Mix 18

Question 1

What Rx would you use to treat GI irritation due to infection, chemo, or gastroenteritis?

Answer 1

5HT antagonists (ondansetron) because GI irritation causes increased mucosal serotonin release&raquo_space; activation of 5HT3 R on vagal and spinal afferents which relay their impulses to the medullary vomiting center&raquo_space; emesis.

Question 2

What Rx would you give to treat central nausea in a migraine headache?

Answer 2

Dopamine R antagonists (metoclopramide, prochlorperazine) [but these have sedating effects and can cause EPS symptoms.

Question 3

What drug class would be the preferred method of treatment for vestibular nausea?

Answer 3

First gen H1 R antagonists (diphenhydramine, meclizine)

Question 4

What drugs could you use to treat diarrhea in patients with carcinoid syndrome or VIPomas?

Answer 4

Somatastatin R agonist (octreotide)

Question 5

Postpartum hemorrhage is an obstetrical emergency where the uterus relaxes (atony) and can’t contract effectively after placental delivery. Bilateral ligation of the ___ artery can decrease BF to the uterus and control post-partum hemorrhage that is unresponsive to medical management.

Answer 5

internal iliac artery.

** Uterus has collateral blood supply from ovarian artery and this is sufficient to maintain uterine function.

Question 6

The ___ nerve supplies sensation to the suprapubic and gluteal regions and motor function to the anterolateral abdominal wall muscles. Damage to this nerve is common with abdominal surgery (appendectomy) and presents as decreased sensation and/or burning pain at the suprapubic region.

Answer 6

iliohypogastric nerve.

Comes off L1 from lateral border of upper psoas. Provides motor function to the anterolateral abdominal wall.

Question 7

The ___ nerve originates from L1 nerve root and accompanies spermatic cord through the superficial inguinal ring. Provides sensation to the upper and medial inner thigh and parts of the external genitalia.

Answer 7

ilioinguinal nerve (L1 root)

Question 8

Why is pancreatitis a major risk factor for developing ARDS?

Answer 8

Pancreatitis is a major risk factor for ARDS because it causes the release of large amounts of inflammatory cytokines and pancreatic enzymes that lead to activation of neutrophils in the alveolar tissues. Diffuse injury to the alveolar epithelium&raquo_space; leaky alveolar capillary membrane and pulmonary edema. Causes waxy hyaline membrane formation due to accumulation of fibrin exudate and remnants of necrotic epithelial cells.

Question 9

Why are COX2 inhibitors assoc with ^ risk of cardiovascular events?

Answer 9

While good for preventing bleeding and gastric ulcers, COX2 inhibitors can prevent formation of prostacyclin, a protein expressed in vascular endothelial cells and vascular SM cells that has anticoag and vasodilatory actions.