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35 Cards in this Set
- Front
- Back
Lab findings in an alcoholic
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fasting hypoglycemia
increased anion gap metabolic acidosis (from lactic acidosis and betahydroxybutryric acidosis) Hyperuricemia (lactic acid and beta hydroxybutryirc acid compete with uric acid for excretion in the proximal tubules) hypertriglyceridemia (from production of glycerol 3 phosphate) elevated AST (etoh is a mitochondrial toxin causing AST release) and increased serum GGT (from hyperplasia of the sER) the metabolism of EtOH produces NADH and acetyl CoA NADH: converts pyruvate to lactace; aceteacetone to betahydroxybutyrate; and DHAP to glycerol 3 phosphate aceyl CoA is used to synthesize fatty acids for triacylglcerides, and to synthesize ketoacids |
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What is the most common complication of intravenous drug abuse?
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Hep B
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Cocaine
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Stimulant
Toxic Effects: Acute MI, CNS infarction, and perforation of the nasal septum Clinical Signs: mydriasis, hypertension and tachycardia |
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MPTP
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byproduct of the synthesis of merperidine, causing irreversible parkinson's disease; cytoxic to cells in the nigrostriatal pathway
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Drug induced aplastic anemia? hemolytic anemia?
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aplastic anemia: chloramphenicol and alkylating agents
hemolytic anemia: penicillin, methyldopa and quinidine |
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What drugs induce SLE like symptoms?
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procainamide and hydralazine
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What drug side effect causes macrocytic anemia?
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methotrexate (most commonly)
phenytoin, oral contraceptives and 5-FU |
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What does Aspirin Overdose look like?
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tinnitus, vertigo, change in mental status, confusion, seizures, tachypnea
acid base disorders: respiratory alkalosis (within12-24 hours) respiratory acidosis later on Shifts to a metabolic acidosis with an increased anion gap (more commonly in kids) Mixed primary respiratory alkalosis with metabolic acidosis more often in adults hyperthermia, because ASA damages the inner mitochondrial membrane, and oxidative energy is released as heat, not ATP |
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What drug side effect causes thrombocytopenia?
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heparin (most commonly) followed by quinidine
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What cutaneous side effects are seen with penicillin?
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maculopapular rash and urticaria
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disorders of unopposed estrogen
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adenocarcinoma of the breast and endometrium
venous thromboembolism because estrogen decreases the synthesis of ATIII, which normally neutralizes coagulation factors estrogen also increases the synthesis of factor I, V and VIII (take your estrogen at 8:15) May also see intrahepatic cholestasis and jaundice, CV effects include MI and stroke |
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How does estrogen promote coagulation?
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it decreases the synthesis of ATIII, which is responsible for neutralizing coagulation factors
estrogen also promotes formation of factors I, VIII, V |
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What is the most commong cause of HTN in young women?
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oral contraceptives
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Oral Contraceptive Risks?
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Decreased risk for endometrial and ovarian cancer
increased risk for breast and cervical cancer venous thromboembolism intrahepatic cholestasis and jaundice cholesterol gallstones, bc estrogren increases cholesterol excretion in the bile Hypertension (due to increased synthesis of Angiotensinogen) |
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what are the toxic effects associated with Mercury Poisoning?
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Diarrhea, Proximal Tubule Nephrotoxicty and constricted visual fields
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acetaminophen toxicity
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conversion to free radicals in the liver, may cause fulminant hepatitis, or renal papillary necrosis
aspirin may also cause fulminant hepatitis |
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toxicity associated with rubbing alcohol
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Deep coma--> end product is acetone
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Lead toxicity
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microcytic anemia, with coarse basophilic stippling, nephrotoxicity in the proximal tubule
lead is in paint, batteries, metal casting |
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methanol toxicity
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seen in washer fluid, the end product is formic acid
increased anion gap metabolic acidosis, blindness due to optic atrophy |
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What does mercury poisoning cause?
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diarrhea, loss of peripheral vision, nephrotoxicity in the proximal tubules
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heat cramps
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body temp is 37, skin in moist and cool, normal mental status
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heat exhaustion
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body temp is more than 37.8 (more than 100) skin is sweaty, and they have minimally altered mental status
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Heat stroke
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Body temp is 40, skin is dry, impaired consciousness
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Which type of electical current is more dangerous, AC or DC?
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AC--> causes tetanic contractions, where DC just causes a single shock
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What is the most common cancer caused by radiation?
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acute leukemia
lymphoid tissue is most sensitive to ionizing damage (bone is least sensitive) |
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Why does Obesity lead to HTN?
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hyperinsulinemia increases sodium retention, leading to increased EABV--> LVH and stroke complicate hypertension
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What is the relationship between hyperinsulinemia and obesity, with regards to T2DM?
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High adipose levels decrease insulin receptor synthesis, leading to hyperinsulinemia (HTN), which will increase fat stores...
weight loss increases insulin receptor synthesis |
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What is the function of Thiamine?
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cofactor for ATP synthesis
Chronic Alcholism is the most common cause of thiamine deficiency, and symptoms are related to decreased ATP Dry (p. neuropathy) or Wet Beri Beri (congestive cardiomyopathy with biventricular failure) |
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Wernicke's Syndrome
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mamillary body hemorrhage, ataxia, confusion, nystagmus
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Korsakoff Syndrome
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antegrade and retrograde amnesia, demyelination in the limbic system
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What generally causes death in a hanging?
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Compression of venous return, not generally compression of airflow
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What is the difference between drowing in salt water, compared to drowning in fresh water?
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salt water: because it is hypertonic, it draws in water from the capillaries, causing pulmonary edema
fresh water: aspired water is absorbed rapidly, causing hemolysis hemodilution with resting cardiac arrhythmias and heart failure |
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What is the pathophysiology of heat stroke?
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core body thermoregulatory mechanisms fail
Rectal temp >106 is a grave sign sweating ceases generalized vasodilation with peripheral pooling decreased circulating blood volume myonecrosis |
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At what point does loss of consciousness occur in hypothermia?
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about 90 degrees F
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What is the first pathway between stress and the immune system?
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sympathetic fibers directly innervate primary (thymus and bone marrow) and secondary lymph tissue (spleen and lymph nodes)
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