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27 Cards in this Set
- Front
- Back
What are the signs and symptoms of digoxin toxicity? What is the antidote for digoxin toxicity?
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Class: cardiac glycoside
Mech: direct inhibition of Na/K ATPase leads to indirect inhibition of Na/Ca exchanger antiport. Increased Ca leads to positive inotropy. Also stimulates vagus nerve. To x sx: nausea, vomiting, diarrhea, blurry yellow vision Antidote: slowly normalize K, lidocaine, cardiac pacer, anti-dig Fab fragments, Mg |
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What GI ligament separates the greater and lesser sacs?
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Gastrohepatic (R)
Connects liver to lesser curvature of the stomach Contains gastric arteries May be cut during surgery to access the lesser sac Gastrosplenic (L) Connect greater curvature and the spleen Contains short gastric arteries |
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What GI ligaments connect the spleen to other structures?
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Gastrosplenic, splenorenal
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What GI ligament contains the portal triad?
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Hepatoduodenal
Connects liver to duodenum Portal triad: hepatic artery, portal vein, common bile duct May be compressed between thumb and index finger placed in omental foramen to control bleeding |
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What is the mechanism of action of the drug lanosoprazole? What other drug works in the same manner?
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PPI (omeprazole, lansoprazole)
Mech: irreversibly inhibit H/K ATPase in stomach parietal cells Use: peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syndrome |
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What is the basic difference between endometriosis and endometrial hyperplasia? How does the clinical presentation of each differ?
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Endometriosis: non-neoplastic endometrial glands and stroma in abnormal locations outside the uterus
Characterized by cyclical bleeding with chocolate cysts Present with several menstrual-related pain Can be due to ascending infection or retrograde menstrual flow and may result in infertility Endometrial hyperplasia: abnormal endometrial gland proliferation from excess estrogen Increased risk for endometrial cancer Present with post-menopausal vaginal bleeding Risk factors: anovulatory cycles, HRT, polycystic ovarian syndrome, late menopause, granulosa cell tumor |
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What is the clinical use of clomiphene? How does this drug work?
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Estrogen partial agonist at the hypothalamus
Prevents normal feedback inhibition leadint to increased release of LH and FSH to stimulate ovulation |
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What are the causes of aplastic anemia? What is the treatment for aplastic anemia?
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Causes:
Radiation/drugs (benzene, chloramphenicol, alkylating agents, antimetabolites) Viral infections (parvo B19, EBV, HIV) Fanconi's anemia (inherited defect in DNA repair) Idiopathic (immune mediated, primary stem cell defect) Tx: stop offending agent, immuno suppress, allogenic bone marrow transplant, RBC and platelet transfuse, G-CSF or GM-CSF |
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A smear of your patient’s blood reveals target cells. What diseases do you immediately suspect?
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HbC disease
Asplenia Liver disease Thalassemia |
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What hormone that is associated with hyperphagia in Prader-Willi syndrome is lost after gastric bypass surgery?
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Ghrelin
Source: P/D1 cells in stomach Action: increases GH, ACTH, cortisol, and prolactin secretin Increases before meals and decreases after meals |
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Which skin cancer has a histopathology revealing keratin pearls?
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Squamous cell carcinoma
Locally invasive but rarely mets Preceded by actinic keratosis Keratoacanthoma is a variant that grows quickly and recedes spontaneously |
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Which skin cancer does a dysplastic nevus precede?
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Melanoma
Significant risk of mets S-100 tumor marker Depth of tumor correlates with risk of mets Dark with irregular borders |
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Which skin cancer has a histopathology revealing palisading nuclei?
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Basal cell tumors
Locally invasive but rarely mets Rolled edges with central ulceration |
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Which skin cancer appears as pearly papules with subepidermal blood vessels?
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Basal cell carcinoma
Commonly with telangiectasias Locally invasive but rarely mets Rolled edges with central ulceration |
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Which skin cancer is associated with sun exposure and arsenic exposure?
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Squamous cell carcinoma
Locally invasive but rarely mets Preceded by actinic keratosis |
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What type of collagen is abnormal in patients with Alport’s syndrome?
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Abnormal type IV collagen (basement membrane of kidney, ears, eyes)
Most common form is X-linked recessive Characterized by rpgressive hereditary nephritis and deafness May be associated with ocular disturbances |
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A woman presents to your clinic with vaginal irritation and greenish vaginal discharge. You take a sample of the discharge and notice Clue cells under the microscope. What drug would you use to treat this infection?
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Tx: metronidazole
Gardnerella vaginalis Pleomorphic gram-variable rod causing vaginosis Associated with sexual activity but not an STD |
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What is the most common tumor of the salivary gland? What is the most common malignant tumor of the salivary gland?
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Pleomorphic adenoma (benign)
Painless movable mass with high rate of recurrance Mucoepidermoid carcinoma (malignant) |
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How does the drug dose response curve change with the addition of a competitive antagonist compared to a noncompetitive antagonist?
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With a competitive antagonist, the curve shifts to the right which decreases potency and increases EC50.
A non-competitive antagonist shifts the agonist curve downward, decreasing efficacy. |
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What is the mechanism of action of bleomycin?
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Mech: G phase specific. Induces the formation of free radicals which cause breaks in DNA strands
Use: testicular cancer, Hodgkins lymphoma Tox: pulmonary fibrosis, skin changes |
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What is the mechanism of action of cyclophosphamide?
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Mech: covalently X-link (interstrand) DNA at guanine N-7. Must be activated by liver
Use: Non-Hodgkin's lymphoma, breast and ovarian cancers, immunosuppression Tox: myelosuppression, hemorrhagic cystitis (prevent with mesna) |
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What is the mechanism of action of doxorubicin?
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Mech: generate free radicals, noncovalently intercalate in DNA causing breaks and decreasing replication
Use: Hodgkins, myelomas, sarcomas, solid tumors Tox: cardiotoxicity, myelosuppression, alopecia. Toxic to tissues with extravasation |
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What is the mechanism of action of 6-mercaptopurine?
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Mech: purine (thiol) analog causing decreased de novo purine synthesis. Activated by HGPRTase
Use: leukemias, lymphomas (not CLL of Hodgkins) Tox: bone marrow, GI, liver. Metabolized by xanthine oxidase to increasing toxicity with allopurinol |
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What are the first generation cephalosporins? What organisms do they kill?
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Cefazolin, cephalexin
Kill gram positive cocci (PEcK) Proteus mirabilis, E coli, Klebsielle pneumoniae |
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What are the second generation cephalosporins? What organisms do they kill?
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Cefoxitin, cefaclor, cefuroxime
Kill gram positive cocci (HEN PEcKS) Haemophilus, Enterobacter aerogenes, Neisseria, Proteus, E. coli, Klebsiella, Serratia marcescens |
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What are the third generation cephalosporins and what organisms do they kill?
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Ceftriaxone, cefotaxime, ceftazidime
Kill serious gram negative infections resistant to other beta lactams, meningitis Pseudomonas killed by ceftazidime Gonorrhea killed by ceftriaxone |
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What are the fourth generation cephalosporins? What organisms do they kill?
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Cefepime
Increased activity against Pseudomonas and other gram positive organisms |