Quiz 4 Flashcards
What is Wilms tumor?
It is a nephroblastoma, a renal tumor found in children, and most common in first 3 years. It is the most common congenital tumor.
Disulfiram
Used to treat Alcoholism. Inhibits ALDH (aldehyde dehydrogenase) with resulting ↑ acetaldehyde after drinking. Abstinence is reinforced to avoid the resulting adverse reaction.
A fetus has severe oligohydramnios and bilateral enlarged kidneys by ultrasound. At birth, there is severe pulmonary hypoplasia, resulting in nearly immediate death. The kidneys are large, but have the normal renal shape. This baby is likely to have: A. Autosomal dominant polycystic renal disease. B. Autosomal recessive polycystic renal disease. C. Renal dysplasia.
B
What are the requirements for chronic bronchitis?
Persistent productive cough for 3 months in 2 consecutive years, and it is caused by smoking, air pollution and has hypersecretion of mucus by airways and infections are often secondarily present. If the mucus glands get expanded and reach greater than 40$ to the epithelium, than it suggests chronic bronchitis - Reid index.
What is primary and secondary hemostasis?
Primary involves platelets, • Typically initiated by injury • Adherence to subendothelium by interacting with von Willebrand factor - Secrete contents of granules • Aggregate with other platelets and form surface for coagulation cascade - Provide a procoagulant surface for the coagulation cascade Secondary involves the coagulation cascade-fibrin formation • Coagulation cascade (factors mostly made from liver) • Cascade of activating enzymatic conversions • Fibrin and platelet aggregates form stable clot a. Factors II, VII, IX and X are vitamin K-dependent-necessary for calcium binding sites activating coagulation cascade b. For final step thrombin catalyzes fibrinogen (soluble) to fibrin (insoluble) [note: thrombin acts at other levels of the cascade]. Fibrin cross-links form under the influence of Factor XIII
What are the pharmacokinetics behind alcohol?
It exhibits passive diffusion, gets everywhere, food slows its absorption, it is distributed everywhere, even through placental barrier and breast milk. it exhibits zero order kinetics, meaning constant rate, and independent of original concentration.
What is COPD?
Chronic Obstructive Pulmonary Disease. Includes emphysema, chronic bronchitis, asthma, bronchiectasis, and the main cause is cigarette smoke.
What can cause thrombocytopenia?
• Decreased bone marrow production • Hemodilution due to multiple transfusions • Immune reaction due to platelet autoantibodies directed at platelet surface proteins
What are the common organisms that cause pulmonary fungal infections?
Histoplasma (Ohio River Valley), Coccidiodes (Valley fever, Utah), Blastomycoses
What are some of the inherited coagulable states?
• Some aspect of cascade abnormal • Factor V Leiden-single nucleotide point mutation in coagulation factor V. Interferes with an anticoagulant factor, thus increasing formation of fibrin and becoming “prothrombic.” The mutation makes factor V resistant to cleavage and inactivation by activated protein C.
What are the basic tests used to evaluate hemostasis?
• Platelet count (part of CBC-complete blood count) Coagulation cascade: • Prothrombin time-PT (12-15 seconds). Extrinsic and common pathways through factor VII • Partial thromboplastin time-PTT. Measures intrinsic and common pathways and includes factors XII, XI, X, VIII • Fibrinolysis • Prolonged coagulation tests may be due to deficiency or inhibitor of a coagulation factor
What are some differences between inherited and acquired abnormalities in coagulation factors?
Inherited usually affect a single coagulation factor, Von-Willebrand disease (associated with factor VIII-get increased bleeding, hemophilia A and B. ), Hemophilia A (factor VIII) and B (factor IX - Christmas Disease): Have prolonged PTT and normal PT and platelet count: severe hemorrhaging internally/organs and soft tissue or into joints Acquired usually affect multiple coagulation factors, liver disease, vitamin K deficiency, DIC
How are influenza viruses classified and what are the main treatments?
They are classified by their core proteins, A, B, or C, species of origin, and geographic site of isolation. Most antiviral drugs for influenza have activity for influenza A. • Oseltamivir (Tamiflu)-prevents separation of virus particle from cell receptors, stopping viral spread—earlier treatment essential (can decrease the duration of flu 1-2 days)-works against type A and B flus.
A 31-year-old otherwise-healthy man presents with severe renal colic, with intermittent mild gross hematuria. He takes megadose vitamin C supplements. Abdominal films show a ureteral calculus. The stone is passed in the urine, and is analyzed chemically. What is the most likely composition? A. Urate. B. Cystine. C. Calcium oxalate. D. Struvite.
C
What does smoking do to alpha-1-antitrypsin?
It inhibits it, so trypsin goes uncontrolled and destroys particles in lungs and good tissue in lungs.
What are the main organisms that cause Community Acquired Pneumonia?
S. pneumoniae, H, influenzae, S. aureus.
Acamprosate
Used to treat Alcoholism. Weak antagonist of NMDA receptors, activator of GABAA receptors; may ↓ mild protracted abstinence syndromes with ↓ feelings of a “need” for alcohol.
What are the symptoms of urinary stones?
Renal Colic, hematuria, pyelonephritis, or asymptomatic
Dabigatran
Is an alternative drug for warfarin, has fewer side effects and is more popular than heparin or warfarin, it affects PTT sensitive pathway, but has unique mechanisms that makes it distinct from heparin and warfarin, used on out patient basis.
What do antimuscarinics do for Asthma?
During an asthma attack, ACh is released from the vagus nerve. Antimuscarinics like ipatroprium bromide reverses the contraction of airway smooth muscles and production of mucus caused in response to this vagal activity.
What are the main features of Benign Prostatic Hyperplasia?
• Very common in older men; 95% > 75 years old • Serious sequelae less common • Cause not well known; perhaps has to do with androgens or even estrogens • Urinary obstruction is common-bladder can’t empty completely • 10% require surgery to relieve
What does a prostatic massage reveal?
leukocytes
Albuterol
Fast acting reliever, the only true “rescue” reliever, acts within 15 minutes and is effective for 4-6 hours. directly relax airway smooth muscle and bronchodilate.
What is the difference between centrilobular emphysema and panacinar emphysema?
Cintrolobular is smoking-related, and panacinar is alpha-1-antitrypsin related.