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Vecuronium, atracurium, tubocuraine
NMJ blockers (i.e. they block nicotinic ACh receptors). Reversible the whole time, unlike succinylcholine.
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Pralidoxime
For cholinesterase inhibitor poisoning: Used to regenerate cholinesterase. (Use with atropine.)
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Echothiophate
Glaucoma -- anti-cholinesterase
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Oxybutynin, glycopyrrolate
Muscarinic antagonists for GU -- ex. reduce urgency w/cystitis
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Methscopolamine, pirenzepine, propantheline
GI -- for peptic ulcers
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Hexamethonium
Nicotinic antagonist: blocks reflex bradycardia after NE administration (Experimental drug)
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Amphetamine & ephedrine vs. cocaine
Cocaine inhibits catecholamine reuptake, while amphetamines & ephedrine cause release in 1st place
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Ritodrine
B2-agonist for premature labor contractions
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Betamethasone
Glucocorticoid to stimulate surfactant production in premature babies
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False aortic aneurysm
Entire vessel wall ruptures -- post-MI, or at vascular graft anastomosis
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Atheroma
Plaque in blood vessel walls, from hyperlipidemia
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In atherosclerosis, what forms the fibrous plaque cap?
Foam cells recruit smooth muscle cells, via PDGF & FGF-Beta
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Enzymes assoc w/plaque rupture vs. stability
Rupture = MMP's, stability = lysyl oxidase (strengthens collagen fibers of cap)
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Ergonovine test
It induces vasospasm in Prinzmetal's angina pts. These pts will still respond to NG.
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Non-ST-elevation MI
Necrosis did occur, but only a partially occlusive thrombus
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Medications that slow HF progress
Captopril (ACE inhibitor), & B-blockers inhibit ventricular remodeling
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Red infarcts
In tissues w/collaterals: liver, lung, intestine... or following reperfusion anywhere
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ST elevation
Injury: MI, Prinzmetal's (even though it still responds to NG), aortic dissection, pericarditis (but no CK-MB elevation)
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Tangier disease
Can't load cholesterol onto HDL (ABCA transporter), so macrophages pick it up instead --> foam cells. Orange tonsils
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Earliest MI changes
- Contraction bands -- 1-2 hours (eosinophilic sarcomeres around infarct borders)
- Coagulative necrosis -- 4 hours (pyknotic nuclei)
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1 day post-MI
Neutrophil infiltration. Most common cause of death: v.fib. Fibrinous pericarditis overlying the necrotic segment.
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Complications 7 weeks post-MI
Dressler's syndrome, ventricular aneurysm. Inc'd collagen, dec'd cellularity.
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Troponin I
Most specific protein marker for MI. Rises after 4 hours, stays elevated for 10 days.
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Endocarditis: Loeffler vs. Libman-Sacks
- Libman-Sacks: SLE causes LSE. Sterile; usually asymptomatic, but mitral regurg.
- Loeffler endocarditis: hypereosinophilia --> fibrosis --> restrictive cardiomyopathy
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Kerley B lines
Increased LA pressure (heart fail) --> pulm edema: more fluid in lung interstitium
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HAECK organisms
Culture-neg endocarditis. Haemophilus, actinobacillus, eikenella, cardiobacter, kingella
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Syphilis heart disease
Vasa vasorum of aorta disrupted --> dilation of aorta, calcification of aortic root --> aneurysm, incompetent aortic valve.
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Long-QT hereditary syndromes
- Jervell & Lange-Nielsen: Auto R, neurosensory deafness
- Romano-Ward: Auto D, no deafness
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Microscopic polyangiitis
- Like Wegener's (nasal/lung/kidney), but lacks granulomas.
- Type III hypersensitivity, from antibiotic use -- often penicillin
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Polyarteritis nodosa
- Med-sized vessels: kidney, melena, cutaneous, neuro.
- Young adults, Hep B.
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Diazoxide vs. minoxidil
- Both open K+ channels. Diazoxide = for HTN emergencies, hyperglycemia.
- Minoxidil = hypertrichosis, pericardial effusion
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Thyroid conditions associated with:
1) Lymphocytic infiltrate w/germinal centers
2) Granulomas, elevated ESR
3) Iodinde deprivation, followed by restoration
- 1) Hashimoto's
- 2) Subacute thyroiditis
- 3) T3/4 release --> toxic multinodular goiter (thyrotoxicosis = Jod-Basedow)
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Chvostek's & Trousseau's signs
- Tetany due to hypocalcemia (hypoparathy).
- Chvostek's = tap on facial nerve --> contract muscles
- Trousseau's = BP cuff causes carpal spasm (occlude brachial A)
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Bromocriptine, cabergoline
Dopamine agonists -- shrink pituitary adenoma
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DM complications that are due to osmotic damage (glucose --> sorbitol --> fructose)
Cataracts, neuropathy. When you have high glucose, it really accumulates in tissues not dependent upon insulin for glucose uptake!
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2 bugs common in: 1) diabetics & 2) DKA
- 1) Klebsiella, Pseudomonas
- 2) Mucor, Rhizopus
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Octreotide
Somatostatin analog for carcinoid syndrome
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