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25 Cards in this Set
- Front
- Back
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What is the classic presentation of a patient with Wegener’s granulomatosis?
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Sx: hemoptysis, hematuria, perforation of the nasal septum, chronic sinusitis, otitis media, mastoiditis, cough, dyspnea
Triad of focal necrotizing vasculitis, necrotizing granulomas in the lung and upper airway and necrotizing glomerulonephritis c-ANCA + Tx: cyclophosphamide and corticosteroids |
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Describe the phases of a myocardial action potential and which ion channels are responsible for each phase.
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Phase 0: rapid upstroke, voltage gates Na channels open
Phase 1: initial repolarization, inactivation of voltage-gated Na channels with K voltage gated channels starting to open Phase 2: plateau with Ca influx through voltage gated channels balancing K efflus Phase 3: rapid repolarization, massive K efflux with opening of slow K voltage gated channels and closure of voltage gated Ca channels Phase 4: resting potential with high K permeability through K channels |
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What is the mechanism of action of vincristine and vinblastine?
What are the toxic side effects of these drugs? |
Mech: alkaloids that bind to tubulin in M phase and block polymerization of microtubules so that the mitotic spindle cannot form
Tox: cristine=neurotoxicity, paralytic ileus Tx: blast=bone marrow suppression |
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What are the clinical features of renal cell carcinoma?
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Most common renal malignancy
Invades IVC to spread hematogenously Mets to lung and bone Epi: Men 50-70, increased in obesity and smoking Ass: VHL, deletion on chr 3 Originates in renal tubule cells-->polygonal clear cells Sx: hematuria, palpable mass, 2ndary polycythemia, flank pain, fever, weight loss Ass: paraneoplastic syn (EPO, ACTH, PTHrP, prolactin) |
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What is the cause of endemic cretinism?
What is the cause of sporadic cretinism? What are the features of cretinism? |
Endemic: occurs due to severe fetal hypothyroidism wherever endemic goiter is present from lack of iodine
Sporadic: defect in T4 formation or development failure in thyroid formation Sx: pot-bellied, pale, puffy faced child with protruding umbilicus and protuberant tongue |
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Which portion of the renal tubule is impermeable to sodium and passively reabsorbs water?
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Thin descending loop of Henle
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Which portion of the renal tubule is influenced by PTH and reabsorbs calcium?
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Distal convoluted tubule
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Which portion of the renal tubule reabsorbs the majority of glucose and amino acids?
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Early proximal tubule
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Which portion of the renal tubule regulates Na reabsorption using aldosterone?
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Collecting tubule
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Which portion of the renal tubule is impermeable to water and actively reabsorbs Na, K, Cl?
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Thick ascending loop of Henle
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Which portion of the renal tubule reabsorbs the majority of bicarbonate, sodium, and water?
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Early proximal tubule
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Which portion of the renal tubule reabsorbs water using ADH regulation?
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Collecting tubules
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What is the role of LH and FSH in spermatogenesis?
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LH stimulates testosterone release from Leydig cells
FSH simulates Sertoli cells to produce ABP and Inhibin |
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Describe how bromocriptine inhibits prolactin secretion.
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Mech: dopamine agonist
Inhibits prolactin secretion by inhibiting the anterior pituitary which constitutively produces prolactin |
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What is the general byproduct of phase I metabolism? What is the general byproduct of phase II metabolism?
What reactions take place in phase I metabolism? What reactions take place in phase II metabolism? |
Phase I: reduction, ox, hydrolysis
Products: slightly polar water sol metabolites Uses cyto P450 Phase II: acetylation, glucuronidation, sulfation Products: very polar inactive metabolites excreted by kidney Uses conjugation Geriatric patients lose phase I first |
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Which cholinergic agonist can be used to treat postop and neurogenic ileus as well as urinary retention?
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Bethanechol
Mech: direct agonist Activates Bowel and Bladder and is resistant to AChE |
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What are the different medications used in the treatment of gout?
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Colchicine: acute gout
Mech: binds and stabilizes tubulin to prevent polymerization NSAIDs (indomethacin): acute gout Probenecid:chronic gout Mech: inhibits reab of uric acid in PCT Allopurinol: chronic gout Mech: inhibits xanthine oxidase to decrease conversion of xanthine to uric acid Do not use in acute attack Do not give salicylates since they depress uric acid clearance |
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What is the life span of an RBC? Define the following terms: polycythemia, anisocytosis, poikilocytosis, reticuloctye.
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Life span 120 days
Polycythemia=erythrocytosis=increased number of RBCs Anisocytosis: varying sizes Poikilocytosis: varying shapes Reticulocyte: immature erythrocyte |
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A patient of yours develops hypercalcemia from the most common nonmetastatic tumor arising within bones in adults. What lab findings would you suspect in this patient?
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Hypercalcemia, renal insufficiency, anemia, bone/back pain
Increased calcium, increased IgG or IgA, Ig light chains in urine |
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What is the underlying problem in Gilbert's syndrome? What form of bilirubin is elevated in the serum in each disease?
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Gilberts: mildly decreased UDP-glucuronyl transferase or decreased bili uptake
Elevated unconjugated bili with no overt hemolysis |
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What is the underlying problem in Crigler-Najjar disease type I? What form of bilirubin is elevated in the serum in each disease?
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Crigler-Najjar syndrome Type I: absent UDP glucuronyl transferase
Elevated unconjugated bilirubin |
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What is the underlying problem in Dubin-Johnson syndrome? What form of bilirubin is elevated in the serum in each disease?
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Dubin-Johnson syndrome: defective liver excretion of bili
Elevated conjugated bilirubin |
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Name the protease inhibitors used to treat HIV.
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Saquinavir, ritonavir, indivanir, nelfinavir, amprenavir
Mech: ihibit maturation of new virus bu blocking protease in progeny viruses Tx: GI intolerance, hyperglycemia, lipodystrophy, thrombocytopenia (indinavir) |
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Name the nucleoside reverse transcriptase inhibitors (NRTIs)
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Zidovudine, didanosine, zalcitabine, stavudine, lamivudine, abacavir
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Name the non-nucleoside reverse transcriptase inhibitors (NNRTIs)
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Nevirapine, Efavirenz, Delaviridine
Mech: preferentially inhibit reverse transcriptase of HIV to prevent incorporation of DNA copy of viral genome into host DNA Tox: bone marrow suppression, peripheral neuropathy, lactic acidosis, rash, megaloblastic anemia |
