Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
|
What causes the S1, S2, S3, and S4 heart sounds?
|
S1: mitral and tricuspid valve closure, loudest at mitral area
S2: aortic and pulmonary valve closure, loudest at L sternal border S3: in early diastole during rapid ventricular filling phase. Associated with increased filling pressures and more common in dilated ventricles. Normal in children and pregnant women S4: atrial kick in late diastole. High atrial pressure. Associated with ventricular hypertrophy. L atrium must push against stiff LV wall |
|
|
A patient with new onset hepatic failure with normal renal function is currently taking a drug metabolized and excreted by the kidneys. Would you need to change the loading dose or maintenance dose of this medication because of this hepatic failure? If this patient were to develop hepato-renal failure would you need to change the loading dose or maintenance dose of the medicine?
|
In patients with impaired renal or hepatic function, the loading dose remains unchanged although the maintenance dose is decreased.
|
|
|
What are the signs of withdrawal from opioids?
|
Morphine, heroin, methadone
Withdrawl: anxiety, insomnia, anorexia, sweating, dilated pupils, piloerection ("cold turkey"), fever, rhinorrhea, nausea, stomach cramps, diarrhea, yawning Tx: symptomatic, naloxone, buprenorphine, methadone |
|
|
How does the mechanism of action of typical antipsychotics differ from the mechanism of action of the atypical antipsychotics?
|
Typical: block dopamine D2 receptors to increase cAMP
Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine Atypical: bblock 5-Ht2, alpha, H1, and dopamine receoptors Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone |
|
|
What is the difference between a promoter region and an enhancer region on DNA?
|
Promotor: site where RNA polymerase and multiple other transcription factors bind to DNA upstream from gene locus (AT-rich upstream sequence from TATA and CAAT boxes)
Mutations: dramatically decreased amount of gene transcribed Enhancer: stretch of DNA that alters gene expression by binding transcription factors May be located close to or far from or within the gene it is regulating |
|
|
Which glycogen storage disease has muscular symptoms?
|
McArdle's (Type V)
Findings: myoglobinuria with strenous exercise, painful muscle cramps Def: skeletal muscle glycogen phosphorylase Increased glycogen in muscle but cannot break it down McArdle's=muscle |
|
|
In which glycogen storage disease does the liver become like a muscle because it traps glucose-6-phospate?
|
Von Gierke's (Type I)
Findings: Severe fasting hypoglycemia, hepatomegaly, increased blood lactate Def: glucose-6-phosphatase Make stores of glycogen, can't use them Autosomal recessive |
|
|
Which glycogen storage disease has cardiomegaly?
|
Pompe's (Type II)
Findings: cardiomegaly, systemic findings, early death Lysosomal storage disease Def: lysosomal alpha 1,4 glucosidase |
|
|
Which glycogen storage disease has a debranching problem?
|
Cori's (Type III)
Milder form of Von Gierke's with normal blood lactate levels Def: debranching enzyme (alpha 1,6 glucosidase) Gluconeogenesis intact |
|
|
What teratogen causes cervical clear cell adenocarcinoma? Which teratogen (previously administered for morning sickness) causes limb defects?
|
Cervical clear cell adenocarcinoma in children=DES (diethystilbesterol)
Morning sickness=thalidomide (used to treat myelodysplasia) |
|
|
What structures form Hesselbach’s triangle? Which type of hernia protrudes through Hesselbach’s triangle?
|
Cervical clear cell adenocarcinoma in children=DES (diethystilbesterol)
Morning sickness=thalidomide (used to treat myelodysplasia) Inferior epigastric artery, inguinal ligament, lateral border of the rectus abdominus Direct inguinal hernia |
|
|
Describe how the fluid within the membranous labyrinth of the inner ear is different from the fluid in the bony labyrinth of the inner ear.
|
Membranous labyrinth: endolymph (potassium rich, similar to ICF)
Bony labyrinth: peri-lymph (sodium rich, like ECF) |
|
|
Describe how a surgical lesion of the subthalamic nucleus might help improve the symptoms of Parkinson’s.
|
The subthalamic nucleus is part of the indirect pathway. Loss of dopamine in parkinson disinhibits the inhibitory pathway. If you lesion that pathway you restore inhibition.
|
|
|
What types of bacterial infections are commonly seen when there is a deficiency in complement?
|
Deficiency of C3=pyogenic sinus and respiratory tract infections
Deficiency in C5-8=Neisseria bacteremia |
|
|
What side effects can be caused by vancomycin? How can “red man syndrome” be prevented?
|
Tox: Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing
Prevent by pretreatment with antihistamines Uses: serious gram positive infection |
|
|
Which antibiotic is used to treat gram negative rods in patients with renal insufficiency?
|
Aztreonam
Mech: inhibits cell wall synthesis It is a beta lactam resistant drug Synergistic with aminoglycosides Only used for gram negatives |
|
|
Which antibiotic is a big gun effective for treating gram positive cocci, gram negative rods, and anaerobes?
|
Imipenem
Mech: broad-spectrum beta lactamase resistant carbapenem Administered with cilastatin to decrease inactivation in renal tubules |
|
|
What is the drug of choice for Enterobacter?
|
Imipenem
Tox: GI distress, skin rash, CNS tox (seizures) |
|
|
Which antibiotic is used as prophylaxis in AIDS patients against P. carinii pneumonia?
|
TMP-SMX and aerosolized pentamidine
|
|
|
Which antibiotic is used as solo prophylaxis against TB?
|
Isoniazid
Mech: decreased synthesis of mycolic acids |
|
|
Which antibiotic is used as prophylaxis in those exposed to someone with meningococcal meningits?
|
Rifampin
Also used in prophylaxis for Hib |
|
|
What are the typical findings in a patient with Klinefelter’s syndrome? What are the typical findings in a patient with Turner’s syndrome?
|
Klinefelter's: XXY
Gynecomastia, testicular atrophy, tall stature, infertility, female fat distrubution Inactivated X=Barr body Turner: XO Web neck, widely spaced nipples, shield chest, short stature, coarctation of the aorta, bicuspid aortic valve, streak ovary |
|
|
What is Virchow’s triad?
|
1. Stasis
2. Hypercoagulability 3. Endothelial damage Causes DVT, PE Prevent with heparin |
