mixed deck 04/08

Question 1

Atrial natriuretic peptide

Answer 1

Kidney
-ANP dilates AFFERENT arterioles increasing the glomerular filtration rate and the urinary excretion of sodium and water. it also limits Na reabsorption in the PT and inhibits renin secretion

Adrenal gland:
ANP restricrits aldosterone secretion

Blood vessels:
ANP relaxes smooth muscle

Question 2

volatile anesthetics

Answer 2

increase cerebral blood flow

Question 3

drug metabolized by first order kinetics, to reach stready state

Answer 3

the steady state concentration is reached in 4-5 half lives, 95%

Question 4

most effective agents for the treament of hypertriglyceridemia?

Answer 4

niacin and fibrates

Question 5

insulin secretion

Answer 5

para and sympathetic nerves innervate the beta islet cells of the pancrease

• parasympathetic activation is respinsible for insulin secretion and is induced by the smell or sight of food.
• stimulate alpha receptor inhibit insulin
• stimulate beta receptors stimulate insulin sectretion
• phenoxybenzamine is a long acting alpha blocker

since epi can bind to both alpha and beta, use an alpha blocker to allow more epi to bind to beta receptor and reults in an increase in insulin secretion

Question 6

juvenile hemangiomas

Answer 6

intially grow grow then regress usually by 7

Question 7

Tricyclic antidepressants toxicity

Answer 7

they have a quinidine like effect (class 1a) on the cardiac conduction system, potentially causing QRS and QT prolongation and cardiac dysrhythmias. These effects are due to inhibiton of fast sodium channels.

in a cardio toxicity due to TCA overdose treat with NaHCO3 to correct the QRS prolongation, reverse hypotension and treat the ventricular dysrhythmia

Question 8

cerebral vascular spasm following SAH

Answer 8

calcium channel blocker nimodipine

Question 9

MVP

Answer 9

is most often caused by defects in mitral valve CONNECTIVE TISSUE proteins that predispose to myxomatous degerenation

Question 10

Linezolid used to treat gram positive bacteria VRE and MRSA butttttt watch out! its a weak MAO inhibitor

Answer 10

seretonin syndrome!

1. neuromuscular excitation:hyperflexia, clonus, myoclonus, rigidity
2. autonomic stimulation:hyperthermia, tachycardia, diaphoresis and tremor
3. altered mental status: agitation and confusion

Question 11

xanthelasma

Answer 11

xanthoma usually found on the medial eyelids

-hyperlipidemia or dyslipidemia