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40 Cards in this Set

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A 60 year old women
Diabetes
High BP
UA positive albumin
Best initial drug
ACE inhibitors - Catopril
Slows progression of diabetic nephropathy
Paget's disease of the breast
Requires investigation for ductal carcinoma
Baby of diabetes mother
Baby may rather large due to infusion of insulin
Hypoglycemic episodes immediately after birth
ACE inhibitors are not prescribed to pregnant women
Or to those considering pregnancy due to RENAL AGENESIS
Week 3-8 of pregnancy are referred to embryonic period during which neural tube is formed and closes
5 year old, fever, painful skin rash on arms and trunk
Skin erythematous, with large blisters, serous fluid exudate
Splitting of epidermis at stratum granulosum
Staph aureus. Scaled-skin syndrome is a toxin-mediated. It causes painful blistering due to splitting the epidermis at stratum granulosum
Furosemide - loop diuretics
Common side effects
Hypokalemic metabolic alkalosis
Ototoxicity
Hyperuricemia
Hypomagnesemia
Allergic reactions
Hypercalciuria
Patient with exacerbation of heart failure.
Loop diuretics such as furosemide are preferred agents in the treatment of symptomatic heart failure
Fisherman, fever, chills, cellulitis with bullae on his hands
Vibrio Vulnificus

Cellulitis on hands of salt-water shellfish handlers
5 year old child, to clinic with 3 weeks hx of impetigo, and recent onset of dark colored urine
Post streptococcal glumerulonephritis - is a glomerular immune complex disease induced by specific nephritogenic strains of group A beta-hemolytic streptococcus
- This response occur due to impetigo or tonsillopharyngitis infection
-Acute Rheumatic fever: only preceded by group A streptococcal tonsillopharyngitis
Post-streptococcal Glomerulonephritis
Type III hypersensitivity
Lithium - DOC for bipolar disorder
Valproic acid and Carbamazepine also can be used
Antidepressants - can cause manic phase if bipolar disorder is misdiagnosed as depression
47 year old, DM II
Initiate on oral medication
Drug lowers her blood glucose
Decrease gluconeogenesis
Increasing glycolysis
Also act to sensitive to Insulin's response. Adverse effect of this drug:
Lactic Acidosis
Metformin (Biguanide) is oral hypoglycemic medication that can lead to lactic acidosis
27 year old female
Increased Urinary Frequency
Dysuria for the last four days
Positive Leukocyte Esterase
Positive Nitrates and WBC
Tx with Trimethoprim/Sulfamethoxazole
Mechanism of Trimethoprim/Sulfamethoxazole?
Prevention of synthesis of dihydrofolic acid
( a substrate for tetrahydrofolic acid)
Mechanism of Cipro?
Ciprofloxacin and other fluoroquinolones
- inhibiting bacterial DNA topoisomerase II
Streptococcus mutans - a gram positive bacteria in oral cavity
Enters compromised gums and may cause vegetative growth on the heart's valves, leading to murmurs
33 year old lanscaper, itchy watery eyes, nasal congestion, rash on flexor surface of extremitis
Symptoms get worse, difficult catching his breath
Most appropriate initial therapy?
Loratadine - second generation anti-histamine.
First generation anti-histamines (diphenydramine, dimenhydrinate, chlopheniramine, and hydroxyzine) are more sedating than 2nd generation
Second generation anti-histamine:
Loratadine
Fexofenadine
Desloratadine
Cetirizine
Patient spill parathion on himself
Parathion acts like a cholinesterase inhibitor
- patient have suymptoms of:
Diarrhea, Urination
Miosis (pin point pupil,) bronchospasm, bradycardia, excitation of skeletal muscles and CNS
Lacrimation, Sweating, Salivation
Panic disorder - associated with fear of closed spaces
DOC for panic attack is benzodiazepine - such as alprazolam
Overdose of benzodiazepines can be managed with
Flumazenil.
MOA of benzodiazepines
Binds to GABA receptor and increase the frequency of its open channel state
Fluconazole
Treat systemic fungal infection
Inhibits synthesis of ergosterol (a steroid found in fungal cell membranes)
Cause gynecomastia and inhibits P 450
Rifampin
Tx Mycobacterium tuberculosis, disrupting mRNA synthesis
-Inhibits DNA-dependent RNA polymerase
Side effect of Rifampin
Red/Orange color change that occurs in body fluids
-May cause hepatotoxicity
-May cause drug-drug interactions due to its activation of cytochrome P450
Doxycycline
Tetracycline - inhibits protein synthesis, binds to 30S subunit
-Prevent attachment of aminoacyl-tRNA (responsible for elongation allowing peptide chains to grow)
Doxycycline is CI in
-Pregnant women and young children due to its potential to disrupt bone growth and
-Discoloration of tooth enemel
-No affect on P450
Erythromycin -
Macrolide useful in tx of gram positive cocci infections, Mycoplasma, Legionella, Chlamydia, Neiserria
-Binds to 50S subunit
-Inhibits translocation
Side effect of erythromycin
GI upset
Acute cholexttic hepatitis
Inhibits P450
Gentamycin
Aminoglycoside
Inhits protein synthesis
Bind to 30S ribosomal subunit
-Aminoglycosides prevent formation of initiation complex for protein synthesis, cause misreading of mRNA
Gentamicin
Aminoglycoside = ototoxicity, which cause hearing loss, a common side effect
CI in pregnancy
NO affect in P450
Common side effect of Gentamicin
- Ototoxicity
-Hearing loss, a common side effect
- No affect on P-450
Rifampin
tx Mycobacterium tuberculosis
disrupting mRNA synthesis
-Inducers of P450
55 yo man, dull epigastric pain
2 hrs worsens 2hr after meals
- Stool is positive
- Antacids: slightly improve his symptoms
- Chronic use of corticosteroids can cause peptic ulcers or worsen existing ulcers.
Thirty minutes after taking her medicine, a 45-year-old type II diabetic complains of sweating, dizziness, heart palpitations and tremor
responsible for her symptoms
- hypoglycemia
- sulfonylureas which includes glyburide
A 55-year-old female doubled her dose of furosemide because she forgot to take it yesterday. She presents with lightheadedness and weakness. Blood pressure is 70/50.
- High renin activity
- Hypotension stimulates baroreceptors causing tachycardia and activation of the renin-angiotensin system leading to salt and water retention.
Hear voices, talk to himself, rampling speech, does not make sense, sloppy clothes that are too big
Disorganized schizophrenia is characterized by disorganized speech, inappropriate affect, inappropriate laughter, poor hygiene and sloppy appearance.
This infant most likely has Erb-Duchenne palsy, the most common brachial plexus injury during delivery, especially when traction is used.
Erb-Duchenne palsy is the most common brachial plexus injury during delivery. It manifests as inability to abduct the shoulder.
A positive linear correlation between two variables (in this case anti-DNA antibody levels and glomerulonephritis severity) means that when one variable increases or decreases the other also increases or decreases respectively. This is stated in choice
A positive linear correlation between two variables means that when one variable increases or decreases the other also increases or decreases respectively.
This patient has classic Alzheimer dementia, and the affected tissue is the brain, through the proposed mechanism of decreased acetylcholine neurotransmission and the buildup of amyloid plaques and neurofibrillary tangles. The ectoderm is the origin for the nervous system, melanocytes and the skin.
Skin, nerves, and melanocytes stem from the ectoderm germ layer.