test #24 4.13 Flashcards Preview

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Flashcards in test #24 4.13 Deck (136)
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1

slow acetylators metabolize which 4 drugs slowly?

P450 acetylation of dapsone, hydralazine, procainamide, and isoniazid

2

methylation is an important drug biotransformation for..

azathioprine and 6-mercaptopurine

3

gilbert syndrome can affect drug metabolism..

bc some drugs require gluronidation for biotransformation.

(dysfunctional glucoronyl transferase)

4

drug hydrolysis occurs with..

esterases and amidases

5

normal amount of amniotic fluid

1000ml.

6

fetal anomalies associated w/ impaired swallowing (2)? increase urination? (polyhydramnios)

impaired swallowing: duodenal, esophageal, or intestinal atresia (GI obstruction) & anencephaly

increased fetal urination: high cardiac output due to (1) anemia or (2) twin-to-twin transfer

7

posterior urethral valve

congenital obstruction to urine flow

8

rachischisis

neural tube defect where vertebral column does not close over spinal cord. (posterior neuropore fails to close).

9

MI w/ normal coronary artery? think (3)

(1) coronary arteritis, (2) hypercoagulability w/ acute thrombosis, (3) coronary vasopasm

10

describe libman-sacks endocarditis

verrucous (wart-like) endocarditis, 25% of patients on EITHER side of valve. sterile, finely granular, fibrinous, eosinophilic. may result from immune complex deposition. can progress to valve fibrosis & regurg or stenosis.

11

Churgg-Strauss

polyarteritis nodosa-associated condition w/ lung vasculitis, severe asthma, and eosinophilia (in atopic patients). have necrotizing granulomas

12

flexor retinaculum aka

transverse carpal ligament.

13

carpa tunnel is associated with what scenarios?

(1) chronic repetitive stress (typing, knitting)
(2) fluid retention (renal failure, hypothyroidism, pregnancy
(3) diabetes mellitus, acromegaly, rheumatoid arthritis

14

dialysis associated amyloidosis

B2-microglobulin. can lead to median nerve compression (often bilateral)

15

endoneural inflammation infiltration with segmental demyelination seen in..

guillain-barre syndrome

16

endoneural arteriole hyalinization occurs in..

diabetic microangiopathy

17

insulin secretion is stimulation by which 3 systems

(1) blood glucose
(2) parasympathetic: secrete

insulin at smell/sight of food
sympathetic can inhibit or stimulate depending on receptor
(1) alpha- INHIBIT insulin release
(2) beta- STIMULATE insulin release

18

diphenhydramine, dimenhydrinate, chorpheniramine

commonly used antihistaminic agent (blocks H1). commonly have (1) anti-muscarinic (2) anti-alpha-adrenergic effects

19

ephedrine

indirect general sympathetic agonist, releases stored catecholamines.

used for nasal decongestion, urinary incontinence, hypotension

20

alpha receptor agonist on insulin?

inhibit insulin release

21

beta receptor agonist on insulin

promote insulin release

22

loratadine, fexofenadine, cetirizine

second generation H1 blockers. less sedating bc less CNS penetration.

still anti-Muscarinic

23

alpha-2 agonists (2)

clonidine & methyl-dopa

24

clonidine use

alpha-2 agonist, does not decrease renal blood flow. hypertensive urgency, ADHD

25

alpha-methyldopa

alpha-2 agonist. hypertension in pregnancy

26

classic anti-inflammatory effects

TGF-beta, IL-10

generally TGF-beta shuts it all down. and IL-10 shuts down cell-mediated and enhances humoral.

TGF-beta: (1) inhibit Th2 lymphocyte differentiation, (2) cytotoxic T cell activities, and (3) B-cell immunoglobulin secretion.

also suppress NK, LAK, and cytotoxicity of mononuclear phagocytes

IL10 (1) inhibits IL-2 and IFN-gamma production by Th1 cells, (2) enhances IL-4 and IL-5 production by Th2 lymphocytes. (3) inhibits TNF-alpha and IL-12 by monocytes and (4) decreases NK cell IFN-gamma production. (5) inhibit monocyte MHC class II and B7 expression (impairing antigen presentation)

27

TNF-alpha

proinflammatory cytokine. made by T cells and monocytes. induces NFKb (important factor in production of inflammatory mediators. IL-1, IL-4, IL-5, IL-12.

28

persistent lymphedema (chronic dilatation of lymphatic channels) predisposes to..

lymphangiosarcoma.

rare malignant neoplasm of endothelial lining of lymphatic channels.

29

pyogenic granuloma

polypoid form of capillary hemangioma. often grow rapidly, as exophytic red nodules attached by a stalk on gingival or oral mucosa or skin. bleed easily, may be ulcerated. resemble hypertrophic granulation tissue.

30

port-wine stain

birthmark of malformed, dilated blood vessels in superficial dermis. permanent.