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20 Cards in this Set
- Front
- Back
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What primary hormone is increased or deccreased in :
*Cushing's *Conn's *Addison's *Graves |
Cushing's: high cortisol
Conn's: high aldosterone Addison's: def in aldosterone and cortisol Graves':thyoroid stimulating/TSHR antibodies |
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Pt dx with DM 3o years ago comes to office for a gen wellnes exam. What would you pay particular attention to on you phys exam?
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Non enzymatic glycosylation: small vessel dz --> retinopathy (hemorrhage, exudates, micro aneurysm, vessel prolif), glaucoma, nephropathy (nodular sclerosis, progressive proteinuria, chronic renal failur, arteriosclerosis leading to Htn, kimmelstiel-wilson nodules
large vessel atherosclerosis, CAD, perip vac occlusive dz, gangrene, CVD Osmtoic damage: neuropathy (motor, sensory, and autonomic degeneration), Cataracts (sorbitol accum) |
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how does the m.o.a of typical antipsychotics differ from the m.o.a of atypicals
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typcials block dopamine D2 R
atypicals block 5HT2, alpha, H1 and dopamine R |
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Do the nitrate drugs have a greater effect on v or art? hydrazlazine?
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nitrates have greater effect veins>>arteries
hydralazine: arterioles>veins |
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What equation is used to calculate the anion gap? Describe what PCO2 and what HCO3 you would find in an anion gap metabolic acidosis.a
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anion gap: Na - (Cl + HCO3)
met acidosis: PCO2<40 HCO3 depressed |
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oral agents for DMII contol characteristisc
*lactic acidoss is rare but worrisome *MC side effect is hypoglycemia *only oral not a/w wt gain *met by liver; excellent for renal dz *primarily effcts postprandrial hyperglycemia *ideal firs line for overwt pts |
lactic acidosis: biguanindes (mefortmin)
hypoglycemia effect: sulfonylureas and meglitinides not a/w wt gain: biguanides for renal dz pts:glitazones postprandial hyperglycemia: alpha-glucosidas inhibitors for overwt diabetics: biguanides |
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Which antifungal drug and diruetic drug inibit steroid synthesis?
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ketoconazole and spirinolactone
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What are the signs of w/d from opioids?
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anxiety insomnia, anorexia, sweating, dilated pupil, piloerction, fever, rhinorrhea, nausea, stomach crampos, diarrhea (flu like symp) yawning
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What are the main differences between the myocardial AP and the pacemaker AP
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Pacemaker differs in:
Phase 0: upstroke - opening of VG Ca ch. don't have fast Vg Na ch --> slow cond vel Phase 2: there is no plateau Phase 3: inactivation of CA chn and increase activation of K ch --> up K efflux Phase 4: slow diastolic depol - mem pot spont depol as Na cond increases. accts for automaticity of AV/SA node. Slope determines HR |
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What urine specific gravity and serum osmalility would you see in a pt with DI?
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urine spec grav = <1.006 and serum osm = >290 mOsm/L
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What are the 2 diff types of second degree AV blocks? differ?
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type 1 : progressive lengthening of PR, then beat drops.
type 2: dropped beats that are not preceded by a change in the lenght of the PR |
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which Mycobact spp fits?
*cause leprosy *pulmonary TB like symp in COPD pts *cervical lymphadenitis in kids *disseminated dz in AIDS pts |
leprosy: M leprae
TB like symptoms: M. kansaii cervical lymphadenitis: M. tb dissemination in AIDS: M avium-intracellulare |
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What common OTC med is used to remove excess thick sputum by stimulating the vagus n. to generate low viscosity secretions in bronchial tree
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Guaifenesin
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What are the clinical manif of Addison's? what casues it?
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hypotensions, skin hyperpigmentation
def in aldosterone and cortisol due to adrenal atrophy or destruction by dz |
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What is the underlying cause of DiGeorge syn? manifestaions?
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thymus and parathyroid fails to dev owing to failure of 3rd and 4th pharyngeal pouches
presents with tetany owing to hypocalcemia. Recurrent viral and fungal infeccton due to T cel def. 22q11 deletion |
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Cinical use of Clindamycin. Well known side effect?
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tx anaerobic infections (Bacteroides fragilis. C prefingens
side effect. Pseudomembranous colitis |
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Which antiviral agent can be used to tx not only Influenza A or B but also swine flu? M.OA?
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Zanamavir and oseltamivir
inhibit influenza neruaminidase, decreasing release of progeny virus |
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What GLUT R would you expect to find on muscle and fat?
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GLUT 4
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what is the most comon form of adrenal hyperplasi? Which hormone levels are altered as a result on this enzyme def? clinical manif of def?
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21 alpha hydroxylase def.
decrease cortisol (up ACTCH), down mineralcorticoids, up sex hormones. leads to masculinization, female pseudohermaphrodites, hypotenstion, hyperkalemia up plasma renin activity and volume depletion |
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What importatn secretory products are secreted fromthe following cells if GI tract?
*G cells *I cells *S cells *D cells *parietal cells *chief cells |
G: gastrin
I: Cholecystokinin S: Secretin D: somatostatin Parietal: IF, gastric acid Chief: pepsin |
