Pharm and week 2 review (8/18) Flashcards
Half life equation
t half= 0.7* Vd/ CL
Where is elastase produced in the lungs?
Macrophages and neutrophils
balanced by serum and tissue protease inhibitors
What is the effect of excess elastase activity in the lungs?
emphysema
paramesonephric duct is also called
mullerian duct
Law of conservation of mass
total flow=flow velocity x cross section area=constant
IL-12 does what?
stimulate Th1–> IFN gamma, IL-2–> macs and CD8 t cells
breakdown of odd chain FA, branched chain aa (valine, isoleucine), threonine, methionine leads to production of what?
propionic acid
can eventually enter TCA cycle as succinyl CoA
CGG repeat
Fragile X
Hypermethylation of FMR1 gene
Cystic hygroma and bilateral extremity swelling with decreased femoral pulses in a baby
Turners syndrome
loss fo paternal X
Reactive arthritis signs and symptoms
Can’t pee, Can’t see, can’t climb a tree + sacroilitis (HLA-B27 association)
Psychosis during depressed episode
Major depressive disorder w/ psychotic features
Psychotic symptoms +/- mood disorder
Schizoaffective disorder
Dystrophic calcification
Ca deposition in abnormal (injured or necrotic) tissues
localized calcification (aortic stenosis)
Nl levels of Ca
damage can be from aging
local calcification of abnl tissue with normal Ca levels
Dystrophic calcification
Canagliflozin
SGLT2 inhibitor that blocks reabs of glucose in PCT
Contraindication for SGLT2
Renal impairment
what is in the femoral ring?
Lymphatics coming out of femoral canal
what is in the femoral sheath?
Femoral artery, vein, lymphatics
from lateral to medial what is the femoral triangle
Nerve, Artery, Vein, lymphatics (NAVeL)
effects of a chronic AV shunt on the heart
increased CO output
decreased total peripheral resistance
increased mean systemic pressure (renal retention)
Acute AV shunt no change in mean systemic pressure
Effects of pulmonary fibrosis on breathing?
rapid shallow breaths
increase elastic resistance
Immune SE of corticosteroids
Neutrophilia–> demargination
Immunosuppression
Increased risk of infection
Fever, generalized lymphadenopathy, facial edema, skin rash, eosinophilia + drugs
Drug reaction with eosinophilia and systemic symptoms (DRESS)
phenytoin, allopurinol, sulfonimides
2-8 wks after
Viral reassortment
only in segmented viruses BOAR Bunyavirus Orthomyxovirus Arenavirus Reovirus
mutation in hemochromatosis
C282Y on HFE gene–> increases iron absorption in intestines
decreases hepatocyte hepcidin synthesis
HLA-A3
parotid gland hypertrophy with low body weight
Anorexia of the binging and purging flavor
parotid gland hypertrophy with normal body weight
Bulimia
Majority of OD deaths
opioids
Reaction formation
responding in a manner opposite one’s actual feelings
Tx for mycobacterium avium
Azithromycin + rifavutin or ethambutol
fever, wt loss, diarrhea, anemia, hepatosplenomegaly, elevated alkaline phosphatase and lactate dehydrogenase, bacteria grows well at high temp
Mycobacterium avium
CD4 count
Proglitazone MOA
PPAR gamma binding
nuclear transcription regulator increases insulin sensitivity
tx for essential tremor
propranolol
Thiopental
Barbiturate
short acting general anesthetic
high lipid solubility so rapidly redistributed from brain to skeletal muscle and fat
cause of SE from Niacin
Prostaglandins (PGD2 and PGE2) cause flushing, warmth, itching
tx: aspirin
Diuretic that improves survival in pts with CHF + decreased EF
SPIRONOLACTONE
k sparing and improved remodeling of ventricles
Chlordiazepoxide
Benzo used for alcohol withdrawal
Chlorthalidone
Thiazide
Metabolic effects of Thiazide
HyperGLUC Glycemia Lipidemia (decreased insulin secretion increased resistance) Uricemia Calcemia
Hypo natremia –> inhibition of Na/Cl in DCT
Hypokalemia–> K wasting
patient with treated symptomatic coronary artery dz with myopathy
statin induced myopathy
esp when used with vibrates or niacin
SE of CCB
Peripheral edema, dizziness or lightheadedness, constipation
Amlodipine
CCB that acts on vascular SM
tx for HTN
Triamterene
diuretic
blocks Na+ channels in cortical collecting tubule
K sparing
tx for trauma pt who is obtunded with HTN
Mannitol
Tx for decompensated systolic HF
beta blocker (carvedilol) decrease work and after load
beta blocker treatment for glaucoma
decrease aqueous production by ciliary epithelium
Tx for Psoriasis that activates a nuclear transcription factor
Topical Vit D analogs
calcipotriene, calcitriol, tacalcitol
Calcipotriene
Tx for psoriasis
activates a nuclear transcription factor
inhibit keratinocyte proliferation and stimulate keratinocyte differentiation
SE of glyburide
hypoglycemia
sulfonyurea (inhibit ATP depends K channels in beta cells leading to exocytosis of insulin)
SE of long term use of omeprazole
decreased Ca abs–> osteoporotic hip fracture
decrease serum Mg+
Ribavirin MOA
interfere with duplication of viral genetic material
SE of mu opioid (morphine)
smooth muscle contraction of the sphincter of Oddi
increases common bile duct pressure
also addiction, constipation, pin point pupils
effect of rat poison
super warfarin (brodifacoum)
deplete vitamin K clotting factors–> like warfarin toxicity
Tx: FFP
Medial hypertrophy in lung vessels, intimal fibrosis, luminal narrowing
Idiopathic pulmonary arterial HTN–BMPR2 gene
TX for pulmonary arterial HTN
Bosetan
endothelin receptor antagonist
vasodilator–> decreases PA pressure and decreases hypertrophy
interstitial myocardial granuloma with plump macrophages and increased cytoplasm.
Aschoff bodies with anitschkow cells
Rheumatic fever–> young kid with myocarditis
Fibular neck fracture
injured common peroneal n.
PED= Peroneal Everts and Dorsiflexes
Foot dropPED
Knee trauma
Tibial n. injury
TIP
Tibial Inverts and Plantarflexes
can’t stand on TIP toes
RA antibodies
Anti-CCP (anti-cyclic citrullinated peptide) Rheumatory factor (IgM anti IgG)
disease frequency in hardy weinberg
q^2
Interferon alpha and beta
Interfere with viruses
prime uninfected cells for viral defense
halt protein synthesis in uninfected cells
Interferon gamma
Th1 differentiation, increased expression of class II MHC APC, Improves intracellular killing by macs
produced by T cells and NK cells
Cause of pulses paradoxus with no pericardia effusion or constrictive pericarditis
Asthma and COPD
Down regulation of gastric acid production?
Intestinal infuence
peptide YY binds ECL
somatostatin and prostaglandins
Dyspnea, tachypnea, prolonged expiration, bilateral wheezing
obstructive pulmonary disease exacerbation
Tx; Beta agonist increases cAMP
Carbon tetrachloride
Free radical injury to liver (H2O2)
lipid per oxidation
where are intracranial schwannomas located?
cerebellopontine angle–> between cerebellum and lateral pons
Buprenorphine
partial opioid agonist
precipitates withdrawal
Uncle herniation effects
Down and out (oculomotor nerve palsy) Blown pupil (dilated pupil)