NBME 18 Flashcards
ENDOTHELIN
Vasoconstrictor in Pulmonary arterial hypertension
Bosentan - Endothelin-1 antagonist used in treatment of PAH
Increased 17-hydroxyprogesterone and hyperkalemia
21-hydroxylase deficiency
Statins upregulate
Transcription of HMG0CoA reductase - adaptive cellular response
COPD
Decreased endothelial nitric oxide synthase production
24,25 dihydroxycholecalciferol
Storage from of vitamin D
Increased serum calcium –> increased storage for (24,25) AND decreased active (1,25)
Chronic kidney disease effect on kidney
Secondary hyperparathyroidism
Decreased Vitamin D synthesis –> decreased serum calcium –> increase PTH, PO4-, and all those. HCO3-decreases
Diphenhydramine
H1 blocker (ranitidine is H2)
Has anti-muscarinic effects = motion sickness/nausea
Anti-alpha adrenergic
CCK release
I cells (duodenum, jejunum)
Increased by fatty acids, amino acids
Acts on neural muscarinic pathways to cause pancreatic secretion.
Somatostatin
Released by D cells (pancreatic islets, GI mucosa)
Decreases gastric acid and pepsinogen secretion, pancreatic and small intestine fluiid secretion, gallbladder contraction, insulin and glucagon release
Increased by by acid
Decreased by vagal stimulation
Inhibits secretion of various hormones. Octreotide is an analog used to treat acromegaly, carcinoid syndrome, and variceal bleeding.
Secretin
Released by S cells in Duodenum
Increased bicarb and bile acid secretion, decrease acid secretion
Cyclophosphamide
Alkylating agent - ant-cancer drug
AE’s: Hemorrhagic cystitis, SIADH, myelosuppression
Cyclosporine
Calcineurin inhibitor - blocks T cell activation and prevents IL-2 transcription
Used in transplant patients
AE’s: Nephrotoxic, neurotoxic, gingival hyperplasia, hirsutism, HTN, hyperlipidemia.
Tacrilomus
Similar to cyclosporine - Calcineurin inhibitor - binds FK506
NO gingival hyperplasia or hirsutism
HIGHLY nephrotoxic
Relation and germ cell origin of 3rd/4th branchial puches
Superior parathyroids - 4th pouch
Inferior parathyroids - 3rd pouch (with thymus)
4th pouch ends up ABOVE 3rd pouch
Myelofibrosis
Obliteration of bone marrow with fibbrosis due to increased fibroblast activity.
Often associated with massive splenomegaly and “teardrop” RBCs
Dry tap