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NMSP > Week 5 (Exam 2) > Flashcards

Week 5 (Exam 2) Flashcards

(46 cards)

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1
Q

DISH

A

Diffuse idiopathic skeletal hyperostosis
Calcification and ossification of spinal ligaments, enthesis
Men, back pain, stiffness, R T-spine more involved
No SI joint involvement
Ossifications of at least 4 contiguous vertebral levels

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2
Q

Ketamine

A

Moderately rapid onset IV anesthetic, NMDA antagonist

CV stimulation, increased cerebral blood, emergence reactions that impair recovery

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3
Q

Propofol

A

Rapid onset IV anesthetic, GABAa agonist
Used in induction and maintenance
Can cause HPTN
Useful antiemetic

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4
Q

Excitatory Ion channels used in general anesthetics

A

Ach
AMPA
5HT

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5
Q

Local anesthesia and the heart

A

Except cocaine, slows conduction velocity and causes arteriolar dilation ad systemic HPTN

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6
Q

Etomidate

A

Rapid onset and pretty fast IV anesthetic, GABAa enhancer
CV stability, decreased steroidogenesis
Involuntary muscle movements

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7
Q

SLE presentation

A

Oral ulcers (nasopharyngeal ulcers, painless)
Arthritis
Serositis (pleurites, rub or PE, EKG changes)
Proteinurea, seizures, anemia, or others

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8
Q

Symmetric Vs Asymmetric Chronic Polyarthritises

A

Symmetrical: Ankylosing Spondylitis, Enteropathic Arth,
Asymmetrical: Psoriatic and Reactive Arthritis

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9
Q

Fentanyl

A

Slow onset IV anesthetic
Naloxone reversal agent
Balanced anesthesia and conscious sedation
Produces marked analgesia

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10
Q

Neck finding in RA

A

Atlantoaxial subluxation (C1C2) due to erosion of odontoid process

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11
Q

IV anesthetics

A 
Diazepam (Valium)
Etomidate
Fentanyl
Ketamine
Midazolam
Propofol
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12
Q

Rip pattern ANA

A

Anti DS DNA, 50% SLE

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13
Q

Dexmedetomidine

A

a2 adrenergic agonist
Produces hypnosis at locus caeruleus
Sedative effect is like a physiologic sleep state
Used for short term sedation of intubated and ventilated patients in ICU or as adjunct

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14
Q

Steroid regimen for gout

A

Prednisone 40mg po/day x5-7 days, taper

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15
Q

Benzo adjunct to anesthesia

A

Increases GABAa receptor sensitivity to GABA
Diazepam, Lorazepam, Midazolam
Flumazenil

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16
Q

Physical criteria for RA

A

Must score at least 7 points!
1 point: 1 large joint
2 points: 2-10 large joints, or 1-3 small joints
3 points: 4-10 small joints
5 points: above 10 joints (at least one small)

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17
Q

Inhibitory Ion channels used in general anesthetics

A

Chloride (GABA and Glycine)

Potassium (K2p, possibly Kv, Katp)

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18
Q

Opiod adjuncts to anesthesia

A

IV fentanyl, sufentanil, remifentanil, morphine

Premedication and adjunct for preoperative analgesia

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19
Q

Inhaled Anesthetics, fastest acting to slowest

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A

NO (incomplete, rapid onset and recovery)
Desflurane
Sevoflurane
Isoflurane
Enflurane
Halothane (medium rate of onset and recovery)

20
Q

Clinical manifestations of Ankylosing Spondylitis

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A

Low back pain for longer than 3 months
Morning stiffness better with exercise, worse at rest
Fatigue, weight loss, fever
SI joint pain, hip arthritis (restricted forward flexion)
Tendonitis, Planter Fasciitis

21
Q

Clinical manifestations of Reactive Arthritis

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A

Arthritis, Enthesitis (achilles, plantar fasciitis), Dactylitis
Eye, Urethra, Joint inflammation

22
Q

Midazolam

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A

Slow onset IV anesthetic
Flumazenil is the reversal agent
Used in balanced anesthesia and conscious sedation
CV stability and marked amnesia

23
Q

The only IV anesthetic to produce profound analgesia

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A

Ketamine

Stimulates Sympathetic Nervous System

24
Q

Labs of Ankylosing Spondylitis (and reactive arthritis)

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A

Increased ESR, CRP
HLA B27
Anemia of chronic disease
Negative RF, ACCP, ANA

25
Barbiturate adjunct to anesthesia
Increases GABAa receptor channel opening Thiopental and methohexital CYP450 enzyme induction
26
Etomidate Endocrine Adverse effects
Adrenocortical suppression by inhibiting 11b-hydroxylase (cholesterol to cortisol)
27
Volatile and gaseous anesthetics given by inhalation
Liquids at room temp: Halothane, Enflurane, Isoflurane, Sevoflurane Gas at room temp: NO
28
Thiopental
``` Rapid onset (bolus dose) Iv anesthetic Slow recovery following infusion Standard induction agent Causes CV depression Avoid in Porphyrias ```
29
Blood:gas partition
Inverse relationship of solubility to speed of onset | The lower it is, the faster it is
30
anterior uveitis / Irisitis DDx
Ankylosing Spondylitis | SLE, HSV
31
Leflunomide (arara)
Pyrimidine Antagonist, rapid excretion w/ cholestyramine | Treats RA, don't use with pregnancy
32
Local anesthetics, shortest to longest lasting / least to most potent
Benzocaine (surface use only) Dibucaine (surface use only) (amide) Procaine (Novocain, primarily for infiltrative) Cocaine Lidocaine (amide, also anti-arrhythmic) Bupivacaine (amide, super long, sensory>motor)
33
Halothane Side effects
Hepatitis
34
Extra-articular manifestations of Enteropathic arthritis
Erythema Nodosum Gangrene Uveitis, Neprolithiasis, Thrombolism, Low bone density
35
Colchicine Regimen for gout
effective within first 24 hours of attack | 0.6mg q8hrs with taper or 1.2 initially then 0.6 later
36
Heberdens and Bouchard nodes
Boney enlargements of PIP and DIPs in OA
37
Three kinds of Anesthesia adjuncts
Opioids, Barbiturates, Benzos
38
Homogenous ANA pattern
Histone Ab, Drug induced Lupus
39
Methohexital
Rapid onset IV anesthetic | Preferred over thiopental for short ambulatory procedures
40
Speckeled ANA pattern
Anti SM, Lupus. Anti SS-A/B, Sjogren
41
Peripheral Arthritis presentation
``` Pitting nails Dactylitis and Enthesitis Some have RF+ or anti CCP Flare up can accompany HIV Soft tissue swelling, erosions, periostitis, joints wrecked ```
42
HLA-B27 associations
Ankylosing Spondylitis | Enteropathic, Psoriatic, Reactive Arthritis
43
Imaging of Ankylosing Spondylitis
Squaring (loss of anterior convexity) Shiny corners. sclerosis at edge of vertebral bodies Bridging of vertebrae (syndesmophytes)
44
Biologic regimen for gout
IL-1B inhibitors | Anakinra 100mg subQ daily
45
Feltys syndrome
RA, Splenomegalia, Neutropenia, Fever, Anemia, Thyrombocytopenia, RF/anti-CCP+
46
Uric acid lowering drugs
``` Xanthine oxidase inhibitors (allopurinol) Uricouric drugs (probenecid, sulfinpyrazone) ```

NMSP (7 decks)

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