U world Flashcards
What is the mechanism of action of Thiazolidinodions?
TZDs (Thiazolidinediones) lower blood glucose by decreasing insulin resistance. TZDs activate peroxisome proliferator-activated receptor gamma, a nuclear receptor that alters the trascription of genes involved in gluose and lipid metabolism.
What do TZD diabetic drugs activate in their mechanism of action?
PPAR-gamma–> this then binds to RXR and then increases fatty acid uptake, increases insulin sensitivity, increases fatty acid uptake.
Fleicanide
Class 1 c antiarrhythmic such as fleicainasde are potent sodium channel blockers that have increased effect at faster heart rates (use dependence) ; this makes me more effective at treating tachyarrhythmia, but cal also prolong QRS duration (a proarrhythmic effect) at higher heart rates.
Name 5 drugs for neuropathic pain
Gabapentin (anticonvulsants), Tricyclic antidepressants, opioids, lidocaine, capsaicin
Dress Syndrome
Drug reaction with eosinophilia and systemic symptoms (DRESS) typically occuess 2-8 weeks after exposire to high risk drugs such as.... anticonculsants, allopurinol sulfonamices antibiotics (vancomycin, micocycline)
Patients typically develop fever, generalized lymphadenopathy, facial edema, diffuse skin rash, eosinophilia, and internal organ dysfunction.
Impairments in glycogenolysis (generally)
typically a rare enzyme disorder
type I: Von gierke disease (glucose 6 phosphatase)
Type II: Pompe Disease (acid alpha glucosidase)
Type III: Cori disease (debranching enzymes– alpha 1 4 transferase, alpha 1 4 glocosidase)
Type V: McArtdle Disease (glycogen phosphorylase)
Impairment in glycogenolysis type II: which enzyme? name? symptoms?
Pompe disease (remember this because II looks like a roman column in pompei)
enzyme: acid alpha glucosidase
findings: normal glucose levels, severe cardiomegaly, glycogen accumulation in lysosomes
impairment in glycogenolysis (type V) name? enzyme? symptoms?
Mcardle disease
enzyme: glycogen phosphorylase
symptoms: muscle phosphorylase deficiency, weakness and fatigue with exercise
not rise in blood lactace levels after exercise
impairment in glycogenolysis ( type III)
Cori Disease
enzymes: (debranching enzymes)
alpha 1 4 transferase
alpha 16 glucosidase
Hepatomegaly
ketotic hypgluycemia
hypotonia and weakness
abnormal glycogen with very short outer chains
impairment in glycogenolysis (type I)
von Gierke disease enzyme: glucose 6 phosphatase signs: hepatomegaly and steatosis fasting hypoglycemia lactic acidosis hyperuricemia and hyperlipidemia
Neonatal meningitis ( frequent causes)
Group B step is #1
E. Coli is 2nd most common cause of neonatal meningitis
E coli possess the K1 capsular antigen. The K1 capsule is a virulence factor that allows the bacteria to survive in the blood stream and establish meningeal infection.
K1 capsule virulence factor
e coli has the k1 virulence factor that allows it to survive in the bloodstream and establish meningeal infection.
membrane permeability during the action potential
resting at -70
sodium voltage gated channels open at -55
membrane potential goes up to +30
pottasssium permanence after we hit +30 and leads to refractory period
Wrist drop (what is damaged?)
Radial nerve
preachers hand (median palsy) explain the movement
you are trying to make a fist (active) but the first three fingers wont go down. only the 4th and 5th
simian hand (median and ulnar palsy)
entire hand looks
Side effects of loop diuretics:
also name 3 loop diuretics
furosemide, bumetanide, torsemide
hypokalemia, hypomagnesemia, hypocalcemia and ototoxicity
Side effects of thiazide diuretics
cholthalidone
hydrochlorothiazide
hypercalcemia, hyperuricemia, hypokalemia, hyponatremia
pottasssium sparing diurectics side effects
triamterene, spironolactone
all: hyperkalemia
spirinolactone: gynecomastia, antiadrogen effects
carbonic anhydrase side effects
acetazolamide metabolic acidosis (proximal renal tubular acidosis type II)
Osmotic diuretics side effects
mannitol
hypernatremia, pulmonary edema
A patient has lactic acidosis–what amino acid is important for him to have right now?
glutamine!
Creates and ammonia buffer system
Donates/releases ammonia which can then bind with H+ and be excreted at NH4+
something about
Which kidney stone will NOT show up on radiograph?
uric acid stone
also is diamond or rhombus shaped :)
Most common type of nephrolithiasis and what is its microscopic appearance?
Calcium oxalate
Calcium phosphate
calcium oxalate will look like a square with an X in the center (an octahedron)
calcium phosphate–> elongated, wedge shaped, forms rosettes
