4/4 micro/rapidreview Flashcards Preview

Final FA review > 4/4 micro/rapidreview > Flashcards

Flashcards in 4/4 micro/rapidreview Deck (99):
1

Direction dilation of arteries & inhibition of platelet aggregation: which drugs?

cilostazol & dipyridamole.
-PDE3 inhibitors: inc. cAMP in platelets + also vasodilate.

2

cilostazol
-mech:
-use?

PDE 3 inhibitors.
-inc cAMP in platelets = prevents aggregation.
-arterial vasodilator.

3

argatroban
-mech:
-use?

direct thrombin inhibitor
-Derivative of hirudin (used by leeches).
-used instead of heparin in pts w/HIT.

*same as bivalirudin.

4

cardinal ligament
-aka?
-contains which vessels?

transverse cervical ligament
-contains uterine vessels.

5

musculocutaneous nerve
-provides sensory info to which region?

lateral forearm.

6

Forceful injury involving separation of neck and shoulder
-which nerve is in trouble?

musculocutaneous

7

medial forearm sensory inn?

ulnar n.

8

heard best over cardiac apex and radiates to axilla
-which murmur

mitral regurg

9

Why do pts w/Crohns disease get gallstones?

dec bile acid resorption leads to too much cholesterol in your bile.
-get cholesterol gallstones.
*dont confuse kidney stones w/gallstones.

10

binge alcohol drinking can precipitate which murmur?
-what will EKG show?

afib.
*pericarditis & inc. sym tone can also precipitate it.
-no discrete P waves.

11

varenicline
-mech:

partial agonist at nicotinic receptor.

12

MEN 1
-mnemonic:

3 Ps
-pituitary, parathyroid, pancreas.

13

MEN 2A
-mnemonic:

PPM
-parathyroid, pheochromocytoma, medullary thyroid carcinoma.
*remember, that has the one that seems to be contradictory - bc medullary thyroid carcinoma releases calcitonin & parathyroids release PTH.
-opposite hormones.

14

MEN 2B
-mnemonic:

MMP
-medullary thyroid carcinoma.
-marfanoid habitus
-pheochromocytoma
*neuromas

15

Normal pressures:
-RV:

max = 25
min = 4

16

Normal pressures
-RA:

max = 8
min = 0

17

Normal perssures
-Pulm art:

max = 25
min = 9

18

which area has higher diastolic/minimum pressure?
RV or pulm art?

Pulm. art.

19

Normal pressure
-LA:

max = 12
min = 2

20

RA vs LA
-which ones normal minimum pressure can drop to 0?

RA.

21

cystine kidney stones
-precipitate at which pH?

acidic

22

Opening snap heard in which murmur?

mitral stenosis

23

Chloroquine
-mech

-Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia.

24

Chloroquine
-which malarial organism is it not effective against?
-why?

P. falciparum.
-Resistance due to membrane pump that dec. intracellular concentration of drug.

25

How do you treat P. falciparum?

Artemether/lumefantrine or atovaquone/proguanil.

26

For life-threatening malaria, :use

quinidine in U.S. (quinine elsewhere) or artesunate.

27

Chloroquine
-tox:

-Retinopathy; pruritus (especially in dark-skinned individuals).

28

Zanamivir, oseltamivir
-mech:
-use:

-Inhibit influenza neuraminidase => dec. the release of progeny virus.
-Treatment and prevention of both influenza A and B.

29

Zanamivir, oseltamivir
-mnemonic:

zaNAmivir & oselNAmivir = NA inhibitors.

30

Ribavirin
-mech:

-inhibiting IMP DH which converts IMP => GMP.

31

mycophenolate
-mech:

Inhibit IMP DH.
-blocks IMP => GMP.

32

Ribavirin
-use:

RSV, chronic hepatitis C.

33

Ribavirin
-tox:

Hemolytic anemia. Severe teratogen.
-depletes intracellular ATP => causes non-immune mediated extravascular hemolysis.
-no ATP = rigid RBC = cant make it thru spleen w/o being phagocytosed = extravascular hemolysis.
-Kind of like same mechanism as pyruvate kinase deficiency.

34

chronic hep C
-Tx:

alpha-interferon & ribavirin.

35

Valacyclovir
-what is it?

Valacyclovir converted to acyclovir by first past metabolism in small intestine & liver.

36

Acyclovir
-how is it activated?

Monophosphorylated by HSV/VZV thymidine kinase.
- not phosphorylated in uninfected cells =Ž few adverse effects.

37

Acyclovir
-mech:

-guanosine analog.
-lack the 3' -OH, so once they are incorporated
into DNA, they are chain terminators.

*guanosine = nucleoside = no phosphates on it.

38

Acyclovir
-use:

-HSV and VZV. Weak activity against EBV.
*NO effect on latent forms!

39

Herpes Zoster
-Tx:

Famciclovir

40

Acyclovir
-tox:
-usually seen in which scenario?

Obstructive crystalline nephropathy and acute renal failure if not adequately hydrated.
*usually seen in HSV-1 encephalitis in hospitalized pt receiving IV acyclovir.

41

Acyclovir
-mech of resistance?

Mutated viral thymidine kinase.

42

Ganciclovir
-how is it activated?

CMV viral kinase.

43

Ganciclovir
-mech:

guanosine analog.
-Preferentially inhibits viral DNA polymerase via chain termination, like acyclovir.

44

Ganciclovir
-which form has best oral bioavailability?

valGANciclovir

45

Ganciclovir
-tox:

Leukopenia, neutropenia, thrombocytopenia, renal toxicity.
*watch out when giving w/other meds that cause BMS like zidovudine.

46

Foscarnet
-mech:

-Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme.
*Does not require activation by viral kinase.

47

Foscarnet
-use:

-CMV retinitis in immunocompromised patients when ganciclovir fails
-acyclovir-resistant HSV.
*usually these will be AIDS pts.

48

Foscarnet
-tox:

-Nephrotoxicity, seizures.
-can chelate calcium

-induces renal wasting of magnesium => hypomagnesemia.
-reduction of PTH release => hypocalcemia.
-both hypomagnesemia & hypocalcemia can => seizures.

49

Foscarnet
-dont use w/pentamidine. Why?

-Watch drug interaction w/pentamidine (treat pneumocystis jiroveci in HIV pts) which is also nephrotoxic.
-You can get life threatening hypocalcemia when these two drugs are combined.

50

Cidofovir
-mech:

Preferentially inhibits viral DNA polymerase. Does not require phosphorylation by viral kinase.
*kind of like foscarnet.

51

Cidofovir
-mech:

CMV retinitis in immunocompromised patients; acyclovir-resistant HSV. Long half-life.

52

Cidofovir
-tox:
-how to dampen toxicity?

Nephrotoxicity (coadminister with probenecid and IV saline to dec. toxicity).

53

HAART therapy
-includes what?

2 NRTIs + (1 NNRTI or 1 protease inhib or 1 integrade inhib).

54

Protease inhibitors
-suffix?
-mnemonic:

-navir.
-Navir (never) tease a protease.

55

Which protease inhibitor inhibits P450 system?

ritonavir

56

Protease inhibitors
-tox:
-mnemonic:

-Hyperglycemia, GI intolerance (nausea, diarrhea), lipodystrophy.
-Nephropathy, hematuria (indinavir).
*side effects look like Cushing syndrome.

-chicks w/hyperglycemia & central weight NAVIR getting
into the club. Even though they have to diarrhea/pee so bad they have hematuria.

57

NRTIs
-which is the only nucleotide in the group?
-mnemonic?

tenofovir
-perfect 10 (ten), doesn't need anything else (no phosphorylation required).

58

How do you reverse the BMS of NRTIs?

Can be reversed with granulocyte colony-stimulating factor [G-CSF] and erythropoietin.

59

NRTIs
-tox:

-BMS (give G-CSF & EPO to reverse)
-peripheral neuropathy
-lactic acidosis (nucleosides)
-rash (non-nucleosides)
-anemia (ZDV)
-pancreatitis (didanosine).

60

Which NRTI causes anemia?

zidovudine (ZDV) (AZT)

61

Which NRTI causes pancreatitis?

didanosine
-dan died by commiting a "sin" and drinking so much he got pancreatitis.

62

Tenofovir
-what is it?

NRTI
*nucleotide

63

Emtricitabine
-what is it?

NRTI

64

Didanosine
-what is it?

NRTI
*pancreatitis

65

Abacavir
-what is it?

NRTI

66

NNRTIs
-name them:
-mnemonic:

Efavirenz
Nevirapine
Delavirdine

"HIV doesnt have to be the END w/NNRTIs."

67

NNRTIs
-tox:

-Rash and hepatotoxicity
-Vivid dreams and CNS symptoms w/efavirenz.
-Delavirdine and efavirenz are C/I in pregnancy.

68

Which NNRTI can cause vivid dreams?

efavirenz

69

Which NNRTI is used in pregnancy?

Nevirapine
-single dose at time of devliery will decrease changes of mother passing HIV to baby (vertical transmission) by 50%
-its also an inducer of P450
*ZDV also given to mothers for prophylaxis of vertical transmission.

70

Raltegravir
-what is it?
-menmonic?

Integrase inhibitor
-ralTEGRAvir = inTEGRAse inhibitor.

71

Raltegravir
-tox:

Hypercholesterolemia.

72

Fusion inhibitors
-name them:

Enfuvirtide
Maraviroc

73

Enfuvirtide
-what is it?
-mnemonic:

enFUviritide = FUsion inhibitor.

74

Enfuvirtide
-mech:
-tox:

-Binds gp41, inhibiting viral entry. *fusion inhibitor.
-Skin reaction at injection sites.

75

Maraviroc
-mech:

Binds CCR-5 on surface of T cells/monocytes,
inhibiting interaction with gp120.
*fusion inhibitor.

76

IFN-α
-use:

-chronic hepatitis B and C
-Kaposi sarcoma
-hairy cell leukemia
-condyloma acuminatum (HPV).
-renal cell carcinoma
-malignant melanoma.

77

IFN-β
-use:

multiple sclerosis

78

IFN-γ
-use:

chronic granulomatous disease

79

Interferons
-side effects:

Neutropenia, myopathy, depression.

80

What can sulfonamides cause in pregnancy?

kernicterus

81

What can aminoglycosides cause in pregnancy?

ototoxicity

82

ABxs to avoid in pregnancy:
-mnemonic?

SAFe Children Take Really Good Care.
-Sulfonamides: Kernicterus
-Aminoglycosides: Ototoxicity
-Fluoroquinolones: Cartilage damage
-Clarithromycin: Embryotoxic
-Tetracyclines: Discolored teeth, inhibition of bone growth
-Ribavirin (antiviral): Teratogenic
-Griseofulvin (antifungal): Teratogenic
-Chloramphenicol: “Gray baby”

83

Two non-obvious cancers associated w/smoking?

Cervical & pancreatic.

84

Piecemeal necrosis is characteristic of:

Chronic active HBV or HCV infection.

85

Does HCV IgG confer immunity?

No!

86

Viral hepatitis -> hepatocyte apoptosis predominately in which zone?

Predominantly zone 1.

87

Most common cause of viral myocarditis in the USA:

Coxsackie B
-Others include: T. Cruzi, B. Burgdorferi, & diptheria.

88

Only protozoa that can phagocytose RBC:

entamoeba histolytica

89

What are some things that gut bacteria will eat up?

bile salts
B12

90

Which tissues are resistant to invasion by cancer?

cartilage & elastic tissue.

91

Diuretics: make you lose what type of solution?

hypertonic salt solution.
*hypertonic relative to plasma conc.

92

Sweat: what type of solution?

hypotonic salt solution
*hypotonic relative to plasma.
*gatorade & pedialyte = hypotonic salt solution.

93

How does fiber dec. chance of colorectal cancer?

Sequesters lithocolic acid away from intestines & into the toilet bowl.

94

screen test for anything in the pancreas:

CT

95

Which lysosomal storage disorders present w/cherry-red macula?
-mnemonic?

Tay-Sachs or Niemann-Pick.
-cherry-red macula = hyphenated term, so are tay-sachs & neimann-pick.

96

Neimann Pick
-mnemonic:
-whats the letter?

-"I"
-nIemann-pick: sphIngomyelinase: sphIngomyelin: bIg organs: lIpid-laden macro.
*also cherry red macula.

97

Tay sachs:
-mnemonic:
-whats the letter?

-"A"
-tAy-sAchs: hex-A: gAngliosides: chArry-red mAcula: brAin.

98

Gaucher disease
-mnemonic?
-whats the letter?

-"U"
-gaUcher: glUcocerebrosidase: glUcocerebroside: hUge organs: U survive: crUnched up paper.

99

lysosomal storage diseases
-inheritance?

-you know its going to be recessive since they're enzyme deficiencies.
-All = auto rec except Hunter/Fabry = x-linked rec.