Combank 2 Flashcards by Judith Lau

The only anti-epileptic medication that is an inhibitor of cytochrome p450 enzymes

Valproic Acid

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What class of drugs is Glyburide in and what does it treat?

sulfonylurea; treatment of diabetes

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MOA of sulfonylureas

block ATP dependent potassium channels thus depolarizing pancreatic beta cells which leads to insulin release (release mediated by calcium influx)

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Carbamazepine, oxcarbazepine and phenytoin are inducers or inhibitors of the CYP450 system?

Inducers

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What is valproic acid commonly used to treat?

a common epileptic medication for tonic-clonic seizures; also used for partial seizures and absence seizures

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What is the MOA of valproic acid?

inactivates Na+ channels and increases GABA concentration in the synapse

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First line option for tonic clonic seizures

Carbamazepine

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What is another use of Carbamazepine other than treating seizures?

Trigeminal neuralgia

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Does phenobarbitol induce or inhibit CYP enzymes?

Induce

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What is the first line prophylaxis for status epilepticus?

Phenytoin

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How does erysipelas present?

A painful raised lesion with sharply demarcated borders

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How is cellulitis different from erysipelas?

Cellulitis can also present with symptoms of pain, erythema and pruritis, but does NOT have a raised lesion with sharply demarcated borders

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What is the major causative agent for both erysipelas and cellulitis?

Streptococcus pyogenes (Group A strep)

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What is the drug of choice to treat streptococcal erysipelas?

Penicillin

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Group B strep is also known as?

Strep agalactiae

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Group A strep is also known as

Strep pyogenes

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The viscerosomatic reflex for the head and neck correspond to what vertebral levels?

T1-T4

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What type of hypersensitivity reaction is Guillain-Barre syndrome?

Type IV

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How are type IV hypersensitivity reactions mediated?

T cells that come into contact with the antigen activate macrophages

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Guillain-Barre can occur several days after an infection with what causative agents?

Campylobacter jejuni, CMV, or influenza

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Goodpasture syndrome and rheumatic fever are examples of what type of hypersensitivity?

Type II, cytotoxic

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Graves disease and myasthenia gravis are examples of what type of hypersensitivity?

Type II, noncytotoxic

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Rheumatoid arthritis and polyarteritis nodosa are examples of what type of hypersensitivity?

Type III

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Agranulocytosis and aplastic anemia are AEs of which AED medication that is first line for tonic clonic seizures and trigeminal neuralgia?

Carbamazepine

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Gingival hyperplasia is a AE of which AED?

Phenytoin

This AED used to treat absence seizures works by depressing the nerve transmission in the motor cortex thereby increasing the threshold for seizures

Ethosuximide

Absence seizures can be treated with which two drugs?

Valproic acid or Ethosuximide

What other drug can be used to treat and prevent congenital syphilis in the case that the patient is allergic to penicillin?

Doxycycline

What is the first line treatment for syphillis in both pregnant mothers and the neonate?

Penicillin G

What type of drug is Alendronate and what is it used for?

It is a bisphosphonate that inhibits bone resorption (osteoclast activity) and is used to increase bone density in women with post menopausal osteoporosis

The description of lancet shaped bacteria points to ...

strep pneumoniae

Name the causative agent - aerobic, gram positive, catalase negative, ALPHA HEMOLYTIC cocci, optochin sensitive

strep pneumoniae

Name the hepatitis virus - DNA genome, reverse transcriptase used to make DNA from viral RNA in the cytoplasm

Hepatitis B

How is hepatitis B transmitted?

blood contact, sexual contact

Name the hepatitis virus - picornavirus, spread through food, prevented by giving a vaccine before travel, self limiting

Hepatitis A

Name the hepatitis virus - RNA flavivirus, spread through blood, no vaccine available, most develop chronic hepatitis

Hepatitis C

Name the hepatitis virus - RNA delta virus, requires coinfection with hepatitis B

Hepatitis D

Name the hepatitis virus - RNA hepevirus, fecal oral spread, causes acute hepatitis, common in developing countries

Hepatitis E

How does hepatitis C infect hepatocytes?

HCV coats itself with low density and very low density lipoproteins

Which hepatitis virus is associated with high infant mortality when occuring in pregnant women?

Hepatitis E (no vaccine is available)

What is the DOC for Loa Loa infection?

diethylcarbamazine

Name the causative agent - transient migratory angiodema, pruritis, localized urticaria in the arms and legs (usually wrists, ankles), ocular symptoms

Loa Loa

What is used to treat gram negative anaerobic rods?

metronidazole or clindamycin

What is the first line treatment for mild persistent asthma?

start an inhaled steroid controller - ex beclomethasone

An anticholinergic drug used as an alternative to albuterol in the treatment of acute asthma. MOA is blocking the M3 receptors found in the bronchi causing bronchodilation.

Ipratropium

Where is Histoplasma capsulatum found?

Mississippi and Ohio River Valleys; located in caves

How would Histoplasma capsulatum present on sputum microscopy?

small intracellular yeasts residing within macrophages

Where is Coccidioides immitis found?

San Joaquin Valley of California and other areas of the southwestern US

How does Coccidioides immitis present on sputum microscopy?

Presence of spherules within endospores

Where is Blastomyces dermatitidis found?

Mississippi and Ohio River basins

Where is Paracoccidioides brasiliensis found?

South and Central America

How does Paracoccidioides brasiliensis present on sputum analysis?

one large mother cell produces multiple daughter cells that arise from multiple sites - resembles a "pilots wheel"

What type of drug is furosemide and how does it work?

Loop diuretic; blocks Na/K/Cl pump in the thick ascending limb of the LOH

What type of drug is Hydrochlorothiazide and how does it work?

Thiazide diuretic; blocks the sodium/chloride channel in the DCT

How does Acetazolamide work?

Reversibly inhibits carbonic anhydrase resulting in reduction of hydrogen ion secretion at the renal tubule and an increased renal excretion of Na, K, HCO3 and H2O

What are some common potassium sparing diuretics?

spironolactone, amiloride, triamterene

How does Amiloride and triamterene work?

Inhibit the Na/K ATPase on the renal distal convoluted tubule which prevents sodium resorption from the lumen

This condition results in upper respiratory symptoms, lower respiratory symptoms and renal symptoms; characterized by inflammation of small and medium sized blood vessels

Wegener's granulomatosis

Wegener's granulomatosis is usually positive for what antibodies?

c-ANCA antibodies

What are rales?

crackling sounds that result from small bronchioles and alveoli popping open due to fluid build up

Name the causative agent - common cause of pneumonia in alcoholic or elderly, currant jelly sputum

Klebsiella pneumoniae

Describe the lab profile of Klebsiella pneumoniae

gram negative lactose fermenting rod; indole negative (vs. E coli is indole positive)

What type of drug is ketamine and how does it work?

intravenous anesthetic; rapid onset, short duration; interacts with NMDA receptors and stimulates sympathetic outflow causing tachycardia, HTN, increased CO; causes vivid dreams and hallucinations during recovery

What is an isotonic contraction?

constact muscle tension as a muscle changes length - ex. push up

MAO-A degrades ...

NE and serotonin

MAO-B degrades ...

dopamine

The frontal bone is a paired or unpaired bone?

paired

This suture is present at birth and runs vertically through the center of the frontal bone separating the frontal bone into two halfs

Metopic suture

A patient with suspected cervicitis should be treated with antibiotics that cover which two causative agents?

Neisseria gonorrhea and Chlamydia trachomatis

Chandelier sign

cervical motion tenderness

Chandelier sign is positive in what condition?

Pelvic inflammatory disease

DOC for Chlamydia trachomatis

Azithromycin or doxycycline; azithromycin preferred due to single dose therapy vs. doxycycline's 7 day dosing

DOC for Neisseria gonorrhoeae

Ceftriaxone

Erythromycin inhibits or induces P450 system?

inhibits

Rifampin inhibits or induces P450 system?

induces

What is a unique AE of rifampin?

red/orange color change that occurs in bodily fluids

What type of mutation causes sickle cell anemia?

point mutation causing glutamic acid to be replaced by valine

How does Clopidogrel work?

inhibits platelet aggregation by irreversibly blocking ADP receptors, which does not allow for GPIIb/IIIa expression thus inhibiting fibrinogen binding

How does hydroxyurea work and what is it indicated for?

Anti-neoplastic agent; indicated for reducing the rate of painful occlusive attacks in patients with sickle cell disease; increases production of fetal hemoglobin

What is a common cause of osteomyelitis in patients with sickle cell disease?

Salmonella

Most common cause of osteomyelitis in general population (those w/o sickle cell disease)

Staph aureus

What are the clinical manifestations of paroxysmal nocturnal hemoglobinuria?

hemolytic anemia, hypercoagulable state, diminished hematopoiesis

What causes paroxysmal nocturnal hemoglobinuria?

genetic defect in red blood cell membrane anchor proteins; there is an absence of CD 59 and CD 55 which act to inhibit membrane lysis, thus there is un-inhibited complement mediated hemolysis

Crohn's disease most often affects what part of the GI tract?

terminal ileum

How does Ezetimibe work?

impairs biliary and dietary cholesterol absorption at the intestinal brush border by inhibiting specific receptors at the border

Name 3 bile acid sequestrants

cholestyramine, chlesevelam, colestipol

How do bile sequestrants work?

bind bile acids in the intestine and prevent their absorption at the brush border

What is the MOA of Niacin as a lipid lowering agent?

decreasing hepatic LDL and VLDL production as well as hepatic triglyceride esterification

What is Sjogren syndrome?

chronic systemic inflammatory d/o characterized by lymphocytic infiltrates in exocrine organs

Patient's with Sjogren syndrome are at risk of developing what condition?

lymphoma

What antibodies are positive in Sjogren syndrome?

Anti-Ro and Anti-La antibodies

What antibodies are positive in CREST syndrome? (calcinosis, raynaud disease, esophageal dysmotility, sclerodactyly, telangiectasia

Anti-centromere antibodies

What antibodies are positive in SLE?

Anti-ds DNA antibodies

What antibodies are found in polymyositis/dermatomyositis?

Anti-Jo1 antibodies

What antibodies are positive in scleroderma?

SCL 70 antibody

What is the DOC for pregnant women with hyperthyroidism in the first trimester?

Propylthiouracil

T4 analog used to treat hypothyroidism

Levothyroxine

What medications are used to treat antipsychotic-induced EPS?

Benztropine, amantadine, diphenhydramine

Combank 2 Flashcards

(98 cards)