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20 Cards in this Set
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Pt with new onset hep failure with normal renal fx currently taking a drug metabolized and excreted by kidneys. Would you need to change loading dose or maint dose of med because of his hepatic failure? if this pt wereto develop hepato-renal failure would you need to change the loading dose or maint dose of med?
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in patients with impaired renal or hepatic function, the loading does remains unchanged but maintenance dose is decreased. Make proper adjustments to maint dose.
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What are 4 examples of obligate aerobic organisms?
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Nocardia, P. aeruginosa, M. TB and Bacillus
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which virus and virus fam is responsible for the following.
*erythema infectiosum (5th dz) *Hep-B *warts, cervical cancer *smallpox *progressive multifocal leukoencephalopathy in HIV *conjunctivitis |
5th dz: Parvo B19
Hep B- Hepadna warts, cerv cancer: Papilloma PMLE in HIV: Polyo (JC) conjunctivitis: Adeno |
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When screening a pop for a particular dz, would you rather have a high sensistivity or a high specificity? what test is used to screen for HIV? confirms HIV?
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High sensitivity because it is the proportion of all people with disease who test positive.
ELISA to screen, Western Blot to confirm. |
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what energy metabolites does the liver secret in the fed state vs in the fasting state?
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in fasting: BGL maintained by hepatic glycogenolysis and glucose release, muscle and liver shfiting fuel use from glucose to FFA and hepatic gluconeogenesis from peripheral tissue lactate and alanine. After 3 days muscle protein is maintained by hepatic formation of ketone bodies supplying brain and heart
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What is the m.o.a of Disulfiram? Why would this drug make you fee so terrible when taken with EtOH? What other drug has similar effects?
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Disulfiram inhibits actaldehyde dehydrogenase. Thus, acetaldehyd accumulates, contributing to hangover symptoms when taken with EtOH.
others: Metronidazole, certain cephalosporins, procarbazine, Ist gen sulfonylureas |
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What lung cells secrete surfactant? What substance can be administered to a pregnant mother prito to a preterm birth to hasten the maturation of these cells?
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Pneumocytes II.
give maternal steroids before birth; artifcial surfactant for infant |
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Adult remnant of:
*umb vein *urachus *ductus venosus *ductus arteriosus *umb arteries *foramen ovale |
Umb v: ligamentum teres hepatis
urachus: median umb lig ductus venosus: ligamentum venosum ductus arteriosus: ligamentum arteriosus foramen ovale: fossa ovalis |
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other than the obovious us of pain control, what are other common use of opiods?
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cough suppression, diarrhea, acute pulm edema, maint programs for addicts
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What factors increase a woman's risk of developing a pregnancy induced htn? what syndrome can be a/w pregnancy induced htn? what time frame would this happen?
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preexisiting htn, diabetes, chronic renal dz, autoimmune disorders.
HELLP syndrome (Hemolysis, Elevated LFTs, Low Platelets) seen 20wks gestation --> 6wks postpartum |
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What syndrome is a/w temporal arteritis?
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associated wth high ESR and polymyalgia rheumatica
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On autopsy of an infant with Crigeler-Najjar syndrome (type1), bilirubin deposition was noted in the brain. What is the name of the condition that is responsible for this baby's death?
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kernicterus
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What is the equation for renal clearance? What will this equation tel lyou about reabsorption and secretion at the renal tubules?
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Cx = UxV/Px units: mL/min
Cx<GFR net tubular reabsorption of x Cx>GFR net tubular secretion of x Cx=GFR no net secretion/reabsorption |
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Classic symptoms of TB?
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fever, night sweats, weight loss, and hemoptysis
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What is the clinical use for the the following antimuscarinic drugs:
*Ipratropium *atropine, homatropine, tropciamide *benztropine *scopolamine |
ipratropium: Asthma, COPD
atropine, homatropine, tropicamide: mydriasis, cycloplegia benztropine: Parkinson's scopolamine: motion sickness |
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Which structures preforate the diaphragm? at what level?
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At T8: IVC
at T10: esophagus, vagus (2trunks) at T12: aorta, thoracic duct, azygous vein |
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How does BP response to epi amdinistrantion change if an alpha blocker is adminstered before hand? why?
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alpha blockers decrease BP via relaxation of vasc smooth muscle.
EPI has both alpah and Beta activity with selectivity for B1 at low doses thus BP will increase after admin because of its alpha and beta agonist effects |
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When taking a hx on a first tim pt,she tell you that she is a professinal femal comanion. What screening test would you consider running on this pt?
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HIV, Hep-B, syphilis, gonorrhea, chlamydia
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What structures froms the blood testis barrier?
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Sertoli cells
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Metastasis ot brain, liver and bone commonly come from which locations?
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Brain: from lung, breast, skin, kidney, GI
Liver: from Colon>stomach>Pancreas>Breast>Lung bone: from Prostat>Thryoid>Testes>Breast> Lung>Kidney (breast and prostate more common) |
