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Step 1 Clues > pp skin, mm, bone, Rheu > Flashcards

pp skin, mm, bone, Rheu Flashcards

1
Q

What are 1st degree burns?

A

Red (epidermis)

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2
Q

What are 2nd degree burns?

A

Blisters (hypodermis)

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3
Q

What are 3rd degree burns?

A

Painless neuropathy (dermis)

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4
Q

What diseases have palm and sole rashes?

A

“TRiCKSSS”
Toxic Shock Syndrome
Rocky Mountain spotted fever Coxsackie A:
Hand-Foot-Mouth disease Kawasaki
Scarlet fever
Staph Scaled Skin
Syphilis

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5
Q

What is Erythema Multiforme?

A

Target lesions (viral, drugs)

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6
Q

What is Stevens Johnson syndrome?

A

Erythema Multiforme Major (mouth, eye, vagina)

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7
Q

What is Toxic Epidermal Necrolysis?

A

Stevens Johnson w/ skin sloughing

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8
Q

What is Pemphigus vulgaris?

A

Ab against desmosomes => circular immunofluorescence, in epidermis, oral lesions, + Nikolsky sign

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9
Q

What is Bullous Pemphigoid?

A

Ab against hemidesmosomes => linear immunofluoresence, subepidermal, “floating” keratinocytes, eosinophils

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10
Q

What is Eczema?

A

Dry flaky dermatitis in flexor creases “itch that rashes”

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11
Q

What is Nummular dermatitis?

A

Circular eczema

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12
Q

What is Spongiotic eczema?

A

Weeping eczema: scratching causes oozing “like a sponge”

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13
Q

What is Lichenification?

A

Scratching => thick leathery skin

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14
Q

What is Pityriasis Rosea?

A

Herald patch that follows skin lines (Tx: sunlight) “C-mas tree pattern”

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15
Q

What is Lichen Planus?

A

Polygonal pruritic purple papules
Very itchy

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16
Q

What is Scabies?

A

Linear excoriation “burrows” in webs of fingers, toes, belt line (Sarcoptes scabies)

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17
Q

What does UV-A cause?

A

Aging

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18
Q

What does UV-B cause?

A

Burns and cancer

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19
Q

What are the ABCD’s that indicate worse prognosis of skin cancer?

A
  • Asymmetric
  • Irregular Borders
  • Color differences
  • > 4mm Diameter
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20
Q

What does the Clark level tell you?

A

Invasion of melanoma

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21
Q

What does Breslow’s classification tell you?

A

Depth of melanoma

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22
Q

Where are Malignant
Melanomas usually found?

A

Males: back Females: leg

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23
Q

What is the precursor of a Malignant Melanoma?

A

Hutchison’s freckle

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24
Q

What are the types of Malignant Melanomas?

A

Superficial spreading: most common, flat brown

Nodular: worst prognosis, black, dome- shape

Lentigo maligna melanoma: elderly pts, fair-skin

Acral lentigous: AIDS pts, dark skin

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25
Q

Where are Squamous Cell carcinomas usually found?

A

Flat flaky stuff on lower face, keratin pearls

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26
Q

What is the precursor of Squamous Cell carcinoma?

A

Actinic keratosis (red scaly plaque)

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27
Q

What are the types of Squamous Cell carcinoma?

A

Bowen’s disease: SCC in situ on uncircumcised penis dorsum
Verrucous carcinoma: wart on foot

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28
Q

Where are Basal Cell carcinomas usually found?

A

Pearly papules on upper face, palisading nuclei, good prognosis

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29
Q

What are the types of Basal Cell carcinomas?

A

Nodular: waxy nodule w/ central necrosis
Superficial: red scaly plaques, like eczema
Pigmented: looks like melanoma
Sclerosing: yellow waxy plaques

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30
Q

What is Acne Rosacea?

A

Blush all the time, worse w/ stress/alcohol

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31
Q

What is a Brown Recluse Spider Bite?

A

Painful black necrotic lesion

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32
Q

What is Cellulitis?

A

Warm red skin

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33
Q

What is Cutaneous Anthrax?

A

Painless black necrotic lesion

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34
Q

What is a Decubitus Ulcer?

A

Bedsore

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35
Q

What is a DVT?

A

Blood clot in veins, associated w/ hypercoagulable state

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36
Q

What is Erysipelas?

A

Shiny red, raised, does not blanch, usually on face, assoc w/ Strep pyogenes

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37
Q

What is Icthyosis?

A

Gradual lizard skin

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38
Q

What is Miliaria?

A

“Heat rash”: burning, itching papules on trunk

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39
Q

What is Molluscum Contagiosum?

A

Fleshy papules w/ central dimple, pox virus (can be STI)

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40
Q

What is Psoriasis?

A

Silver scales on extensors, nail pitting, differentiated too fast, worse w/ stress
* Auspitz sign: remove scale =>
pinpoint bleeding
* Koebner’s phenomenon: lesions at
sites of skin trauma

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41
Q

What is a Pyogenic Granuloma?

A

Vascular nodule at site of previous injury

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42
Q

What is Seborrheic Dermatitis?

A

Dandruff in eyebrows, nose, behind ears

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43
Q

What is Seborrheic Keratosis?

A

Rubbery warts with aging, greasy

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44
Q

What is Thrombophlebitis?

A

Vein inflammation w/ thrombus

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45
Q

What is Vitiligo?

A

White patches, anti-melanocyte Ab

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46
Q

What is Xeroderma Pigmentosa?

A

Bad DNA repair

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47
Q

What is Erythema Chronicum

A

Lyme disease (solitary lesion that spreads)

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48
Q

What is Erythema Infectiosum?

A

Fifth disease “slapped cheeks” due
to Parvovirus B19

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49
Q

What is Erythema Marginatum?

A

Rheumatic fever (red margins)

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50
Q

What is Erythema Multiforme?

A

Target lesions due to HSV,
Phenytoin, Barbs, Sulfas

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51
Q

What is Erythema Multiforme Major?

A

Stevens Johnson syndrome (> 1 mucosal surface)

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52
Q

What is Erythema Nodosum?

A

Fat inflammation (painful red nodules on legs), sarcoidosis

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53
Q

Where is CK-MB found?

A

Heart

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54
Q

Where is CK-MM found?

A

Muscle

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55
Q

Where is CK-BB found?

A

Brain

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56
Q

Why should you wait 30min after a meal before swimming?

A

All blood in gut and skeletal mm. have ran out of ATP

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57
Q

How does a neurogenic muscle disease present?

A

Distal weakness + fasiculations

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58
Q

How does a myopathic muscle disease present?

A

Proximal weakness + pain

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59
Q

What is a light chain composed of?

A

Actin

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60
Q

What is a heavy chain composed of?

A

Myosin

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61
Q

What band of the sarcomere does not change length?

A

A band

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62
Q

Where are the T-tubules located?

A

Cardiac muscle: Z line
Skeletal muscle: A-I
junction

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63
Q

What is Duchenne’s MD?

A

Dystrophin frameshift, Gower sign, calf pseudohypertrophy

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64
Q

What is Becker’s MD?

A

Dystrophin missense, sx >5 y/o

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65
Q

What is Myotonic Dystrophy?

A

Bird’s beak face, can’t let go when shake hands

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66
Q

What is Myasthenic syndrome = Lambert-Eaton?

A

Gets stronger as day goes by, stronger w/ EMG, not small cell CA associated

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67
Q

What is Myasthenia gravis?

A

Gets weaker as day goes, stronger w/ Edrophonium, weaker w/ EMG, rule out thymoma

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68
Q

What is Multiple sclerosis?

A

Anti-myelin Ab, young woman w/ vision problems, sx come &go

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69
Q

What is Metachromatic Leukodystrophy?

A

Arylsulfatase deficiency, kid with MS presentation

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70
Q

What is Ataxia Telangectasia?

A

Spider veins, IgA deficiency

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71
Q

What is Freidrich’s ataxia?

A

Retinitis pigmentosa, scoliosis

72
Q

What is Adrenal Leukodystrophy?

A

Carnitine shuttle problem, adrenal failure

73
Q

What is Guillane-Barre?

A

Ascending paralysis, 2 wk after URI

74
Q

What is ALS?

A

Middle age male w/ fasiculations, descending paralysis, no sensory problems

75
Q

What is Werdnig-Hoffman?

A

Fasciculations in a newborn, no anterior horns

76
Q

What is Polio?

A

Asymmetric fasiculations in child, 2 wk after gastroenteritis

77
Q

What is Choreoathetosis?

A

Dance-like movements, wringing of hands, quivering voice

78
Q

What is Atonic cerebral palsy?

A

No muscle tone, floppy

79
Q

What is Slipped Capital femoral Epiphysis?

A

Obese boys w/ dull achy pain in the hip and a limp

80
Q

What is Legg-Calves-Perthes?

A

Limp (femur head avascular necrosis)

81
Q

What is Osgood-Schlatter?

A

Knee pain (tibial tubercle
avascular necrosis)

82
Q

What is Septic arthritis?

A

Joint pain (Staph aureus) with fever

83
Q

What is Ankylosing Spondylitis?

A

Ligament ossification => vertebral body fusion, ↓lumbar curve, stiffer in morning, kyphosis, uveitis, HLAB-27

84
Q

What is Cauda Equina Syndrome?

A

“Saddle anesthesia”: can’t feel butt, thighs, perineum

85
Q

Where does bone cancer metastasis occur from?

A

Breast, prostate, lung, kidney

86
Q

What is Costochondritis?

A

Painful swelling of chest joint- bone attachments, worse w/ deep breath

87
Q

What is Disk Herniation?

A

Straight leg raise => shooting pain

88
Q

What is Lumbar Stenosis?

A

MRI “hourglass”, low back pain

89
Q

What is Ochronosis = Alkaptonuria?

A

Kids w/ OA, black urine, homogentisic acid oxidase deficiency

90
Q

What is Osteitis Fibrosis cystica?

A

Inflammation of bone w/ holes due to high PTN

91
Q

What is Osteogenesis Imperfecta?

A

Blue sclera, multiple broken bones

92
Q

What is Osteomalacia = Rickets?

A

Soft bones (waddling gait)
Craniotabes (soft skull)
Rachitic rosary (costochondral thickening)
Harrison’s groove
Pigeon breast (sternum protrusion)

93
Q

What is Osteomyelitis?

A

Infected bones

94
Q

What is Osteonecrosis = Legg- Calve- Perthes?

A

Wedge-shaped necrosis of femur head

95
Q

What is Osteopenia?

A

Lost bone mass

96
Q

What is Osteopetrosis?

A

↓Osteoclast activity => marble
bones (obliterate own bone
marrow)

97
Q

What is Osteoporosis?

A

Loss of bone matrix (not calcification) => compression fractures

98
Q

What is Osteosclerosis?

A

Thick bones from scarring

99
Q

What is Paget’s Disease?

A

“My hat doesn’t fit”, paramyxovirus, ↑osteoclasts/blasts, fluffy bone, osteosarcoma, ↑CO heart failure, deafness, ↑alkaline phosphatase alone

100
Q

what is Rheumatoid Factor?

A

An IgM against IgG Fc

101
Q

What are Tophi?

A

Gout crystals + giant cells

102
Q

What is Podagra?

A

Big toe inflammation from gout

103
Q

What is CREST syndrome?

A

Calcinoss
Raynaud’s
Esophageal dysmotility
Sclerodactyly
Telangiectasia

104
Q

What Ab is associated with CREST?

A

Anti-centromere Ab

105
Q

What diseases have Raynaud’s syndrome?

A
  • Scleroderma
  • Takayasu’s
  • RA
  • SLE
106
Q

What platelet count do most types of vasculitis have?

A

Low platelets

107
Q

Which vasculitis has a high platelet count?

A

Kawasaki disease

108
Q

Which vasculitis has a normal platelet count?

A

Henoch-Schönlein purpura

109
Q

What is Osteoarthritis?

A

Pain worse w/ activity, PIP/DIP joints

110
Q

What is Rheumatoid Arthritis?

A

Pain worse in morning, MCP/PIP joints

111
Q

What is Stills’ Disease?

A

Juvenile RA

112
Q

What is Pseudogout?

A

Pyrophosphate crystals in knees/wrists

113
Q

What is Gout?

A

Urate crystals in big toe, (-) birefringence

114
Q

What is Myositis?

A

1 muscle hurts

115
Q

What is Polymyositis?

A

> 1 muscle hurts

116
Q

What is Dermatomyositis?

A

Myositis + rash

117
Q

What is Fibromyalgia

A

Hurt all the time, 11 trigger points

118
Q

What is Polymyalgia Rheumatica?

A

Weak shoulders, temporal arteritis

119
Q

What is SLE = Lupus?

A

Meet 4 criteria: “DOPAMIN RASH”
Discoid rash
Oral ulcers
Photosensitivity
Arthritis
Malar rash
Immunologic disorder: Anti-ds DNA, antiSmith,
Cardiolipin Ab
Neurologic disorder: seizure or psychosis
Renal failure: die of this
ANA
Serositis: pleuritis/pericarditis (Libman-
Hemolytic anemia
Sacks endocarditis)

120
Q

What is Scleroderma?

A

Tight skin, fibrosis
CREST
Esophageal dysmotility due to dilation

121
Q

What is Takayasu’s Arteritis?

A

Asian women with weak pulse, aorta inflammation

122
Q

What is Polyarteritis Nodosa?

A

p-ANCA Ab, attacks gut/kidney, Hep B

123
Q

What is Wegener’s Granulomatosis?

A

c-ANCA Ab, attacks ENT, lungs, kidney

124
Q

What is Goodpasture’s?

A

Anti-GBM Ab, attacks lung/kidney, RPGN

125
Q

What is Reiter’s syndrome?

A

Males that can’t see, pee, or climb a tree

126
Q

What is Sjögren’s syndrome?

A

Females that have dry eyes/mouth, RA

127
Q

What is Behçet’s syndrome?

A

Oral and genital ulcers, uveitis

128
Q

What is Churg-Strauss?

A

Asthma, eosinophils, multi-organ involved

129
Q

Any permanent neurological damage suffered PRIOR to the age of 21 years

A

Cerebral Palsy

130
Q
  • No muscle tone
  • Frontal cortex is involved
  • Involves corticospinal tract (CST)
A

Atonic

131
Q

Dance-like movements. Basal ganglia is
involved.

A

Choreoathetosis

132
Q

Kernicterus is most common in a
newborn

A

buildup of bilirubin
choreoathetosis

133
Q

2 bugs that manifest spastic Hemiplegia

A

Toxo–parietal lobe
Herpes- temporal lobe

134
Q

midline cortical problem
Legs are worse than arms

A

Spastic Diplegia

135
Q

condition Involving the cortical white matter early Adrenal gland failure (electrolyte
imbalances i.e., aldosterone)

A

adrenoleukodystrophy

136
Q

Increased incidence of Retinitis
Pigmentosa, Scoliosis, and Hypertrophic Cardiomyopathy

A

Friedreich’s Ataxia

137
Q

cerebellar, DNA breakage, cancer, malabsorption, spider veins

A

Ataxia-Telangiectasia

138
Q

Enterovirus that hides in the dorsal root ganglion (DRG)

A

polio

139
Q

Two weeks following a gastroenteritis asymmetrical paralysis

A

polio

140
Q

Fasciculations in a newborn Floppy baby
Congenital anterior horn degeneration

A

Werdnig Hoffman’s Disease

141
Q

Fasciculations in a middle-aged man
Descending paralysis

A

Amyotrophic Lateral Sclerosis (ALS)

142
Q

Upper and Lower Motor Neuron Disease
NO sensory neuron involvement

A

ALS

143
Q

when is plasmapheresis used in autoimmune neuropathies

A

respiratory compromise

144
Q

when is IV gamma globulins used in autoimmune neuropathies

A

significant weakness

145
Q

RX for autoimmune neuropathies early in dx

A

steroids

146
Q

middle-aged female with visual disturbance
CN 5 is commonly involved

A

MS

147
Q

attack MLF, internuclear ophthalmoplegia, optic neuritis

A

MS/metachromatic leukodystrophy

148
Q

arylsufatase enzyme def. in 5-10 yo

A

demyelination of neurons
Metachromatic leukodystrophy

149
Q

atropine and pralidoxime indication

A

organophosphate poisoning

150
Q

anticholinergic: Atropine use for

A

heart blocks and dry up secretion b4 surgery

151
Q

glycopyrrolate indication (Anticholinergic)

A

dry up lungs secretions b4 surgery

152
Q

anticholinergic: benztropine indication

A

parkinson and dystonia

153
Q

use for COPD bc they do not dry up secretions

A

ipratropium
Tiotropium

154
Q

mc mucolytic

A

Guaifenesin
N-acetylcysteine

155
Q

Reversible ACH inhibitor

A

Edrophonium(DX of MG)
Neostigmine (RX of myasthenia Gravis)

156
Q

paraneoplastic syndrome that is a presynaptic Ca2+ channel blocker

A

Lambert Eaton

157
Q

Edinger-westphal nucleus damaged by syphillis

A

eye accommodate but slow to react

158
Q

glove and stocking distribution of neuropathy is due to

A

sorbitol accumulation

159
Q

ascending paralysis with anemia post gastroenteritis

A

GB dt campylobacter jejuni

160
Q

Birds beak facial appearance and hand spasm and slow to release shaked hands

A

myotonic dystrophy

161
Q

Nonsense and frameshift mutations disease occurrence

A

early in life

162
Q

missense mutation disease occurrence

A

late onset

163
Q

Becker’s and duchenne’s inheritance patterns

A

x-linked recessive

164
Q

Chronic pain treatment

A

Amitriptyline (best for fibromyalgia)
Gabapentin
Carbamazepine

165
Q

what modulates pain signal

A

serotonin

166
Q

pain inhibition

A

GABA

167
Q

mcc causes of myositis and polymyositis

A

hypothyroidism/Cushing’s syndrome and drugs

168
Q

autoimmune cause of myositis and polymyositis

A

JO-1

169
Q

infectious cause of myositis and polymyositis

A

Trichinella spiralis
Taenia Solium

170
Q

Drugs that block ADH and correct

A

Conivaptan or Tolvaptan
does not decrease mortality

171
Q

Aldo blockers (decrease mortality)

A

Eplerenone
spironolactone(block 5-a-reductase–gynecomastia)

172
Q

decrease mortality in pt only if BP can tolerate (high BP)

A

Beta blocker: metoprolol, Bisoprolol and carvedilol

173
Q

decrease TPR, increase Bradykinin, Angioedema

A

ACE-I/ARBs

174
Q

inhibit neprilysin to increase ANP

A

Sacubitril

175
Q

Digitalis Toxicity RX

A

Digibind and Digifab

176
Q

MOA of Digitalis

A

block the K on the Na/K pump
slurring QRS dt k leaking out

177
Q

2 mean causes of Digit toxicity

A

more likely to depolarize

hypercalcemia and hypokalemia

Step 1 Clues (27 decks)

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