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Principles of Medicine
Principles of Medicine II
50
Other
Professional
05/03/2011

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Term
Virchow's Triad
Definition
1) Reduction in blood flow
2) Changes in the blood vessel wall
3) Increased coagulability of the blood
Term
What are the Vitamin K dependent clotting factors?
Definition
II, VII, IX, and X
Term
The conversion of fibrinogen to fibrin is mediated by __________.
Definition
Thrombin (which is mediated by Xa)
Term
The extrinsic pathway of clotting involves Factor __ while the intrinsic pathway involves exposure of Factor __.
Definition
VII...........XII
Term
____________ can cause megakaryocyte suppression while __________ and _________ are most common to cause platelet destruction.
Definition
Thiazide diuretics...............quinidine and quinine.
Term
Ehlers-Danlos Syndrome
Definition
A hereditary connective tissue disorder than results in vascular abnormalities (which do not affect PT or PTT).
Term
Hereditary Hemorrhagic Telangiectasia
Definition
Telangiectasies replace capillaries; causes AVMs primarily in PULMONARY and MUCOSAL areas.
Term
___________ is the most common acquired coagulation disorder and results in _____________.
Definition
Vitamin K deficiency.........increased PT.
Term
Heparin is reversed by _________, and Coumarin is reversed by _________.
Definition
Protamine sulfate........FFP.
Term
Amyloidosis causes a Factor X clotting deficiency (True/False)
Definition
True
Term
Degrees of hemophilia
Definition
Mild: 5-25% of normal amount

Moderate: 2-5%

Severe: <2%
Term
HIV is defined as having a CD4 count of less than ___.
Definition
200
Term
Lupus anticoagulant
Definition
Elevated PTT in vitro but hypercoagulability in vivo!
Term
Thrombin time tests......
Definition
The conversion of fibrinogen to fibrin to cross-linked fibrin; the test can also be modified to measure fibrinogen levels.
Term
Type II diabetes is generally resistant to ketoacidosis (true/false).
Definition
True
Term
Diabetics have a fasting glucose levels of _______.
Definition
>126 mg/dl; normal is <110 mg/dl.

Other values for diabetics are >200 mg/dl in other tests.
Term
Degrees of HbA1c levels:
Definition
1) <7% good control
2) 7-9% fair control
3) >9% poor control

This test shows glycemic control over the last 8-12 weeks. Use serum fructosamine level for preceding 2 weeks (normal = 2.0-2.8 mmol/L).
Term
RAGE
Definition
Receptors for advances glycation end products; recruits and activates inflammatory pathways.
Term
Avoid dental treatment in diabetics if their blood glucose is above ______.
Definition
400 mg/dl.
Term
One option for a hypoglycemic diabetic with an IV in place is......
Definition
25-30 mL of D50 (dextrose solution).
Term
Dental complication of SLE.
Definition
Pulpal obliteration leading to decreased pain perception.
Term
Rheumatoid arthritis is strongly linked to MHC Class II antigens (true/false).
Definition
True
Term
The inflammatory myopathies of connective tissue diseases include:
Definition
Polymyositis (CPK and adolase levels) and dermatomyositis.
Term
_________ and _________ are often the primary symptoms of perennial allergic rhinitis.
Definition
Nasal congestion and post nasal drip.
Term
Cromolyn
Definition
A non-steroidal nasal spray that can prevent symptoms if given before exposure.
Term
Prednisone burst can be used in an acute asthma attack when SABA alone is not effective (true/false).
Definition
True
Term
Rule of 2 with asthma
Definition
Need more than a rescue bronchodilator when:

1) Use quick relief inhaler more than 2 times per week
2) Have night asthma attacks more than 2 times per month
3) Refill inhaler more than 2 times per year.
Term
Proliferative Verrucous Leukoplakia
Definition
High risk of progression to SCC (70%); more common in males.
Term
The more differentiated the tumor, the more responsive it is to radiotherapy (true/false).
Definition
False
Term
Amifostine (Ethyol)
Definition
A radioprotective drug that scavenges free radicals and promotes repair of damaged DNA.
Term
Which three NRTIs can cause oral ulcerations?
Definition
1) Didanosine
2) Zalcitabine (can also cause esophageal ulceration)
3) Abacavir
Term
__________ is a protease inhibitor than can cause perioral paresthesia.
Definition
Ritonavir

Protease inhibitors can help induce shingles.
Term
Glomerular disease is a common cause of acute renal failure (true/false).
Definition
False
Term
___________ is the most common cause of acute renal failure.
Definition
Tubulointerstitial diseases; acute interstitial nephritis (eosinophils in urine) and acute tubular necrosis (renal ischemia or nephrotoxins).
Term
BEANS treatment of renal failure:
Definition
Blood pressure lower than 130/85
Erythropoietin to maintain hemoglobin at 10-12 g/dl.
Access for dialysis created when creatinine >4.0 mg/dl.
Nutritional monitoring
Specialty evaluation by a nephrologist when creatinine >3.0 mg/dl.
Term
Oral manifestations are common for renal failure patients (true/false).
Definition
True

Uremic stomatitis (two forms), xerostomia, metallic taste, etc.
Term
Renal osteodystrophy
Definition
Ground glass bone, radiolucent giant cell lesions, metastatic soft tissue calcifications, and sclerotic bone in extraction healing sites.
Term
___________ is an antibiotic that should be avoided in renal failure patients; _________ is an analgesic that is ok to give.
Definition
Tetracyclin.......acetaminophen
Term
ALT/AST is found primarily in the liver.
Definition
ALT
Term
_______________ is a very sensitive indicator of hepatobiliary disease but is not specific to the liver.
Definition
Gamma Glutamyltransferase (GGT) levels
Term
Normal weight of serum albumin is _____.
Definition
500g; 20 day half-life so it does not help diagnose acute liver disease.
Term
Hepatocellular/Necro-Inflammatory liver failure is marked by......
Definition
AST/ALT levels >5 times normal and ALP levels >2-3 times normal.

Cholestatic liver failure is marked by ALP levels >5 times normal.
Term
Stigmata of liver failure:
Definition
1) Jaundice
2) Spider angiomas
3) Gynecomastia
4) Palmar erythema
5) Leukonychia
6) Ascites
Term
Which type of hepatitis develops in a superinfection?
Definition
HDV occurring on top of a HBV infection; chronicity.
Term
Risk of HBV infection is 10 times higher if __________ is present in the patient's blood along with HBsAg.
Definition
HBeAg
Term
Oral manifestations of liver disease include......
Definition
Glossitis and Sjogren's-like syndrome/lichen planus (HCV).
Term
Limit Xylocaine to __ carpules in patients with severe liver disease.
Definition
3
Term
Hashimoto's Thyroiditis
Definition
Autoimmune hypothyroidism resulting in a goiter for 20-50% of women.
Term
Primary adrenal insufficiency is only evident when.......
Definition
90% of the cortex is nonfunctional.
Term
Mild risk adrenal insufficiency requires ____mg of hydrocortisone the day of dental surgery; moderate to major adrenal insufficiency requires ____mg.
Definition
25mg.....50-100mg.
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