Midterm 2 Flashcards by Justin Moody

Which of the following cells are least prone to injury

Hematopoietic cells
Neurons
Hepatocytes
Testicular cells

Neurons

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Highly active, injury prone cells

Hematopoietic cells
Hepatocytes
Testicular cells
Intestinal cells

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Hypertrophy

Increased size of an organ or cell

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Atrophy

Decreased size of organ or cell or cell count

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Hyperplasia

Increased number of cells

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Metaplasia

Replacement of one cell type with another

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Dysplasia

Disordered, unregulated cell proliferation without maturation

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Orderly cell death without inflammation

Apoptosis

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Disorderly cell death with inflammation

Necrosis

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Death of a body part

Gangrenous necrosis

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Cell death occurring in a granuloma

Caseous necrosis

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Left sided heart failure complications

Hypertension
Ischemic heart disease
Pulmonary edema
Orthopnea - hypertension laying down
Reduced blood to kidneys

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Right sided heart failure
caused by
effects

caused by lung disease/ left sided heart disease
causes hepatomegaly
hypertension

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Select incorrect statement concerning myocardial infarction

as many as 10-20% of these patients experience no pain
The majority of these patients experience pulmonary edema
These are often associated with a mural thrombus (40%)
Typically precipitated by an atrial premature beat

Typically precipitated by an atrial premature beat

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Complications of MI

Arrhythmias (75-95%)
Pericarditis (50%)
Mural thrombus (40%)
Extension of infarct

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Tachy-arrhythmias

cardiac contraction rates more than 100 bpm

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Most common ineffective cardiac contraction

Atrial fibrillation

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Essential/primary hypertension

don’t know what causes it
very common - 90-95% of hypertensive patients
narrowing of arterioles especially in kidneys

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Secondary hypertension

Caused by pheochromocytoma or other endocrine cause
and by congestive heart failure
5-10% of hypertensives
Drugs
Pregnancy
Renal failure
Sleep apnea

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Which of the following is least likely to be a compensation for congestive heart failure

Cardiohypertrophy
A reduction in cardiac stroke volume
Increased catecholamine (sympathetic) activity
Tachycardia

A reduction in cardiac stroke volume

Will want to increase stroke volume

Also will want to redistribute blood flow

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Fixed (stable) stenosis/angina

Symptoms resolve after exerted effort

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Variant angina

at rest, brief

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Unstable angina

prolonged at rest

most dangerous

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Risk of atrial fibrillation

Thrombus
25% of strokes
no MI danger

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Select the incorrect statement Valvular heart disease can be caused by streptococcal infections Endocarditis can cause fatal thromboemboli Atrial premature beats are usually very dangerous Bradycardia is defined as fewer than 60 bpm and can be caused by cardiac conduction blocks

Atrial premature beats are usually very dangerous | Ventricular are dangerous

Thrombus

blood clot clogging an artery

Embolus

anything blocking a vessel

Select the incorrect statement concerning cardiac arrhythmias Tachy-arrhythmias can be caused by multiple ectopic foci A risk of atrial fibrillation is stroke-causing emboli Often are associated with congestive heart failure Procainamide is the first choice for ventricular arrhythmias

Procainamide is the first choice for ventricular arrhythmias

First choice for ventricular arrhythmias

Lidocaine

Treat atrial fibrillation

Amiodarone

Metoprolol

B1 blocker treats heart failure, reduce heart rate and block sympathetic nervous system activity treats heart failure

Dobutamine

Increases HR - B1 agonist can cause arrhythmias treats heart failure

Captopril

Decrease TPR ACE inhibitor - angiotensin converting enzyme Reduces salt and water retention treats heart failure

Hydralazine

vasodilator smooth muscle relaxer treats heart disease

Digitalis

Increases Ca and contractility of heart | treats heart failure

Procainamide

Anti-arrhythmic slows action potential conduction Na channel blocker not first choice

Select the incorrect statement concerning the following antihypertensive drugs ``` Furosemide is a loop diuretic more potent than hydrochlorthiazide Mannitol is an osmotic diuretic Clonidine is an alpha 1 antagonist Diltiazem is a calcium channel blocker Captopril is an ACE inhibitor ```

Clonidine is a alpha 2 agonist

Most likely to treat cholesterol and lipid condition Fenobrate Cholesteramine Exetimibe Lovastatin

Lovastatin - Inhibits synthesis of cholesterol

Fenobrate

Decreases LDL and VLDL Increases HDL Increases lipolysis in liver and muscles

Cholesteramine

Reduces bile reabsorption of lipid/cholesterol

Exetimibe

Decreases fat absorption

Select the incorrect statement concerning pulmonary pathology Asthma is associated with smooth muscle hypertrophy and hyper-inflated lungs Fibrosing lung diseases are often associated with rheumatoid arthritis The main cause of COPD (congestive obstructive pulmonary disease) is car emissions Cystic fibrosis is associated with destruction of elastin and muscle in the pulmonary bronchial walls

The main cause of COPD is not car emissions | it's smoking

Which is described as a 'controller' agent and is most likely to be prescribed as the primary drug for regular use to treat long-term stable moderate to severe asthma ``` Theophylline Mentelukast Cromolyn Albuterol Fluticasone ```

Fluticasone - steroid, thrush, ulcers

Theophylline

Add on controller increased cyclic AMP Phosphodiester inhibitor combined with cortical steroids to treat asthma

Mentelukast

Leukotriene modifier | Prophylactic for serious/chronic asthma

Cromolyn

Inhibits release of histamine from mast cells | prophylactic before exercise

Albuterol

beta 2 agonist | treats asthma

Which of the following is responsible for the majority of renal/ureter stones Magnesium ammonium phosphate Calcium oxalate Uric acid Cystine

Calcium oxalate - 80% of stones, mostly men, alkalize, stop soda

Struvite, 10% of stones

Magnesium ammonium phosphate Infection mostly women

Acidify this stone to treat

Struvite/Magnesium ammonium phosphate

Uric acid stone

Purines, men alkalize

Cystine stones

alkalize

Order of kidney stone commonality

Calcium oxalate - 80% Struvite/Magnesium - 15% Uric Acid - 5% Cystine - 2-5%

Select the incorrect statement concerning pyelonephritis The most common cause is kidney stones Often associated with flank pain 10-20% result in kidney failure Often causes kidney scarring

The most common cause is not kidney stones | Retrograde spread from cystitis

Select the incorrect statement concerning urogenital diseases The majority of renal cancers are renal cell carcinomas 3 weeks of complete urinary tract obstruction by a stone typically causes permanent kidney damage (partial blockage- 3 months) Females tend to have more bladder infections (cystitis) than males The most frequent drug treatment for bacterial cystitis or urethritis is erythromycin

the most frequent drug treatment for bacterial cystitis or urethritis is erythromycin it is trimethoprim sulfamethoxazole

Used to treat a heparin overdose

Protamine

Platelet aggregate inhibitor

Clopidagrel

Dissolves an established clot

streptokinase

antagonized by vitamin K

Warfarin

actions are similar to heparin

Enoxaparin

Which of the following is incorrect about struvite (magnesium ammonium phosphate) kidney stones and their treatment They are the second most common type of kidney stone (10-15%) Must alkalinize the urine pH to dissolve Trimethoprim-sulfamethoxazole is often give to prevent or control the underlying urinary tract infection in these patients More common in females than males

Must alkalinize the urine pH to dissolve Must acidify struvite

Woman with enlarged thyroid, chronically nervous, weight loss, high thyroxine (T4), mostly likely has ``` DeQuervain thyroiditis Graves disease Hashimoto disease Nodular goiter Toxic nodule ```

Graves disease

autoimmune | agonist of thyroid receptor

DeQuervain thyroiditis

subacute granulomatous thyroiditis, viral, painful, | self limited

Hashimoto disease

``` auto-immune causes hypothyroidism (with some hyper beforehand) ```

Nodular goiter

low iodine levels

Most appropriate treatment for hyperthyroidism lady, Graves disease T3 supplements T4 supplements Antiserum for TSH beta blocker and radioactive iodine

beta blocker and radioactive iodine beta blocker for symptoms T3 and T4 would be for Hashimoto disease Antiserum for TSH is not effective, TSH levels are already low in Graves

Hours after thyoidectomy, the patient has severe muscle spasms, anxious, and depressed. Low calcium in blood, what happened

Inadvertent removal of parathyroid glands during thyroid surgery

Man with hypercalcemia, constipation, anorexia, weakness and kidney stones Pulmonary metastatic carcinoma Multiple myeloma Thyroid hyperplasia Parathyroid adenoma

Parathyroid adenoma

Acromegaly ``` Parathyroid adenoma hypothalamus infarct anterior pituitary adenoma posterior pituitary insufficiency Cushing's disease ```

anterior pituitary adenoma

Main effect of parathyroid adenoma

increased serum calcium

effect of hypothalamus infarct

shuts down blood to hypothalamus and anterior pituitary | decreases hormone release

effects of anterior pituitary adenoma

increase in TSH, LH, FSH, Prolactin, GH, ACTH

Posterior pituitary insufficiency

less oxytocin and ADH

Cushing's disease

``` Increase cortisol increased ACTH caused by pituitary adenoma moon face buffalo hump ```

Hypertension, headaches, flushing, nervousness, increased catecholamines, right adrenal mass.

Pheochromocytoma

Neuroblastoma

Catecholamines possible | Usually in children

Normal range of HbA1c

4-5.6%

a 54 year old male informs you he has HbA1c value at 9.0%. Without any additional info, which are correct statements Patient has type 1 diabetes Patient has Addison's disease Infections of the periodontal tissues may be a particular problem With proper treatment, the HbA1c value can be returned to normal range Daily insulin treatments are required for this patient

Infections of periodontal tissues and Treatment can normalize HbA1c levels He has diabetes, but don't know which

Addison's disease

Adrenal gland does not produce as much cortical steroids

Which favor type 2 diabetes over type 1 Age less than 15 Experiences polydipsia and polyphagia Serum insulins is normal Thin rather than obese

Serum insulin is normal

Type I diabetes

Be cells don't work Ketoacidosis need insulin to treat

Which is not associated with insulin activity Reduces HbA1c Promotes glucose uptake in kidney cells connected with a C-peptide in its precursor form Prevents glucosuria

Promotes glucose uptake in kidney cells - nope Every cell but kidney, RBC, Neurons, Retina and lens

Insulin receptors are resistant to activation by insulin

type II diabetes | gestational

Diuresis

all types of diabetes (including gestational and insipidus)

Severe abnormal lipid metabolism

type I diabetes

no insulin

type diabetes

increased thirst

all diabetes

Long-term increased risk of atherosclerosis and hypertension

Type I and II

Increased risk of major periodontal disease

Type I type II Gestational diabetes

Lispro

Rapid onset and early peak action insulin

metformin

a biguanide that decreases glucose production in the liver

acarbose

slows digestion and absorption of starch and disaccharides from intestines

tolbutamide

a sulfonylurea that increases the release of insulin from beta cells

orlistat

diminishes fat absorption in intestines

rosiglitazone

reduces insulin resistance in muscle cells

Which weight reduction drug is thought to suppress appetite by stimulating the 5HT2c receptors in they hypothalamus Glucagon Phentermine Qsymia (topiramate) Lorcaserin

Lorcaserin

Glucagon

pancreas increase gluconeogenesis increase glycogenolysis weight loss

Phentermine

inhibits NE and DA uptake | weight loss

Lorcaserin

Suppresses appetite in hypothalamus | weight loss

Correct statements concerning Addison's disease Often associated with hyperpigmentation in skin Typically associated with weight gain Often associated with a deficiency of aldosterone Frequently treated with prednisone Administration of mifepristone worsens the symptoms

All are right but - association with weight gain | associated with weight loss

Which is a monoclonal antibody to treat excessive bone resorption Alendronate Denosumab Thiazide diuretics Calcitonin

Denosumab

Alendronate

a bisphosphonate, inhibits osteoclasts

Thiazide diuretics

decreased renal secretion of calcium

Calcitonin

secreted by thyroid gland, C cells gets Ca from blood to bone not an antibody

Legal limit of alcohol percent

0.08%

``` Sedation and slower reaction Impaired motor and slurred speech Emissis and stupor Comma Respiratory dysfunction and death ```

``` .05 - .1 .1-.2 .2-.3 .3-.4 more than .4 ```

Alcohol metabolized to what order of kinetics

zero-order | fixed rate - usually saturated

Alcohol can cause which concentration in low doses

can increase HDL

abrupt withdrawal from alcoholics can cause

seizures

Men or women more sensitive to alcohol

women

Freak bone break accident, most important questions before appointment

What medications are you taking | Do you have a history of osteopororsis or Pagets disease

Bisphosphonates and bone/implants

can't do them when on bisphosphonates

Alendronate

bisphosphonate

Midterm 2 Flashcards

(114 cards)