World - Resp

Question 1

Propofol

Answer 1

Question 2

Etomidate

Answer 2

Question 3

Ketamine

Answer 3

Question 4

Why should dextromethorphan (cough suppressant) not be mixed with SSRIs, MAOIs, or Triptans?

Answer 4

Serotonin syndrome
* hypertonia
* autonomic instability
* encephalopathy

Question 5

NMJ TOF pattens

Answer 5

Question 6

Dantrolene

Answer 6

• Relaxes skeletal muscle by reducing the release of Ca2+ from the sarcoplasmic reticulum
• Uses – malignant hyperthermia & neuroleptic malignant snydrome

Question 7

Methacholine Challenge

Asthma Dx

Answer 7

• Inhaled muscarinic cholinergic agonist
• induces bronchoconstriction
• serial spiromtery test
• Asthma patients demonstrate hyperresponsivility to bronchoprovocation with a reducation in FEV1 at lowers doses (than those without asthma)

Question 8

Clinical suscipicion alert: Young women with chronic RLQ pain with tenderness and intermittent diarrhea

Answer 8

Crohn disease w/ ongoing active inflammation
* Rx = budesonide, which inhibits NF-kB at the nucleus

Question 9

• Azathioprine
• Mycophenolate

Answer 9

Reduce inflammation in patients with moderate-severe Crohn disease
* Inhibition of de novo purine synthesis
* B&T cells are especially dependent for proliferation

Question 10

Infliximab

Answer 10

Induce remission in patients with mod-severe Crohn disease
* MAB that reduces inflammation – binds/inhibits pro-inflammatory TNF-a (cytokine found extracellularly)

Question 11

Methotrexate

Answer 11

Folic acid analogs
* Reduce inflammation by competitively inhibiting folate-dependent enzymes

Question 12

CYP450 Inhibitors & Inducers

Answer 12

Question 13

Chart with the 3 most commonly administered anesthesias (rapid onset and short duration of effect):

Answer 13

Question 14

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Answer 14

A = omalizumab (anti-IgE antibody)
B = glucocorticoids (inhibits phospholipase A2 cleavage of lipid membranes)
C = Zileuton (LOX pathway inhibitor)
D = Zafirlukast, Montelukast (LK recpetor antagonists)
E = Cromolyn, Nedocromil (mast cell stabilizers)
F = antihistamines (block histamine receptor on the target cell)

Question 15

Arachinoid Acid pathway, NSAIDs, & respiratory disease

Answer 15

Question 16

Nifedipine - resp side effect

Answer 16

Bronchodilation by blocking calcium influx into bronchial smooth muscle cells
* But not used to treat obstructive lung diseases

Question 17

Zileuton

Answer 17

Inhibits 5-LOX
* decreases production of leukotrienes (C4, D4, E4)&raquo_space; to reduce bronchoconstriction and improve asthma symptoms
*

Question 18

Neostigmine

Answer 18

Cholinesterase inhibitor
* Increases the amount of acetylcholine (in synapse) that can potentiate muscle contraction

Question 19

nondepolarizing NMJ blockers

Answer 19

• Pancuronium
• Tubocurarine

Question 20

depolarizing NMJ blocker

for rapid sequence intubation – TOF stimulation

Answer 20

Succinylcholine

Adverse
* malignant hyperthermia (Rx = dantrolene – blocks the defective RYR receptors on the sarcoplasmic reticulum
* hyperkalemia (Na enters, K exits)

Question 21

Empyema

Answer 21

Loculated pleural effusion with complex septations
* pus accumulation
* organized fibrosis & fibrin accumulation

Rx
* tPA (fibrinolytic agent) can improve drainage
* activates fibrin-bound plasminogen to break down organized fibrin
* sometimes may add DNase

Question 22

• Rivaroxaban
• Apixaban

Factor 10a inhibitors

Answer 22

Systemic Rx to treat thromboembolic disease

Question 23

• Aspirin
• P2Y12 inhibitors

Answer 23

Inhibit platelet activity
* used to systemically lower the risk of intra-arterial thrombosis

Question 24

tPA stands for:

Answer 24

Tissue plasminogen activator
* (fibrin-bound plasminogen)

Question 25

Topical corticosteroids - mechanism of action

Rx for atopic dermatitis

Answer 25

• Inhibition of phospholipase A2 activity in cell membranes