drsnm
Forum Junior
Topics: 12
Posts: 28
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1- Halothane ~ vagomimetic ~ bradycardia ~ treat it with atropine
2- Halothane ~ hypotension ~ treat it with phenylepherine
3- Halothane ~ not hepato toxic in children
4- A blockers helpful in Rx of tyramine induced HTN
5- Litium : IP3 ~ Ca
6- D1,5 ~ inc cAMP
7- D2,3,4~ dec cAMP
8- Doc in hiccups : chlorpromazine
9- Patho of tardive diskinesia : inc number of dopamine rec.
10- ALL opioid rec ~ dec cAMP
11- Pts treated w morphine r still aware of presence of pain but the sensation is not unpleasant
12- Respiratory dep maj cause of death in acute opioid overdose
13- Morphine : NO maj eff on BP or HR
14- Morphine : CI in severe brain injury
15- Morphine ~ bronchoconstriction ~ DO NOT use it in asthmatic pt.
16- Hormonal action of Morphine : dec GnRh,CRH,LH,FSH,Testos,Cortisol,
17- Hormonal action of Morphine : inc prolactin, GH, ADH
18- Codeine greater antitussive action than Morphine
19- In BPH, Morphine can cause acute urinary retention
20- Pt w Addison or myxedema may experience extended/inc eff of opioids.
21- Mepridine ~ during labor ~ mydriasis
22- T cell dependent response ~ ALL class of Igs r made
23- T cell independent respone ~ primary IgM is made
24- Secondary Ab response does NOT occur in T cell independent immune response
25- In Lepromatous Leprosy : excess CD8 cells in lesions à removal of some CD8 cells can restore cellular immunity .
26- Absence seizure :ethosux
27- Myoclonic : valproic
28- Febrile seizure : phenobarb
29- Status : diazepam
30- Mech of pheny: dec flux of Na,dec flux of Ca
31- Fetal hydantoin synd : cleft lip, cleft palate , congenital heart dis , slowed growth , MR
32- Mech of CBZ: blocking Na channels
33- Ehto can cause steven Johnson , leukopenia, thrombocytopenia
34- Val : inc risk of neuro tube def.
35- ACEi agent of choice in CHF,
36- Thizadies lose eff if clearance of cr in less than 50 ( think about it RF)
37- Use Loop diuretics in renal failure.
38- Dig is NOT indicated in pt w diastolic / R sided heart failure.
39- AE of DIG : alteration of color perception, haloes on dark obj.
40- HYPOkalemia, HYPOmagnesemia , HYPERca ~ inc DIG toxicity.
41- AE of NO: headache.
42- Tolerance to Nitrates: think about Monday syn.
43- Nifedipine ~ reflex tachycardia , verapmail ~ bradycardia
44- Asthmatic pt w HTN ~ want to use B blocker, use selective ones.
45- Ticlopidine : inhi ADP pathway -à no binding of PLTs to fibrinogen and eachother.
46- Dipyridamole :inc cAMP à inhibi TXA2, induce PGI2
47- Chronic /intermittent admin of heparin à reduc of antithrombin III activity ~ inc risk of thrombosis
48- Intramuscular heparin : risk of hematoma
49- Heparin : longer half life in A)hepatic cirrohis B)renal failure.
50- Protamine combines ionically w heparin to form stable/inactive complex
51- U can c heparin induced thrombocytopenia in about 8 days after beginning of therapy.
52- Warfarin ~ 90% bound to albumin, preventing its diff into CSF,urine and breast milk but it WILL CROSS placenta
53- Streptokinase and Anistreplase : both high in Ag.
54- Toxicity w wafarin : immediate action , FFP
55- Niacin : inhi lipolysis in adipose tissue , dec liver triacylglycerol syn à dec LDL , inc HDL ( most potent)
56- Cutaneous flush ( due to inc in PG) ~ use Aspirin
57- Inhi tubular sec of uric acid àGout
58- Gemfibrozil : inc LPL activity , most dec in triacylglycerol
59- Can cause Gallstones ( due to inc biliary choles excretion ) , myostitis ( in comb w statins )
60- CLOFIBRATE ~ malignancy
61- Pruritis cause by accumulation of bile acids in pts w biliary obstruction : use cholestyramine/colestipol
62- Can cause fat soluble vit def.
63- Statins CI in pregnancy / nursing mothers/children/teenagers
64- DOC in mod to severe asthma : inhale glucocortico
65- It will dec NUMBER and ACTIVITY of cells involved in airway inflammation
66- It has EXTENSIVE first pass in liver.
67- H2 rec antagonists : dec cAMP àdec H+
68- Misoprostol ~ analogue of PGE1 , only agent approved for prevention of gastric ulcers induced by NSAIDs
69- It will cause uterine contraction , so know she is pregnant or not (bHCG)
70- Hyoscyamine ( antimuscarinic ) used as adjuncts in management of ZES
71- Sucralfate needs aciditic environment so u can't use it w H2 blockers
72- D2/5HT3 ~ critical role in emeting.
73- Metoclopromide highly eff at high doses against highly emetogenic cisplatin , but beware of ext pyramidal eff.
74- Benzodizepines ~ useful in anticipatory vomiting.
75- IL4 : class switching of Bcells , inc IgE
76- IL5: inc IgA, inc eos
77- IL10 by Th2 , inhi Th1 à inhi type IV hypersensivity
78- IL12 by macrophages ~ inc development of Th2
79- IL13 ~ asthma
80- TGF-b : inhi growth and activity of Tcells BUT stimulates wound healing by enhancing syn of collagen .
81- Chemokines : activates INTEGRINS on surface of neutro and macro that bind to ICAM proteins on endothelial cell surface.
82- Alpha chemokines ( cys-X-Cys) like IL8 , produced by activated mononuclear
83- Beta chemokines (cys-cys) like RANTES/MCAF , produced by activated T cells
84- IL3 : growth/diff of bone marrow stem cells.
85- Class switching : SAME Variable Heavy genes w diff Constant Heavy genes.
86- Light chains DO NOT undergo class switching
87- Genes for HLA : chromosome 6
88- MHC I on surface of ALL nucleated cells.
89- MHC II on surface of macrophages , B cells, dendritics of spleen , langerhans of skin.
90- Syngenic graft: transfer b/w genetically identical twins .
91- Main pathologic finding in chronic rejection: atherosclerosis of vascular endothelium
92- Corneas , easily grafted ( due to lack of vessels and lymphs) . immunosupp is usually necessary for A YEAR.
93- Sign/symp of GVH : maculopapular rash , jaundice, hepatosplenomegaly diarrhea.
94- GVH can be reduced by : treating DONOR tissue w ANTI THYMOCYTE globulin or monoclonal Ab before grafting./ also u can use cyclosporine
95- Somatotropin therapy CI in closed epiphyses , ENLARGING CRANIAL MASS
96- Normal THYROID status is essential for successful somatotropin therapy.
97- Octerotide : somatostatin analogue , use in ACROMEGALY caused by hormone secreting tumors
98- Oxytocin,vasopressing: have disulfide bridges , reduction of disulfide bridge inactivates hormone.
99- Levothyroxine : once daily ( long half life)
100- several doses of PTU/day , single dose of methimazole /day
101- Iodide : thyroid storm / prior to surgery will dec vascularity of thyroid.
102- Mech of delayed action of NPH insulin : delayed absorption of insulin b/c of conjugation of insulin w protamine to form less soluble complex.
103- Clomiphen: inc GnRh àstimulation of ovulation
104- Combination pill: CONSTANT LOW dose of estrogen w Concurrent LOW but INCREASING dose of proges given or 3 successive 7 days periods.
105- Postcoital contraception : A) high doses of ESTEROGEN /BID/5d or
B) 2 doses of ethinyl estradiol + norgestrol given within 72 hours of coitus followed by another 2 doses 12 hours later.
106- testos in BRAIN will become ESTRADIOL
107- Danazol : treatment of endometriosis
108- Blood & glucocortico : dec eos,baso,mono,lympho
109- Blood & glucocortico : inc Hgb.erythro, plt , PMN.
110- Anti inflamm eff of glucocortico: indirect inhibi of phospholipase A2 ( due to inc lipocortin ) which blocks release of arachidonic acid.
End of Part 1
111- Hydrocortisone in Addison :2/3 in morning , 1/3 in evening
112- first regulatory step in classic pathway ( complement) at the level of Ab.
113- C1 inhibi , regulator of classic pathway.
114- Regulation of alternative pathway: binding of factor H to C3b. and cleavage of this complex by factor I .
115- enhancer of alternative pathway: PROPERDIN : protects C3b.
116- DAF: protection of human cells from lysis by membrane attack à destabilizing C3 convertase and C5 convertase
117- def of C3 : recurrent phyogenic sinus.
18- def of DAF: PNH
19- IgG/IgM fix complement
20- Ca is required 4 activation of C1.
21- Penicillin : inhi transpeptidation or cross linkage
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