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First Aid Pharm Review
for step/shelf
254
Pharmacology
Professional
05/09/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
What is the Km?
Definition
Km is the concentration of a substrate at which an enzyme has 1/2V(max); the Km reflects the affinity of the enzyme for its substrate
Term
Vmax is directly proportional to the concentration of _____.
Definition
the enzyme
Term
What happens to the Km as you increase affinity of an enzyme for its substrate?
Definition
Km decreases
Term
In a graph plotting 1/v versus 1/[s], what values are the y and x intercept?
Definition
x intercept is 1/-km; y intercept is 1/vmax
Term
What is the slope of a graph where 1/v is plotted against 1/[s]?
Definition
km/vmax
Term
What happens to the volume of distribution of a drug that binds plasma proteins if you decrease the protein binding?
Definition
increases the volume of distribution
Term
How do you calculate the volume of distribution if you know the plasma drug concentration?
Definition
amount of drug in teh body/plasma drug concentration
Term
What is the volume of distribution of drugs that are large or charged molecules?
Definition
low (4-8L)
Term
What is the volume of distribution of small hydrophilic molecues that do not bind plasma proteins?
Definition
medium Vd; distribute in extracellular space or body water
Term
What is the volume of distribution of small lipophilic molecules that bvind strongly to extravascular proteins?
Definition
high Vd (distributes into all tissues)
Term
How can you calculate the clearance of a drug?
Definition
rate of elimination of a drug/plasma drug concentration = Vd X Ke (elimination constant)
Term
How long does it take for a drug infused at a constant rate to reach steady state?
Definition
4-5 half lives
Term
What order of elimination has half lives?
Definition
first order
Term
How do you calculate the half life of a drug?
Definition
= (0.7 X Vd)/CL
Term
What is the "bioavailibility" of a drug?
Definition
the fraction of administered drug that reaches circulation
Term
How do you calculate a loading dose?
Definition
target plasma concentration X Volume of distribution / bioavailability
Term
How do you calculate the maintenence dose of a drug?
Definition
target plasma concentration X clearance / bioavailability
Term
What is the term for a rate of elimination that is constant regardless of the plasma concentration of the drug?
Definition
zero order elimination
Term
Name some examples of drugs that are eliminated with zero order kinetics?
Definition
ethanol, aspirin, phenytoin
Term
What kind of drugs overdoses can you treat with bicarbonate?
Definition
weak acids because they will be trapped in the basic urine; examples are phenobarbital, methotrexate, aspirin
Term
You can theoretically treat what overdose with ammonium chloride IV?
Definition
weak bases because they will be trapped in an acidic environment; example is amphetamine
Term
Describe phase I versus phase II metabolism.
Definition
phase I (reduction, oxidation, hydrolysis) via CYPs, phase II is conjugation (glucuronidation, acetylation, sulfation)
Term
As patients age the loose the ability to metabolize drugs via...
Definition
phase I metabolism
Term
What is the difference between two drugs that have the same efficacy but different potency?
Definition
the drug with lower potency has a decreased affinity to the receptor
Term
What kinds of drugs are known for their high efficacy?
Definition
analgesics, antibiotics, antihistamines, and decongestants
Term
What kinds of drugs are known for their high potency?
Definition
chemotherapeutic drugs, antihypertensive drugs, and antilipid drugs
Term
Is phenoxybenzamine a competetive or noncompetative inhibitor of epinephrine?
Definition
noncompetitive
Term
Is flumazenil a competetive or noncompetetive inhibitor on GABA receptors?
Definition
competetive
Term
What is the therapeutic index?
Definition
LD50/ED50
Term
Botulism toxin prevents the release of neurotransmitter from which nerves?
Definition
ALL cholinergic terminals
Term
What type of receptor are nicotinic ACh receptors?
Definition
ligand-gated Na/K channels
Term
Nicotinic recor subtype N is found where in the body?
Definition
autonomic ganglia
Term
Where in the body is nicotinic receptor subtype M found?
Definition
neuromuscular junction
Term
What type of receptor are muscarinic ACh receptors?
Definition
G protein coupled receptors
Term
What type of receptor is an alpha 1 receptor?
Definition
GQ
Term
What type of receptor is an alpha 2 receptor?
Definition
Gi
Term
What are the major functions of alpha 1?
Definition
increase vascular smooth muscle contraction, increase pupillary dilator muscle contraction (mydriasis), increase intestinal and bladder and sphincter muscle contraction
Term
What are the effects of alpha 2 receptors?
Definition
decreased sympathetic outflow and decrease insulin release
Term
What type of receptor are beta 1s?
Definition
Gs
Term
What type of receptors are beta 2s?
Definition
Gs
Term
What are the major functions of beta 2 receptors?
Definition
vasodilation, bronchodilation, increased heart rate, increased contractility, increased lipolysis, increased insulin release, decreased uterine tone
Term
What are the major functions of beta 1 receptors?
Definition
increased heart rate, increased contractility, increased renin release, increased lipolysis
Term
What type of receptor are M1 (muscarine type 1) receptors?
Definition
Gq
Term
What are the major functions of M1 receptors?
Definition
CNS, enteric nervrous system
Term
What type of receptor are M2 receptors?
Definition
Gi
Term
What type of receptors are M3 receptors?
Definition
Gq
Term
What are the major functions of M2 receptors?
Definition
decrease heart rate and contractility of atria
Term
What e the major functions of M3?
Definition
increased exocrine gland secretions (e.g. sweat, gastric acid), increased gut peristalsis, increased bladder contraction, bronchoconstriction, increased pupillary sphincter muscle contraction (miosis), ciliary muscle contraction (accommodation)
Term
What type of receptor are D1 receptors?
Definition
Gs
Term
What are the major functions of D1 receptors?
Definition
relaxes renal vascular smooth muscle
Term
What type of receptor are D2 receptors?
Definition
Gi
Term
What are the major functions of D2 receptors?
Definition
modulates transmitter release, especially in brain
Term
What type of receptor are H1 receptors?
Definition
Gq
Term
What type of receptors are H2 receptors?
Definition
Gs
Term
What are the major functions of H1 receptors?
Definition
increase nasal and bronchial mucus production, contraction of bronchioles, pruritus, and pain
Term
What are the major functions of H2 receptors?
Definition
increase gastric acid secretion
Term
What type of receptor are V1 (vasopressin subtype 1) receptors?
Definition
Gq
Term
What types of receptors are V2 receptors (vasopressin type 2 receptors)?
Definition
Gs
Term
What are the major functions of V1 receptors?
Definition
increase vascular smooth muscle contraction
Term
What are the major functions of V2 receptors?
Definition
increase H2O permeability and reabsorption in the collecting tubules of the kidney
Term
What is the downstream pathway of Gq receptors?
Definition
phospholipase C -> PIP2 -> DAG or IP3; DAG-> protein kinase C; IP3 -> increase Ca
Term
What is the downstream signaling pathway for Gs receptors?
Definition
adenylyl cyclase -> cAMP -> protein kinase A
Term
What is the effect of protein kinase A in muscle?
Definition
increases calcium in the heart; phophorylates myosin light chain kinase in smooth muscle
Term
What drug blocks the reuptake of choline into the nerve terminal?
Definition
hemicholinium
Term
What drugs block the reuptake of ACh into vesicles?
Definition
vesamicol
Term
What is ACh broken down into in the nerve terminal?
Definition
choline and acetate
Term
What is the effect of the drug metyrosine?
Definition
blocks the reuptake of tyrosine into the noradrenergic nerve terminal
Term
Where in the nerve is DA converted into NE?
Definition
inside the secretory vesicle
Term
What drug blocks the movement of DA into vesicles in nerves that secrete catecholamines?
Definition
reserpine
Term
What drug blocks the release of catecholamines from nerve terminals?
Definition
guanethidine
Term
What receptors on a presynaptic sympathetic nerve terminal prevent the release of catecholamines?
Definition
alpha 2 autoreceptors and M2 receptors
Term
What receptor on the presynaptic adrenergic nerve terminal enhances the release of neurotransmitter?
Definition
ang II
Term
What is the clinical use of bethanechol?
Definition
postoperative and neurogenic ileus and urinary retention
Term
Name cholinomimetic agents that are resistant to AChE.
Definition
bethanechol and pilocarpine
Term
What are the clinical applications of carbachol?
Definition
cholinomimetic agent that is used in glaucoma, pupillary contraction, and relief of intraocular pressure
Term
What is methacholine used for?
Definition
(cholinomimetic agent) used in a challenge test for diagnosis of asthma by stimulating muscarinic receptors in airway when inhaled
Term
What is the clinical use of neostigmine?
Definition
post operative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade
Term
What is the clnical use of pyridostigmine?
Definition
myasthenia gravis (does not penetrate CNS)
Term
What is the clinical use of edrophonium?
Definition
diagnosis of myasthenia gravis (extremely short acting anticholinesterase)
Term
What is the clinical use of physostigmine?
Definition
glaucoma (crosses the blood-brain barrier into the CNS) and atropine overdose
Term
What is the clinical application of echothiophate?
Definition
anticholinesterase used in the treatment of glaucoma
Term
What is the clinical use of donepezil?
Definition
anticholinesterase used in the treatment of alzheimer's disease
Term
Cholinomimetics can exacerbate many common diseases such as...
Definition
PUD, asthma and COPD
Term
T/F Organophosphate poisoning can have muscle fasciculations as a symptom.
Definition
true; because organophosphates inhibit the breakdown of ACh, it will cause increased ACh at the neuromuscular junction resulting in fasciculations
Term
What is the antidote to organophosphate poisoning?
Definition
atropine + pralidoxime (which regenerates active AchE, because organoposphates irreversibly inhibited the AchE that was present)
Term
What is homatropine?
Definition
muscarinic antagonist used to produce mydriasis and cycloplegia
Term
What is tropicamide?
Definition
muscarinic antagonist that is used to produce mydriasis and cycloplegia
Term
What is benztropine used for?
Definition
muscarinic antagonist used in the treatment of parkinsons
Term
What is scopolamine used for?
Definition
muscarinic antagonist used in the treatment of motion sickness
Term
What is ipratropium used for?
Definition
muscarinic antagonist used for asthma and COPD
Term
What is oxybutynin used for?
Definition
reduce urgency in mild cystitis and reduce bladder spasms
Term
What is the clinical use of glycopyrrolate?
Definition
muscarinic antagonist used to reduce urgency in mild cystitis and reduce bladder spasms
Term
What is the clinical use of methscopolamine?
Definition
muscarinic antagonist used in peptic ulcer treatment
Term
What is the cilnical use of pirenzepine?
Definition
muscarinic antagonist used for peptic ulcer treatment
Term
What is the clinical use of propantheline?
Definition
muscarinic antagonist used in the treatment of peptic ulcers
Term
What is the clinical use of atropine?
Definition
muscarinic antagonist; used to treat bradycardia and for opthalmic applications
Term
What is a toxicity of atropine specifically seen in infants?
Definition
hyperthermia
Term
What is a toxicity of atropine seen in the elderly?
Definition
acute angle-closure glaucoma
Term
What is the toxicity of atropine in men with prostatic hyperplasia?
Definition
urinary retention
Term
What are the clinical uses of epinephrine?
Definition
anaphylaxis, glaucoma (open angle), asthma, hypotension
Term
What is the clinical use of isoproterenol?
Definition
AV block
Term
What is the clinical use of dobutamine?
Definition
heart failue, cardiac stress testing, inotropic, and chronotropic
Term
What are the clinical uses of phenylephrine?
Definition
pupillary dilation, vasoconstriction, nasal decongestion (alpha 1 and alpha 2 agonist)
Term
What receptors are activated with increasing doses of dopamine?
Definition
low dose= D1; medium dose= beta 1 and 2; high dose= alpha 1 and 2
Term
What is the MOA of isoproterenol?
Definition
beta 1 mostly; little beta 2
Term
T/F Epinephrine works at D1 receptors.
Definition
false
Term
What is the clinical use of metaproterenol?
Definition
beta 2 (and a little beta 1) agonist; used for treatment of acute asthma
Term
What is the clinical use of albuterol?
Definition
beta2 (and a little beta1) agonist for the treatment of acute asthma
Term
What is the clinial use of salmeterol?
Definition
beta 2 (and a little beta1) agonist; used for long term treatment of asthma
Term
What is the clinical use of terbutaline?
Definition
beta 2 (and a little beta 1) agonist; used to reduce premature contractions
Term
What is the clinical applications of ritodrine?
Definition
beta 2 agonist used to reduce premature uterine contractions
Term
What are teh clinical uses of amphetamine?
Definition
narcolepsy, obesity, ADD
Term
What is the MOA of amphetamines vs cocaine?
Definition
amphetamines cause the release of stored catecholamines; cocaine inhibits uptake
Term
What is the MOA of alpha-methyldopa?
Definition
centrally acting alpha2 agonist; decreased central adrenergic outflow which treats hypertension (especially with renal disease because no decreased blood flow to the kidneys)
Term
What is phenoxybenzamine used for?
Definition
pheochromocytoma (use phenoxybenzamine before removing tumor, since high levels of released catecholamines will not be able to overcome blockage)
Term
What is the clinical application of phentolamine?
Definition
give to patients on MAOIs who eat tyramine-containing foods (reversible alpha blocker)
Term
What is prazosin, terazosin and doxazosin used for?
Definition
ALPHA 1 selective antagonists; used for hypertension, urinary retention in BPH
Term
What is the toxicity of alpha 1 selective blockers?
Definition
first dose orthostatic hypotension dizziness, headache
Term
Name a drug that blocks alpha 2 receptors and is used for treating depression?
Definition
mirtazapine
Term
What is the toxicity of mirtazapine?
Definition
sedation, increased serum cholesterol, increased appetite
Term
How do beta blockers help treat supraventricular tachycardia?
Definition
decreased AC conduction (class II antiarrythmic)
Term
You should use beta blockers with caution in patients with what diseases?
Definition
asthma and diabetes
Term
How do beta blockers help treat glaucoma?
Definition
decreased secretion of aqueous humor
Term
Which beta blockers are selective for beta 1?
Definition
acebutolol (partial agonist), betaxolol, esmolol (short acting), atenolol, metoprolol
Term
Name some beta blockers that are partial beta agonists?
Definition
pindolol, acebutolol
Term
What is the antidote for acetaminophen toxicity?
Definition
N-acetylcysteine (replenishes glutathione)
Term
What is the treatment for salicylate toxicity?
Definition
NaHCO3 (alkylininze urine), dialize
Term
What is the antidote for amphetamine toxicity?
Definition
NH4Cl (acidify urine)
Term
What is the antidote for acetylcholinesterase inhibitors?
Definition
atropine, pralidoxime
Term
What is the antidote for antimuscarinic toxins?
Definition
physostigmine salicylate
Term
What is the antidote to beta blocker overdose?
Definition
glucagon
Term
What is the antidote to digtalis toxicity?
Definition
stop digoxin, normalize K+, lidocaine, anti-digoxin Fab fragments, Mg2+
Term
What is the antidote to iron toxicity?
Definition
deferoxamine
Term
What is the treatment for lead toxicity?
Definition
CaEDTA, dimercaprol, succimer, penicillamine
Term
What is the clinical use of dimercaprol (BAL)?
Definition
treats overdose of mercury, arsenic, or gold
Term
What is the clinical use of sucimer?
Definition
overdose of mercury, arsenic, or gold
Term
How can you treat a copper overdose?
Definition
penicillamine
Term
ow can you treat an arsenic overdose?
Definition
dimercaprol, succimer, or penicillamine
Term
How can you treat a cold overdose?
Definition
dimercaprol, succimer, penicillamine
Term
How do you treat a mercury overdose?
Definition
dimercaprol (BAL), succimer
Term
How do you treat a gold overdose?
Definition
dimercaprol (BAL), succimer, penicillamine
Term
What is the treatment for cyanide toxicity?
Definition
nitrite, hydroxocobalamin, thiosulfate
Term
What is the treatment of methemoglobin?
Definition
methylene blue and vitamin C
Term
What treatment for carbon monoxide poisoning?
Definition
100% O2 (hyperbaric O2)
Term
What is the trment for methaol overdose?
Definition
fomepizole >ethanol, dialysis
Term
What is the treatment for ethylene glycol (antifreeze) toxicity?
Definition
fomepizole > ethanol, dialysis
Term
What is the antidote to opioid overdose?
Definition
naloxone, naltrexone
Term
How do you treat benzodiazepine overdose?
Definition
flumazenil
Term
How do you treat TCA overdose?
Definition
NaHCO3 (plasma alkalinization)
Term
How do you treat heparin overdose?
Definition
protamine
Term
How do you treat warfarin overdose?
Definition
vitamin K, fresh frozen plasma
Term
How do you treat tPA, streptokinase, or urokinase overdose?
Definition
aminocaproic acid
Term
How do you treat theophylline overdose?
Definition
beta blocker
Term
What drugs can cause a coronary vasospasm?
Definition
cocaine, sumatriptan
Term
Which drugs can cause cutaneous flushing?
Definition
vancomycin, adenosine, niacin, Ca2+ channel blockers
Term
What drugs can cause a dilated cardiomyopathy?
Definition
doxorubicin (adriamycin), daunorubicin
Term
What drugs cause torsades de pointes?
Definition
class III (sotalol) and IA (qunidine) antiarrhythmics
Term
What drugs cause agranulocytosis?
Definition
clozaine, carbamazepine, colchizine, propylthiouracil, methimazole, dapsone
Term
What drugs cause aplastic anemia?
Definition
chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole
Term
What drug can cause a direct coombs-positive hemolytic anemia?
Definition
methyldopa
Term
What drug causes gray baby syndrome?
Definition
cholamphenicol
Term
What drugs cause hemolysis in G6PD deficient patients?
Definition
isoniacid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin
Term
What drugs cause megaloblastic anemia?
Definition
phenytoin, methotrexate, sulfa drugs
Term
T/F Angiotensin receptor blockers can cause cough.
Definition
false
Term
Name some drugs that cause pulmonary fibrosis.
Definition
bleomycin, amiodarone, busulfan
Term
Name some drugs that cause acute cholestatic hepattis?
Definition
macrolides
Term
Name some drugs that cause focal tomassive hepatic necrosis?
Definition
halothane, acetaminophen, valproic acid, amanita phalloides
Term
T/F INH can cause hepatitis?
Definition
true
Term
What drugs can cause seudomembranous colitis?
Definition
clindamycin and ampicillin
Term
What drugs can cause gynecomastia?
Definition
spironolactone, digitalis, cimetidine, chronic alcohol use, estrogens, ketoconazole
Term
What drugs can cause hot flashes?
Definition
tamoxifen, clomiphene
Term
What drugs can cause hypothyroidism?
Definition
lithium, amiodarone, sulfonamides
Term
What drugs can cause hot flashes?
Definition
tamoxifen, clomiphene
Term
What drugs can cause hypothyroidism?
Definition
lithium, amiodarone, sulfonamides
Term
What drugs can cause hyperglycemia?
Definition
niacine, tacrolimus, protease inhibitors
Term
What drugs can cause fat redistribution?
Definition
glucocorticoids and protease inhibitors
Term
What drugs can cause gingival hyperplasia?
Definition
phenytoin, verapamil
Term
What drugs can cause gout?
Definition
furosemide, thiazides, niacin, cyclosporine, pyrazinamide
Term
What are drugs that can cause myopathies?
Definition
fibrates, niacin, colchicine, hydroxychlorquine, interferon alpha, penicillamine, statins, glucocorticoids
Term
What drug cause osteoporosis?
Definition
corticosteroids, heparin
Term
What drugsan cause photosensitivity?
Definition
sulfonamides, amiodarone, tetracyclines
Term
What drugs can cause rash/stevens-johnsons syndrome?
Definition
penicillin, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital
Term
What drugs cause SLE-like syndrome?
Definition
hydralazine, INH, procainamide, phenytoin
Term
What drugs can cause tendonitis, tendon rupture and cartilage damage (esp in kids)?
Definition
flouroquinolones
Term
What drugs cause diabetes insipidus?
Definition
lithium and demeclocycline
Term
Whatdrugs can cause Fanconi's syndrome?
Definition
expired tetracycline
Term
What drugs can cause an interstitial nephritis?
Definition
methicillin, NSAIDs, furosemide
Term
What drugs can cause a hemorrhagic cystitis?
Definition
cyclophosphamide, ifosfamide
Term
What can you coadminister with cyclophosphamide or ifosfamide to prevent hemorrhagic cystitis?
Definition
mesna
Term
How drugs can cause SIADH?
Definition
carbamazepine and cyclophosphamide
Term
What drugs can cause cinchonism as a side effect?
Definition
quinidine, quinine
Term
What drugs can cause parkinson-like syndromes?
Definition
antipsychotics, reserpine, metoclopramide
Term
What drugs can cause a disulfiram-like reaction?
Definition
metronidazole, certain cephalosporins, procarbazine, 1st generation sulfonylureas
Term
What drugs can cause neephrotoxicity and ototoxicity?
Definition
aminoglycosides, vancomycin, loop diuretics, cisplatin
Term
Name some drugs that are inducers of P-450.
Definition
quinidine, barbiturates, St. John's wort, phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use
Term
Name some drugs that are inhibitors of the CYP P450s.
Definition
macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir, acute alcohol abuse, ciprofloxacin, ketoconazole, sulfonamides
Term
What are the symptoms of allergy to sulfa drugs?
Definition
patients with sulfa allergies may develop fever, urinary tract infection, puritic rash, Stevens-Johnsons syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, and urticaria (hives). Symptoms range from mild to life-threatening
Term
Name the sulfa drugs.
Definition
probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonamide antibiotics, sulfasalazine, sulfonylureas
Term
Drugs that end in -ane are...
Definition
inhalational general anesthetics (like halothane)
Term
What drugs end in -operidol?
Definition
butyrophenones (neuroleptic like haloperidol)
Term
What drugs end in -etine?
Definition
SSRIs
Term
What kinds of drugs end in -terol?
Definition
beta 2 agonists
Term
What drugs end in -zosin?
Definition
alpha 1 antagonists
Term
What types of drugs end in "tropin"?
Definition
pituitary homrones
Term
What drugs end in "tidine"?
Definition
H2 antagonists
Term
What is teh MOA of cisplatin and carboplatin?
Definition
cross-link DNA
Term
What is the clinical use of cisplatin and carboplatin?
Definition
testicular, bladder, ovary and lung carcinomas
Term
What is the toxicity of cisplatin and carboplatin?
Definition
nephrotoxicity and acoustic nerve damage
Term
How can you prevent the nephrotoxicity associated with cisplatin and carboplatin?
Definition
prevent nephrotoxicity with amifostine (free radical scavenger) and chloride diuresis
Term
What is the MOA of hydroxyurea as a anticancer agent?
Definition
inhibits ribonucleotide reductase causing decreased DNA synthesis (s-phase specific)
Term
What is the clinical use of hydroxyurea?
Definition
melanoma, CML, and sickle cell diseases (increases HbF)
Term
What are the toxicities of hydroxyurea?
Definition
bone marrow supression and GI upset
Term
What is the most commonly used glucocorticoid in cancer chemotherapy?
Definition
prednisone; used in CLL, hodgkin's lymphoma (part of the MOPP regimen)
Term
How does prednisone treat cancer?
Definition
may trigger apoptosis; may even work on non dividing cells
Term
Name a "SERM".
Definition
(selective estrogen receptor modulator)= tamoxifen and reloxifen
Term
T/F Both tamoxifen and raloxifene increase your risk of endometrial cancer.
Definition
false; only tamoxifen increases your risk of endometrial carcinoma because of partial agonist effects; raloxifene causes no increased risk of endometrial cancer because it is an endometrial antagonist
Term
What is the MOA of trastuzumab?
Definition
monoclonal antibody against HER-2 (erb-B2) a tyrosine kinase; helps kill breast cancer cells that overexpress HER-2, possibly through antibody-dependent cytotoxicity
Term
What is trastuzumab used for?
Definition
metastatic breast cancer
Term
What is the MOA of imatinib?
Definition
philadelphia chromosome bcr-abl tyrosine kinase inhibitor
Term
What other cancer besides CML is imatinib used for?
Definition
GI stromal tumors
Term
What is an adverse side effect of imatinib?
Definition
fluid retention
Term
What is the MOA of rituximab?
Definition
monoclonal antibody against CD20, which is found on most B-cell neoplasms
Term
What is the clinical use of rituximab?
Definition
non-hodgkin's lymphoma, rheumatoid arthritis (with methotrexate)
Term
What is the MOA of propofol?
Definition
potentiates GABA A
Term
T/F Sexual interest declines as people age.
Definition
false
Term
What sexual changes occur as you age?
Definition
men get lower erection/ejaculation and longer refractory period; women have vaginal shortening, thinning, and dryness
Term
What are the changes in sleep pattern as you age?
Definition
decreased REM and slow wave sleep; increased latency and awakenings
Term
Which group of people have the highest suicide rate in the US?
Definition
males 65-74 yoa
Term
What is the difference between normal bereavement and pathologic greif?
Definition
normal=shock, denial, guilt and somatic symptoms, can last up to 2 months, may experience illusions
pathologic= excessively intense grief; prolonged grief lasting more than two months; or greif that is delayed inhibited for denied; may experience depressive symptoms, delusions,a nd hallucinations
Term
How does stress cause GI symptoms?
Definition
alters the gastrocolic reflex, water absorption, and mucosal circulation
Term
T/F Stress has an effect on muscle tone.
Definition
true
Term
What are the different types of sexual dysfunction?
Definition
sexual desire disorders, sexual arousal disorders (erectile dysfunction), orgasmic disorders, and sexual pain disorders
Term
What drugs can cause sexual dysfunction?
Definition
antihypertensives, neuroleptics, SSRIs, ethanol
Term
T/F Diabetes can cause sexual dysfunction.
Definition
true
Term
How do you calculate BMI?
Definition
weight in kg/height in meters squared
Term
What BMI is considered underweight?
Definition
less than 18.5
Term
During fetal development, what structure traps the inferior poles of the kidney resulting in a horseshoe kidney?
Definition
inferior mesenteric artery
Term
Horseshoe kidney is associated with what cytogenetic abnormality?
Definition
tuner's syndrome
Term
What is potter's syndrome?
Definition
bilateral renal agenesis leading oligohydramnios leading to limb deformities, pulmonary hypoplasia, and facial deformities. Caused by malformation of ureteric bud
Term
What are the stages of kidney embryology?
Definition
pronephros at week 4 degenerates; mesonephros functions as interim kidney for first trimester; later contributes to male genital system; metanephros is the permanent structure that appears during the fifth week of gestation
Term
What kidney precursor during fetal life contributes to the male genital system?
Definition
mesonephros
Term
What does the ureteric bud arise from?
Definition
derived from the caudal end of the mesonephros
Term
What does the ureteric bud give rise to?
Definition
ureter, pelvises, and through branching, calyces and collecting ducts
Term
When during fetal development should the ureteric bud be fully canalized?
Definition
10th week
Term
What happens when the ureteric bud interacts with the metanephric mesenchyme?
Definition
interaction induces differentiation and formation of glomerulus and renal tubules to distal convoluted tubule
Term
What is the most common site of obstruction in the fetus?
Definition
uretopelvic junction
Term
Rejection of a transplanted organ months to years after surgery is caused by what type of immunity?
Definition
class I MHC non-self is percieved by CTLs as class I MHC self presenting a non-self antigen; t cell and antibody mediated vascular damage (obliterative vascular fibrosis); fibrosis of graft tissue and blood vessels= irreversible
Term
What embryologic material is the thymus derived from?
Definition
epithelium of the third branchial pouch
Term
Where in the thymus do positive and negative selection occur?
Definition
corticomedullary junction
Term
What organ contains hassall's corpuscles?
Definition
thymus
Term
What are the symptoms of graft versus host disease?
Definition
maculopapular rash, jaundice, hepatosplenomegaly and diarrhea
Term
What types of transplants lead to graft versus host disease?
Definition
bone marrow and liver transplant
Term
T/F Graft versus host disease can be potentially beneficial in bone marrow transplant.
Definition
true
Term
What type of organ transplant rejection happens weeks after tranplantation?
Definition
acute= cell mediated due to CTLs reacting against foreign MHCs causes vasculitis of graft vessels with dense interstitial lymphocytic infiltrate
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