Set 14 Flashcards
What are Cheyne-Stokes respirations?
Repeating cycles of apnea and hypercapnia followed by a compensatory phase of hyperventilation and hypocapnia (oscillating slow/fast breathing)
Due to diminished sensitivity of medullary respiratory center (drug overdose, cerebral atherosclerosis, cerebral lesions, and prolonged circulation time from heart failure). Seen in CHF or increased intracranial pressure
What type of immunodeficiency disorder is caused by DiGeorge syndrome? Development of what branchial pouches is affected in DiGeorge syndrome?
Decreased T cells (thymic aplasia - no place for T cells to mature). Hypocalcemia due to lack of PTH is also seen
Failure to develop 3rd and 4th pharyngeal pouches (absent thymus and parathyroids)
3rd - inferior parathyroids and thymus, 4th - superior parathyroids
What drugs and endogenous hormones regulate the secretion of gastric acid?
Drugs that regulate include: PPI (omeprazole), H2 blockers (cimetidine, famotidine, ranitidine) and Ocreotide (somatostatin analog - inhibits ECL cells from stimulating parietal cells).
Phenylalanine and tryptophan are potent stimulators
Increased by stomach distention/alkinization, amino acids, peptides, vagal stimulation
Stimulation: histamine, gastrin, acetylcholine (from vagus nerve)
Inhibition: PGs, somatostatin, secretin, GIP
The E4 variant of Apo E is a known risk factor for Alzheimer’s disease. What is the primary function of the following major apoproteins? Apo A-I Apo B-48 Apo B-100 Apo C-II ApoE
Apo A-I: Activates LCAT - needed for maturation of HDL particles
Apo B-48: Mediates chylomicron secretion from enterocytes
Apo B-100: Binds LDL receptor
Apo C-II: Lipoprotein lipase cofactor - removes FFA from lipid particles
ApoE: Mediates extra (remnant) uptake
Name five or more drugs that inhibit acetylcholinesterase. What is the clinical application for each?
Neostigmine - Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative)
Pyridostigmine - Myasthenia gravis (long acting), does not penetrate CNS
Physostigmine - Anticholinergic toxicity (crosses BBB -> CNS)/Atropine overdose
Donepezil, rivastigmine, galantamine - Alzheimer disease
Edrophonium (Tensilon) - Historically, diagnosis of myasthenia gravis (extremely short acting). Myasthenia now diagnosed by anti-AChR Ab (anti-acetylcholine receptor antibody test)
Echothiopate - treat open-angle glaucoma
*With all cholinomimetic agents, watch for exacerbation of COPD, asthma and peptic ulcers when giving to susceptible patients
What are the positive symptoms of schizophrenia (adding a symptom)? What are the negative symptoms of schizophrenia (removing a normal finding/trait)?
Positive: delusions, hallucinations, disorganized speech (loose associations), disorganized or catatonic behavior
Negative: flat affect, social withdrawal, lack of motivation, lack of speech or thought
Describe the anatomy of the femoral sheath. When placing a femoral line for central venous access you palpate a femoral pulse. Where do you place the guide needle in relation to this pulse: medially or laterally?
The femoral sheath is a fascial tube 3-4 cm below inguinal ligament. Contains femoral vein, artery and canal (deep inguinal lymph nodes) but not nerve.
Medial to artery (NAVEL)
What area of the brain is damaged in Klüver-Bucy syndrome? What are the symptoms of Klüver-Bucy syndrome?
Amygdala (bilateral)
Hyperorality, hypersexuality, disinhibited behavior
Associated with HSV-1
What long-term complication is associated with having to receive multiple blood transfusions?
Infection transmission (low), transfusion reactions, *iron overload, hypocalcemia (citrate is a calcium chelator), and hyperkalemia (RBCs may lyse in old blood units)
Iron overload may lead to hemosiderosis (or hemochromatosis)
