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Classic Treatments Flashcards

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1
Q

Kaposi sarcoma

A

Painless violaceous skin lesions that progress in size

Spindle cells and lymphocytic infiltrate in skin bx

Tx with IFN alpha

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2
Q

Ticlodipine

A

Anti platelet drug

Rare side effect- NEUTROPENIA dt agranulocytosis

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3
Q

Acute gout flare treatment

A

NSAIDS- reversible inhibit prostaglandin synthesis by inhibiting COX1 and COX2

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4
Q

Legionella pneumonia

A

Macrolides (ie azithromycin)

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5
Q

Left shift of Hb dissociation curve

A

Increased O2 affinity- want to hold onto O2

LOW pCO2
LOW body temp
LOW H+ (high pH)
LOW 2,3 BPG

POLYCYTHEMIA VERA

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6
Q

Warfarin reversal

A 
FFP (acute)
Vitamin K (non acute)
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7
Q

Granulomatosis with polyangiitis

A

Cyclophosphamide, steroids

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8
Q

Treponema pallidum

A

PCN G

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9
Q

Temporal arteritis

A

High dose steroids

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10
Q

tPA reversal

A

Aminocaproic acid
Tranexamic acid
Work by inhibiting activation of plasminogen

tPA increases thrombolysis by converting plasminogen to plasmin, which directly dissolved thrombus by degrading fibrin

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11
Q

Glomus tumor

A

Benign tumor arising from modified smooth muscle cells of the glomus body (involved in dermoregulation)

Small, solitary, PAINFUL, blue red papules/nodules on hand, foot, under nails of patients 20-40 yo

Pain is paroxysmal, severe, EXACERBATED BY COLD

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12
Q

Acute promyelocytic leukemia (M3)

A

All trans retinoic acid

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13
Q

Diabetes insipidus

A

Central- desmopressin

Nephrogenic- HCTZ, indomethacin, amiloride

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14
Q

Ethylene glycol/methanol intoxication

A

Fomepizole (alcohol dehydrogenase inhibitor)

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15
Q

First line treatment for Lyme disease in pregnant abs nursing women and kids under 8

A

Oral amoxicillin

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16
Q

ER+ breast cancer

A

Tamoxifen

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17
Q

Paradoxical embolism

A

Associated with ASD, PFO, VSD

Allows right sided emboli to enter left sided circulation bypassing pulmonary circulation

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18
Q

Bike acid sequestrants (cholestyramine, colestipol, colesevelam)

A

Lowers LDL, raises HDL and TGs

Reduce bile acid absorption abs decrease enterohepatic circulation of bile. To synthesize new bile, liver up regulates HDL production AND TG rich VLDL cholesterol- secreted directly into blood and cannot be taken up by liver, TGs increase

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19
Q

Streptococcus bovis

A

PCN prophylaxis

Eval for colon cancer if linked to endocarditis

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20
Q

Infertility

A

Leuprolide, GnRH (pulsatile), clomiphene

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21
Q

MSSA

A

Nafcillin
Oxaclin
Dicolxacillin

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22
Q

C tetani

A

Anti toxin

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23
Q

Carbamazepine

A

Antiepileptic
Used for trigeminal neuralgia

Inhibits voltage gated sodium channels in brain, which reduces excitability of neurons

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24
Q

Chronic hepatitis B and C

A

IFN alpha

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25
Pneumocystis jirovecii
TMP SMX (prophylaxis and treatment in immunosuppressed pts CD4<200)
26
Cryptococcus neoformans
Induction with amphotericin B and flucytosine, maintain with fluconazole (in AIDS)
27
Arrhythmia in damaged cardiac tissue
Class IB anti arrhythmics | Lidocaine, mexilitine
28
Heparin reversal
Protamine sulfate
29
Glucagonoma
Tumor of pancreatic alpha cells ``` S/s: Hyperglycemia Chronic diarrhea Neuropsychiatric symptoms DVT Normocytic anemia NECROLYTIC MIGRATORY ERYTHEMA ```
30
Candida albicans
Vaginal: topical azoles: nystatin, fluconazole, caspofungin Oral/esophageal: systemic: fluconazole, caspofungin, amphotericin B
31
Sporothrix schenkii
Itraconazole, oral potassium iodide
32
Factor Xa inhibitors MOA
Blocks active site of factor Xa—> prevents Xa from converting prothrombin to thrombin Rivaroxaban, apixaban Oral, no monitoring, used in CVA prevention in a fib
33
N meningiditis
PCN/ ceftriaxone Rigampin for prophylaxis
34
CML
Imatinib
35
Beta catenin
Intracellular protein that acts as transcription factor for cell proliferation Normally- Wnt signaling mediates destruction of beta catenin via tumor suppressor APC Failure of this regulatory process implicated in CRC
36
Anticoagulation in pregnancy and renal disease
LMWH
37
Medical abortion
Mifepristone
38
Right shift of Hb o2 dissociation curve
Decreased O2 affinity- want to unload O2 HIGH pCO2 HIGH body temp HIGH H+ (low pH) HIGH 2,3 BPG
39
Specific marker for monocyte-macrophage cell line
CD14 Caseating granulomas of TB are usually surrounded by large macrophages (CD14+)
40
Sarcoidosis s/s
``` Fatigue, dyspnea, hepatomegaly, erythema nodosum, Lupus pernio (erythematous/violaceous indurated lesions on face ``` Biopsy of NON CASEATING GRANULOMA shows asteroid bodies (eosinophilic inclusions in starry patter) or Schaumann bodies RLD Elevated ACE and high CD4:CD8 ratio
41
Long term anti coagulation
Warfarin Dabigitran Rivaroxaban Apixaban
42
Cyclophosphamide hemorrhagic cystitis
Mesna
43
Pseudomonas aeroginosa
Piperacillin/tazobactam Aminoglycosides Carbapenems
44
What is subacute sclerosing panencephalitis?
Rare complication of MEASLES that may develop years after infection CSF analysis shows high levels of anti measles antibodies Untreatable
45
Toxoplasma gondii
Sulfadiazine and pyramethamine
46
Cause of meckels diverticulum
Failed obliteration of vitelline (omphalomesenteric) duct Presents with spontaneous painless lower GIB Dx 99technecium scan- ectopic gastric mucosa, 99tech radioisotope has high affinity for PARIETAL CELLS
47
Entacapone
Peripherally acting COMT inhibitor that reduces methylation of levodopa and dopamine—> more stable and long lasting plasma concentration of drug
48
Immediate anti coagulation
Heparin
49
MRSA
Vancomycin Daptomycin Linezolid Ceftaroline
50
Fixed, wide splitting of S2
ASD Caused by increased volume within pulmonary circulation
51
Hyper IgM syndrome
Impaired interaction between Th cells and B cells resulting in B cell class switching defect CD40 ligand deficiency MC—> CD40L deficiency in Th cells leads to abnormal interaction between B cells which express CD40 receptor—> disrupts B class switching—> depleted Igs B cells produce IgM but cannot produce other Igs LN bx shows absent germinal centers (where B cells proliferate and class switching occurs) Recurrent infections with Pneumocystis jirovecii and Histoplasma, Cryptosporidium, CMV hepatitis
52
Physostigmine and neostigmine
Acetylcholinesterase inhibitors Used for myasthenia gravis and reversal of nondepolarizing neuromuscular blockers Act peripherally, do not cross bbb
53
Essential tremor
Primidone Barbituate- primary active metabolite is phenobarbital Also used as anticonvulsant for grand mail, psychomotor, focal seizures
54
Malaria
Chloroquine, mefloquine, atovaquone/proguanil (for blood schizont) Primaquine (for liver hypnozoite)
55
Tiotropium, ipratropium
Competitive inhibition of muscarinic receptors, —> prevents bronchoconstriction COPD and asthma
56
Breast cancer in post menopausal women
Aromatase inhibitor (anastrozole)
57
Acute tubular necrosis
BUN/Cr < 20:1 Caused by ischemia- straight segment of PCT and thick ascending limb - hypotension (hypovolemia (dehydration, sepsis), shock - thromboembolism - thrombotic microangopathy Caused by toxins- convoluted segment of PCT - contrast induced - aminoglycosides, cisplatin, amphotericin, lead, ethylene glycol, myoglobinuria, hemoglobinuria, uric acid Diagnostics: azotemia, MUDDY BROWN CASTS, epithelial casts, free renal tubular epithelial cells Spontaneous recovery
58
C botulinum
Antitoxin
59
Lateral nucleus of hypothalamus
Regulates hunger Damage to lateral nucleus causes anorexia, starvation, failure to thrive Stimulated by ghrelin, inhibited by leptin
60
HCV treatment
Ribavirin, simeprivir, sofosbuvir
61
Chlamydia trachomatis
Doxycycline (with ceftriaxone for gonorrhea coinfection) Erythromycin for chlamydial conjunctivitis in infants
62
Buerger disease
Smoking cessation
63
N gonorrhea
Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia trachomatis)
64
Haemophilus influenzae B
Mucosal infections- Amoxicillin with clavulanate Meningitis- ceftriaxone Prophylaxis- rifampin
65
Leydig and Sertoli cells in MALES
Leydig cells—> Testosterone Sertoli cells- inhibin
66
Hepatitis B 3 major facts
1. Partially dsDNA 2. Reverse transcriptase 3. Envelope comes from ENDOPLASMIC RETICULUM
67
MAOIs (transcyclomine, phenelzine, isocarboxazid)
Inhibit monoamine oxidase—> increased serotonin and NE in synaptic cleft NO ANTIMUSCARINIC EFFECTS Side effects- dizziness, weakness, fatigue, anxiety, HYPOTENSION **if MAOIs patients ingest TYRAMINE, tyramine will not be broken down and will be absorbed and displace NE stores in peripheral neurons —> excess NE will not be broken down because of MAO inhibition—> HYPERTENSIVE CRISIS
68
MHCI
Encoded by HLA A, B, C, etc Bind to TCR and CD8 cells 1 long chain (alpha chain), 1 short chain (beta2 microglobulin) Expressed on: ALL NUCLEATED CELLS, APCs, PLATELETS NOT ON RBCS Present ENDOGENOUS antigens (viral, cytosolic, cancer) to CD8 cytotoxic T cells Ag PEPTIDE loaded onto MHCI in RER after delivery via TAP (transporter associated with antigen processing)
69
MHCII
Encoded by HLA DP, DQ, DR Binds TCR and CD4 2 alpha and 2 beta chains Expressed ONLY on APCs- dendritic cells, B cells, macrophages Present EXOGENOUS antigens (bacterial proteins) to CD4 Th cells Ag loaded following release of INVARIANT CHAIN in ACIDIFIED LYSOSOME - invariant chain blocks any binding in ag binding pocket before it merges with lysosome
70
Cardiac arrest acid base disturbance
MIXED ACIDOSIS - high pCO2 dt ventilators standstill leading to respiratory acidosis - low bicarb and low pH dt lactic (metabolic) acidosis (poorly perfumed tissues) - high anion gap dt lactate accumulation - metabolic acidosis and respiratory acidosis

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