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Imhotep > RX Flash 255 > Flashcards

RX Flash 255 Flashcards

1
Q

A 5-alpha-reducatase inhibitor that inhibits the conversion of testosterone to DHT

A
  • Finasteride
  • Prevents further growth of the prostate that has been sensitized by elevated estradiol levels
  • SIDE EFFECT= Hair growth
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2
Q

Shared side-effect of Flutamide, ketoconazole, and spironolactone

A

Gynecomastia

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3
Q

Can lead to decreased salivation, lacrimation, urination (bad for BPH), defecation, and peristalsis in GI

A

ANTI-HISTAMINES

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4
Q

In polycystic ovarian syndrome what can be used to prevent hirsutism?

A

Spironolactone and ketoconazole

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5
Q
  • Inhibit phosphodiesterase→increase in cGMP
  • Treats ED
  • Loss of blue-green color vision
A

Sildenafil and vardenafil

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6
Q

PIG-A Gene

A
  • Helps to produce glycophosphatidylinositol (GPI)

- Defective in PNH (paroxysmal nocturnal hemoglobinuria)

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7
Q

CD59 (membrane attack complex inhibitory factor) and CD55 (decay accelerating factor)

A

-Without GPI on RBCs (lost in PNH), these two complement inhibitors are missing→hemolysis of red blood cells ensues

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8
Q

Can exacerbate volume expansion and cause pulmonary edema. Thus it is contraindicated in CHF

A

-Mannitol

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9
Q
  • HTN

- Diabetes insipidus (nephrogenic) unresponsive to ADH

A

HCTZ

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10
Q

HCTZ adverse effects

A
  • Hypochloremic metabolic alkalosis, Hypokalemia, Hyperuricemia, Hyponatremia
  • Contra: sulfa allergy, history of diabetes, hypersensitivity reactions
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11
Q

Mental retardation, facial dysmorphisms, cardiac defects, thrombocytopenia, and TRIGONOCEPHALY (premature fusion of the metopic suture)

A

Jacobsen’s syndrome

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12
Q

Jacobsen’s syndrome

A

CCG trinucleotide

Chromosome 11

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13
Q

Fragile X Trinucleotide Repeat

A
  • CGG

- Most common cause of inherited mental retardation second to Down’s Syndrome

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14
Q

Myotonic dystrophy associated trinucleotide repeat

A

CTG on chromosome 19 (AD)

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15
Q

Friedreich’s Ataxia (AR)

A
  • Pyramidal, dorsal and spinocerebeller tracts affected

- GAA repeat on chromosome 9

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16
Q
  • Weakness of upper extremities (intrinsic hand and wrist extensors)
  • Atrophy of facial muscles (characteristic facies)
  • Presents in late childhood with GAIT abnormalities
A

Myotonic dystrophy (AD)

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17
Q

Reflex bradycardia effect of norepinephrine

A

NE→increased VR to heart→increased SV→heart no longer needs to beat as fast to maintain sufficient cardiac output→reflex decrease in HR

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18
Q

A splice-site mutation in gene intron 16 is one of the mutations….

A

On CFTR that can cause CF, but it is not the most common

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19
Q

Inferior vena cava compression

A
  • 3rd trimester
  • Big ole’ uterus compresses IVC
  • SLEEP ON LEFT SIDE or PILLOW UNDER THE HIP
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20
Q
  • High PTT
  • Easy bruising and epistaxis
  • Menorrhagia
  • Primary hemostasis (prolonged bleeding immediately after trauma invasive procedure)
A

vWD presentation (AD)

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21
Q
  • Post trauma and surgery show appropriate hemostasis
  • Later exhibit hemorrhage into joints (hemarthrosis), muscle compartments (compartment syndrome), or intracranially SECONDARY hemostasis
A

Hemophiliacs (hemophilia A and B)

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22
Q
  • Inactivation of factors V and VIII normally carried out by protein C
  • Prothrombotic if deficient
A

Protein C

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23
Q

Factor XIIIa’s function?

A
  • Crosslink the alpha and gamma chains of fibrin→reinforce fibrin plug
  • Can form a clot without but inadequate to maintain hemostasis
  • Detected with 5M urea
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24
Q

What is detected with 5M urea?

A
  • XIIIa deficiency

- 5M can solubilize clots that have not been cross –linked

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25
Q

How is factor XIIIa activated?

A

-By thrombin in the presence of calcium

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26
Q

11B-Hydroxylase deficiencies

A
  • 11-deoxycorticosterone builds up (the precursor)
  • Acts as a weak mineralocorticoid, HYPERtension, and salt retention
  • Masculinization (androgen build up)
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27
Q

17alpha-Hydroxylase deficiencies

A
  • Blocks glucocorticoid and sex hormone production→excess aldosterone (mineral corticoids)
  • Hypertension
  • Default female gender (lack of mullerian-inhibiting factor)
  • Immature female phenotype
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28
Q

Hold on more…CF patients also susceptible to

A
  • Pseudomonas aeruginosa and Burkholderia Cepacia

- Cause obstruction and dilation of bronchi (bronchiectasis)

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29
Q

The most common cause of lung abscesses

A

-Staph Aureus

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30
Q

Antiphospholipid antibodies react to what in VDRL positive (syphilis)

A

-Cardiolipin

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31
Q 
Irregular boarders
Ulcerations
Radial and vertical growth
Origin= neural crest cells
Sun exposed locations
A

Malignant melanoma

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32
Q

Phases of ALL treatment

A

1) Induction
2) Consolidation
3) Maintenance
4) CNS prophylaxis

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33
Q

Induction therapy for ALL 4 drug regime

A

1) STEROID (prednisone or dexamethasone)
2) Asparaginase
3) Doxorubicin/Duanorubicin
4) Vincristine

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34
Q

Phenelzine

A
  • MOA inhibitor rarely used
  • ADRs: HTN crisis, subarachnoid hemorrhage, stroke in patients who consume tyramine-containing foods (red wine, aged cheese, liver)
  • Tyramine= vasoactive
  • Tyramine on MOA inhibitor is not adequately metabolized→ Drastic increase in BP and HTN crisis
  • Serotonin storm if taken with meperidine, SSRI or TCA
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35
Q

Lithium ADRs

A
  • Diarrhea
  • Edema
  • Weight GAIN
  • Hypothyroidism
  • Nephrogenic diabetes insipidus
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36
Q

Venlafaxine (heterocyclic antidepressant) ADRs

A
  • Anxiety
  • Agitation
  • H/A
  • Weight loss
  • Insomnia
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37
Q

Best first line treatment for a patient with persistent a-fib in the presence of structural heart damage (mitral stenosis→enlarged left atrium)

A

-Metoprolol (beta1-seletive antagonist)

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38
Q
  • QT prolongation
  • Lupus-like syndrome (slow acetylators)
  • Arrhythmias
  • HYPOtension
  • N/V
A

Procainamide (Class Ia antiarrhythmic) ADRs

39
Q

Propafenone

A
  • Class Ic antiarrhythmic
  • NO EFFECT ON PHASE 3 repolarization or on the AP duration
  • Last resort for SVT and V-fib that progress to ventricular fibrillation
  • Do NOT use in post MI or structural heart damage
40
Q
  • Hepatotoxicity
  • Blue-grey photodermatitis
  • Bradycardia
  • Heart block
  • Pulmonary fibrosis
  • Hypo or Hyperthyroidism
A

AMIODARONE (Class III antiarrhythmic)

41
Q

Requirements for Amiodarone

A

MONITOR: pulmonary, liver, and thyroid function tests frequently

42
Q

Warfarin Overdose w/ symptoms antidote

A

Fresh frozen plasma

43
Q

Warfarin Overdose w/out symptoms

A

Vitamin K

44
Q

What acts as a carrier for factor VIII?

A

vWF (protects from hepatic clearance)

45
Q
  • Low levels of factor VIII
  • Qualitative or quantitative deficiency of vWF
  • It can be mild with increased bleeding with menses or with dental procedures
  • Or it can be severe and mimic hemophilia
  • Prolonged PTT
A

Von Willebrand Disease

46
Q

Factor IX deficient

A
  • Severely deficient→Hemophilia B/Christmas disease that is clinically identical to hemophilia A
  • Tx: Recombinant factor IX
47
Q
  • Emergent IV Diazepam

- Note: can start patient on phenytoin too (prophylaxis for SE)

A

Status Epilepticus Tx

48
Q

Phenytoin and Valproic acid

-Can also be used for tx of simple and complex partial seizures

A

First line treatment for tonic clonic seizures

49
Q
  • Gingival hyperplasia
  • Eosinophilia
  • Megaloblastic anemia via B9 (folate deficiency)
  • Teratogenesis
  • Systemic SLE-like symptoms
A

Adverse effects of phenytoin

50
Q

Phenytoin MOA (CLASS Ib antiarrhythmic)

A
  • Blocks Na+ channels

- Use dependent effect→altering conductance and transmission of the epileptic focus

51
Q

Ethambutol mechanism of action

A

Inhibition of polymerization of cell wall precursors

52
Q

Heparin MOA

A
  • Catalyzing the activation of antithrombin III

- Prevents further clot formation but does NOT break down existing clots

53
Q

Inhibit the ADP pathway involved in the binding of fibrinogen to platelets during aggregation

A

Clopidogrel and Ticlopidine

54
Q

Petechiae

A

Think Thrombocytopenia

55
Q

Common sites of tophus formation in gout

A
  • Achilles tendon

- Helix of the external ear

56
Q
  • Bind tubulin→ inhibits microtubule polymerization
  • Blocks mitosis as well as neutrophil migration
  • 2nd line tx of ACUTE gout due to low therapeutic window and risk of toxicity
  • GI upset and diarrhea in 80% of people
A

Colchicine MOA and facts

57
Q
  • ANGII receptor inhibitor
  • HTN tx and delay progression of diabetic nephropathy
  • Moderately potent uricosuric effect thus can be used in chronic gout but not first line
A

Losartan

58
Q
  • Canned goods (duh) and SMOKED FISH

- Toxin cleaves SYNAPTOBREVIN, snap25, synaptin (?) (preventing release of acetylcholine)

A

Botulism

59
Q

OH DANG (loop diuretics) ADRs

A 
Ototoxicity
Hypokalemia
Dehydration
Allergy (sulfa) and metabolic alkalosis
Nephritis (interstitial) 
Gout
60
Q
  • Indirect Bilirubin elevated
  • Decreased hematocrit
  • Lactate dehydrogenase INCREASED
  • Normal PT and PTT
  • Schistocytes on smear
A

TTP

61
Q
  • HSM
  • Chipmunk face (extramedullary hematopoiesis)
  • Blood transfusions since birth
  • Increased HbF (alpha2gamma2)
  • Increased HbA2 (alpha2delta2)
  • Absence of HbA1 (alpha2beta2)…in minor it is decreased but not absent
A

Beta Thalassemia MAJOR (Cooley’s anemia)

62
Q

Beta thalassemia minor = mild protective effect against what?

A

Plasmodium falciparum

63
Q

Common cause of death of Beta Thal Major

A

Cardiac failure secondary to hemochromatosis

64
Q

ASD murmur

A

Wide and fixed S2

65
Q

PDA murmur

A

Continuous machine like murmur that is loudest at S2

66
Q

Congenital absence of Vas Deferens

A

CF patient

Infertility not sterility

67
Q

LAD (leukocyte adhesion deficiency)

A

LFA-1 integrin (CD18) defect
Recurrent bacterial infections with no pus
Delayed separation of the umbilicus at birth

68
Q

Abetalipoproteinemia (AR)

A
  • Hereditary inability to synthesize lipoproteins due to …
  • Apo B100 and B48
  • Failure to thrive, steatorrhea, acanthocytosis (spur cell), NIGHT blindness and ataxia
69
Q

Zinc Finger

A
  • Zinc atom bound to four cysteine amino acids

- Steroid receptors

70
Q

Histological findings of Craniopharyngioma

A

Cystic spaces filled with motor oil-like fluid; cholesterol clefts; calcifications

71
Q

Histological findings of pituitary adenoma

A

Sheets of lactotrophs, acidophilic staining

72
Q

Hypothyroidism, Growth failure, DIABETES insipidus, supratentorial tumor

A

-Craniopharyngioma

73
Q

Adverse effects of haloperidol → acute dystonia

A

Benztropine (or other anticholinergic agents)

74
Q

Acanthocytes (spur cells) are associated with…

A

Abetalipoproteinemia and liver disease

75
Q

Target cells associated with…

A

Thalessemia, liver disease, HbC disease, and asplenia

76
Q

Bochdalek Hernia

A

Abdominal contents herniate into thorax

77
Q

Foregut is the embryonic precursors to…

A
  • Lungs, esophagus, stomach, duodenum, liver, gallbladder, and part of pancreas
  • Celiac trunk is arterial supply
78
Q

Polyhydramnios is common in (weird)

A

Congenital diaphragmatic hernia

79
Q

What is considered a high anion gap? (Na-HCO3-Cl)

A

> 12mmol/L

80
Q

TTP and Legionella

A

Legionella can cross-react with ADAMTS13→TTP

81
Q

Legionella pneumophila infection culture

A
  • Buffered charcoal yeast extract agar with iron and cysteine
  • Typical gram stain shows large neutrophils but no organisms
82
Q

Laryngeal carcinoma most common modifiable risk

A
  • Alcohol

- Smoking (greatest)

83
Q

Benign laryngeal polyps on true vocal cords

A

-HPV 6 and 11

84
Q

Squamous cell carcinoma is the most common cancer of …

A

Head and neck (heavy alcohol and tobaccy use)

85
Q

Amphotericin B 4 ADRs

A

1) Renal toxicity
2) Acute febrile reaction (shaking and chills w/ infusion)
3) Anemia
4) Phlebitis

86
Q 
Hot as a hare
Dry as a bone
Red as a Beat 
Blind as a Bat
Mad as a hatter
A

Anti-muscarinic side effects:

87
Q

Mental status changes, HYPOtension, and anticholinergic (flushing, hyperthermia, dilated pupils, intestinal ileus, and urinary retention)

A

Classic Sings of TCA overdose

88
Q

Mechanism of TCAs (amitriptyline and imipramine)

A

Inhibit neuronal reuptake of NE and serotonin in the central nervous system

89
Q
  • Misinterpretation that other people’s (often famous) statements or actions or neutral objects in the environment are directed towards oneself, when of course they are not
  • The notion that everything one perceives in the world relates to one’s own destiny
A

Idea of reference

90
Q

Atherosclerosis associated aortic dissection

A
  • DESCENDING AORTA or AORTIC ARCH

- Smoking, HTN, Diabetes, Hyperlipidemia, middle aged or older

91
Q

Aortic Dissection in Marfan’s

A

-Cystic medial necrosis

92
Q

Marfan’s Characteristics

A
  • Pectus excavatum
  • Hyperextensible joints
  • Tall
  • Long fingers
  • MVP and aortic aneurysms
  • Ectopia Lentis (up and out)
  • Hyperextensible joints
93
Q

ED (Ehlers-Danlos Syndrome)

A

Joint hypermobility, skin hyperelasticity, easy bruising and tissue weakness
Type IV collagen is most common

94
Q

New-onset of seizures in an HIV patient with a CD4 count less than 100?

A

Toxoplasmosis

  • Ring-enhancing lesion
  • Encephalitis (seizures or focal neurological defects)
  • Chorioretinitis (eye pain)

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