Rx_Random Set #7 Flashcards
Placenta previa presentation and sx
- placenta previa = placenta overlies internal cervical os
- subtypes: complete, partial, marginal, low-lying
- major sx:
- significant vaginal bleeding after 20 weeks
- absence of pain
Abruptio placentae definition, sx, risk factors
- abruptio placentae = premature separation of placenta from uterus
- presentation:
- vaginal bleeding after 20 weeks
- uterine contraction
- pain
- risk factors
- HTN
- cocaine use
- short umblical cord
- trauma
- smoking
- uterine fibroids
- advanced age
- prior abruption/premature membrane rupture
- sudden uterine decompression
- bleed diathesis
Tx of neonatal respiratory distress syndrome
- administration of exogenous surfactant
- surfactant = mixture of lipids (dipalmitoulphosphatidylcholine) & proteins
Drug of choice for TB prophylaxis (+MOA)
- Isoniazid (or INH)
- MOA = inhibition of mycolic acid synthesis
Common drugs in combination tx for TB (+MOA)
- Rifampin = inhibits DNA-dependent RNA polymerase
- Ethambutol = inhibition of arabinogalactan syntehsis ==> inhibition of cell wall synthesis
Macrolides: MOA + e.g.
- used in tx of bacterial infection
- e.g. erythromycin
- MOA = methylation of rRNA ==> prevents ribosomal binding
Vancomycin: MOA + common use
- MOA = binds to D-ala-D-ala portion of cell wall precursors ==> inhibition of cell wall peptidoglycan formation
- common use =
- gram-positive infections
- methicillin-resistant Staph. aureus
Presentation and cause of waterhouse-friderichsen syndrome
- cause = N. meningitidis ==> menigitis and sepsis & W-F syndrome
- presentation
- disseminated intravascular coagulation (purpura)
- shock (hypotension)
- adrenal failure
Mass effects of neoplasm at pyloric zone
- obstruction of hepatoduodenal ligament = common bile duct, hepatic artery, hepatic portal vein ==> jaundice
Pathologic consequences of giardia infections
- ==> inflammation and villous atrophy in the gut
- ==> malabsorption
Characteristics of Reed-sternberg cells
- binucleate cells w/inclusion-like nucleoli
- B-cell origin
- CD15 and CD30 positive
- present in Hodgkin’s lymphoma
Pathologic characteristics of Lymphocyte-rich Hodgkin lymphoma
- few Reed-Sternberg cells (more present in mixed cellularity Hodgkin’s)
- binucleate cells w/inclusion-like nucleoli
- numerous lymphocytes
- high lymphocyte count
- dark-staining nuclei and little cytoplasm
- lack areas of collagen banding or lacunar cells (found in nodular sclerosis Hodgkins lymph)
Presentation/pathologic characteristics of Kartagener’s syndrome
- presentation
- recurrent sinusitis
- infertility in males due to immotile sperm
- situs inversus (=major visceral organs reversed or mirrored from normal positions)
- bronchiectasis
- pathology
- lack of dynein arms in micrtobules in cilia and flagella ==> immotile
Presentation of Immune Thrombocytopenic Purpura
- low platelet count
- antiplatelet antibodies
- enlared platelets
Common chemotherapeutic agents associated with cardiotoxicity (+MOA)
- doxorubicin/daunorubicin
- fluorouracil
- busulfan
- cisplatin
- mitoxantrone
- paclitaxel
Doxorubicin: MOA
MOA = intercalating DNA
Tx of bulimia
- psychotherapy and antidepressants
- usually SSRI ==> fluoxetine
Presentation of bulimia
- calluses/scars on dorsum of hand
- due to abrasian from teeth during gagging
- parotid enlargement
- erosion of tooth surfaces
Hydralazine: MOA/use/SE
- MOA = potent arteriole vasodilator ==> reduced BP
- use = first-line for HTN in pregnancy
- SE
- ==> reflex tachycardia
- administer w/B-blocker (e.g. labetalol)
- ==> reflex tachycardia
Treatment for refractory Parkinson’s (not responsive to medication)
- ablative surgery pf globus pallidus
Lab results in metabolic alkalosis
- increased pH (> 7.4)
- increased plasma bicarb
- increased CO2 (due to respiratory compensation)
Common causes of metabolic alkalosis
- general: loss of hydrogen ions or increase in bicarb concentation
- vomiting ==> loss of H+ in gastric acid
- antacid use
- diuretic use
- hyperaldosteronism
Presentation of interruption of posterior inferior cerebellar artery
- ==> “lateral medullary syndrome”
- ispilateral Horner’s syndrome
- ptsois, miosis, anhidrosis
- absent pain & temp on ispilateral face and contralateral body
- damage to spinal trigeminal and spinothalamic tract
- ataxia
- damage to inferior cerebellar peduncle
- nystagmus
- vestibular nucleus
- hoarsness
- nucleus ambiguus of the vagus
Low alpha-fetoprotein (AFP) on prenatal triple triple screen ==> dx?
- fetus may have Down’s syndrome
- “AFP goes down in Down’s”
