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Farias-Test II
Farias-Test II Drug Actions Spring 2007
| Question | Answer |
|---|---|
| Alpha Cells | Glucagon |
| D cells | Somatostatin |
| Beta Cells | Insulin, Amylin |
| Proteases | Typsinogen, Chymotrypsinogen, Procarboxypeptidase (digest proteins and peptides) |
| Lipases | Triglycerides into monoglycerides and free fatty acids |
| Amylases | hydrolyze starch into maltose |
| insulin | glucose into live, muscle, and adipose tissue |
| glucagon | inc. glycogenolysis, gluconeogenesis, and lipolysis |
| Somatostatin | supress release of pancreatic hormones, GI homrones, GH, and TSH |
| Amylin | slows gastric emptying, promotes satiety, and regulates glucagon secretion |
| acute pancreatitis | clinical syndrom of acute inflammation and destructive auto digestion of pancreas and extrapancreatic tissue |
| Acute Pancreatitis etiology | Alcohol, Biliary tract obstruction, viral or bacterial, trauma, familiar |
| acute pancreatitis pathophysiology mild | no hemmorrhage, infiltraiton of neutrophills, swelling of pnacrease, suppuration |
| acute pancreatits severe | massive necrosis, liquefaction, avscess, hemorrhage, pancreatic ascites, fat necrosis |
| acute pancreatitis clinical manifestations | pain, severe, deep, constant, N/V, Fever, Shock, coagulopathy, metabolic irregularities (acidodis, hyperkalemia, hypocalcemia), jaundice |
| Kalikrien | edema inflammation |
| chymotrypsin activation | edema vascular damage |
| elastase activation | vascular damage, hemorrhage |
| phospholipase A2 activation | coagulation, necrosis |
| lipase | fat necrosis |
| Chronic Pancreatitis | relapsing; inflammatoiin of parenchyma, progressive destruction of acini, ductule stenosis, dilation, fibrosis |
| chronic pancreatitis etiology | alchol, long term obstruction of pancreatic duct, autoimmunity, idiopathic |
| chronic pancreatitis pathophysiclogy | scaring, fibrosis, shrinkingi, stenosis, dilation of ducturles, lymphocyctic infiltrate, increase ductlin permeability due to chronic inflammation, inc. free radicals, toxic metabolites, lysosomal activity |
| chornic pancreatitis manifestations | sever ab. pain, N/V, weight loss, steatorrhea, hyperglycemia, jaundice |
| pancreatic insuffienciency | maldigestion resulting from disorders interfering with effective pancreatic enzyme activity |
| pancreatic insufficiency etiology | chronic pancreatitis, cystic fivrosis, surgery, increased gastreic acid, hyperlipidemia |
| pancreatic insuffieciency pathophysiology | fat melabsorption, decrease in lipase of bicarbonate |
| pancreatic insuffienciency clinical manifestation | steatorrhea, diarrhea, hypoclacemia, nephrolithiasis, Wieght loss, edema/ascites |
| diabetes mellitus acute manifestation | hyperglycemia, hypoglycemia, glucosuria, polyuria, polydipsia, pholyphagia, diabetic ketoacidosis, hyperosmolar coma |
| DM clinical chronic manifestations | blindness, nephropathy, atherosclerosis, endotherlial dysfunction, hypertension, neuropathy, diabetic foot ulcers, infections |
| throid hormone | increase activity of metabolic enzymes and NA/K atpases, o2 consumption, protein catabolism-adult, anabolism-children, normla development of NS |
| parathyroid hormone | inc. vit. D synthesis, renal calcium adsorption, born resortion, increase plasma calcium levels |
| Graves disease manifestations | nervouseness, irritability, alertness, muscular weakness, palpitations, tachycardia, DEC. TSH; INC T4, metabolic rate, exophtalmos, optic nerve pressure -> blindness |
| Hashimotos Thyroiditis | myxedema (skin irritation), hyothermia, DEC. basla metabolic rate, mental retardation in children, slow thinking, ataxia, forgetfulness, lethargy in adults, bradycardia, INC TSH; DEC T4 |
| Hyperparathyroidism | excess PTH secretion and hypercalcemia |
| hyperparathyroidism etiology | adenoma, idiopathic, iatrogenic |
| hyperparathyroidism pathiophysiology-primary | excess autonomous produciton and release of PTH by PTH gland |
| Hyperparathyrodism pathophysiology-secondary | defect outside glands, sever calcium or vit. d deficiency; chronic renal failur, dec. calsium reabsorption, skeletal resistance to PTH |
| hypoparathyroidism | low PTH secreation and hypocalcemia |
| hypoparathyroidism etiology | uncommon, truama, surgical damage, autoimmunity |
| hypoparathyroidism clinical manifestations | confusion, weakness, mental retardation, tetany, seizure, CHF, enamel hypoplasia of teeth |
| Asthma | airway inflammation and airflow obstuction and bronchial hyperresponsiveness |
| asthma etiology | most common, 3-5%, hyper-immune response, increased reactivity of airway, triggers: histamine, cold, polution, viruses, allergens, genetic |
| asthma clinical manifestations | cough, wheezing, dyspnea, tachypnea, tachycardia, hypoxemia, bronchial hyper-responsiveness, poor performance on pulmonary function test |
| Chronic bronchitis | air inflammation and airflow obstruction |
| chronic bronchitis etiology | cigarrettes, irritants: ozone, coal burning |
| chronic bronchitis clinical manifestations | wheezing, CRACKLES, dyspnea, PULMONARY HTN, poor performance on pul. perf. test., hypoxemia, polycythemia |
| Emphysema | decreased recoil tension, expiration more work, trouble getting air out |
| emphysema etiology | cigarettes, genetics (alpha 1 proteatse inhibitor deficiency, alpha-1 antitrypsin deficiency |
| emphysema CM | NO PRODUCTIVE COUGH, dyspnea, decreased beath sounds, HYPER INFLATION, tachycardia, hypoxemia, poor pef. pul. funct. test, HYPERCAPNIA, polycythemia |
| Pulmonary Fibrosis | scarring of lung parenchyma (air trouble in and out) |
| plumonary Fibrosis Etiology | chornic inflammation of alveolar walls, diffuse and professive severe fibrosis, recruitment and activation of inflammatory cells, cigarette smoke main cause |
| pulmonary fibrosis CM | NONPRODUCTIVE COUGH, tachypnea, INSPIRATORY CRACKLES, pulmonay HTN, SMALL VOLUME, hypoxemia, hypercapnia, |
| Pulmonary Edema | accumulation of excess fluid in the extravascular space |
| Pulmonary Edema CM-cardiogenic | dyspnea, non-productive cough, ORTHOPNEA, SHALLOW TACHYPNEA, hypoxemia, wheezing, INSPIRATORY CRACKLES, increase hyrostatic pressure, protein poor edema fluid |
| Pulmonary Edema CM-non cardiogenic | mechanical ventailation, may lead ot pulmonary fibrosis, protein rich edema fluid, normal hydrostatic pressure |
| Pulmonary Embolism | venous thrombi from legs migrate to lung circulation |
| pulmonary embolism | secondary to disease, virchow's triad of risk factors |
| virchows triad of risk factors, | statis of blood, injury to vessel wall, increased clotting |
| pulmonary embolism CM | dyspnea, PLEURITIC CHEST PAIN, HEMOPTYSIS, SYNCOPE, swollen, tender, warm, red calf, abnormal ECG. |
| Alzheimers | degernerative disease of brain with insidious onset of dementia |
| alzheimse Pathophsyiology | plaque build up-amyloid b-peptide, presenilin mutaitons, apo-lipoprotein E, neurofibrillary tangles, astrocytosis, microglial proliferaiton, neuronal loss |
| Alzheimers Disease CM | dementia, 5-10 years, memory loss, impairment of learning, spatial disorientation, aphasia, anomia |
| Parkinsons disease | progessive degenerative neurological disease |
| parkinsons disease Pathophysiology | degeneration of dopamine cells in SN, lewis bodies, abnormal protein degreadation, oxidative stress |
| parkinsons disease CM | bradykinesia, freezing, involuntray movements, motor fluctuations, postural instability, orthostatic hypotension, rigidity,tremor |
| Epilepsy | disorder of recurrent seizures |
| epilepsy-pathophysiology | after brain lesion, abnormal calcium currents, GABA dyscuntion, paroxysmal disturbances, synchronous discharge of cortical neurons |
| epilepsy-CM-partial seizures | small brain lesion, concious or unconcious |
| epilepsy-CM absences | staring in childhood, brieg loss of conciousness, slight head movement, spacing out, alert after seizure |
| Epilepsy CM tonich clinic seizures | loss of conciousness, tonich limb and back, confusion after regain conciousness |
| Myasthenia Gravis | autoimmune disorder or neuromuscular transmission |
| myasthenia gravis-pathophysiology | Ab formed against nicotine receptors, less nicotine recptions, stufcutally deficient synaptic clefts |
| myasthenia gravis CM | fluctuating fatige, weakenss that gets better with rest, mild to severe weakness in ocular and skeletal muscles |
| MS | autoimmune disorder of demylination |
| MS-pathophysiology | T&B cell immunity involved, CNS demylination, relapsing vs. chronic |
| MS-CM | visual loss, extra-ocular movement, parathesias, loss of senation, weakness, dysarthria, spasticity, ataxia, bladder dysfunction |
| hypothalamic insuffieciency | anterior pituitary trophic hormones |
| hypothalamic insufficiency Etiology | developmental, traumatic, neoplastic, inflammatory, vascular, infection |
| hypothalamic insuffienciency-pathophysiology | PROP-1 mutation, TF mutations -> deficiency GH, PRL, TSH, gonadotropin |
| hypothalamic insuffieciency-CM | Kallman, Laurence-Moon-Bardet-Beidl, Frolich, Prader Willi |
| Kallman syndrome | defective GnRH color blindness, nerve eagness, cleft palate, low FSH, LH |
| Laurence-Moon-Bardet-Beidl syndrome | mental retardation, obesity, hexadactyly, brachydactyly, retinal degeneration (blind before 30) |
| Frolich syndrom | hypothalmic lesions, central hypogonadism, hyperphagia, obesity |
| Prader Willi Syndrome | mental retardation, hyperphagia, obesity, TII diabetes, muscle hypoonia, multiple somatic defects |
| Anterior Pituitary Hyperprolactinemia | hypersecretion of prolactin; most common |
| Hyperprolactinemia-etiology | pituitray adenoma, pregnancy, lactation, radiation, trauma, systemic disorders (renal failure, hypthyroidism, cirrhoisis, epileptic seizures) |
| Hyperprolactinemia-CM | amenorrhea, galactorrhea, diminished libido or visual loss, PRL lvls >1000 ug/L |
| Anterior Pituitary-Growth hormone disorders | hyper or hyposecreiton of GH |
| pituityar dwarfism | anterior pituitary, short stature, high pitch voice, hypoglycemia, GHRH receptor mutations, growth hormone insensitivity, GH respons <7 ug/L |
| Anterior Pit-Acromegaly | GH hypersecretion, acral bony, voice deepening, oily skin, arthropathy, kypohosis, muscle weakness, fatigue, GH supress less 1ug/L challenged with glucose, surgery is only option |
| Anterior Pit-Adrenocorticotropin hormone disorder | hyper or hyposecretion of ACTH |
| ACTH deficiency | Anter. pit hypo; surgery, supression of HPA axis, ademnoma, low serum corticsol, fatigue, weakness, anorexia, nausea, vomiting, hypoglycemia |
| cushings disease | ant. hormone, pit corticotrop adenoma, iatrogenic, ectopic tumor secreting ACTH; thin brittle skin, cetnral ovesity, HTN, plethoric moon faces, purple striae, diabetes, osteoporisis, leukocytosis, lymphopenia, eosinopenia, immune supression, DXM diagnosis |
| Ant. Pit.-FSH and LH | gonadotropin |
| gonadotorpin deficiency | kallman syndrom, DAX1 gene mutation, stress, anorexia, starvations, extreme exercise, amenorrhea, infertility, decresed libido, dec. muscle mass, reduced body hair |
| gonadotropin producing adenoma | FSH, LH, optic X pressure, menstrual disturbances, ovarian hyperstimulation |
| Ant-Pit. TSH hormone def. | low basal TSH, altered biological activity, low thyroid hormone, pituity hypothyroidism, TRH increase TSH 2-3 times |
| TSH secreting adenoma | rare, large, locally invasive, thyroid goiter, hyperthyroidism, high TSH and T4, positive MRI |
| syndrome inappropraite vassopressin secretion | acute inflammation and destructive auto digestion of the pancreas and extra pancreatic tissue |
| inappropriate vasopressin secretion-etiology | primary: agenesis destruciton of neurohyphpysis, Xq28 gene disruption, secondary: excessive intake of fluid, polydipsia |
| vasopressin secretion-pathophysiology | decresase urin concentraiton, diabetes insipidus |
| vasopressin secretions-CM | decreased vasopression secretion, nocturia, enuresis, polyuria |
Created by:
Alexia4
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