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19 Cards in this Set
- Front
- Back
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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.
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Anion gap=Na-Cl-HCO3-
PCO2<40 mmHg Decreased HCO3 Decreased pH |
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A patient of yours was diagnosed with diabetes mellitus 30 years ago and comes to you today for a general wellness exam. What would you pay particular attention to on your physical exam of this patient (ie. chronic manifestations of diabetes)?
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Retinopathy, glaucoma, neuropathy, renal failure, HTN, Kimmelstiel Wilson nodules, gangrene, cerebral vascular disease
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What are the endocrine functions of the kidney?
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Erythropoietin: released in response to hypoxia from endothelial cells of peritubular capillaries
1,25 OH2 Vitamin D: PT cells convert to active form. PTH stim these cells Renin: secreted by JG cells in response to decreased renal arterial pressure and increased renal sympathetic discharge Prostaglandins: paracrine secretion to vasodilate the affterent arterioles to increase GFR |
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What is the appearance of asbestos fibers in the lung? What cancers are associated with asbestosis?
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Associated with shipbuilding, roofing, plumbing
Results in "ivory white" calcified pleural plaques Increased incidence of bronchogenic carcinoma and mesothelioma Asbestos bodies are golden brown fusiform rods resembling dumbbells located inside macrophages |
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What is the structure of HbH? What disease results in HbH production? What is the structure of Hb Barts? What disease results in Hb Barts production?
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HbH=3 deletions in alpha thalassemia. Beta 4.
HbBarts=4 deletions in alpha thalassemia. Gamma 4. Incompatible with life. |
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Which types of cancer are associated with the following chromosomal translocations?
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9;22 Philadelphia chromosome, CML
8;14 Burkitt's lymphoma, cmyc activation 14;18 Follicular lymphoma, bcl-2 activation 15;17 AML (M3) 11;22 Ewings sarcoma 11;14 Mantle cell lymphoma |
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What are the causes of normocytic, normochromic anemia?
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Hemolytic: hereditary spherocytosis, 6GPD, sickle cell anemia, pyruvate kinase deficiency, HbC, PNH, autoimmune, microangiopathic, infections, mechanical destruction
Non-hemolytic: aplastic anemia, anemia of chronic disease, kidney disease |
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The most common cause of osteomyelitis in all patients is Staph. aureus. What organism would you also suspect in a sickle cell patient with osteomyelitis? What about a drug addict with osteomyelitis?
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Sickle cell diseases: salmonella
Drug addict: pseudomonas |
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What is Charcot’s triad?
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Jaundice, fever, RUQ pain
Positive Murphy's sign: inspiratory arrest on deep palpation |
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Why is diphenhydramine (Benadryl) a poor medication choice in the elderly and those with BPH?
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Diphenhydramine is a first generation H blocker
Tox: sedation, antimuscarinic (contra in elderly with glaucoma?), anti-alpha adrenergic (Contra in BPH) |
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Which antifungal may cause arrythmias?
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Amphotericin B
Mech: binds ergosterol and forms membrane pores Uses: wide spectrum Tox: fever, chills, hypotension, arrythmias, nephortoxic, anemia, IV phlebitis |
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Which antifungal may cause liver dysfunction?
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Azoles
Mech: inhibit ergosterol synthesis Uses: systemic mycoses Tox: hormone synth inhibition (gynecomastia), liver dys (inhibits P450), fever, chills |
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Which antifungal interferes with microtubule function?
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Griseofulvin
Uses: oral tx of superficial infections, good for dermatophytes Tox: teratogen, carcinogen, confusion, headaches, increases P450 and warfarin metabolis |
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Which antifungal inhibits steroid synthesis in fungi and in humans?
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Caspofungin
Mech: inhibits cell wall synthesis by inhibiting synthesis of beta glucan. Use: invasive aspergillosis Tx: GI upset, flushing |
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Which antifungal is an oral treatment for superficial fungal infections?
Which antifungal is an oral treatment for superficial fungal infections? |
Nystatin
Mech: binds ergosterol and disrupts fungal membranes Swish and swallow for oral candidiasis, topical for diaper rash or vaginal candidiasis |
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How can you determine whether hypoglycemia is caused by an endogenous abnormality (such as an insulinoma) or by exogenous insulin uptake?
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Serum C peptide is not present if someone is taking exogenous insulin.
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What are some of the problems encountered with menopause?
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HHAVOC
Hirsuitism Hot flashes Amenorrhea, atrophy of the vagina Vaginal dryness Osteoperosis Coronary artery disease |
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What is the general mechanism of action of the steroid/thyroid hormones? Which hormones are considered steroid hormones?
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Lipophilic and insoluble in plasma so carried by binding globulins. Must be transcribed so protein synthesis delays onset of action.
PET CAT Progesterone, estrogen, testosterone, cortisol, aldosterone, thyroxine and T3 |
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Describe how heart failure, liver failure, infections and toxins, and lymphatic blockage would affect the Starling forces of fluid movement through capillaries.
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They all cause edema
Heart failure increases capillary pressure Nephrotic syndrome and liver failure decrease the plasma protein conten Toxins and infections increase capillary permeability Lymphatic blockage increases intersitital fluid colloid osmotic pressure |
