- Bone marrow suppression - HTN - Constipation - Muscle Cramps

- Late S and early G2 - Inhibits topoisomerase II (increased DNA degradation) - Testicular Cancer and SCLC

- Tachycardia - N/V - SOB - Hematuria - Melena - Myelosuppression - Alopecia

- Bone marrow suppression - Alopecia - SIADH

RX Flash 254 Flashcards by Keegan Sturgill

Vinblastine ADRs

Bone marrow suppression
HTN
Constipation
Muscle Cramps

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What correlates to a better prognosis in breast cancer?

Estrogen (most) and progesterone receptors in breast cancer cells correlates to better prognosis

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Common cause of blindness in AIDs
Rapidly diminishing sight
Loss of central vision with floaters and blind spots
Cotton-wool exudates
Necrotizing retinitis
Perivascular hemorrhages
RETINAL DETACHMENT

CMV retinitis

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Cherry-red spot on the macula (due to the absence of ganglion cells within the fovea allowing the choroid’s normal color to show) are seen in…

Tay-Sachs
Niemann-Pick disease
Both lysosomal storage diseases

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Acetylcholinesterase concentrations can test for …

-Neural tube defects and other anatomic abnormalities

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TXA 2 (thromboxane A2)

Produced by platelets
Vasoconstriction
Platelet aggregation

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Virchow Triad (3 factors that increase risk for DVT)

Stasis
Endothelial injury
Hypercoagulability

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Inhibit the incorporation of cholesterol into micelles in the GI tract
Decrease overall amount of cholesterol absorbed

Phytosterols

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Etoposide

Late S and early G2
Inhibits topoisomerase II (increased DNA degradation)
Testicular Cancer and SCLC

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Etoposide ADRs

Tachycardia
N/V
SOB
Hematuria
Melena
Myelosuppression
Alopecia

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Myelosuppression
Mucositis
Renal toxicity
Elevated renal enzymes

Methotrexate ADRs

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Vinblastine Toxicity

Bone marrow suppression
Alopecia
SIADH

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Ulcerative Stomatitis- N/V and diarrhea

Methotrexate (MTX)

- Pancytopenia also obviously seen

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Odansetron ADRs
-HA
-Malaise
-Constipation
But what is its use?

SSRI

- Used for antiemetic

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Phosphatidylcholine (aka lecithin)

Dominate component of pulmonary surfactant
If pregnancy can be delayed: glucocorticoids to mother/fetus to induce surfactant production
If can not be delayed give EXOGENOUS phosphatidylcholine

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Lecithin: sphingomyelin ratio

-A ratio less than 2 is associated with a high risk for neonatal respiratory distress syndrome

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Cluster headaches symptoms:

LACRIMATION (wtf)
Conjunctival injection
Ptosis
Nasal Congestion
Abortive RX = O2

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What symptoms are seen in migraines but NOT cluster headaches?

Nausea
Photophobia
Visual auras

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What kind of headache can vertigo be seen in?

Basilar Type Migraine Headaches

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What is the genetic predisposition to ALL? (Acute Lymphocytic Leukemia)

Chromosomal anomalies:
-Trisomy 21 and Klinefelter syndrome
Diseases with chromosomal fragility:
-Fanconi anemia, Bloom syndrome, Ataxia telangiectasia

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ALL (acute lymphocytic leukemia) symptoms:

RAPID onset of all the symptoms of bone marrow suppression:
-Anemia→weakness
-Thrombocytopenia→Petechiae
LAD

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Nonedemic Burkitt lymphoma subtype

Large abdominal mass

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HIV→ non-Hodgkin lymphoma
HTLV→ Adult T-cell leukemia/lymphoma (ATLL)
Note: ATLL patients often present with SKIN LESIONS and with lytic bone lesions

T-lymphocyte cancers associated with Retroviruses

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What does a positive Romberg sign indicate?

Problem with proprioception or vestibular apparatus
Dorsal columns/ MEDIAL LEMNISCUS TRACT
NOT cerebellar b/c motor coordination defects would be evident before and after the patient closes eyes

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Tectospinal tract is responsible for…

-Head movements in response to visual signals

Nimodipine (DHP calcium channel blocker)

-MANAGEMENT of SUBARACHNOID induced VASOSPAM

Bronchodilation is mediated via Beta-2 and…

IV drug user with leukopenia, index of suspicion should be high for…

AIDS

Nitroglycerin (low dose)

- Venodilation→Decrease in VR→ Decrease in preload→ Decreased myocardial O2 demand - Tolerance to vasodilatory effects can occur: NITORGLYCERIN HOLIDAYS

Drugs that can cause LUPUS-LIKE SYNDROME: Anti-histone and ant-nuclear antibodies

- Isoniazid - Quinidine - Minocycline - Valproate - Tetracycline (mind blown) - Hydralazine - PROCAINAMINE (antiarrhythmic) - Penicillamine - Sulfasalazine

Postductal coarctation of the aorta is associated with a high risk of what?

-Bacterial endocarditis and cerebral hemorrhage

What cells produces beta-interferon

-Connective tissue fibroblasts (used to treat MS) | Stimulate suppressor T-lymphocytes

Alpha-Interferon uses?

- Hep. B and C - Kaposi - Malignant melanoma - Certain Leukemias (hairy cell)

Gamma-Interferon

- Produced by T-lymphocytes - Activates tumoricidal macrophages - USED IN CGD patients

Gamma-Interferon

CLL vs. SLL

Vary only in degree of peripheral lymphocytosis | >4,000 cells/mm3 = CLL

What are the markers for CLL?

CD19, CD20 and CD23 (B-cell) | CD5 (Primitive B-cell but usually T-cells) ***

Helper T-lymphocytes are involved in what leukemias?

ALL, T-lymphocyte non-Hodgkin’s lymphoma, and MYCOSIS FUNGOIDES

Pearly boarders of fine telangiectasias | Tumor cells nests with PALISADING NUCLEI in the dermis

Basal Cell Carcinoma

- Monoclonal antibody against VEGF - Used to treat solid tumors (colon, breast, non-small cell lung) - Given in combo with 5-FU, Leucovorin, Oxaliplatin or Irinotecan

Bevacizumab

- Most common precancerous dermatosis | - Cytologic atypia with intercellular bridging

Actinic Keratosis

What else is hypertrophic cardiomyopathy known as?

-IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS | Abnormally enlarged ventricular septum

- Tinnitus, N/V, and lethargy with fever and tachypnea - Mixed respiratory alkalosis-metabolic acidosis - Tx: ABCs and initial dose of activated charcoal (absorbs whatever is left in GI) - TX: Next step = alkalization of the plasma and urine is essential (use sodium bicarbonate) - Tx: monitor potassium and glucose levels

Aspirin Overdose

Two injected treatments for age-related neovascular macular degeneration

- Ranibizumab is an anti-VEGF monoclonal antibody (binds VEGF) - Pegaptanib is a pegylated anti-VEGF aptamer - Risks hypertension and elevated risk of bleeding

Gold standard for Hodgkin lymphoma:

ABVD - Adriamycin (doxorubicin)→intercalates DNA - Bleomycin→ DNA breaks via inhibiting thymidine DNA strands - Vinblastine→ binds tubulin (inhibits microtubule assembly) - Dacarbazine→ alkylating agent

Name the Anti-androgens that block androgen receptors in prostate

- Flutamide - Bicalutamide - Nilutamide - Cyproterone acetate

Direct acting vs. indirect sympathomimetics

- Direct enter CNS less rapidly than indirect | - Direct have more selective receptor activity than indirect at postsynaptic

L1 dermatome

- At the level of inguinal ligament - Femoral triangle - Superolateral quadrant of the buttox

Belly button

T10

McBurney point dermatome

T12

Xiphoid process

-Kneecaps

Melanoma associated mutations

-Chromosome 9 p16 gene of

- AR - Inborn error in methionine metabolism - Accumulation of homocysteine - Deficiency of enzyme cystathionine synthase - Subluxation of the lens (ectopia lentis) - Tall stature (tall and long thin limbs/ marfanoid habitus) - Similar to Marfan’s symptoms PLUS life threatening thromboembolic events

Homocystinuria

Conduction aphasia

- Only repetition is impaired | - Arcuate fasciculus

- Abnormal dilation of proximal and medium-size bronchi (>2mm in diameter) - Caused by destruction of elastic and muscular components of bronchial walls - Decreased breath sounds - Pleuritic chest pain - Order sputum culture and CT of chest

Bronchiectasis

Bronchitis

- Increased secretion/ hyperplasia of submucosal glands | - Reid Index > 0.4 indicated chronic bronchitis

Abciximab use

Treat acute coronary syndromes if allergic to aspirin

-Non-steroidal anti-androgen that acts competitively to inhibit androgens at the TESTOSTERONE receptor

Flutamide

Fist signs of lead poisoning

-Intermittent vomiting, pain, and constipation →Progress to ataxia, altered consciousness, coma, seizures, and encephalopathy -Fucked up heme synthesis due to inhibition of several enzymes (aminolevulinic acid dehydratase→ build up of various products→ lead-induced porphyria

Abortive therapy for migraine

Ergotamine and Sumatriptan

Tension Headaches (AKA muscle contraction headaches)

- Band-like pain encircling the head and no other associated symptoms - Tx: Acetaminophen or NSAIDs - TCA in refractory cases

Tension Headaches (AKA muscle contraction headaches)

Weakness of the eye muscles that may result in diplopia and/or nystagmus

Opthalmoplegia

Irreversible condition, ANTEROGRADE amnesia, confabulation, and personality change

Korsakoff’s psychosis

Where is the lesion in Wernicke-Korsakoff syndrome located?

Mammillary bodies

Kluver-Bucy (hyperorality, hypersexuality, disinhibition) is bilateral lesions of the …

AMYGDALA

Bleomycin ADRs

Pulmonary fibrosis Stomatitis and Mucositis Hyperpigmentation (Good because causes very MINIMAL bone marrow suppression)

- High-pitched blowing diastolic murmur | - Wide pulse pressure

Murmur of Aortic Regurgitation

Late diastolic murmur that follows an opening snap

Mitral stenosis

- HOLOSYSTOLIC BLOWING MURMUR | - Heard loudest at the apex

Mitral Regurgitation murmur

What can be used to improve the efficacy of 5-FU even though 5-FU myelosuppression is irreversible?

LEUCOVORIN b/c it stabilizes the bond between thymidylate synthetase and 5-deoxyuracil monophosphate

DRUG OF CHOICE FOR BPH

Finasteride (5-alpha-reducatase inhibitor) and /or Alpha1-ANTAGONISTS: TERAZOSIN (BPH too) or TAMUSULOSIN

RX Flash 254 Flashcards

(73 cards)