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

4/4 micro/rapidreview Flashcards

1
Q

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

A

cilostazol & dipyridamole.

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

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2
Q

cilostazol

  • mech:
  • use?
A

PDE 3 inhibitors.

  • inc cAMP in platelets = prevents aggregation.
  • arterial vasodilator.
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3
Q

argatroban

  • mech:
  • use?
A

direct thrombin inhibitor

  • Derivative of hirudin (used by leeches).
  • used instead of heparin in pts w/HIT.

*same as bivalirudin.

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4
Q

cardinal ligament

  • aka?
  • contains which vessels?
A

transverse cervical ligament

-contains uterine vessels.

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5
Q

musculocutaneous nerve

-provides sensory info to which region?

A

lateral forearm.

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6
Q

Forceful injury involving separation of neck and shoulder

-which nerve is in trouble?

A

musculocutaneous

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7
Q

medial forearm sensory inn?

A

ulnar n.

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8
Q

heard best over cardiac apex and radiates to axilla

-which murmur

A

mitral regurg

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9
Q

Why do pts w/Crohns disease get gallstones?

A

dec bile acid resorption leads to too much cholesterol in your bile.

  • get cholesterol gallstones.
  • dont confuse kidney stones w/gallstones.
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10
Q

binge alcohol drinking can precipitate which murmur?

-what will EKG show?

A

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

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11
Q

varenicline

-mech:

A

partial agonist at nicotinic receptor.

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12
Q

MEN 1

-mnemonic:

A

3 Ps

-pituitary, parathyroid, pancreas.

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13
Q

MEN 2A

-mnemonic:

A

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.
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14
Q

MEN 2B

-mnemonic:

A

MMP

  • medullary thyroid carcinoma.
  • marfanoid habitus
  • pheochromocytoma
  • neuromas
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15
Q

Normal pressures:

-RV:

A 
max = 25
min = 4
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16
Q

Normal pressures

-RA:

A 
max = 8
min = 0
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17
Q

Normal perssures

-Pulm art:

A 
max = 25
min = 9
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18
Q

which area has higher diastolic/minimum pressure?

RV or pulm art?

A

Pulm. art.

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19
Q

Normal pressure

-LA:

A 
max = 12
min = 2
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20
Q

RA vs LA

-which ones normal minimum pressure can drop to 0?

A

RA.

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21
Q

cystine kidney stones

-precipitate at which pH?

A

acidic

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22
Q

Opening snap heard in which murmur?

A

mitral stenosis

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23
Q

Chloroquine

-mech

A

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

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24
Q

Chloroquine

  • which malarial organism is it not effective against?
  • why?
A

P. falciparum.

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

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25
Q

How do you treat P. falciparum?

A

Artemether/lumefantrine or atovaquone/proguanil.

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26
Q

For life-threatening malaria, :use

A

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

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27
Q

Chloroquine

-tox:

A

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

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28
Q

Zanamivir, oseltamivir

  • mech:
  • use:
A
  • Inhibit influenza neuraminidase => dec. the release of progeny virus.
  • Treatment and prevention of both influenza A and B.
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29
Q

Zanamivir, oseltamivir

-mnemonic:

A

zaNAmivir & oselNAmivir = NA inhibitors.

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30
Q

Ribavirin

-mech:

A

-inhibiting IMP DH which converts IMP => GMP.

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31
Q

mycophenolate

-mech:

A

Inhibit IMP DH.

-blocks IMP => GMP.

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32
Q

Ribavirin

-use:

A

RSV, chronic hepatitis C.

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33
Q

Ribavirin

-tox:

A

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.
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34
Q

chronic hep C

-Tx:

A

alpha-interferon & ribavirin.

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35
Q

Valacyclovir

-what is it?

A

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

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36
Q

Acyclovir

-how is it activated?

A

Monophosphorylated by HSV/VZV thymidine kinase.

- not phosphorylated in uninfected cells =Ž few adverse effects.

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37
Q

Acyclovir

-mech:

A

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

*guanosine = nucleoside = no phosphates on it.

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38
Q

Acyclovir

-use:

A
  • HSV and VZV. Weak activity against EBV.

* NO effect on latent forms!

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39
Q

Herpes Zoster

-Tx:

A

Famciclovir

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40
Q

Acyclovir

  • tox:
  • usually seen in which scenario?
A

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

41
Q

Acyclovir

-mech of resistance?

A

Mutated viral thymidine kinase.

42
Q

Ganciclovir

-how is it activated?

A

CMV viral kinase.

43
Q

Ganciclovir

-mech:

A

guanosine analog.

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

44
Q

Ganciclovir

-which form has best oral bioavailability?

A

valGANciclovir

45
Q

Ganciclovir

-tox:

A

Leukopenia, neutropenia, thrombocytopenia, renal toxicity.

*watch out when giving w/other meds that cause BMS like zidovudine.

46
Q

Foscarnet

-mech:

A
  • Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme.
  • Does not require activation by viral kinase.
47
Q

Foscarnet

-use:

A
  • CMV retinitis in immunocompromised patients when ganciclovir fails
  • acyclovir-resistant HSV.
  • usually these will be AIDS pts.
48
Q

Foscarnet

-tox:

A
  • Nephrotoxicity, seizures.
  • can chelate calcium
  • induces renal wasting of magnesium => hypomagnesemia.
  • reduction of PTH release => hypocalcemia.
  • both hypomagnesemia & hypocalcemia can => seizures.
49
Q

Foscarnet

-dont use w/pentamidine. Why?

A
  • 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
Q

Cidofovir

-mech:

A

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

51
Q

Cidofovir

-mech:

A

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

52
Q

Cidofovir

  • tox:
  • how to dampen toxicity?
A

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

53
Q

HAART therapy

-includes what?

A

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

54
Q

Protease inhibitors

  • suffix?
  • mnemonic:
A
  • navir.

- Navir (never) tease a protease.

55
Q

Which protease inhibitor inhibits P450 system?

A

ritonavir

56
Q

Protease inhibitors

  • tox:
  • mnemonic:
A
  • 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
Q

NRTIs

  • which is the only nucleotide in the group?
  • mnemonic?
A

tenofovir

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

58
Q

How do you reverse the BMS of NRTIs?

A

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

59
Q

NRTIs

-tox:

A
  • BMS (give G-CSF & EPO to reverse)
  • peripheral neuropathy
  • lactic acidosis (nucleosides)
  • rash (non-nucleosides)
  • anemia (ZDV)
  • pancreatitis (didanosine).
60
Q

Which NRTI causes anemia?

A

zidovudine (ZDV) (AZT)

61
Q

Which NRTI causes pancreatitis?

A

didanosine

-dan died by commiting a “sin” and drinking so much he got pancreatitis.

62
Q

Tenofovir

-what is it?

A

NRTI

*nucleotide

63
Q

Emtricitabine

-what is it?

A

NRTI

64
Q

Didanosine

-what is it?

A

NRTI

*pancreatitis

65
Q

Abacavir

-what is it?

A

NRTI

66
Q

NNRTIs

  • name them:
  • mnemonic:
A

Efavirenz
Nevirapine
Delavirdine

“HIV doesnt have to be the END w/NNRTIs.”

67
Q

NNRTIs

-tox:

A
  • Rash and hepatotoxicity
  • Vivid dreams and CNS symptoms w/efavirenz.
  • Delavirdine and efavirenz are C/I in pregnancy.
68
Q

Which NNRTI can cause vivid dreams?

A

efavirenz

69
Q

Which NNRTI is used in pregnancy?

A

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
Q

Raltegravir

  • what is it?
  • menmonic?
A

Integrase inhibitor

-ralTEGRAvir = inTEGRAse inhibitor.

71
Q

Raltegravir

-tox:

A

Hypercholesterolemia.

72
Q

Fusion inhibitors

-name them:

A

Enfuvirtide

Maraviroc

73
Q

Enfuvirtide

  • what is it?
  • mnemonic:
A

enFUviritide = FUsion inhibitor.

74
Q

Enfuvirtide

  • mech:
  • tox:
A
  • Binds gp41, inhibiting viral entry. *fusion inhibitor.

- Skin reaction at injection sites.

75
Q

Maraviroc

-mech:

A

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

76
Q

IFN-α

-use:

A
  • chronic hepatitis B and C
  • Kaposi sarcoma
  • hairy cell leukemia
  • condyloma acuminatum (HPV).
  • renal cell carcinoma
  • malignant melanoma.
77
Q

IFN-β

-use:

A

multiple sclerosis

78
Q

IFN-γ

-use:

A

chronic granulomatous disease

79
Q

Interferons

-side effects:

A

Neutropenia, myopathy, depression.

80
Q

What can sulfonamides cause in pregnancy?

A

kernicterus

81
Q

What can aminoglycosides cause in pregnancy?

A

ototoxicity

82
Q

ABxs to avoid in pregnancy:

-mnemonic?

A

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
Q

Two non-obvious cancers associated w/smoking?

A

Cervical & pancreatic.

84
Q

Piecemeal necrosis is characteristic of:

A

Chronic active HBV or HCV infection.

85
Q

Does HCV IgG confer immunity?

A

No!

86
Q

Viral hepatitis -> hepatocyte apoptosis predominately in which zone?

A

Predominantly zone 1.

87
Q

Most common cause of viral myocarditis in the USA:

A

Coxsackie B

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

88
Q

Only protozoa that can phagocytose RBC:

A

entamoeba histolytica

89
Q

What are some things that gut bacteria will eat up?

A

bile salts

B12

90
Q

Which tissues are resistant to invasion by cancer?

A

cartilage & elastic tissue.

91
Q

Diuretics: make you lose what type of solution?

A

hypertonic salt solution.

*hypertonic relative to plasma conc.

92
Q

Sweat: what type of solution?

A

hypotonic salt solution

  • hypotonic relative to plasma.
  • gatorade & pedialyte = hypotonic salt solution.
93
Q

How does fiber dec. chance of colorectal cancer?

A

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

94
Q

screen test for anything in the pancreas:

A

CT

95
Q

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

A

Tay-Sachs or Niemann-Pick.

-cherry-red macula = hyphenated term, so are tay-sachs & neimann-pick.

96
Q

Neimann Pick

  • mnemonic:
  • whats the letter?
A
  • “I”
  • nIemann-pick: sphIngomyelinase: sphIngomyelin: bIg organs: lIpid-laden macro.
  • also cherry red macula.
97
Q

Tay sachs:

  • mnemonic:
  • whats the letter?
A
  • “A”

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

98
Q

Gaucher disease

  • mnemonic?
  • whats the letter?
A
  • “U”

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

99
Q

lysosomal storage diseases

-inheritance?

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

Final FA review (52 decks)

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