NMBE 15 Flashcards
Zanamivir MOA
inhibits neuraminadase
Zanamivir use
influenza
Fomepizole uses?
methanol and ethyne glycol poisoning
How does fomepizole work?
Competitively inhibits alcohol dehydrogenase (which converts ethanol to acetaldehyde and is involved in the first steps of converting methanol and ethylyne glycol to their toxic metabolites
if someone comes in with ethylyne glycol or methanol poisoning, what should you give them?
fomepizole
presentation of methanol toxicity
decreased level of consciousness, poor coordination, vomiting, abdominal pain, and a specific smell on the breath. Decreased vision.
how does lithium cause nephrotoxicity?
enters principal cells in collecting duct and prevents ADH from working properly
What is a normal A-a gradient oxygen?
Around 10
will barbituate induced respiratory suppression effect the A-a gradient?
No -the alveoli themselves are fine but there is hypoventilation leading to decreased O2 and increased CO2
Where is folate absorbed?
duodenum and jejunum
Where is B12 absorbed?
ileum
what keeps the ductus arteriosis open?
prostaglandins (especially E2)
why does the ductus arteriosis close after birth?
PE2 which was produced by the placenta is gone -> closure
Why does deoxygenated blood can carry more carbon dioxide for a given Pco2 than oxygenated blood?
Because Deoxyhemoglobin is a better H buffer
CO2 + H2O → H2CO3 → H+ + HCO3−
The enhanced affinity of deoxyhb for the H means that it will stabilized it, and the equation will shift to the right, allowing more CO2 to be bound
What causes the dissociation of CO2 from hemoglobin in the lungs?
oxygen binds and induces a conformational change, promoting the release of CO2
What is IkB?
inhibitory protein that binds Nfkb. When phosphorylated, it releases it so that NFKB can go to the nucleus.
loading dose formula?
load dose = desired (concentration)(Vd)/Bioavailability
what properties of inahled anesthetic lead to rapid onset?
low solubility in the blood
bosentan MOA?
Bosentan is a competitive antagonist of endothelin-1
endothelin function in the lungs?
causes constriction of pulmonary vessels
What is rheumatoid factor?
ats an igM autoantibody against igG
what lymph nodes does the cervix drain to?
internal iliac
alcoholism decreases which important liver enzyme?
glutathione
what does strep pneumonia look like on gram stain?
lancet shaped diplococci
wha does strep mitis look like on grain stain?
may be in long chains
what nerve innervates the inferior constrictor muscles?
motor fibers of vagus nerve
does the vagus nerve innervate all of the pharyngeal muscles?
all EXCEPT for stylopharyngeas which is innervated by the glossopharyngeal
where does HSV1 lay dormant?
the SENSORY ganglia of the trigeminal nerve
if a patient has bleeding after a progestin challenge test, what does that mean?
sufficient estrogen is present and the amenorhia is due to anovulation
where does degradation of very long chain fatty acids occur?
peroxisomes
what is volume contraction?
it refers to a decrease in body fluids - can be from loop/thiazide diuretics
what is medullary thyroid carcinoma?
cancer of the parafollicular (c cells) of the thyroid which secrete calcitonin
antibiotic treatment of salmonella results in what?
prolonged excretion of the organism
what kind of receptors do thyroxine (t4) and triodothyronine bind?
nuclear (they are HORMONES)
the adrenal medulla arises from the..
neural crest cells
when vit D is absorbed it first goes to the …..and then..
liver where it is converted to 25-OH(D) and then the kidenys wheres its converted to 1,25-OH(D)
carcinoid syndrome results in the secretion of …
serotonin
presentation of central retinal artery occlusion
acute-onset painless monocular vision loss, as well as the cherry red spot on physical exam
NO consensual light reflex in other eye
how is neuroathic pain described?
burning
an aneurism of the posterior communicating artery may result in what?
CNIII palsy
cytopenias are common in…
LUPUS
which kidney disease is associated with lupus?
diffuse proliferative glomerulonephritis
what commonly causes a furuncle?
S aureus
what effect will precocious puberty have on height?
at first they may grow quickly and be tall, but because their bones mature more quickly than normal, they often stop growing earlier than usual, making them shorter adults
CML is often treated with…
imatinib
having a burnt almond smell is classic of which poisoning?
cyanide
how to treat cyanide poisoning?
Nitrites-oxidize iron to fe3
what drugs is malignant hyperthermia associated with?
inhaled anesthetics or succinycholine
mutations in WHAT increases your risk of malignant hyperthermia?
ryr receptor
treatment of malignant hyperthermia?
dantrolene (blocks the release of Ca from the SR by blocking ryr receptors)
why does smoking make GERD worse?
nicotine relaxes the lower esophageal sphinctor
furthermore, it interferes with the gastric mucosa and acid production and thus is linked to stomach ulcers
what is irradiated blood products?
irradiation of blood products is done to prevent graft vs host diseaes
which type of blood products are commonly irradiated?
all granulocyte products, anything with lymphocytes, and tissue typed matched products
are albumin and immunoglobulins irradiated before being given to the receiver?
no they dont contain lymphocytes and dont risk host vs graft disease
what is graft vs host disease?
when the recipient cells view the receivers cells as foreign and attack them
