Path/Pharm Flashcards
histology apoptosis
eosinophilic cytoplasm and basophilic nucleus
DNA laddering
fragments in multiples of 180
indicator of apoptosis
BAX and BAK
pro apoptotic
extrinsic death receptor pathway
ligand (FasL/Fas) or TNF-alpha
defective Fas-FasL
autoimmune lymphoproliferative syndrome
histology coagulative necrosis
cell outlines with no nuclei
increase eosin
cause of fibrinoid necrosis
type III HSR
seen in vasculitis, pre-eclampsia, malignant HTN
histology fibrinoid necrosis
vessel walls and thick and pink
cause of cellular swelling
decrase ATP leads to decrease activity Na/K and Ca pumps
reperfusion
red infarct
damage from free radicals
associated conditions dystrophic calcification
TB, shistosomiasis, congenital CMV, toxo, rubella, CREST, psammoma bodies
margination and rolling
e-selectin from TNF and IL-1
p-selectin
CD34
tight binding
ICAM-1 and VCAM-1
decreased in decreased CD18
PDGF
secreted by activated platelets and macrophages
stimulates fibroblasts
FGF
angiogenesis
EGF
growth via tyrosine kinases
TGF-beta
angiogenesis and fibrosis
formation granuloma
Th1 secrete IFN gamma
macrophages secrete TNF alpha
hypercalcemia from granuloma
due to calcitriol
exudates
cloudy due to lymph obstruction, inflammation, malignancy
ESR
inflammation products coat RBCs and cause aggregation
secondary amyloidosis
in inflammatory conditions
fibrils of amyloid a
dialysis amyloidosis
beta 2
may present as carpal tunnel syndrome
familial amyloid polyneuropathies
due to transthyretin gene mutaiton
islet amyloid polypeptide
in T2DM
caused by deposition of amylin in pancreatic islets
cause of lipofuscin
oxidation and polymerization of autophagocytosed organellar membranes
hamartoma
disorganized growth in native location
choristoma
normal tissue in foreign location (Meckel)
acanthosis nigrans association
gastric adenocarcinoma and other visceral malignancies
insulin resistance and obesity
seborrheic keratoses
GI adenocarcinoma and other visceral malignancies
PTHrP paraneoplastic
squamous cell of head, neck, lung
renal, bladder, breast, and ovarian
incrase calcitriol paraneoplastic
lymphoma
increase EPO paraneoplastic
renal cell carcinoma, hepatocellular carcinoma, hemangioblastoma, pheo, leiomyoma
thymoma paraneoplastic
hypogammaglobulinemia (Good syndrome), pure red aplasia, migratory thrombophlebitis
anti-NMDA receptor encephalitis
ovarian teratoma
dancing eyes, dancing feet
neuroblastoma and small cell lung cancer
anti-Hu
small cell
breast
anti-Yo
Hodgkin lymphoma
anti-Tr
ALK
lung adenocarcinoma
BRAF
melanoma, non-Hodgkin, papillary thyroid
KRAS
GTPase
colon cancer, lung cancer, pancreatic cancer
mycl1
lung tumor
mycn
transcription factor
neuroblastoma
CDKN2A
blocks G1-S
melanoma and pancreatic cancer
DCC
colon cancer
DPC
pancreatic cancer
neurofibromin
NF1 (Ras GTPase activating)
PTEN
phosphatase of PIP3
breast cancer, prostate cancer, endometrial cancer
Li Fraumeni cancer
sarcoma, breast, leukemia, adrenal gland
TSC1
hamartin
TSC2
tuberin
VHL
inhibits hypoxia inducible factor 1a
WT1
regulates urogenital development (nephroblastoma)
HTLV1
adult T cell leukemia/lymphoma
psammoma bodies
papillary carcinoma of thyroid
serous papillary cystadenocarcinoma of ovary
meningioma
malignant mesothelioma
alpha fetoprotein
hepatocellular carcinoma, hepatoblastoma, yolk sac, mixed germ cell
p glycoprotein
multidrug resistance protein, seen in adrenocortical carcinoma
mediators of cachexia
TNF, IFN-gamma, IL-1, IL-6
carcinomas spread hematogenously
follicular thyroid
chorio
renal cell
hepatocellular
brain mets
lung>breast>melanoma, colon, kidney
at grey-white junction
liver
colon»stomach> pancreas
mixed bone met
breast
Km
inversely related to affinity
increase y intercept on Lineweaver
decrease Vmax
changes with competitive inhibitors
increase Km
decrease potency
irreversible competitive and noncompetitive
decrease Vmax
decrease efficacy
clearance
volume of plasma cleared of drug per unit time
rate/concentration=Vd(Ke)
half lives to reach steady state
4-5 half-lives
loading dose in renal and liver disease
decrease maintenance dose but loading dose is unchanged
permissive
presence of substance A required for full effects of substance B
cortisol and catecholamine
zero order elimination
constant amount of drug
phenytoin, ethanol, aspirin
first order elimination
directly proportional to drug concentration (fraction)
applies to most drugs
weak acids
phenobarbital, methotrexate, aspirin
trapped in basic
treat with bicarb to alkalinize urine
weak bases
amphetamines, TCAs
trapped in acidic
treat with ammonium to acidify urine
phase I
reduction, oxidation, hydrolysis
geriatric lose phase I
phase II
conjugation through methylation, glucuronidation, acetylation, sulfation making polar metabolites (slow acetylators have increased side effects)
increased in geriatric
left shifting potency
increased potency
decrease drug needed
therapeutic index
TD/ED
higher TI are safer
low TI-warfarin, theophylline, digoxin
nicotinic Ach receptors
ligand-gated Na/K channels
found in autonomic ganglia, adrenal medulla
muscarinic Ach receptors
G protein coupled receptors
beta 3
increase lipolysis, thermogenesis, bladder relaxation
Gs
dopamine receptors
si
D1 renal relaxation, direct in striatum
D2 inhibits direct in striatum
histamine receptors
qs
vasopressin
qs
V2 at tubules
NET
two ways
into vesicles and then out of vesicles once they have met NE into synaptic cleft
neostigmine
no CNS penetation
pyridostigmine
gets rid of myasthenia gravis
does not penetrate CNS
organophosphates (parathion)
irreversibly inhibit AchE
antidote-atropine and pralidoxime
glycopyrrolate
for preop secretion
drooling, peptic ulcer
muscarinic antagonists
hyoscyamine
antispasmodics for IBS
dobutamine
inotropic>chronotropic
dopamine
low dose beta, high dose alpha
midodrine
alpha1
causes hypotension
mirabegron
beta3
treat overactive bladder
ephedrine
releases stored catecholamines
indirect general agonist
reflex tachy
norepi
also increase PP and MAP
MAP decrease
isoproterenol
rebound hypertension with abrupt cessation
clonidine, guanfacine
alpha methyldopa adverse
direct coombs + hemolysis
SLE-like syndrome
phentolamine
reversible
mirtazapine
depression
increases serum cholesterol and appetite
net depressor effect
epinephrine and phentolamine
beta blockers in angina
decrease rate and contractility
beta blockers for variceal bleeding
nadolol, propranolol
dyslipidemia beta blocker
metoprolol
nebivolol
b1 with stimulation of b3 (activate nitric oxide synthase in the vasculature and decrease SVR)
teterotoxin
binds fast Na preventing depolarization
ciguatoxin
opens Na causing depolarization
leads to reversal hot/cold sensations, heart block, hypotension
scombroid poisoning
bacterial histidine decarboxylase converts histidine to histamine
mimics anaphylaxis
treatment arsenic
dimercaprol, succimer
beta blockers treatment
atropine, glucagon
cyanide treatment
nitrite+thiosulfate, hydroxocobalamin
lead treatment
EDTA, dimercaprol, succimer, penicillamine
methanol, ethylene glycol
fomepizole>ethanol, dialysis
causes coronary vasospasm
amphetamines, cocaine, ergot alkaloids, sumatriptan
cutaneous flushing causes
vancomycin, adenosine, niacin, nitrates, Ca channel blockers, echinocandins
causes hot flashes
tamoxifen, clomiphene
causes hyperglycemia
tacrolimus, protease inhibitors, niacins, HCTZ, corticosteroids
cause acute cholestatic hepatitis
erythromycin
focal to massive hepatic necrosis
halothane, amanita (death cap mushroom), valproic acid, acetaminophen
drugs cause hepatitis
rifampin, isoniazid, pyrazinamide, statins, fibrates
drugs cause pancreatitis
didanosine, corticosteroids, alcohol, valproic acid, azathioprine, diuretics
pill induced esophagitis
bisphosphonates, ferrous sulfate, NSAIDs, potassium chloride, tetracyclines
pseudomembranous colitis
ampicillin, cephalosporins, clindamycin, fluoroquinolones
CYP inducers
alcohol
St. John
phenytoin, phenobarbital, nevirapine, rifampin, griseofulvin, carbamazepine
sulfa drugs
sulfonamide, sulfasalazine, probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonylureas
agranulocytosis
clozapine, carbamazepine, propylthiouracil, methimazole, colchicine, ganciclovir
aplastic anemia
carbamazepine, methimazole, NSAIDs, benzene, chloramphenicol, propylthiouracil
DRESS
allopurinol, anticonvulsants, antibiotics, sulfa drugs
hemolysis in G6PD
isoniazid, sulfonamides, dapsone, primaquine, aspirin, ibuprofen, nitrofurantoin
megaloblastic anemia
hydroxyurea, phenytoin, methotrexate, sulfa drugs
gingival hyperplasia
phenytoin, Ca channel blockers, cyclosporine
hyperuricemia
pyrazinamide, thiazides, furosemide, niacin, cyclosporine
myopathy
statins, fibrates, niacin, colchicine, daptomycin, hydroxychloroquine, IFN-alpha, penicillamine, glucocorticoids
osteoporosis
corticosteroids, depot medroxyprogesterone acetate, GnRH agonists, aromatase inhibitors, anticonvulsants, heparin
photosensitivtiy
sulfonamides, amiodarone, tetracyclines, 5FU
rash-SJS
anti-epileptic, allopurinol, sulfa drugs, penicillin
SLE
sulfa drugs, hydralazine, isoniazid, procainamide, phenytoin, etanercept
parkinson like
antipsychotics, reserpine, metoclopramide
seizures
isoniazid (B6), bupropion, imipenem, tramadol, enflurane
fanconi syndrome
cisplatin, isofamide, expired tetracyclines, tenofovir
hemorrhagic cystitis
cyclophosphamide, ifosfamide
interstitial nephritis
penicillins, furosemide, NSAIDs, proton pump inhibitors, sulfa drugs
pulmonary fibrosis
methotrexate, nitrofurantoin, carmustine, bleomycin, busulfan, amiodarone
disulfuram like reaction
sulfonylureas, procarbazine, cephalosporins, griseofulvin, metronidazole
nephrotoxicity/ototoxicity
aminoglycosides, vancomycin, loop diuretics, cisplatin, ampho B