Step 1 Flashcards
Etoposide, teniposide
Etoposide inhibits topoisomerase II ➡️ increase DNA degradation.
Chemotherapy used in solid (particularly testicular and small cell lung cancer), leukemias, lymphomas
SEs: myelosuppression and alopecia
Infusion rate
Steady state concentration (Plasma concentration) X clearance/F
Maintenance dose
(Plasma concentration X Clearance X T)/F
Lymphatic drainage of testicular cancer
The lymphatic drainage from the testes is to the para-aortic lymph nodes in the lumber region just inferior to the renal arteries. Because testes’ development starts high in the abdomen and descend to their final resting place in the scrotum.
Causes of acute interstitial nephritis
P's: Pee (diuretics) Pain-free (NSAIDs) Penicillins and cephalosporins/B-lactams PPIs RifamPin
Cerebellar hemisphere
Intention tremor, limb ataxia, loss of balance, dysmetria, lack of coordination ➡️ ipsilateral deficits, fall toward side of lesion (cerebellar hemisphere are laterally located - affect lateral limbs)
Gerstmann syndrome
Damage at the left angular gyrus - agraphia, acalculia, a finger agnosia, right-left disorientation
ADH (vasopressin) effects
V1: Gq - increase vascular smooth muscle contraction/increase total peripheral resistance
V2: Gs - increase water permeability and transit potion (the insertion of aquaporins) into the renal collecting duct.
Pseudomonas aeruginosa
An aerobic gram (-), oxidase (+) bacteria that produces Pyocyanin, which gives it its blue-green color. A major virulence factor of Pseudomonas is exotoxins A, which ADP ribosylates and inhibits elongation factor 2 in the host cell, thereby inhibiting protein synthesis (Diphtheria toxin acts in a similar fashion).
Autograft Syngeneic graft (isograft) Allograft Xenograft Combination graft
From self
From identical twin or clone
From nonidentical individual of same species
From different species
Usually composed of a mixture of auto generic and allogenic tissue
Erythema migrans
Lyme D.
Hydralazine
Increase cGMP➡️smooth muscle relaxation. Vasodilates arterioles>veins; afterload reduction.
Used in severe HTN (particularly acute), HF (with organic nitrate), Safe to use during pregnancy. Frequently coadministered with a B-blocker to prevent reflex tachycardia.
Drugs induce SLE
Having lupus is “SHIPP-E”
Sulfa drugs, Hydralazine, Isoniazed, Procainamide, Phenytoin, Etanercept
Virulence factor of Staph. Aureus
Pathogenesis (exfoliative toxin - the microscopic study of cells shed or obtained from the body especially for diagnostic purposes) of Toxis Shock Syndrome
“Protein A” binds Fc region of IgG. Inhibiting complement activation (preventing opsonization) and phagocytosis.
Toxic Shock Syndrome Toxin 1 (TSST-1) is an example of a superantigen: TSST-1 cross-links MHC II molecules with certain T-lymphocyte activation. Anywhere from 2-20% of all T lymphocytes can be activated. This leads to Supra physiologic production of cytokines, including IL-1 & ТNF-@ by Th1 cells but also IL-6, IL-12, and INF-gamma. These cytokines are most responsible for the clinical sx.s of TSS.
Sotalol
An antiarrhythmic with class II (B-blocking) and class III (potassium channel blocking) properties. It is a non selective B-antagonist thus not suitable for use in pt with asthma. Its class III properties are only seen at high oral doses, this includes prolonging repolarization by blocking outward potassium conductance (prolongs QT interval), with typically little effect on the rate of depolarization (no effect on QRS interval).
Granulocyte colony-stimulating factor (G-CSF)?
G-CSF is a glycoprotein growth factor that stimulates immature neutrophils to differentiate in BM. As a glycoprotein, G-CSF binds a transmembrane receptor to effect downstream changes.
Heroin and the opiates’ function?
Primarily function by “stimulation of M-receptor in the brain and GI tract.” M-receptor stimulation is responsible not only for the pleasure sensation derived from opiates but also for the decreased bowel motility and constipation with which opiates are associated. Narcotic pain medications have similar adverse effects, because they are opiate-derived drugs. It is important to minimize opiate use in pts with suspected small-bowel obstruction, ileus, or infectious diarrhea, because these pts tolerate constipation and slowed GI motility poorly.
Cyanide poisons
Cyanide poisons the cytochrome c electron transport chain necessary for oxidative metabolism in the mitochondria. Hence, increased anaerobic metabolism takes place, leading to a metabolic lactic acidosis.
Tx: sodium thiosulfate and amyl nitrite.
Causes of high anion gap metabolic acidosis:
MUDPILES Methanol Uremia Diabetic ketoacidosis Paraldehyde Isoniazid Lactic acidosis Ethylene glycol Salicylates
Phosphatidylcholine is formed from which amino acid?
Phosphatidylcholine is formed by donation of methyl groups. Methionine can donate methyl groups.
10 essential amino acids?
PVT TIM HALL: Phenylalanine Valine Threonine Tryptophan Isoleucine Methionine Histidine Arginine Leucine Lysine
The absorption of fluoroquinolones can be changed by what?
The oral absorption of levofloxacin is impaired by polyvalent cations (Ca, Mg, and Fe), including those in common antacids such as calcium carbonate, which this pt is likely taking to treat GERD.
What is Biopterin?
Biopterin is an enzyme cofactor that can be synthesized de novo by somatic cells. It is required for the function of aromatic amino acid hydroxylases.
Breast fibrocystic disease
Manifest with diffuse breast pain and multiple bilateral masses commonly bound in the upper outer quadrants of the breast. It is one of the most common causes of breast lumps from age 25 years to menopause. Fibrocyst changes can be characterized histologically as fibrosis and cysts. Fibrocystic change can cause masses that fluctuate in size with menstruation and caffeine intake.
Drugs that act on microtubules
Microtubules Get Constructed Very Poorly: Mebendazole (antihelminthic) Griseofulvin (antifungal) Colchicine (antigout) Vincristine/Vinblastine (anticancer) Paclitaxel (anti cancer)
