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Imhotep > RX FLASH 257 > Flashcards

RX FLASH 257 Flashcards

1
Q
  • Random plasma osmolality = up/concentrated/hypertonic
  • Random urine osmolality = down/hypo-osmolality/dilute (no ADH to concentrate urine)
  • Urine osmolality during water deprivation= no change
  • Urine osmolality after IV DDAVP= up/hyperosmolarity/concentrated
  • Plasma ADH= down (low ADH)
A

Central DI- THINK elderly lady w/hypernatremia and dilute urine

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2
Q
  • Random plasma osmolality = hypertonic/up
  • Random urine osmolality = hypotonic/dilute
  • Urine osmolality during water deprivation= no change
  • Urine osmolality after IV DDAVP= NO CHANGE (interstitial is not concentrated)
  • Plasma ADH= normal to increased
A

NEPRHOGENIC DI

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3
Q
  • Random plasma osmolality = Down/hypotonic/dilute
  • Random urine osmolality = down/ Dilute
  • Urine osmolality during water deprivation= Increased/Concentrated
  • Urine osmolality after IV DDAVP= Increased/ CONCENTRATED
  • Plasma ADH= Decreased
A

Primary polydipsia

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4
Q

Cluster A personality disorders

A

Paranoid
Schizoid
Schizotypal

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5
Q

Cluster A personality disorders associated illness

A

Schizophrenia

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6
Q

Cluster C personality disorders

A

Avoidant
Obsessive-compulsive
Dependent

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7
Q

Cluster C personality disorders associated illness

A

Anxiety disorder

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8
Q

Mood disorder and substance abuse are associated with what cluster of personality disorders?

A

Cluster B (histrionic, anti-social, borderline, narcissistic)

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9
Q
  • A thiazolidinedione that acts to sensitize peripheral tissues to insulin and increase target cell response
  • Not a mono therapy b/c does it does not compensate for insulin deficiency
A

Rosiglitazone

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10
Q

Glargine

A
  • Long-acting synthetic insulin that is used in combo w/ a short acting insulin (lispro)
  • Provides continuous baseline level of insulin in the blood
  • Feasible initial treatment for newly diagnosed type 1 diabetes mellitus
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11
Q

Only double stranded RNA virus known to infect humans

A

Reoviruses:
Coltivirus→Colorado tick fever
Rotavirus→ Gastroenteritis

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12
Q

ABCDE’s for melanoma

A 
Asymmetry
Borders (irregular)
Color Variation
Diameter >6mm
Elevation/Evolution
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13
Q

What happens to B12-Rproteins in the duodenum?

A

B12 is released from are Rproteins (via pancreatic enzymes)
B12 binds intrinsic factor
It is then endocytosed by enterocytes in the ILEUM

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14
Q

B12 Pernicious Anemia

A

Autoimmune→Loss of parietal cells (IF deficiency and chronic gastritis)
Autoimmune→Anti-bodies against IF

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15
Q

Negative Schilling Test in Pernicious Anemia

A

No radiolabeled cyanocobalamin seen in urine

IT WAS SHIT OUT

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16
Q

What cells are seen in non-Hodgkin’s lymphomas?

A

Neoplastic B cells

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17
Q

What neoplastic cells are seen in AML?

A

Myeloblasts

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18
Q

What are the neoplastic cells seen in Hodgkin disease?

A

Reed-Sternberg cells

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19
Q

What is the only non-Hodgkin’s lymphoma not associated with neoplastic B-lymphocytes?

A

Lymphoblastic lymphoma = T-lymphocytes

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20
Q

Typical have a greater risk than atypical anti-psychotics for what?

A 
EPS (extra-pyramidal symptoms)—Jaw or buccolingual spasms
ACUTE DYSTONIA (blockade of Dopa receptors in striatum)
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21
Q

What are the typical anti-psychotics?

A

1) Haloperidol (worst for acute dystonia due to potent Dopa antagonist w/ few anticholinergic effects)
2) Thioridazine
3) Chlorpromazine
4) Fluphenazine

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22
Q

Thioridazine (typical) ADRs

A
  • Retinal Pigmentation

- Cardiac affects→sudden death possible

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23
Q

What is used to treat neuroleptic-induced acute dystonia?

A
  • Anticholinergic agents/ acetylcholine receptors blockers

- BENZTROPINE

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24
Q
  • 1st generation H1 blocker
  • Can be used to treat acute dystonia (anticholinergic)
  • Also a competitive inhibitor of histamine
A

Diphenhydramine

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25
Q

Long term used of anti-psychotics

A

-Prolactin increased (due to Dopa block)
-Prolactin inhibits GnRH synthesis and release→ leads to low GnRH→low FSH and LH release from anterior pituitary
Thus a patient very well may present with amenorrhea

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26
Q
  • Acute onset hyperpyrexia
  • Sever pneumonia
  • Neutrophils
  • Shitty gram stain
A

Legionella pneumophila

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27
Q

Name 4 Class III (K+ blockers) antiarrhythmics (BIAS)

A
  • Bretylium
  • Ibutilide
  • AMIORDARONE
  • Sotalol
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28
Q

-Prolong phase III→ prolonged ERP

A

Class III (K+ blockers) antiarrhythmics affect what phase of myocyte action potential? How?

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29
Q

First-line agents for treatment of depression and are the preferred choice in patients who express suicidal ideation

A 
SSRIs
1) Fluoxetine
2) Paroxetine
3) Citalopram
4) Sertraline
Note: Effects take 4-6 weeks (8-12 in elderly)
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30
Q

ADRs of SSRIs

A
  • You suck at sex
  • You get pissed (lol)—agitation
  • Serotonin storm (careful with other serotonergic medications esp. MOAIs)
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31
Q
  • Prevent reuptake mechanism that terminates actions of NE and 5HT (more in cleft now)
  • Have anti-cholinergic effects (avoid in glaucoma)→ mydriasis may reduced caliber of aqueous humor outflow tract
A

TCAs (nortriptyline and amitryptiline)

32
Q
  • Heterocyclic antidepressant with serotonergic properties
  • Profound sedation
  • GREAT FOR INSOMNIA (bad for patient w/ fatigue)
A

Trazodone (TRAZOBONE)

33
Q

Anti-depressant with weak dopaminergic and noradrenergic mechanisms
NO SEXUAL DYSFUCTION
BUT…can’t use in seizure, bulimia, or anorexic people

A

Bupropion

34
Q

Risk of total thyroidectomy

A

Hypoparathyroidism → Hypocalcemia and hyperphosphatemia

Accidental removal of the parathyroid glands

35
Q

What is B7?

A

Co-stimulatory molecule on antigen presenting cells

Necessary for proper T-cell activation

36
Q

What is CTLA4

A
  • T-cell “off switch”

- Inhibitory signal to T-cells

37
Q

Recombinant IL-2/ALDESLEUKIN/T-cell growth factor

A
  • Stimulates T-cells to proliferate

- Used to treat renal cell carcinoma

38
Q

Cricoid cartilage and arytenoid cartilage

A

Sixth pharyngeal arch

39
Q

Crosslink with DNA (alkylating agent)
Cycle NONSPECIFIC (also Cisplatin)
ADR: pulmonary fibrosis

A

Busulfan

40
Q

M-phase specific
Hyperstabilizes polymerized microtubules and prevent mitotic spindle breakdown
ADR: Bone marrow suppression

A

Paclitaxel

41
Q

G2-phase-specific
Testicular cancer and lymphoma
Induces free radicals→ breaks in DNA
ADR: pulmonary fibrosis, skin pigment changes

A

Bleomycin

42
Q

Most common brain stem stroke

A

Lateral medullary syndrome= Wallenberg’s Syndrome

  • Thrombosis of vertebral artery = supplies lateral tegmentum of the medulla is most common cause
  • Infarct of PICA = another common cause
43
Q

Symptoms of Wallenberg’s syndrome (lateral medullary syndrome) 5

A

1) Contralateral body pain and temp decreased (decussate near lesion)
2) Ipsilateral face pain and temp decreased (Trigeminal nucleus and tract)
3) Ipsilateral ataxia (falling to affected side due to Inferior cerebellar peduncle)
4) Hoarseness and dysphagia = Nucleus ambiguus
5) Ipsilateral decreased taste= Nucleus solitarius

44
Q

Black woman in 30’s
Bilateral Hilar LAD
INCREASE IN ACE (weird)
Erythema Nodosum (inflammatory panniclulits/ tender red bumps)
Increased activation of vitamin D by macrophages→Hypercalcemia

A

Sarcoidosis

45
Q
  • Inflammation of microvasculature and mucous membranes

- ADRs, HSV, mycoplasma (most often)

A

Erythema multiforme

46
Q

-High methylmalonic acid and homocysteine

A

Cobalamin (B12) deficiency

47
Q
  • Prolongation of PR (esp. AV nodal cells)
  • Useful in preventing nodal arrhythmias
  • Decrease in upslope of phases 0 and 4
A

Diltiazem (non-DHP)

48
Q
  • Tumor suppressor involved in cellular adhesion

- Mutations in some breast and stomach cancers

A

E-cadherin

49
Q

HYPOVOLEMIC STATES (blood loss)

A

-Heart rate is increased
Vasoconstriction
-Renin and vasopressin increased→ vasoconstriction and H20 reabsorption

50
Q

Tumor suppressor genes such as APC (gastrointestinal tumors and melanoma) and NF1 inhibit…

A

Signal transduction

51
Q

Classic MS triad

A

1) Nystagmus
2) Intention tremor
3) Scanning Speech (word syllables are separated by pauses)

52
Q

HIV encephalitis is caused by infection of what in the brain?

A

Macrophages and microglia

53
Q
  • Complexes with FK-BP12 (an immunophilin)→ inhibits calineurin→inhibits T-lymphocyte signaling
  • P450 CYP3A metabolism
A

Tacrolimus

54
Q

Normal: DOPA neurons inhibit the putamen (which inhibits GPe)→ Disinhibition of GPe→ Leads to inhibition of subthalamic (which stimulates GPi)→ GPi now not stimulated→ thalamus is not inhibited and can provide excitatory input to motor cortex→ increased motion
Parkinson’s: No inhibition of putamen→ over-inhibition of GPe→ Disinhibition of subthalamic→STIMULATES GPi→ Thalamus is inhibited→ decreased excitatory input to motor cortex→ decreased motion

A

Parkinson’s pathophysiology vs. Normal

55
Q

Wernicke’s Encephalopathy (Confusion, Opthalmoplegia, Ataxia)

A

-Symmetric lesions in the paraventricular regions of the thalamus, hypothalamus, mammillary bodies and PAG region of midbrain

56
Q 
Neurofibrillary tangles (abnormally phosphorylated TAU)
Found in frontal and temporal lobes
A

Alzheimer’s Disease

57
Q

Polymyxins B and E

A

Cationic basic proteins
Act as detergents that bind cell membranes
Disrupt the osmotic and cell membrane integrity
Used in resistant gram negative infections

58
Q

Polymyxins B and E ADRs:

A

Neurotoxicity,

Acute renal tubular necrosis

59
Q

SSRI and Carbamazepine can both cause…

A

SIADH

60
Q

Amiodarone

A

-Prolongs action potential in cardiac phases 1 and 3 via blockage of sodium AND potassium channels.

61
Q

Lithium Toxicity

A

Nephrogenic diabetes insipidus b/c it acts as an ADH antagonist
Lithium can be used to treat SIADH (lol wow lol)

62
Q

Threonine dehydrogenase (catabolism)

A

Converts threonine to pyruvate

63
Q

Cystic medionecrosis

A

-Feature of BVs in Marfan’s syndrome

64
Q

In carotid sheath, anterior to vagus and lateral to the common carotid

A

Location of internal jugular

65
Q

Basic Metabolic panel quantifies serum…

A

Sodium, potassium, chloride, bicarb, creatinine, BUN and glucose

66
Q

Risk of Beta-agonist overuse: Example: Salmeterol (LABA) and albuterol (SABA)

A
  • Tremor
  • Tachycardia
  • HYPOKALEMIA
67
Q
  • Chromosome 17
  • Encodes GTPase- activating protein that decreases the activity of Ras (a signaling molecule important in cell proliferation)
A

WOW more NF1 things you do not know (AD)

68
Q
  • MENIIA and MENIIB
  • Tyrosine Kinase on 10q11.2
  • Medullary carcinoma of thyroid
A

Ret proto-oncogene

69
Q

Xeroderma pigmentosum inheritance

A

AR

70
Q

Breast cancer risks factors

A
  • Late menopause (>55 years old) *more ovulations
  • Early menarche (30 years old)
  • Family history of a relative with breast cancer at a young age
71
Q

“Sundowning”

A

-Increased severity of symptoms seen at night (a specific time) in patients with delirium

72
Q
  • Oculocutaneous albinism (devils eyes), light hair and skin
  • Mutation is in TYROSINase (Rate-limiting step of melanin production)
  • Impairs conversion of tyrosine to dopaquinone…to…Melanin
A

Albinism (AR)

73
Q

Galactokinase deficiency (AD)

A
  • Impairs conversion of galactose into glucose

- Galactosemia and galactosuria

74
Q

What is the congenital deficiency in Alkaptonuria? (AD)

A
  • Homogentisic acid oxygenase
  • Black urine after long periods of standing or when wake up
  • Arthralgias
75
Q

How does MENSA work?

A

Binds cyclophosphamide metabolites in the urine and neutralizes them

76
Q
  • Homogentisic acid oxygenase
  • Black urine after long periods of standing or when wake up
  • Arthralgias
A

What is the congenital deficiency in Alkaptonuria? (AD)

77
Q
  • Impairs conversion of galactose into glucose

- Galactosemia and galactosuria

A

Galactokinase deficiency (AD)

Imhotep (11 decks)

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