WGU D027 Pathopharm Exam 2023

color blindness and hemophilia - ANSWER-sex-linked traits, cones lack one or more wavelength-sensitive chemicals, you will be unable to distinguish the colors red, green or blue. Some conditions that can cause color deficits are sickle cell anemia. Thiazide diuretics mechanism of action - ANSWER--Inhibit Na reabsorption in the *distal tubule* -Promotes up to 10% of Na and H2O excretion -Increase urinary excretion of other electrolytes Diuril (chlorothiazide) - ANSWER-1st line drug tx for antihypertensive, thiazide diuretic, tx by reducing bld vol, increased urination Calcium Channel Blockers - ANSWER-(INE)agents that inhibit the entry of calcium ions into heart muscle cells, causing a slowing of the heart rate, a lessening of the demand for oxygen and nutrients, and a relaxing of the smooth muscle cells of the blood vessels to cause dilation; used to prevent or treat angina pectoris, some arrhythmias, and hypertension Ca Channel Blockers - ANSWER-Dilate the arteries and reduce the force of the heart's contractions Norvasc (amlodipine) Cardizem (Diltiazem) ACE inhibitors adverse effects - ANSWER-1. first dose hypotension 2. orthostatic hypotension cardia sensitvity insufficiency 6. hyperkalemia 7. Angioedema 8. Bone marrow depression Beta Blockers - ANSWER-decrease heart rate and dilate arteries by blocking beta receptors by inhibiting effects of norepi Escitalopram - ANSWER-Lexapro SSRI pituitary gland - ANSWER-The endocrine system's most influential gland. Under the influence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands. atherosclerotic plaque - ANSWER-fatty deposits accumulated due to elevated glucose levels Primary HTN risk factors - ANSWER-1. Genetic predisposition 2. Excess dietary salt intake 3. Adrenergic tone 4. racial pattern (HIGHEST : African Americans) Primary HTN causes - ANSWER-Renal Parenchymal disease Renal vascular disease essential HTN Cardiovascular disease CNS abnormalities Endocrine disease Syndromes Medication related (rare). EGFR (epidermal growth factor receptor) proteins, mutation driving lung cancer - ANSWER-medicate with Tagrisso, a type of tyrosine kinase inhibitor. Tagrisso (osimertinib) - ANSWER-non-small cell lung cancer muscular dystrophy (MD) - ANSWER-group of hereditary diseases characterized by degeneration of muscle and weakness Becker muscular dystrophy (BMD) - ANSWER-Dx based on physical symptoms, family history, an elevated concentration of creatine kinase (CK) in the blood indicating destruction of muscle, and molecular genetic testing. Duchenne muscular dystrophy symptoms - ANSWER-Pseudohypertrophy of calf muscles; use upper extremity to help them stand up; waddling gait Autosomal Recessive Inheritance - ANSWER-Skips generations, usually seen in only 1 generation. 25% of offsprings from 2 carrier parents affected. Often due to enzyme deficiencies, more severe than dominant disorders; symptoms presents in childhood. autosomal dominant inheritance - ANSWER-presence of certain genes that means there is a 100% chance of the person eventually getting the disease autosomal dominant disorders - ANSWER-Huntington's Disease Achondroplasia Neurofibromatosis autosomal recessive disorders - ANSWER-Tay-Sachs, Cystic fibrosis, sickle cell anemia, phenylketonuria anterior pituitary gland - ANSWER-AKA the adenohypophysis, the anterior pituitary is made of glandular tissue. It makes and secretes six different hormones: FSH, LH, ACTH, TSH, prolactin, and growth hormone. The anterior pituitary is controlled by releasing and inhibiting factors from the hypothalamus posterior pituitary gland - ANSWER-ADH and oxytocin adrenal glands - ANSWER-a pair of endocrine glands just above the kidneys. the adrenals secrete the hormones epinephrine (adrenaline) and norepinephrine (noradrenaline), which help to arouse the body in times of stress. CHF (congestive heart failure) - ANSWER-condition in which the heart cannot pump enough blood to the rest of the body etiologies include arrhythmia, pulm embolism, hypertension, valvular heart disease, myocarditis, unstable angina, renal failure, severe anemia; coronary artery disease (CAD) - ANSWER-a condition affecting arteries of the heart that reduces the flow of blood and the delivery of oxygen and nutrients to the myocardium; most often caused by atherosclerosis Glucocorticoids (cortisol) - ANSWER-Adrenal cortex stimulates gluconeogenesis anti-inflammatory immunosuppression chemotherapeutic agents - ANSWER-synthetic chemicals used to interfere with the functioning of foreign cell populations; this term is frequently used to refer to the drug therapy of neoplasms, but it also refers to drug therapy affecting any foreign cell chemotherapeutic index - ANSWER-maximum tolerable dose per kilogram of body weight, divided by the minimum dose per kilogram of body weight, that will cure the disease breast cancer treatment - ANSWER-Trust HER! {Trastuzumab is used to treat Breast Cancers with HER2/neu receptors. This drug is a monoclonal antibody specific for HER2/neu receptor } Topoisomerase inhibitors - ANSWER-interfere with the action of topoisomerase enzymes (topoisomerase I and II). During the process of chemo treatments, topoisomerase enzymes control the manipulation of the structure of DNA necessary for replication. Methotrexate (Rheumatrex) - ANSWER-rheumatoid arthritis Folic acid antagonist Nitrosureas (Carmustine, Lomustine & Streptozocin) - ANSWER-spontaneously form active intermediates that cross-link DNA; can cross blood-brain-barrier and is indicated for brain tumors Statin drugs - ANSWER-hyperlipidemia drugs that reduce cholesterol by blocking the enzyme necessary for cholesterol production in the liver; HMG-CoA reductase inhibitor drugs atrial fibrillation - ANSWER-occurs when the normal rhythmic contractions of the atria are replaced by rapid irregular twitching of the muscular heart wall A Fib treatment - ANSWER-oxygen, meds, synchronized cardioversion, radiofrequency cath ablation, maze procedure, bi-ventricular pacing Pressors - ANSWER-Epinephrine, Norepinephrine, Dopamine, Vasopressin, if the afterload is low Increase vascular tone (constrict bld vessels) Acetylcholine - ANSWER-A neurotransmitter that enables learning and memory and also triggers muscle contraction ACE inhibitor drugs - ANSWER-vasodilation & decreases blood pressure. CaptoPRIL (Capoten), EnalaPRIL (Vasotec), EnalaPRILat (Vasotec), FosinoPRIL(Monopril), LisinoPRIL (Prinivil) Thalassemia - ANSWER-inherited defect in ability to produce hemoglobin, leading to hypochromia (decreased HGB content of RBCs) Sicle cell disease - ANSWER-Caused: substitution of a single amino acid in the hemoglobin protein in red blood cells Weakness, pain, organ damage, paralysis Autosomal recessive (parents each carry 1 copy of the mutated gene, typically do not show S/S of the condition.) Beta Thalassemia - ANSWER-Anemia: Low levels of hgb lead to a lack of oxygen in many parts of the body. Abnl peripheral blood smear, reduced RBCs sickle cell management - ANSWER--monitor organ function -avoid hypoxia/ emia -hydrate -supportive care reduced risk of getting malaria diabetes mellitus - ANSWER-a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both PioglitaZONE, RosiglitaZONE - ANSWER-Drug class: Thiazolidinedione TZD increase insulin sensitivity in peripheral tissue used as monotherapy in type 2 DM or in combo w/ other diabetes drugs Toxicity: weight gain, edema, hepatotoxicity, heart failure, ↑risk of fractures Metformin and the TZDs - ANSWER-contraindicated in patients with advanced heart failure. Cause /exacerbate heart failure & pulmonary edema AVOID in patients with left ventricular dysfunction (impaired pumping ability of the heart) or chronic renal insufficiency. Empagliflozin and liraglutide - ANSWER-reduce the risk of CV death in adults with diabetes and CVD SGLT-2 inhibitors - ANSWER-inhibits sodium and glucose co-transport in the proximal tubule, leading to increased glucose in the urine (increased glucose excretion) canagliflozin, dapagliflozin, and empagliflozin. SGLT-2 inhibitors side effects - ANSWER--Hypoglycemia -Hyperkalemia -Genital mycotic infection Empagliflozin (Jardiance) - ANSWER-Sodium-Glucose Cotransporter 2 Inhibitor (SGLT2) color blindness - ANSWER-A sex-linked trait in which an individual cannot perceive certain colors. Normal Thyroid Levels - ANSWER-TSH = 0.2 - 5.4 T3 = 80 - 230 T4 = 5 - 12 Hypothyroid Lab findings - ANSWER-Increased TSH Decreased T3,T4, T3 uptake myasthenia gravis (MG) - ANSWER-Autoimmune disease Affects the neuromuscular junction Produces serious weakness of voluntary muscles Crohn's disease - ANSWER-a chronic autoimmune disorder that can occur anywhere in the digestive tract; however, it is most often found in the ileum and in the colon Crohn's - ANSWER-skip lesions (ASCA) is used to help distinguish between Crohn disease (CD) and ulcerative colitis (UC), the two most common types of inflammatory bowel disease (IBD). Ashkenazi Jewish people, who have origins in Eastern Europe, are two to four times more likely to develop an IBD than people who aren't Jewish. G6PD deficiency - ANSWER-Low NADPH leads to hemolytic anemia (free radicals) with bite cells and heinz bodies Fava beans, sulfonamides, primiquine, dapsone X-linked recessive Postural orthostatic tachycardia syndrome (POTS) - ANSWER-a condition that affects blood flow. POTS causes the development of symptoms -- usually lightheadedness, fainting and an uncomfortable, rapid increase in heartbeat -- that come on when standing up from a reclining position and relieved by sitting or lying back down. Varicella exposure - ANSWER-Pts 1 y/o should be given the varicella vaccine for post-exposure prophylaxis. Only give IVIg when pt is immunocompromised or immunosuppressed. Varicella exposure in pregnancy - ANSWER-a small risk your baby could develop fetal varicella syndrome (FVS). FVS can damage the baby's skin, eyes, legs, arms, brain, bladder or bowel. Between weeks 28 and 36 of pregnancy: the virus stays in the baby's body but does not cause any symptoms. VARIVAX (Varicella vaccine) - ANSWER-varicella virus vaccine (live) should not be administered to pregnant females since wild-type varicella can sometimes cause congenital varicella infection. Pregnancy should be avoided for three months following vaccination parathyroid glands - ANSWER-four small glands on the posterior of the thyroid gland. Release of calcium by bones into the bloodstream. Aldosterone/Kidney physiology in regulation of blood pressure - ANSWER-causes the tubules of the kidneys to increase the reabsorption of sodium and water into the blood. This increases the volume of fluid in the body, which also increases blood pressure. If the renin-angiotensin-aldosterone system is too active, blood pressure will be too high. MMR vaccine - ANSWER-vaccination to protect against mumps, measles & rubella. 1st dose: 9-15 months 2nd dose: 15 mo-6 yo (at least 4 wks between doses) Fragile X Syndrome - ANSWER-In Fragile X the methylation turns off the FMR1 gene, so no FMRP is produced. Normally, the FMR1 gene produces an important protein called FMRP. When the gene is turned off, the individual does not make this protein. The lack of this specific protein is what causes Fragile X syndrome. Hutchinson-Gilford Progeria Syndrome - ANSWER-Growth retardation and premature aging The gene, known as lamin A (LMNA), makes a protein necessary for holding the center (nucleus) of a cell together. When this gene has a defect, progerin is produced and makes cells unstable. This appears to lead to progeria's aging process. Acetylcholine release inhibitors - ANSWER-(Botox)primarily used to treat cervical dystonia, overactive bladder, migraines, excessive sweating, and spasticity. They work by preventing muscle spasms and relaxing muscles and by blocking nerves that produce sweat. Which medications in the drug class Tricyclic antidepressants are used in the treatment of Esophageal Motility Disorders? - ANSWER-Calcium channel blockers, smooth muscle relaxants, anticholinergics, and antianxiety medications. No one single drug has proven efficacy in the treatment of spastic motility disorders. Effective treatments for esophageal motility disorder - ANSWER-include dilation with a large size balloon dilator, botulinum toxin (Botox) injection in the lower esophageal sphincter Eating with Esophageal motility disorder - ANSWER-Take small bites of food and chew foods well. Avoid tough meats, fresh "doughy" bread or rolls, hard bread crust, and abrasive foods. Sip fluids when taking solids at meals and snacks to moisten foods. Stop eating when you start to feel full. Eat slowly in a relaxed atmosphere. smooth muscles of the lower end of the esophagus (LES) and diaphragmatic sphincter - ANSWER-constitute two active sphincters mechanism at the lower end of the esophagus. The neuromuscular mechanisms that maintain tonic or reflex contraction of these sphincters are essential for their antireflux behavior. Eaton-Lambert Syndrome - ANSWER-Body's immune system attacks the connections between nerves and muscles. Antibodies formed against presynaptic calcium channels STRONGLY associated with Small Cell Carcinoma and Smokers What is the difference between myasthenia gravis and Lambert Eaton syndrome? - ANSWER-In myasthenia gravis, they attack and damage muscle cells; in Lambert-Eaton myasthenic syndrome, they attack nerve cells that send messages to muscle. Transposition of the great vessels - ANSWER-Aorta arises from right ventricle and pulmonary artery arises from left ventricle- creates two separate shunts that do not mix Transposition of the great arteries - ANSWER-An echocardiogram showing an aorta lying anterior to and to the right of the pulmonary artery is diagnostic of transposition of the great arteries. TGA results from failure of the fetal aorticopulmonary septum to spiral normally during septation of the trucus arteriosus. Presents - lifethreatening cyanosis at birth. UTI - ANSWER-E. coli, Staphylococcus saprophyticus (young women) UTI treatment - ANSWER-Complicated: Fluoroquinolones are typically the first-line choice. Uncomplicated: Trimethoprim/sulfamethoxazole may be used first-line in younger men without evidence of complicated UTI and with consideration to local resistance patterns. Fluoroquinolones MOA - ANSWER-Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV. Bactericidal. Must not be taken with antacids. Fluoroquinolones adverse effects - ANSWER-Gi discomfort, achilles tendon rupture, suprainfection (thrush, yeast infection), photosensitivity, Increased risk for C. difficile, can affect CNS, use cautiously in older adults with cardiovascular disorders Fluoroquinolones - ANSWER-have been hypothesized to compromise tendon function and increase risk of injury, especially in weight-bearing joints most subject to mechanical force via several possible mechanisms. These medications may cause direct tissue injury, including necrosis or exposure-dependent cellular apoptosis. Do not take ciprofloxacin with - ANSWER-Dairy products such as milk or yogurt, or with calcium- fortified juice. You may eat or drink these products with your meals, but do not use them alone when taking ciprofloxacin. They could make the medication less effective. Ciprofloxacin (Cipro) - ANSWER-Do not drink or eat a lot of caffeine-containing products such as coffee, tea, energy drinks, cola, or chocolate. Ciprofloxacin may increase nervousness, sleeplessness, heart pounding, and anxiety caused by caffeine. Make sure you drink plenty of water or other fluids every day while taking the Fluoroquinolone abx Sulfasalazine - ANSWER-MOA: combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid; activated by colonic bacteria Clinical use: ulcerative colitic, Crohn's disease Toxicity: sulfonamide toxicity, reversible oligospermia Amlyn analogs MOA - ANSWER-slows gastric emptying leading to a feeling of satiety decreases PP glucagon secretion may cause weight loss is considered 3rd line tx due to lack of efficacy in lowering BS