Residual follicles are often surrounded by Hurthle cells (large oxyphilic cells with granular cytoplasm), which represent follicular epithelial cells that have undergone metaplastic change in response to inflammation.
Dapsone is an alternative Rx to TMP/SMX and can be used in people with sulfa allergies. What major side effect should you look out for with dapsone use?
Check for G6PD deficiency because dapsone puts oxidative stress on the body. Want to avoid hemolytic anemia.
