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Imhotep > RX Flash 254 > Flashcards

RX Flash 254 Flashcards

1
Q

Vinblastine ADRs

A
  • Bone marrow suppression
  • HTN
  • Constipation
  • Muscle Cramps
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2
Q

What correlates to a better prognosis in breast cancer?

A

Estrogen (most) and progesterone receptors in breast cancer cells correlates to better prognosis

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3
Q
  • Common cause of blindness in AIDs
  • Rapidly diminishing sight
  • Loss of central vision with floaters and blind spots
  • Cotton-wool exudates
  • Necrotizing retinitis
  • Perivascular hemorrhages
  • RETINAL DETACHMENT
A

CMV retinitis

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4
Q

Cherry-red spot on the macula (due to the absence of ganglion cells within the fovea allowing the choroid’s normal color to show) are seen in…

A
  • Tay-Sachs
  • Niemann-Pick disease
  • Both lysosomal storage diseases
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5
Q

Acetylcholinesterase concentrations can test for …

A

-Neural tube defects and other anatomic abnormalities

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6
Q

TXA 2 (thromboxane A2)

A
  • Produced by platelets
  • Vasoconstriction
  • Platelet aggregation
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7
Q

Virchow Triad (3 factors that increase risk for DVT)

A
  • Stasis
  • Endothelial injury
  • Hypercoagulability
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8
Q
  • Inhibit the incorporation of cholesterol into micelles in the GI tract
  • Decrease overall amount of cholesterol absorbed
A

Phytosterols

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9
Q

Etoposide

A
  • Late S and early G2
  • Inhibits topoisomerase II (increased DNA degradation)
  • Testicular Cancer and SCLC
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10
Q

Etoposide ADRs

A
  • Tachycardia
  • N/V
  • SOB
  • Hematuria
  • Melena
  • Myelosuppression
  • Alopecia
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11
Q
  • Myelosuppression
  • Mucositis
  • Renal toxicity
  • Elevated renal enzymes
A

Methotrexate ADRs

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12
Q

Vinblastine Toxicity

A
  • Bone marrow suppression
  • Alopecia
  • SIADH
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13
Q

Ulcerative Stomatitis- N/V and diarrhea

A
  • Methotrexate (MTX)

- Pancytopenia also obviously seen

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14
Q 
Odansetron ADRs
-HA
-Malaise
-Constipation
But what is its use?
A
  • SSRI

- Used for antiemetic

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15
Q

Phosphatidylcholine (aka lecithin)

A
  • Dominate component of pulmonary surfactant
  • If pregnancy can be delayed: glucocorticoids to mother/fetus to induce surfactant production
  • If can not be delayed give EXOGENOUS phosphatidylcholine
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16
Q

Lecithin: sphingomyelin ratio

A

-A ratio less than 2 is associated with a high risk for neonatal respiratory distress syndrome

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17
Q

Cluster headaches symptoms:

A
  • LACRIMATION (wtf)
  • Conjunctival injection
  • Ptosis
  • Nasal Congestion
  • Abortive RX = O2
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18
Q

What symptoms are seen in migraines but NOT cluster headaches?

A
  • Nausea
  • Photophobia
  • Visual auras
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19
Q

What kind of headache can vertigo be seen in?

A

Basilar Type Migraine Headaches

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20
Q

What is the genetic predisposition to ALL? (Acute Lymphocytic Leukemia)

A

Chromosomal anomalies:
-Trisomy 21 and Klinefelter syndrome
Diseases with chromosomal fragility:
-Fanconi anemia, Bloom syndrome, Ataxia telangiectasia

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21
Q

ALL (acute lymphocytic leukemia) symptoms:

A

RAPID onset of all the symptoms of bone marrow suppression:
-Anemia→weakness
-Thrombocytopenia→Petechiae
LAD

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22
Q

Nonedemic Burkitt lymphoma subtype

A

Large abdominal mass

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23
Q

HIV→ non-Hodgkin lymphoma
HTLV→ Adult T-cell leukemia/lymphoma (ATLL)
Note: ATLL patients often present with SKIN LESIONS and with lytic bone lesions

A

T-lymphocyte cancers associated with Retroviruses

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24
Q

What does a positive Romberg sign indicate?

A
  • Problem with proprioception or vestibular apparatus
  • Dorsal columns/ MEDIAL LEMNISCUS TRACT
  • NOT cerebellar b/c motor coordination defects would be evident before and after the patient closes eyes
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25
Q

Tectospinal tract is responsible for…

A

-Head movements in response to visual signals

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26
Q

Nimodipine (DHP calcium channel blocker)

A

-MANAGEMENT of SUBARACHNOID induced VASOSPAM

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27
Q

Bronchodilation is mediated via Beta-2 and…

A

H1

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28
Q

IV drug user with leukopenia, index of suspicion should be high for…

A

AIDS

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29
Q

Nitroglycerin (low dose)

A
  • Venodilation→Decrease in VR→ Decrease in preload→ Decreased myocardial O2 demand
  • Tolerance to vasodilatory effects can occur: NITORGLYCERIN HOLIDAYS
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30
Q

Drugs that can cause LUPUS-LIKE SYNDROME: Anti-histone and ant-nuclear antibodies

A
  • Isoniazid
  • Quinidine
  • Minocycline
  • Valproate
  • Tetracycline (mind blown)
  • Hydralazine
  • PROCAINAMINE (antiarrhythmic)
  • Penicillamine
  • Sulfasalazine
31
Q

Postductal coarctation of the aorta is associated with a high risk of what?

A

-Bacterial endocarditis and cerebral hemorrhage

32
Q

What cells produces beta-interferon

A

-Connective tissue fibroblasts (used to treat MS)

Stimulate suppressor T-lymphocytes

33
Q

Alpha-Interferon uses?

A
  • Hep. B and C
  • Kaposi
  • Malignant melanoma
  • Certain Leukemias (hairy cell)
34
Q

Gamma-Interferon

A
  • Produced by T-lymphocytes
  • Activates tumoricidal macrophages
  • USED IN CGD patients
35
Q
  • Produced by T-lymphocytes
  • Activates tumoricidal macrophages
  • USED IN CGD patients
A

Gamma-Interferon

36
Q

CLL vs. SLL

A

Vary only in degree of peripheral lymphocytosis

>4,000 cells/mm3 = CLL

37
Q

What are the markers for CLL?

A

CD19, CD20 and CD23 (B-cell)

CD5 (Primitive B-cell but usually T-cells) ***

38
Q

Helper T-lymphocytes are involved in what leukemias?

A

ALL, T-lymphocyte non-Hodgkin’s lymphoma, and MYCOSIS FUNGOIDES

39
Q

Pearly boarders of fine telangiectasias

Tumor cells nests with PALISADING NUCLEI in the dermis

A

Basal Cell Carcinoma

40
Q
  • Monoclonal antibody against VEGF
  • Used to treat solid tumors (colon, breast, non-small cell lung)
  • Given in combo with 5-FU, Leucovorin, Oxaliplatin or Irinotecan
A

Bevacizumab

41
Q
  • Most common precancerous dermatosis

- Cytologic atypia with intercellular bridging

A

Actinic Keratosis

42
Q

What else is hypertrophic cardiomyopathy known as?

A

-IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS

Abnormally enlarged ventricular septum

43
Q
  • Tinnitus, N/V, and lethargy with fever and tachypnea
  • Mixed respiratory alkalosis-metabolic acidosis
  • Tx: ABCs and initial dose of activated charcoal (absorbs whatever is left in GI)
  • TX: Next step = alkalization of the plasma and urine is essential (use sodium bicarbonate)
  • Tx: monitor potassium and glucose levels
A

Aspirin Overdose

44
Q

Two injected treatments for age-related neovascular macular degeneration

A
  • Ranibizumab is an anti-VEGF monoclonal antibody (binds VEGF)
  • Pegaptanib is a pegylated anti-VEGF aptamer
  • Risks hypertension and elevated risk of bleeding
45
Q

Gold standard for Hodgkin lymphoma:

A

ABVD

  • Adriamycin (doxorubicin)→intercalates DNA
  • Bleomycin→ DNA breaks via inhibiting thymidine DNA strands
  • Vinblastine→ binds tubulin (inhibits microtubule assembly)
  • Dacarbazine→ alkylating agent
46
Q

Name the Anti-androgens that block androgen receptors in prostate

A
  • Flutamide
  • Bicalutamide
  • Nilutamide
  • Cyproterone acetate
47
Q

Direct acting vs. indirect sympathomimetics

A
  • Direct enter CNS less rapidly than indirect

- Direct have more selective receptor activity than indirect at postsynaptic

48
Q

L1 dermatome

A
  • At the level of inguinal ligament
  • Femoral triangle
  • Superolateral quadrant of the buttox
49
Q

Belly button

A

T10

50
Q

McBurney point dermatome

A

T12

51
Q

Xiphoid process

A

T7

52
Q

L4

A

-Kneecaps

53
Q

Melanoma associated mutations

A

-Chromosome 9 p16 gene of

54
Q
  • AR
  • Inborn error in methionine metabolism
  • Accumulation of homocysteine
  • Deficiency of enzyme cystathionine synthase
  • Subluxation of the lens (ectopia lentis)
  • Tall stature (tall and long thin limbs/ marfanoid habitus)
  • Similar to Marfan’s symptoms PLUS life threatening thromboembolic events
A

Homocystinuria

55
Q

Conduction aphasia

A
  • Only repetition is impaired

- Arcuate fasciculus

56
Q
  • Abnormal dilation of proximal and medium-size bronchi (>2mm in diameter)
  • Caused by destruction of elastic and muscular components of bronchial walls
  • Decreased breath sounds
  • Pleuritic chest pain
  • Order sputum culture and CT of chest
A

Bronchiectasis

57
Q

Bronchitis

A
  • Increased secretion/ hyperplasia of submucosal glands

- Reid Index > 0.4 indicated chronic bronchitis

58
Q

Abciximab use

A

Treat acute coronary syndromes if allergic to aspirin

59
Q

-Non-steroidal anti-androgen that acts competitively to inhibit androgens at the TESTOSTERONE receptor

A

Flutamide

60
Q

Fist signs of lead poisoning

A

-Intermittent vomiting, pain, and constipation
→Progress to ataxia, altered consciousness, coma, seizures, and encephalopathy
-Fucked up heme synthesis due to inhibition of several enzymes (aminolevulinic acid dehydratase→ build up of various products→ lead-induced porphyria

61
Q

Abortive therapy for migraine

A

Ergotamine and Sumatriptan

62
Q

Tension Headaches (AKA muscle contraction headaches)

A
  • Band-like pain encircling the head and no other associated symptoms
  • Tx: Acetaminophen or NSAIDs
  • TCA in refractory cases
63
Q
  • Band-like pain encircling the head and no other associated symptoms
  • Tx: Acetaminophen or NSAIDs
  • TCA in refractory cases
A

Tension Headaches (AKA muscle contraction headaches)

64
Q

Weakness of the eye muscles that may result in diplopia and/or nystagmus

A

Opthalmoplegia

65
Q

Irreversible condition, ANTEROGRADE amnesia, confabulation, and personality change

A

Korsakoff’s psychosis

66
Q

Where is the lesion in Wernicke-Korsakoff syndrome located?

A

Mammillary bodies

67
Q

Kluver-Bucy (hyperorality, hypersexuality, disinhibition) is bilateral lesions of the …

A

AMYGDALA

68
Q

Bleomycin ADRs

A

Pulmonary fibrosis
Stomatitis and Mucositis
Hyperpigmentation
(Good because causes very MINIMAL bone marrow suppression)

69
Q
  • High-pitched blowing diastolic murmur

- Wide pulse pressure

A

Murmur of Aortic Regurgitation

70
Q

Late diastolic murmur that follows an opening snap

A

Mitral stenosis

71
Q
  • HOLOSYSTOLIC BLOWING MURMUR

- Heard loudest at the apex

A

Mitral Regurgitation murmur

72
Q

What can be used to improve the efficacy of 5-FU even though 5-FU myelosuppression is irreversible?

A

LEUCOVORIN b/c it stabilizes the bond between thymidylate synthetase and 5-deoxyuracil monophosphate

73
Q

DRUG OF CHOICE FOR BPH

A

Finasteride (5-alpha-reducatase inhibitor) and /or Alpha1-ANTAGONISTS: TERAZOSIN (BPH too) or TAMUSULOSIN

Imhotep (11 decks)

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