glucagon: effect on cAMP?
Incr Protein Kinase A
insulin: effect on cAMP?
drug for pt with HTN + BPH?
(doxazosin, prazosin, terazosin)
drug for pt with HTN + coronary artery disease or CHF?
drug for pt with HTN + DM?
ACE inhibitors (ramipril)
drug NOT to use for pt with HTN + diabetes, hyperCa, or gout?
drug for pt with HTN + vasospasm?
(Raynauds, Prinzmetal angina)
First line for essential hypertension?
(also first line for isolated systolic HTN)
(also first line for osteoporosis)
drug for pt with HTN + pregnancy?
drugs that affect microtubules?
Microtubules Get Constructed Very Poorly
Vincristine (anti cancer)
Paxlitaxel (anti cancer)
drug that halts DNA in metaphase? use?
used to do karyotype analysis (need chromosomes in condensed/metaphase state)
Electron transport chain inhibitors?
(decr H+ gradient, block ATP sythesis)
R - A C CO
Rotenone (Complex I)
nothing (Complex II = succinate dehydrogenase)
Antimycin A (Complex III)
Cyanide, CO (Complex IV = Cytochrome C)
ATP synthase inhibitor?
Oligomycin (blocks Complex V = ATP synthase)
increases protin gradient
No ATP produced
2,4 dinitrophenol (illicit weight loss)
aspirin (fever due to OD)
thermogenin (brown fat)
muscle tissue cannot do gluconeogenesis why?
muscle can only break down glycogen stores for its own use
difference between odd chain FAs and even chain FAs?
odd chain can produce propionyl-CoA --> succinyl-CoA (source of glucose via TCA)
even chain can only produce acetyl-CoA equivalents - no new glucose.
tissues that use the HMP shunt? (4)
lactating mammary glands
adrenal cortex (to synth FAs or steroids)
isolated elevated alkaline phosphatase level indicates what disease?
Paget disease of bone
localized imbalance between clast and blast activity
mosaic pattern of lamellar bone
incr hat size
alk phos elevation due to incr blast activity (alk phos creates alkaline env't for osteoid to be mineralized with Ca)
treatment for Paget disease of bone?
calcitonin - inhibits osteoclast function, anti-PTH
bisphosphonates - induce osteoclast apoptosis
complications of Paget disease of bone?
high output cardiac failure (AV shunts through bone!!)
osteosarcoma (incr cellular activity overall)
most common cause of osteomyelitis overall?
invasive: alpha toxin can lyse host cell membranes, has superantigens
most common cause of osteomyelitis in SA young adults?
most common cause of osteomyelitis in sickle cell pts?
most common cause of osteomyelitis in diabetics?
most common cause of osteomyelitis in IVDU?
most common cause of osteomyelitis in pts with a dog/cat bite?
most common cause of osteomyelitis in vertebrae?
complications of Rheumatoid arthr?
-tophi (rheumatoid nodules)
-anemia of chronic disease (chronic inf, production of acute phase reactants incl hepcidin, sequesters iron in RBCs)
Reiter syndrome triad
arthritis (seroneg spond), urethritis, conjunctivitis
(cant see cant pee cant climb a tree)
usually after a GI of chlamydia inf
extra-articular complications of seroneg spond?
(think axial skeleton and what allows you to move it/see where you're going?)
Myasthenia Gravis associated with what other finding?
thymic hyperplasia or thymoma
removal of thymus improves symptoms!
Acronym for defects of Mesodermal derivatives?
Limb (bone and muscle)
CHF, diabetic nephropathy, pulmonary HTN
inhibits platelet aggregation
tx for atherosclerotic ischemia, to prevent stent thrombosis
COX 1 and COX 2 inhibitor
decreases prostaglandin synthesis
anti-inflammatory, pain relief
anti-inflammatory for RA, psoriasis, psoriatic arthritis
endothelin receptor antagonist
primary pulmonary arterial hypertension
stimulates proliferation of endothelium
renal failure (monitor serum creatinine)
Cardio vs vascular selectivity of
(all are calcium channel blockers)
Most cardioselective: Verapamil
Most selective for peripheral vasculature: Nifedepin
Diltiazem = in the middle
drugs with high hepatic clearance have what other qualities?
tend to be lipophilic (because these drugs are filtered in kidney but then re-enter circulation via prox tubule - ie, not excreted)
tend to have high volume of distribution (if low distribution, don't make it to the liver)
captopril v losartan
Captopril: ACE inhibitor. can cause dry cough due to increased levels of bradykinin
Losartan: ARB. good for HTN & diabetes
asthma due to atopy - treatment?
possible side effect with first dose of ACE inhibitor?
make sure patient is not on thiazide diuretics
Thiazide diuretics: HYPER and HYPO?
kalemia (common to all diuretics except K sparing)