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NMSP > Week 5 (Exam 2) > Flashcards

Week 5 (Exam 2) Flashcards

1
Q

DISH

A

Diffuse idiopathic skeletal hyperostosis
Calcification and ossification of spinal ligaments, enthesis
Men, back pain, stiffness, R T-spine more involved
No SI joint involvement
Ossifications of at least 4 contiguous vertebral levels

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2
Q

Ketamine

A

Moderately rapid onset IV anesthetic, NMDA antagonist

CV stimulation, increased cerebral blood, emergence reactions that impair recovery

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3
Q

Propofol

A

Rapid onset IV anesthetic, GABAa agonist
Used in induction and maintenance
Can cause HPTN
Useful antiemetic

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4
Q

Excitatory Ion channels used in general anesthetics

A

Ach
AMPA
5HT

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5
Q

Local anesthesia and the heart

A

Except cocaine, slows conduction velocity and causes arteriolar dilation ad systemic HPTN

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6
Q

Etomidate

A

Rapid onset and pretty fast IV anesthetic, GABAa enhancer
CV stability, decreased steroidogenesis
Involuntary muscle movements

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7
Q

SLE presentation

A

Oral ulcers (nasopharyngeal ulcers, painless)
Arthritis
Serositis (pleurites, rub or PE, EKG changes)
Proteinurea, seizures, anemia, or others

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8
Q

Symmetric Vs Asymmetric Chronic Polyarthritises

A

Symmetrical: Ankylosing Spondylitis, Enteropathic Arth,
Asymmetrical: Psoriatic and Reactive Arthritis

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9
Q

Fentanyl

A

Slow onset IV anesthetic
Naloxone reversal agent
Balanced anesthesia and conscious sedation
Produces marked analgesia

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10
Q

Neck finding in RA

A

Atlantoaxial subluxation (C1C2) due to erosion of odontoid process

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11
Q

IV anesthetics

A 
Diazepam (Valium)
Etomidate
Fentanyl
Ketamine
Midazolam
Propofol
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12
Q

Rip pattern ANA

A

Anti DS DNA, 50% SLE

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13
Q

Dexmedetomidine

A

a2 adrenergic agonist
Produces hypnosis at locus caeruleus
Sedative effect is like a physiologic sleep state
Used for short term sedation of intubated and ventilated patients in ICU or as adjunct

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14
Q

Steroid regimen for gout

A

Prednisone 40mg po/day x5-7 days, taper

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15
Q

Benzo adjunct to anesthesia

A

Increases GABAa receptor sensitivity to GABA
Diazepam, Lorazepam, Midazolam
Flumazenil

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16
Q

Physical criteria for RA

A

Must score at least 7 points!
1 point: 1 large joint
2 points: 2-10 large joints, or 1-3 small joints
3 points: 4-10 small joints
5 points: above 10 joints (at least one small)

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17
Q

Inhibitory Ion channels used in general anesthetics

A

Chloride (GABA and Glycine)

Potassium (K2p, possibly Kv, Katp)

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18
Q

Opiod adjuncts to anesthesia

A

IV fentanyl, sufentanil, remifentanil, morphine

Premedication and adjunct for preoperative analgesia

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19
Q

Inhaled Anesthetics, fastest acting to slowest

A

NO (incomplete, rapid onset and recovery)
Desflurane
Sevoflurane
Isoflurane
Enflurane
Halothane (medium rate of onset and recovery)

20
Q

Clinical manifestations of Ankylosing Spondylitis

A

Low back pain for longer than 3 months
Morning stiffness better with exercise, worse at rest
Fatigue, weight loss, fever
SI joint pain, hip arthritis (restricted forward flexion)
Tendonitis, Planter Fasciitis

21
Q

Clinical manifestations of Reactive Arthritis

A

Arthritis, Enthesitis (achilles, plantar fasciitis), Dactylitis
Eye, Urethra, Joint inflammation

22
Q

Midazolam

A

Slow onset IV anesthetic
Flumazenil is the reversal agent
Used in balanced anesthesia and conscious sedation
CV stability and marked amnesia

23
Q

The only IV anesthetic to produce profound analgesia

A

Ketamine

Stimulates Sympathetic Nervous System

24
Q

Labs of Ankylosing Spondylitis (and reactive arthritis)

A

Increased ESR, CRP
HLA B27
Anemia of chronic disease
Negative RF, ACCP, ANA

25
Q

Barbiturate adjunct to anesthesia

A

Increases GABAa receptor channel opening
Thiopental and methohexital
CYP450 enzyme induction

26
Q

Etomidate Endocrine Adverse effects

A

Adrenocortical suppression by inhibiting 11b-hydroxylase (cholesterol to cortisol)

27
Q

Volatile and gaseous anesthetics given by inhalation

A

Liquids at room temp: Halothane, Enflurane, Isoflurane, Sevoflurane
Gas at room temp: NO

28
Q

Thiopental

A 
Rapid onset (bolus dose) Iv anesthetic
Slow recovery following infusion
Standard induction agent
Causes CV depression
Avoid in Porphyrias
29
Q

Blood:gas partition

A

Inverse relationship of solubility to speed of onset

The lower it is, the faster it is

30
Q

anterior uveitis / Irisitis DDx

A

Ankylosing Spondylitis

SLE, HSV

31
Q

Leflunomide (arara)

A

Pyrimidine Antagonist, rapid excretion w/ cholestyramine

Treats RA, don’t use with pregnancy

32
Q

Local anesthetics, shortest to longest lasting / least to most potent

A

Benzocaine (surface use only)
Dibucaine (surface use only) (amide)
Procaine (Novocain, primarily for infiltrative)
Cocaine
Lidocaine (amide, also anti-arrhythmic)
Bupivacaine (amide, super long, sensory>motor)

33
Q

Halothane Side effects

A

Hepatitis

34
Q

Extra-articular manifestations of Enteropathic arthritis

A

Erythema Nodosum
Gangrene
Uveitis, Neprolithiasis, Thrombolism, Low bone density

35
Q

Colchicine Regimen for gout

A

effective within first 24 hours of attack

0.6mg q8hrs with taper or 1.2 initially then 0.6 later

36
Q

Heberdens and Bouchard nodes

A

Boney enlargements of PIP and DIPs in OA

37
Q

Three kinds of Anesthesia adjuncts

A

Opioids, Barbiturates, Benzos

38
Q

Homogenous ANA pattern

A

Histone Ab, Drug induced Lupus

39
Q

Methohexital

A

Rapid onset IV anesthetic

Preferred over thiopental for short ambulatory procedures

40
Q

Speckeled ANA pattern

A

Anti SM, Lupus. Anti SS-A/B, Sjogren

41
Q

Peripheral Arthritis presentation

A 
Pitting nails
Dactylitis and Enthesitis
Some have RF+ or anti CCP
Flare up can accompany HIV
Soft tissue swelling, erosions, periostitis, joints wrecked
42
Q

HLA-B27 associations

A

Ankylosing Spondylitis

Enteropathic, Psoriatic, Reactive Arthritis

43
Q

Imaging of Ankylosing Spondylitis

A

Squaring (loss of anterior convexity)
Shiny corners. sclerosis at edge of vertebral bodies
Bridging of vertebrae (syndesmophytes)

44
Q

Biologic regimen for gout

A

IL-1B inhibitors

Anakinra 100mg subQ daily

45
Q

Feltys syndrome

A

RA, Splenomegalia, Neutropenia, Fever, Anemia, Thyrombocytopenia, RF/anti-CCP+

46
Q

Uric acid lowering drugs

A 
Xanthine oxidase inhibitors (allopurinol)
Uricouric drugs (probenecid, sulfinpyrazone)

NMSP (7 decks)

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