mixed deck 04/09 Flashcards
Familial dyslipiedemias
type 1: hyperchylomicronemia
Autosomal recessive
Deficiency: Lipotprotein lipase or apoliprotein C-II
Specifically in this case, lipoprotein lipase issue
The body is unable to clear dietary lipid loads due to defective hydrolysis of triglycerides in chylomicrons
- hyperlipidemia
- panceatisis
- lipemia retinalis
- eruptive skin xanthomas
- hepatosplenomegaly
- Tg >1000 increased risk for pancreatitis
in normal people heparin release endothelium-bound lipase, but with lipoprotein lipase deficiency, heparin induced lipoprotein lipase activity is significantly reduced
Heparin not as readily known affect?
- releases endothelium bound lipase’s
- encourage the clearance of TG’s from the circulation
classic features for secondary (reactivation) tuberculosis
-cough, hemoptysis, weight loss, acid fast bacilli on sputum culture and a cavitary UPPER lobe pulmonary lesion on chest X-ray
Primary TB
occurs when a patient inhales aerosolized M.tuberculosis
- organisms are depositied in the lower lung fields and phagocytosed by alveolar macrophages
- the mycobacteria proliferate within the macrophages until TH1 lmphocytes can activate the macrophages
- the infection then is wall off and eliminated if small enough
- if large enough the necrotic area , TV can survive in a dormant state without causing disease or symptoms.
- later in life when the patient is immunosupressed, by drugs or HIV the patient can establish a caviatry infection in the upper lobes.
Tryptase
-released by mast cell degranulation and is relatively specific for mast cells, so it is used as a marker of mast cell activation
degranulation of mast cells is accomplished by the cross-linking of multiple membrane-bound IgE antibodies by a specific antigen. This recults in the aggregation of IgE-Fc receptors on the mast cell surface, which produces various intracellular cascades that ultimately cause mast cell degranulation
adverse effect of beta blocks on patients with asthma and COPD
nonspecific beta andrenergic blockade can result in increased difficulty with breathing due to B2 block causing vasoconstriction
verenicline
partial agonist of the nicotine receptor, stimulate the a4b2 nicotonic acetyl choline receptor
- partial agonist –> reduces symptoms of nicotine withdrawal by myild stimulation
- since partial it only causes limited downstream release of DA resulting in less stimulation of reward pathway
thus reduces nicotine withdrawal, prevents nicotine from binding and inducing a reward response
n-acetylcysteine is a mucolytic agent used in the treatment of CF
-n-acetylcysteine works by cleaning the disulfide bonds within mucus gylcoproteins, thus loosening thick sputum
rifampin
inhibits DNA-dependant RNA synthesis thereby preventing transcription
some examples of molecules that activate platelets
thrombin, ADP, thromboxane A2 by cell surface receptors
dipyridamole and cilostazol
- decrease the activity of phosphodiesterase
- thus more cAMP
- more cAMP decreases platelet aggregation by preventing plately shape change and granule release
also note, cilostazol is also a direct arterial vasodilator
argatroban
is an antithombotic drug largely used in the treatment of heparing-induced thrombocytopenia, argatroban is a direct thrombin inhibitor
acute pacreatitis
80% are gallstones and alcoholism
the 20% are inheretied or acquired hypertriglyceridemia can cause acute pacreatitis if the serum level of triglycerides exceeds 1000 mg/dl
ghon complex
a lower lobe lesion (ghon) accompanied by ipsilateral hilar adenopathy (calcified lymph node)
-ghon complex occurs during initial infection with M-tuberculosis
primary spontaneous pneumothorax
-thought to result from rupture of apical subpleural blebs
tall thin males around the age of 20 are most commonly affected
