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34 Cards in this Set

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65 year old woman with COPD in sever respiratory distress has cyanosis and signs of right-sided heart failure. What are the endothelin-1 antagonists that you can use to treat?
bosentan and ambrisentan
65 year old woman with COPD in sever respiratory distress has cyanosis and signs of right-sided heart failure.What are the prostaglandins you could use to treat?
iloprost and epoprostenol
causing vasodilation
65 year old woman with COPD in sever respiratory distress has cyanosis and signs of right-sided heart failure.What are the cGMP phosphodiesterase inhibitors you could use to treat?
tadalafil and sidenafil
65 year old woman with COPD in sever respiratory distress has cyanosis and signs of right-sided heart failure.What is the dihydropyridine you could use to treat?
nifedipine- Ca channel blocker
If PSA blood test has a high false positive rate what does that mean?
It will come up positive even when the person doesnt have the disease
person is fasting for religious reasons. what is going on in this persons liver?
gluconeogenesis, release of ketone bodies and glycogenolysis
If you have a 22 year old man with drug- resistant gonorrhea urethritis what would you give him?
ceftriaxone or 3rd generation cephalosporin
and a lifetime supply of condoms
A 34 year old women with lyme disease..treat with? MOA?
tetracyclines- bind to 30s and prevent tRNA
44 year old female with history of recurrent UTI give her prophylaxis of...?
Trimethoprim (TMP/SMX)- inhibts bacterial folate
nitrofurantoin
cephalosporin
amoxicillin
you went to greenbrier trail and got thirsty on your run so you drank the river water. Now you have Giardia lamblia (boo) what are you going to need to prescribe yourself?
metronidazole which forms free radical metabolites which damage bacterial DNA
23 year old pt has antibiotic induced C diff colitis. What is the treatment for this?
metronidazole is DOC
or oral vancomycin if you can't give metronidazole
You have a 54 year old male who had a heart attack and is on a statin, baby aspirin and metoprolol. he now has trouble achieving and maintaing an erection (boo) what could possibly be the cause?
B blocker- causes impotence
atherosclerosis in the arteries supplying the penis
fear of having a heart attack while having sex
What are side effects of B blockers?
exacerbation of asthma,
cardiovascular adverse effects ( bradycardia),
sedation and sleep alterations
What patient population should you use caution with when taking B blockers?
diabetics
asthma
bradycardia or AV block or on a Ca channel blocker
acute CHF pts
Pts blood pressure is 200/160. You hear a bruit 2 fingerbreathes up and 2 finger breaths right of the umbilicus. How does renal artery stenois cause hypertension?
stenosis= not a lot of blood getting through so kidney perceives low blood perfusion. JG apparatus increases RAAS and increases renin increasing blood pressure
Would you expect high or low renin levels with secondary aldosteronism?
high renin!
What are causes of secondary hyperaldosteronism?
renal artery stenosis
chronic renal failure
CHF
cirrhosis
nephrotic syndrome
56 year old business woman was traveling from Japan to California when she developed right lower extremity edema. She had a positive homan's sign. What does this mean?
She has a DVT
homan's sign- tender calf muscle with dorsiflexion
56 year old business woman was traveling from Japan to California when she developed right lower extremity edema. She had a positive homan's sign.What is virchow's triad
stasis
hypercoagulability
endothelial damage
56 year old business woman was traveling from Japan to California when she developed right lower extremity edema. She had a positive homan's sign.What is the most common hyerpcoagulability syndrome?
Factor V leiden- can't break down protein C so no control over clotting cascade
7. A 25-­‐year-­‐old woman presents to clinic with scanning speech, intention tremor, intermittent incontinence, and internuclear ophthalmoplegia. What is internuclear ophthalmoplegia?
Dx: multiple sclersosis
lesion in medial longitudinal fasciculus (bilaterally).
when pt looks to right, their right eye has nystagmus ( will track back to center- left beating nystagmus) and their left eye has medial rectus palsy and wont look right will only look center.
convergence is normal but divergence causes diplopia
A 5-­‐year-­‐old boy is treated with mebendazole for a pinworm infection. Mebendazole acts on
Microtubules to inhibit the helminthic infection. What other medications act on microtubules?
mebendazole/thiabendazole= antihelminthic
griseofulvin- antifungal
vincristine/vinblastine- anticancer
paclitaxel- anti breast cancer
colchicines- anti gout
A 5-­‐year-­‐old boy is treated with mebendazole for a pinworm infection. Mebendazole acts on
Microtubules to inhibit the helminthic infection.
What syndrome demonstrates a defect in microtubule polymerization?
chediak-higashi syndrome- microtubule polymerization defect resulting in decreased phagocytosis. results in recurrent pyogenic infections, partial ablinism, and peripheral neuropathy. Macrophages have poor microtubule function.
. A 23-­‐year-­‐old male undergoes a splenectomy due to splenic rupture from blunt abdominal trauma. What would you expect to find on this patient’s peripheral RBC smear after the splenectomy?
Howell Jolly bodies!
(maybe target cells too)
. Asplenic patients are susceptible to which encapsulated organisms?
S SHiN
salmonella
s pneumoniae/ klebsiella pnuemonia
h influenza
n meningitiis
12. What vaccines for these encapsulated organisms should be given to asplenic patients?
s pneumonia
h influenza type B
n. meningitidis
A 44-­‐year-­‐old male hepatitis C patient is undergoing recombinant interferon treatment for his disease. In what ways do interferons interfere with viral protein synthesis?
interferons induce ribonuclease to inihibit viral protein synthesis by degrading viral mRNA
activates NK cells to kill virus infected cells
53 year old has heart attack. What is the most common artery that causes heart attacks?
LAD> RCA>circumflex
53 year old has heart attach and on EKG you see ST elevation in leads II, III and aVF where is his heart attack?
inferior wall = RCA
. A 45-­‐year-­‐old white female presents with a 1cm x 1cm, painless, mobile mass in her right parotid gland. You inform the patient that most tumors in the parotid gland are benign. What is the
Most common benign tumor of the salivary gland?
pleomorphic adenoma
What is a Warthin's tumor?
benign, heterotopic, salivary gland tissue trapped in lymph node surrounded by lymphatic tissue
Youre on the magic school bus traveling to the parotid gland. What is the highway youre traveling on that goes through the parotid gland?
CN VII- facial!
What affect does stress have on adipocytes?
Sympathetic activation- NE and Epi released from adrenal medulla and activate hormone sensitive triglyceride lipase from fat cells which rapidly breaksdown triglycerides and mobilizes fatty acids to have energy for muscles
stress releases corticotrphin from anterior pituitary to activate adrenal cortex releasing glucocorticoids and that also activates the hormone sensitive lipase breaking down triglycerides to float on in your blood
What bacteria are commonly responsible for sialadenitis? What else would expose someone to sialadenitis?
Staph aureus and strep viridans cause infection and stone obstruction ( sialothiasis) can also cause sialadenitis