UWorld_4.6 Flashcards
Classes of Dopamine agonists
- ergot compounds
- bromocriptine
- pergolide
- non-ergot compounds
- pramipexole
- ropinirole
CCl4 toxicity ==>
- CCl4 oxidized by P450 ==> CCl3 = free radical that reacts with lipid membrane components
- ==> fatty change and hepatocyte necrosis
Primidone: MOA, use
- first line for benign essential tremor
- breaks down to phenobarbitol <== must track levels to prevent toxicity/AMS
Mechanism of sympathetic transmission
- generally: 2 neuron system from spinal cord
- first neuron releases ACh @ nicotinic receptor @ sympathetic ganglion
- second neuron releases NE @ various organs: heart, smooth m., nerve terminals)
- exceptions:
- adrenal medulla = one neuron releases ACh directly @ medulla ==> systemic epinephrine + NE release
- sweat glands = second neuron releases ACh onto a muscarinic receptor
- kidney vasculature = second neuron releases DA
t1/2 =
t1/2 = (Vd x ln2)/CL
ln2 = ~.7
common mechanism of carcinogenesis of chemical in human pody
- many chemicals enter as pro-carcinogens
- **oxidation by CYP450 system ==> carcinogen
- e.g. cyp450 monooxogenase = present @ hepatic microsomes & ER of other cells
SGLT2 inhibitors: MOA, use, SE
- e.g. canagliflozin, dapagliflozin
- oral anti-diabetic agents
- work to decrease proximal tubular reabsorption of glucose
- SE
- renal damage
- UTIs
- hypotension
- **monitor Cr
E.coli virulence factors
- LPS ==> IL-1, IL-6, TNF-alpha ==> bacteremia and sepsis
- K1 capsular polysacc ==> prevents phago/complement lysis ==> neonatal meningitis
- Vertoxon/Shiga-like ==> 60S inhibition => cell death ==> bloody diarrhea + HUS
- Heat-labile/stable toxins ==> fluid and electrolyte secretion ==> watery diarrhea
- P fimbraie ==> urothelial adherence ==> UTI
Amlodipine: MOA, use, SE
- MOA: ca-channel blocker
- use: HTN
- SE: flushing and peripheral edema
Enzyme mutation ==> hyperglycemia in pregnancy
glucokinase = glucose sensor in pancreatic beta cells
Proton-pump i: e.g. and MOA
- Omeprazole
- Lansoprazole
- MOA: acts on H+/K+ ATPase pump ==> inhibition of final common pathway of acid secretion
- will decrease acid secretion in response to any stimulus
Product that accumulates in aging cells
lipofuscin = product of lipid peroxidation
HIV tx ==> fat redistribution/hyperglycemia
protease inhibitors (-navirs)
Antibiotic tx for lung abcess
clindamycin (for anaerobic coverage)
Nerves and vessels that supply ovary contained in…
suspensory ligament
Prophylaxis in HIV patients
- TMP/SMX
- PCP pneumo (@ <200 T cells)
- Toxo (@ <100 T cells)
- Azithromycin
- MAC (@ <50 T cells)
- Itraconazole
- Histoplasma (@ <150 T cells)
Structure under 12th rib left side
kidney
Digoxin toxicity sx
- GI
- abdominal pain
- N/V
- anorexia
- Neuro
- fatigue
- confusion
- weakness
- color vision alterations
Rubella virus type
toga virus
Estrogen impact on thyroid hormones
estrogen ==> decreased catabolism of TBG ==> increasted total T4 with normal thyroid fxn
marker for mast cell activation
histamine
tryptase
tryptophan forms…
serotonin
niacin (B3)
Fenoldapam: MOA
D1 agonist ==> arteriolar dilation + increased renal perfusion/diuresis
Low c1 esterase inhibitor ==>
- elevated bradykinin
- do not use ACE-i in these patients because ==> angioedema
Pseudomonas tx
- Pen = Piperacillin; Ticeracillin
- Ceph = Cefepime, Ceftazidime
- Gentamicin
- Cipro/Levofloxacin
- Aztreonam
- Imipenem
Common cause of lacunar infarcts
hypertensive arteriolosclerosis of small, penetrating arterioles
