First Aid 221-244 Flashcards by Mary Slome

Q

What is defective in Leukocyte adhesion deficiency type 2

A

Low amounts of sial-lewis-x

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Q

What is the role of metalloproteinases in wound healing?

A

tissue remodeling

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Q

What is the role of FGF in wound healing?

A

stimulates angiogenesis (VEGF also does this)

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Q

Pathogenesis of granuloma formation

A

Th1 cells secrete IFN-gamma –> macrophages activated

TNF-alpha from macrophages induces and maintains granuloma

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Q

Type of amyloid found in chronic inflammatory conditions

A

AA (secondary)

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Q

Deposition of proteins from Ig light chains is what kind of amyloid?

A

Primary - AL

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Q

Fibrils composed of beta-2-microglobulin in patients with ESRD or long-term dialysis;
May present at carpal tunnel syndrome;
Dx?

A

Dialysis-related amyloidosis

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Q

Transthyretin mutations result in what kind of heritable disorder?

A

Amyloidosis

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Q

What kind of cancer is implicated by:

ALK

A

Oncogene - need to damage only one allele
Receptor tyrosine kinase
Lung adenocarcinoma

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Q

What kind of cancer is implicated by:

BRAF

A

Oncogene - need to damage only one allele
serine/threonine kinase
melanoma, non-Hodgkin lymphoma

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Q

What kind of cancer is implicated by:

c-KIT

A

Oncogene - need to damage only one allele
cytokine receptor
Gastrointestinal stromal tumor

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Q

What kind of cancer is implicated by:

KRAS

A

Oncogene - need to damage only one allele
GTPase
Colon cancer, lung cancer, pancreatic cancer

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Q

What kind of cancer is implicated by:

MYCL1

A

Oncogene - need to damage only one allele
TF
Lung tumor

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Q

What kind of cancer is implicated by:

MYCN

A

Oncogene - need to damage only one allele
TF
Neuroblastoma

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Q

What kind of cancer is implicated by:

JAK2

A

Oncogene - need to damage only one allele
TK
chronic myeloproliferative disorders

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Q

What kind of cancer is implicated by:

HER2/neu (c-erbB2)

A

Oncogene - need to damage only one allele
TK
breast and gastric carcinomas

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Q

Psammoma bodies are seen in:

A

PSaMMoma bodies:
Papillary carcinoma of the thyroid
Serous papillary cystadenocarcinoma of the ovary
Meningioma
Malignant mesothelioma

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Q

Serum tumor marker for Paget’s disease and mets to liver and bone:

A

alk phos

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Q

Serum tumor marker for seminoma

A

placental alk phos

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Q

Serum tumor marker for:
hepatocellular carcinoma
hepatoblastoma
yolk sac (endodermal sinus) tumor
mixed germ cell tumor

A

alpha-fetoprotein

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Q

CA 15-3
CA 27-29
serum tumor markers for

A

breast cancer

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Q

CA 19-9

serum tumor marker for

A

pancreatic adenocarcinoma

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Q

CA 125

serum tumor marker for

A

ovarian cancer

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Q

Calcitonin

serum tumor marker for

A

medullary thyroid carcinoma

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Carcinoembryonicantigen (CEA) | serum tumor marker for

non-specific - colorectal, pancreatic, gastric, breast, medullary thyroid carcinomas

P-glycoprotein is aka multidrug resistance protein 1 (MDR1). What is its function and in what conditions is it seen?

Used to pump out toxins ie chemotherapy agents | Seen in adrenal cell carcinoma, also seen in colon and liver cancer

Explain "lead kettle" - Pb-KTL

``` Prostate breast lung thyroid kidney all produce bone mets ```

Most common cancer to metastasize to the liver

colon

Km is inversely related to

the affinity of the enzyme for its substrate

Vmax is directly proportional to

enzyme concentration

Why does a competitive inhibitor not change Vmax?

Because Vmax only depends on the enzyme concentration and so an inhibitor can be overcome

How does a noncompetitive inhibitor influence Vmax?

Lowers it | So does a competitive inhibitor but only if it is *irreversible*

Equation for Loading Dose

LD = Css x Vd

MD = Css x CL

Maintenance dose equation

Km changes with what kind of inhibitor?

Competitive inhibitor

Slope of a Lineweaver-Burk plot

Km/Vmax

Y-intercept of a Lineweaver-Burk plot

1/Vmax | y-int is inversely proportional to the Vmax

X-intercept of a Lineweaver-Burk plot

1/-Km

What is the effect of an irreversible competitive inhibitor on Km?

No effect

Km =

[S] at 0.5Vmax

Vd =

Drug / [ ] plasma

What is a permissive drug interaction?

Presence of substance A is required for the full effects of substance B ie cortisol on catecholamine responsiveness

Clopidogrel and aspiring given together represents:

Synergistic drug effect effect of substance A and B together is greater than the sum of their individual effects (ie additive would be aspirin and acetominophen)

What is a tachyphylactic drug interaction?

Acute decrease in response to a drug after initial/repeated administration MDMA and LSD

PEA for zero-order elimination drugs

Phenytoin Ethanol Aspirin

What are examples of Phase II drug metabolism (conjugation)

Methylation Glucuronidation Acetylation Sulfation

The efficacy of a drug is proportional to

Vmax

What is the effect on potency of a competitive antagonist?

Lowers potency | No change in efficacy (bc can be overcome)

MOA Flumezenil

competitive GABA antagonist | for benzodiazepine overdose

MOA Phenoxybenzamine

noncompetitive alpha-receptor antagonist

MOA Buprenorphine

Partial agonist at opioid mu receptors

"After QISSeS you get a QIQ out of SIQ Super Qinky Sex"

``` GPCRS and pathways --Sympathetic q - alpha 1 i - alpha 2 s - beta 1,2,3 --Parasympathetic M1 - q M2 - i M3 - q --Dopamine D1 - s D2 - i --Histamine H1 - q H2 - s --Vasopressin V1 - q V2 - s ```

M1, M3, H1, alpha-1, V1 | pathway

Gq --> PLC (DAG --> PKC or IPS --> increase in Ca)

M2, alpha-2, D2 | pathway

Gi --> inhibits AC

Cholinomimetics are aka

parasympathomimetics

``` Bethanechol Carbachol Methacholine Pilocarpine drug class? ```

Bethanechol - activates bowel and bladder Carbachol - same as acetylcholine Methacholine - contracts bronchial SM Pilocarpine - contracts ciliary muscle of eye DIRECT cholinomimetics

Cholinomimetic used in tx of Sjogrens bc it causes salivation

Pilocarpine

Challenge test in asthma drug

Methacholine | Cholinomimetic can exacerbate COPD/asthma

Treatment of open angle glaucoma | Direct cholinomimetic

Carbachol

Donepezil Galantamine Rivastigmine drug class

Indirect cholinomimetic agonists Increase ACh Tx Alzheimer disease

Edrophonium | drug class

Indirect cholinomimetic agonists Increase ACh for 5-15 min Diagnosis of MG

Neostigmine | CNS penetration?

Neostigmine - NO CNS penetration bc quarternary amine; Indirect cholinomimetic agonist Increase ACh reversal of neuromuscular junction blockade

Physostigmine | CNS penetration?

YES - Physo phyxes atroping OD tertiary Indirect cholinomimetic agonist Increase ACh

Pyridostigmine | Use

Indirect cholinomimetic agonist Increase ACh - treat MG does not cross BBB (quarternary amine)

With all cholinomimetic agents, be careful for:

peptic ulcers | exacerbation of COPD, asthma

DUMBBELSS pneumonic

DUMBBELSS ``` Diarrhea Urination Miosis Bronchospasm Bradycardia Excitation Lacrimation Sweating Salivation ``` Cholinesterase inhibitor poisoning (ie insecticides) Can become irreversible if prolonged ("aging") Cholinergic/Parasympathomimetic toxidrome