USMLE March on! Flashcards
_________ stones are the most common of all renal calculi.
Calcium oxalate
rx: potassium citrate should be taken at mealtime to increase urinary pH and urinary citrate (SOR B).
Fomepizole (Antizol) is?
Ethylene glycol poisoning antidote
once severe acidosis and renal failure have occurred hemodialysis is necessary
In patients with a drug-eluting stent, _________________- is needed because of the increased risk of late stent thrombosis
combined therapy with clopidrogel and aspirin is for 12 months
Primidone in essential tremor
Primidone has been effective in the treatment of essential tremor, and in head-to-head studies with propranolol has been shown to be superior after 1 year.
First-line therapies for urge urinary incontinence include
issue of detrusor instability.
behavioral therapy, such as pelvic muscle contractions, and anticholinergic therapy.
a hemoglobin A 1c of __________ signifies impaired glucose tolerance.
5.7%–6.9%
Patients meeting these criteria have a significantly higher risk of progression to diabetes and should be counseled about lifestyle modifications such as weight loss and exercise.
Pain from spinal stenosis is relieved by sitting and aggravated by standing, whereas the opposite is true for pain from a __________.
herniated disk
↑ insulin sensitivity in peripheral tissue. Binds to PPAR-γ nuclear transcription regulator
Glitazones/ thiazolidinediones
Pioglitazone, rosiglitazone
Ethylene glycol poisoning antidote
Fomepizole (Antizol)
once severe acidosis and renal failure have occurred hemodialysis is necessary
Insulin, rapid acting
Lispro,
Aspart,
Glulisine
Binds insulin receptor (tyrosine kinase activity) rapidly, no LAG
Glitazones/ thiazolidinediones
Pioglitazone, rosiglitazone
side effects
Weight gain edema Hepatotoxicity HF ↑ risk of fx
Insulin, long acting
Detemir, glargine
Stimulate postprandial insulin release by binding to K+ channels on β-cell membranes (site differs from sulfonylureas).
Meglitinides- Nateglinide, repaglinide
inpatient insulin to outpatient therapy
determine the total amount of insulin used while hospitalized
divide that dose during the day.
2/3 am, with 1/3 pm.
Each time the patient receives insulin, 75% of the dose
should be NPH, and 25% should be regular.
Adding NPH in DM
estimating 0.1 unit/kg of body weight in addition to the current regimen
NPH= Insulin, intermediate acting
____________- should be withheld before a procedure with radiocontrast dye, as contrast-induced nephropathy may predispose to developing lactic acidosis
Metformin
Of all the lipid values, _____ is the single best predictor of an adverse outcome (like CAD).
HDL
Smoking and cholesterol
Smoking cessation increases HDL by 5–10 mg/dL, but does not affect LDL, VLDL, or triglycerides
___________ blocks much of the flushing that is associated with sustained release niacin preparations
Aspirin
Fibrates
Upregulate LPL–> ↓ TG
Gemfibrozil, bezafibrate, fenofibrate
Myopathy (↑risk with statins), cholesterol gallstones
Prevent cholesterol absorption at small intestine brush border
Ezetimibe
Prevent intestinal reabsorption of bile acids; liver must use cholesterol to make more
Bile acid resins
Cholestyramine, colestipol, colesevelam
Inhibits lipolysis (hormone sensitive lipase) in adipose tissue; reduces hepatic VLDL synthesis
Niacin (vitamin B3)
_________ lowers cholesterol by interfering with the absorption of cholesterol in the gut.
Ezetemibe (Zetia)
Ranolazine
CLINICAL USE Angina refractory to other medical therapies.
Hypertension with heart failure rx
Diuretics, ACE/ARBs, β-blockers (compensated HF), aldosterone antagonists.
β-blockers must be used cautiously in decompensated HF and are contraindicated in cardiogenic shock.
Ezetemibe (Zetia)
lowers cholesterol by interfering with the absorption of cholesterol in the gut.
Hypertension with diabetes mellitus rx
ACE inhibitors/ARBs, Ca2+ channel blockers, thiazide diuretics, β-blockers.
ACE inhibitors/ARBs are protective against diabetic nephropathy.
Hypertension in pregnancy rx
Hydralazine, labetalol, methyldopa, nifedipine
