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71 Cards in this Set

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drugs that cause hemolysis in pts with G6PD deficiency
sulfonamides, INH, ASA, ibruprofen, primaquine
drugs that cause pulmonar fibrosis
bleomycin
aminodarone
busulfan
causes acute cholestatic hepatitis
macrolides (erythromycin, etc)
drugs that cause gynecomastia
Some Drugs Create AwEsome Knockers
spironolactone, digitalis, cimetidine, [chronic] alcohol, estrogens, ketoconazole
photosensitivity
sulfonamides, amiodarone, tetracycline

"SAT for a photo"
SLE like syndrome
Hydralazine, INH, Procainamide, Phenytoin

"it's not HIPP to have lupus"
SEs of fluroquinolones in kids
tendonitis, tendon rupture, and cartilage damage
P-450 inducers
quinidine, barbiturates, phenytoin, rifampin, griseofulvin, carbamazepine

"Queen Barb takes Phen-phen and Refuses Greasy Carbs"
P-450 inhibitors
isoniazid, sulfonamides, cimetidine, ketoconazole, erythromycin, grapefruit juice, st. john's wort

"Inhibitors Stop Cyber-Kids from Eating GrapefruitS"
volume of distribution
amt of drug in body to plasma concentration
Vd of plasma protein bound drugs can be altered by liver and kidney disease
Vd = amt of drug in body / plasma drug [ ]
dosages
loading dose remains the same in pts with impaired renal or hepatic fxn
but maintenance dose is [because it depends on clearance rate]
cholinesterase inhibitor effects
DUMBBELSS

diarrhea, urination, miosis, bronchospasm, bradycardia, excitiation of skeletal muscle/CNS, lacrimation, sweating, salivation

(also abdominal cramping)

**antidote = atropine + pralidoxime [regenerates AChE]
embryo is most susceptible to teratogens during this period
weeks 3-8 [organogenesis and neural tube is formed]
rule of 2s for 2nd week of gestation
2 germ layers [bilaminar disk]
->epiblast and hypoblast
2 cavities: aminotic cavity and yolk sac
2 components to placenta: cytotrophoblast, syncytiotrophoblast
blood in umbilical vein (from placenta) is ____% saturated with O2
80%

umbilical vein -> portal vein -> ductus venosus-> IVC-> RA-> foramen ovale -> aorta -> head
1st aortic arch
part of maxillary artery
2nd aortic arch
stapedial artery and hyoid artery
3rd aortic arch
common carotid and proximal internal carotid
4th aortic arch
on left: aortic arch
on right: proximal R subclavian artery

(4th arch = 4 limbs = systemic)
6th aortic arch
proximal pulmonary arteries and (on left only) ductus arteriosus
branchial apparatus
Clefts = ectoderm
Arches = mesoderm
Pouches = endoderm

(clefts are also called grooves)
branchial arch 1
M's
mandible, malleus, incus, sphenomandibular ligament, muscles of mastication, mylohoid, anterior belly of digastric, tensors, anterior 2/3 of tongue

**CN V2 and V3
branchial arch 2
S's
stapes, styloid, lessor horn of hyoid, stylohyoid ligament, muscles of facial espression, stapedius, posterior belly of digastric

**CN VII
branchial arch 3
greater horn of hyoid
stylopharyngeus

**CN IX [glossopharyngeal]
branchial arch 4-6
thyroid, cricoid, aretenyoid, etc
muscles of 4th: most pharyngeal constrictor muscles, cricothyroid, levator veli palatini
muscles of 6th: all intrinsic mucles of larynx except cricothyroid

4th: CN X (superior laryngeal)
6th: CN X (recurrent laryngeal)

*arch 3 and 4 = posterior 1/3 of tongue
branchial cleft derivatives
1st cleft: external auditory meatus

2nd-4th: temporary cervical sinuses [persistant can lead to branchial cyst in neck]
ear development
maleus/incus = 1st arch
stapes = 2nd arch
tensor tympani = 1st (V3)
stapedius musc = 2nd (VII)
3rd and 4th pouches
thymus and parathyroids

abberent development = DiGeorge syndrome
cleft lip
failure of fusion of the maxillary and medial nasal processes
cleft palate
failure of fusion of the lateral palatine proceses, nasal septum and medial palatine process
pancreas is derived from _____
foregut
ventral pancreatic bud = head and main pancreatic duct
dorsal bud = everything else
spleen arises from _____
dorsal mesentery, but is supplied by artery from foregut
mesonephric [wolffian] duct
seminal vesicles, epididymis, ejeculatory duct, ductus deferens [SEED]

*high androgen levels cause development of mesonephric ducts
paramesonephric [mullerian] duct
fallopian tubes, uterus, part of vagina

mullerian inhibiting substances secreted by testes
arsenic poisoning
vomiting, rice water stools, hypotension, and garlic-breath

antidote = succimer or dimercaperol
SEs of antidote = HTN, nausea, vomiting, headache

**succimer is more toxic than dimercaperol
falciform ligament is a remnant of
embryologic umbilical vein

(divides L and R lobes of liver)
neuroleptic malignant syndrome
ass'd with antipsychotics and amoxapine (TCA)

sx: hyperpyrexia, muscle rigidity, altered mental status, evidence of autonomic instability [tachycardia, diaphoresis, irregular pulse/bp, arrhythmias]
volume for 1/2 life
t 1/2 = (0.693 x Vd)/ CL
drug used to increase appetite in chemo patients
megestrol acetate
treatment of hemorrhagic cystitis due to cyclophosphamide/ifosfamide (nitrogen mustardes)
mesna (reacts with toxic metabolites)
equation for steady state
Css = dosing rate/ CL
omental bursa and greater omentum are derived from
dorsal mesogastrum [in the mesentary of the stomach region]
adrenal medulla is derived from
neural crest cells
adrenal cortex is derived from
mesoderm
notochord gives rise to
(is from the primitive streak)

and gives rise to nuclei pulposus of intervertebral disks
which placental component is derived from mom?
lacunar network

fetus produces syncytiotrophoblast and cytotrophoblast {together = the chorion}
ammonium chloride does this to urine
acidifies

(used to hasten excretion of such drugs as amphetamines)
efficacy of a drug
maximum effect produced by a drug, regardless of dose
potency of a drug
dose or [ ] required to produce 50% of the drug's maximal effect
maintenance dose equation
MD = CL x Cpss / F

F = bioavailability, Cpss = plasma [ ] at SS

*for IV admin, F = 1 (100%)
Rb mutation (chromosome 13q14)
at risk for retinoblastoma and osteosarcoma


(also seen in some cases of breast, lung, prostate, and bladder cancer)
an hour after endurance exercise training, _____ will be increased
VEGF (targets vascular endothelial cells)

improves oxygen transport to tissues
wound contraction causing a scar is due to this cell type
myofibroblasts

express actin and myosin like sm muscle cells
oncogene associated with small cell lung carcinoma
L-myc
the parotid gland is transversed by the _________ nerve
facial
elastic fibers found in 3 main areas
large arteries (esp aorta)
vocal cords
ligamental flava [connect the vertebrae]
Peutz-Jegher's syndrome
widespread 'freckles'
hamartomatous colonic polyps
->but will NOT progress to colon cancer
increased risk of carcinomas of pancreas, breast, ovary, uterus and lung
compensatory hypertrophy of the bladder smooth muscle develops in response to ______
BPH (b/c there is a chronic impediment to urine outflow)
Sturge-Webber syndrome
port wine stain lesion [telangiectasia that occurs on the head and grows w/the body]
may be ass'd with angiomatous masses in the leptomeninges
also see MR, seizures, hemiplegia
common muscles affected by diabetic neuropathy
foot lumbricals and interossei
pathophysiology of cancer cachexia
TNF-a, IFN-gamma and IL-1 are involved
increase catabolism of proteins and fat
Leigh disease
subacute necrotizing encephalomyelopathy
VERY RARE
involves defects of mt DNA rather than chromosomal DNA

defective enzyme = cytochrome oxidase (ETC)

sx: progressive intellectual deterioration, weakness, ataxia, and seizures
SVC syndrome
obstruction of venous return from head, neck, and upper extremities
85% of cases of SVC are related to malignancy, usually SCLC and squamous cell lung CA
most frequent paraneoplastic syndrome associated with squamous cell lung CA
hypercalcemia
dislocated shoulder joint
loss of normal contour of the shoulder
abnormal appearing depression below the acromonion
mucopolysaccharidoses that do not cause MR
Morquio syndrome
Scheie syndrome
Boerhaave's syndrome
lower esophageal rupture
follows excessive straining and vomiting
gastric contents enter pleural space, has high mortality rate
pain in chest, upper abdomen, can radiate to back, left chest or left shoulder
_____ causes AST elevation w/out elevation of ALT or other liver enzymes
myocardial infarction
Baker cyst
enlarged semimembranous bursa
more commonly seen at extremes of age
benign, due to accumulation of fluid
tumor suppressor genes on long arm of chromosome 18
DPC (pancreatic)

DCC (colon)
_____ is used to evaluate the mutagenicity of a compount
the Ames test