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27 Cards in this Set
- Front
- Back
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How is fetal lung maturity assessed prenatally?
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Amniocentesis looking for a L/S ratio (lecithin:sphingomyelin) >2.
Lecithin is a major component of surfactant. |
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What drugs are used to treat ED and how doe they work? SE's?
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Sildenafil & vardenafil (FILL the penis)
cGMP PDE-inhibitors. Cause ↑cGMP b/c it's not broken down → relax the corpus cavernosum SE: Hot (flushing), H/A, Heartburn (dyspepsia), HYPOTENSION (if given w/ nitrates) |
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What is required to release vesicles at a NMJ?
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When an AP reaches the Pre-Synaptic terminal, CaV channels open → Ca2+ stimulates vesicle fusion w/ the PM.
Vesicle fuses, releases ACh or NE |
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What lab value should be monitored in a person at high risk for DIC?
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Fibrinogen levels (will drop) and platelet count (also will drop).
The PT, PTT, and BT will all increase. There will be ↑ in FV and VIII. There will be an ↑ in D-dimers (fibrin split products) and you will see schistocytes on PB. |
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What are the causes of DIC?
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STOP M-aking N-ew T-hrombi
S - Sepsis (gram negative) T - Trauma O - Obstetric complications P - Pancreatitis (acute) M - Malignancy N - Nephrotic syndrome T - Transfusion |
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What are the clinical manifestations of botulism?
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3 D's of Botulism:
- Diplopia - Dysphagia - Dysphonia All d/t botulinum toxin preventing release of ACh @ NMJ → prevents muscle contraction |
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What are 3 drugs that interfere w/ DHFR?
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1) MTX = methotrexate (eukaryotes - prevent purine & thymidilic acid synthesis)
2) TMP = trimethroprim (bacteria; used for UTI, shigella, salmonella, PJP) 3) Pyrimethamine (parasite; used for malaria and toxoplasmosis) |
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What immune cells predominate in acute inflammatory response? In chronic?
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Acute = PMN's / Neutrophils
(e.g. pyogenic organisms like staph aureus) Chronic = mononuclear cells (e.g. TB) |
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Which condition presents with primary amenorrhea, absent secondary sexual characteristics, and olfactory sensory defects?
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Kallmann Syndrome.
Is an absence of GnRH secretion in the hypothalamus (results in decreased LH/FSH from the anterior pituitary gland) |
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What is glyburide?
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Glyburide is an oral hypoglycemic.
It is a sulfanurea (SU) that increases release of ß-cell vesicles that contain insulin. Taking glyburide will increase serum insulin and C-peptide. |
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How do sulfonylureas work?
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SU's bind similarly to ATP on the ATP sensitive K+ channel.
They close this K+ channels in ß-Cells → depolarization This opens CaV and results in a Ca2+ influx → insulin release (vesicles fuse w/ PM) |
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How does Abciximab work?
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Binds to platelet GpIIb/IIIa receptors and prevents:
- linkage of platelets - fibrinogen binding Similar effect to the disease: - Glanzmann trhombasthenia (a deficiency of the GpIIb/IIIa receptors) |
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What drugs interfere with platelet plug formation and at what targets?
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1) Clopidogrel & ticlopidine (CLOPS) = inhibit ADP-induced expression of GpIIb/IIIa
2) Abciximab = inhibits GpIIa/IIIb directly 3) Aspirin = COX inhibitor that prevents formation of TXA2 (pro-aggregator) |
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What kind of vaccine is the flu vaccine and how is immunity mediated?
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Vaccine = killed viral vaccine
Immunity mediated by Anti-Hemagluttinin (which promotes viral entry) Ab's: - IgA multimers in mucosa - IgG in circulation |
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What kind of virus is the influenza virus?
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Orthomyxovirus:
- Enveloped - SS RNA - 8 segmented genome - Antigens: 1) hemagglutinin - entry 2) neuraminidase - promotes progeny virion release Pt @ risk for bacterial SUPER infection Sudden Shifts = pandemics (human - swine) graDual Drifts = epidemics (random mutations) |
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What nerve roots are compressed in sciatica? What are the most common and their presentations?
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L4-S3
Most common: - L5 - Posterior & lateral pain shooting to inner foot - S1 - Posterior ONLY pain shooting to foot; weak plantar flexion; ↓ ankle reflex |
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What UTI is characterized by dysuria and hematuria?
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Hemorrhagic cystitis.
Most common viral cause in kids is Adenovirus (subgroup B: 11, 21); affects males esp. |
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What kind of virus is Adenovirus?
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DNA Virus
- NO Envelop - DS DNA Causes the 4 P's of Adenovirus: - Pharyngitis (phebrile) - Pneumonia - Pink eye (conjunctivitis) - Pink pee (acute hemorrhagic cystitis) |
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What are the insertion points of the sternocleidomastoid muscle and its innervation? What is its function?
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3 insertion points:
- Sterno - sternum (manubrium) - Cleido - clavicle (medial) - Mastoid - mastoid process (skull) Innvervation by CN XI Fx - turn head in opposite direction |
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What are the phases of pacemaker action potentials and what mediates each one?
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Phase 4 = If (funny current) slow inward Na current
- slope of phase 4 determines HR; + by catecholamines; - by ACh and Adenosine Phase 3 = @ about -40, inward Ca2+ current depolarizes (~100msec) Phase 3 = Outward K+ efflux (IK) |
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What is encoded in mtDNA?
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mtDNA has 37 genes:
- 13 proteins - 22 tRNA - 2 rRNA = 37 |
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What therapy would you give for an acute manic episode?
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1) Mood stabilizer
- valproate - lithium - carbamazepine 2) Atypical antipsychotic - olanzepine (60% are fine w/ monotherapy of mood stabilizer) |
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What are e.g.'s of TCA's and what is their major toxicity?
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TCA's - 3 naming groups:
1) Iptylines: - amitriptyline - nortriptyline 2) Ipramines - clomipramine - desipramine - imipramine 3) Ox's: - amoxapine - doxepin Toxicity = the Tri-C's: - Convulsions - Coma - Cardiotoxicity → arrhythmias |
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What is cimetidine and what are some side effects?
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H2 blocker for PUD/gastritis.
- Inhibits P450 - Antiandrogenic - gynecomastia - PRL release - impotence/↓libido |
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What causes follicular lymphoma?
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Overexpression of the anti-apoptosis gene product BCL-2.
90% of the time a translocation of: t(14;18) Adults |
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What enzymes are used in the non-oxidative reactions of the HMP shunt?
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Transketolase
Transaldolase All cells can therefore convert F6P → ribose |
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Which nutrients are deficient in breast milk?
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Vitamins D & K.
K is given as IM injection @ birth to prevent hemorrhagic diseases. D usually from sunlight; in dark skinned babies, supplement. |
