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Flashcards in Medical 1.1 Deck (27)
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1

Pradaxa

Dabigitran

2

Fragmin

Dalteparin

3

Anti-Scl-70

Scleroderma (diffuse cutaneous version)- High specificity, but only 10-40% sensitive

4

Which auto-antibody?Associated with CNS lupus

Anti-ribosomal P protein

5

Buprenorphine: mechanism?

Partial opioid agonist

6

Natalizumab: Mechanism?

Monoclonal antibody against integrin molecules

These molecules are important to adhesion and migration of cells from the vasculature into inflamed tissue. Natalizumab blocks integrin association with vascular receptors, limiting adhesion and transmigration of leukocytes. Efficacy in specific disorders may be related to reduction in specific inflammatory cell populations in target tissues. In multiple sclerosis, efficacy may be related to blockade of T-lymphocyte migration into the central nervous system

7

Dalfampridine

Nonspecific potassium channel blocker, used in MS

Improves conduction in focally demyelinated axons by delaying repolarization and prolonging the duration of action potentials. Enhanced neuronal conduction is thought to strengthen skeletal muscle fiber twitch activity, thereby, improving peripheral motor neurologic function

8

Cholecalciferol

Vitamin D

9

Bivalirudin: Mechanism?

Direct thrombin inhibitor

10

CADASIL: Clinical Features?

1) Migraine with Aura
2) Ischemic strokes/TIAs
3) Cognitive features
4) Neuropsyciatric symptoms

11

Etomidate: advantages?

Hemodynamically neutral

12

Etomidate: disadvantages?

- Adrenal suppression
- No analgesic properties

13

Thiopental: advantages?

Suppresses neural activity

Good for patients with elevated intracranial pressure, seizures, or CNS bleeding

14

Ursodiol: Mechanism?

Reduced secretion of cholesterol from liver, as well as absorption of cholesterol from intestines. This decreases the cholesterol content of bile and bile stones.

15

Valproic Acid: adverse effects?

Hyperammoniemia

Hyperammonemia is believed due to propionic acid, a metabolite of VPA, which inhibits mitochondrial carbamoyl phosphate synthetase, an enzyme necessary for ammonia elimination via the urea cycle. If the action of this enzyme is sufficiently impaired, ammonia levels will accumulate, frequently producing encephalopathy

16

Ketamine: adverse effects?

Emergence Reactions

These reactions vary in their intensity and have been described as disorientation, dream-like experiences, or hallucinations that may be frightening. They occur in up to 20 percent of adults but can be prevented or treated by giving a small dose of midazolam

17

Cholangitis: etiology?

Anything that causes biliary obstruction and/or stasis

Examples:
- Biliary calculi (28 to 70 percent)
- Benign stenosis (5 to 28 percent)
- Malignancy (10 to 57 percent)

18

Erythema Nodosum: associated conditions?

- Antecedent Streptococcal infection (most common cause worldwide)
- Sarcoidosis (will also see Hilar adenopathy)
- Tuberculosis
- Fungal (Coccidioidomycosis, Histoplasmosis)
- Inflammatory Bowel Disease
- Bechet's disease

19

Lofgren's Syndrome

Triad of:
- Hilar adenopathy
- Acute polyarthritis
- Erythema Nodosum

Seen in patients with Sarcoidosis

20

Calciphylaxis: AKA?

Calcific Uremic Arteriolopathy

21

Calciphylaxis: symptoms?

- Excruciatingly painful ischemic necrosis in high adiposity areas (abdomen, buttock, thigh)
- Violaceous, plaque-like subcutaneous nodules

22

Calciphylaxis: pathogenesis?

Systemic medial calcification of arterioles, leading to ischemia and necrosis

23

Calciphylaxis: risk factors?

- Hyperphosphatemia
- Elevated plasma Ca x PO4 product
- Hyperparathyroidism
- Active Vitamin D administration

24

Cerebral T waves: etiology?

- Stroke
- Intracranial bleeding

25

Urine pH = 7.5

Proteus UTI (highly likely)

Proteus produces the enzyme Urease, which converts ammonia (NH4+) to ammonium (NH3), causing an alkaline urine

26

Staghorn calculus

Implies presence of Proteus bacteria in the urinary tract

Proteus -> Urease, causing alkaline urine. The alkalinity promotes the precipitation of phosphate, carbonate and magnesium. This causes the formation of struvite stones, that often form large staghorn calculi.

27

Pes planus

Flat feet