Physiology

Question 1

Which part of the kidney does vasopressin work on?

Answer 1

1. Distal convoluted tubule
2. Collecting ducts

Question 2

What clinical signs will you see with the lack of vasopressin production or lack of vasopressin action?

Answer 2

*Vasopressin’s main effect = anti-diuretic activity (

Question 3

Pressure in pulmonary artery vs aorta

Answer 3

15mmHg pulmonary arterial pressure vs 100 mmHg in aortic P

Question 4

2 most common causes of right axis shift of the mean electrical axis

Answer 4

right ventricular hypertrophy (Figure 5) and right bundle branch block (RBBB).

Question 5

Differentiate RVH from RBBB on ECG

Answer 5

Right ventricular hypertrophy is associated with a normal duration QRS complex, while RBBB results in a prolonged QRS complex duration because of slow myocyte-to-myocyte conduction

Question 6

How does LBBB change the MEA and QRS complex duration?

Answer 6

LBBB is characterized by a normal mean electrical axis with a prolonged QRS complex duration

Question 7

3 types of rhythm without p waves

Answer 7

1. Atrial standstill (4 criteria - no p, slow, regular, supraventricular QRS)
2. Atrial fibrillation (4 criteria - no p, fast, irregular, supraventricular QRS)
3. Sinus arrest (no sinus complex for 2 R-R interval)

Question 8

What antagonizes angiotensin II?

Answer 8

ANP

Question 9

What causes hyperkinetic and hypokinetic pulses?

Answer 9

Hyperkinetic: PDA, AI, stress, HyperT4 • Hypokinetic: SAS, Pericardial disease, DCM, CHF, shock

Question 10

chemotherapy drugs crosses BBB/reaches therapeutic concentrations

Answer 10

Cytosar
CCNU
hydroxyurea

Question 11

How does MM interfere w. Platelet function?

Answer 11

Hyperparaproteinemia interferes with platelet adhesion, activation, aggregation

Question 12

Most common Primary and Secondary brain tumor

Answer 12

Primary: meningioma
Secondary: HSA

Question 13

Gastric tumor assoc. w. Hypoglycemia

Answer 13

Leiomyosarcoma

Question 14

Cyclophosphamide side effects

Answer 14

Acrolein
Hemorrhagic sterile cystitis
Given with furosemide
Mesna

Question 15

Side effects vincristine

Answer 15

Vincristine- GI ileus, neurotoxicity, peripheral neuropathy

Question 16

Which infectious dz can look like CD8 T-cell leukemia on flow cytometry?

Answer 16

Ehrlichiosis

Question 17

Hyperkinetic pulses

Answer 17

AI, PDA

Question 18

Life cycle of babesia, toxoplasma, cytauxzoon

Answer 18

a. Babesia- merozoites burst out of RBC and cause disease b. Toxoplasma – the sporozoites cause infection via placenta c. Cytauxzoon- schizonts cause blockage of vessels

Question 19

Metronomic chemotherapy

Answer 19

Inhibits T-reg
Inhibits DNA replication

Question 20

Heinz bodies

Answer 20

Intacellular hemoglobin aggregation, signifies oxidative changes (onion, acetaminophen, zinc)

Different from Howell-jolly bodies - micronuclei

Question 21

Tumor lysis syndrome

Answer 21

hyperK, hyperP, hyperuricemia
Hypocalcemia

Question 22

Which aa stimulates insulin secretion?

Answer 22

leucine, isoleucine, alanine, and arginine

Question 23

main nutrient for enterocytes

Answer 23

glutamine

Question 24

pimobendan MOA

Answer 24

INODILATOR
1) Increase contractility by sensitizing cardiomyocytes (troponin C) to Ca
2) Vasodilation through PDE3 inhibitor activity

Question 25

Digoxin side effect

Answer 25

Narrow therapeutic index GI signs Use in caution with patients with kidney disease Use in caution in herding breeds/MDR1

Question 26

Digoxin drug interaction

Answer 26

Some drugs may decrease digoxin levels (antacids, kaopectate, certain chemotherapy drugs, metoclopramide) Some drugs may increase digoxin levels (erythromycin, clarithromycin, tetracycline, spironolactone, traconazole, alprazolam)

Question 27

Digoxin MOA

Answer 27

Increase contractility: Inhibits Na-K-ATPase pump --> increase Na/Ca exchange --> increase Ca intracellular --> increase contractility Reduce HR: Parasympathetomimetic --> slow AV conduction --> reduce HR

Question 28

Diazoxide MOA

Answer 28

Thiazide with no diuretic activity. It slows release of insulin from pancreas. Used for hypoglycemia.

Question 29

What is streptozosin used for?

Answer 29

Streptozocin is an antitumor ab used for the treatment of metastatic islet cell carcinoma of the pancreas

Question 30

Differentiate intravascular vs extravascular hemolysis.

Answer 30

Intravascular hemolysis: presence of hemoglobinemia/hemoglobinuria Extravascular hemolysis: no hemoglobinemia/hemoglobinuria

Question 31

Endocrine pancreatic cells and secretions

Answer 31

Alpha (20%) - glucagon Beta (70%) - insulin Delta (10%) - somatostatin

Question 32

What hormones antagonize glucagon?

Answer 32

Insulin and somatostatin Note: Insulin antagonizes glucagon Somatostatin antagonizes insulin and glucagon Glucagon - insulin - somatostatin

Question 33

What is glucagon used for?

Answer 33

Gluconeogenesis Glycogenolysis Lipolysis Increase satiety

Question 34

What hormones do somatostatin antagonize?

Answer 34

Insulin Glucagon Growth hormone Parietal cell to stop H secretion Gastrin from G cells Histamine from ECL cells

Question 35

Treatment for polycythemia Vera

Answer 35

Hydroxyurea (anti metabolite)- interferes with DNA synthesis via inhibition of thymidine