Wiki 2s – Flashcard
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What are the 2 most common symptoms of GERD?
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Heartburn and acid regurgitation
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What is the most effective pharmacological tx for GERD?
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PPIs
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What is NOT a common cause of GERD
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Belching
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What CAN'T prolonged exposure to gastric acid in the esophagus lead to?
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Bell's Palsy
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When H pylori releases what, the body responds with inflammation?
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Lipopolysaccharide
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The common tx for H pylori infection triple therapy consists of administration of what?
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2 antibiotics and 1 acid suppressor
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What 2 factors do over 90% of PUD cases have in common?
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H pylori infection and NSAID use
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What is NOT a reason for bleeding in elderly PUD patients?
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Antiemetic like Phenergan
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Ulcerative colitis is defined as
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Chronic inflammation of a mucosa lining of the colon
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Pathophysiological effects of ulcerative colitis include increased production of what?
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Cytokines, immunoglobulins, NK cells
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What are common clinical manifestations of ulcerative colitis?
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Bloody diarrhea, weight loss, ab pain
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Tx of ulcerative colitis may include a tumor necrosis factor inhibitor. Which med is it?
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Infliximab
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What is NOT associated with increased risk of celiac disease?
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OA
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The lymphocyte-mediated cytotoxic response against enterocytes results in what type of response from the small intestine?
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Crypt hypoplasia
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What is NOT a common clinical manifestation of celiac disease?
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Weight gain
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What is considered the only tx for celiac disease?
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Gluten-free diet
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Who is most likely to be diagnosed with primary ciliary cirrhosis (PBC)?
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50 yr old female with sister with PBC
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What is a hallmark condition found in 95% of primary biliary cirrhosis cases?
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Increased anti-mitochondrial antibodies
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Early stages of PBC manifest in which symptoms?
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Fatigue and pruritus
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Which of the following is false about treatment of PBC?
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Exercise should be avoided
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Which of the following best describes one way to reduce your risk of gallstones?
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Don't skip meals
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Physical activity may play an important role in prevention of gallstone disease. Studies show increasing exercise to how many minutes of endurance training how many times per week is recommended?
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30 minutes 5x/week
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Medical dissolution is one effective way to breakdown and remove gallstones in some patients. Which of the following statements regarding this process is FALSE?
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After tx, patients are unlikely to form new gallstones
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Which of the following is not a diagnostic test for gallstones?
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DEXA
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All of the following are common clinical signs of pancreatic cancer except
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Edema
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Where is the Virchow Node?
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Cervical
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What is the only cure for pancreatic cancer?
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Surgery but often doesn't work
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"Aggressive and quick-spreading" describes this form of pancreatic cancer?
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Squamous
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What are bacterial that commonly cause acute and chronic bacterial prostatitis?
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E. coli and P mirabilis
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In a pt with prostatitis, the prostate becomes enlarged, painful and boggy due to
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Build up of inflammatory cells
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Which of the following symptoms are associated with chronic prostatitis /chronic pelvic pain syndrome
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Frequency and urgency of urination
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Common pharm management of prostatitis includes all of the following except
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Antivirals
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All of the following are risk factors for prostate cancer except
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High vitamin E levels
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All of the following are common places for prostate cancer metastasis except
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Liver
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Generally, the primary symptom of prostate cancer that people report is
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Pain
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Which of the following would indicate a likely need for medical referral when treating a patient with a history of prostate cancer?
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Unexplained thoracic pain
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Incidence of testicular cancer is 35 times higher in individuals with which of the following
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Cryptorchidism
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Which are of physical therapy management should be most prioritized when treating a patient who has undergone surgical treatment for testicular cancer?
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Lymphedema and surgical scar management
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In a patient with testicular cancer, surgical removal of both testes will result in a loss of what and what production?
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Testosterone and sperm
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Testicular cancer can often refer generalized pain/discomfort to where?
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Abdomen and low back
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Seventy percent of patients younger than 35 are diagnosed with which kind of ED?
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Psychogenic
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Vascular reconstruction for ED works by
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Reconstructing arteries and/or blocking veins to increase likelihood of achieving or maintaining an erection
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All of the following are treatment options for ED except
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Testosterone injections
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Which of the following is not considered a yellow flag for ED?
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Blood in semen
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Pelvic inflammatory disease (PID) is an inflammatory disease that occurs in women usually due to
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STIs
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Which of the following is the main pathological cause of PID?
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N gonorrhoeae or C trachomatis
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Which is a common clinical manifestation of PID?
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Pain in lower abdominal region
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Which of the following is NOT used to treat PID?
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Amlodipine
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Endometriosis is a condition where lesions made of endometrial-like tissue are found outside of the uterus. The lesions lead to pathology by
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Growing and bleeding in rhythm with menstrual cycle leading to adhesions and scar tissue formation
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What percentage of women with endometriosis will have problems with infertility?
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30-40%
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Which is NOT a common treatment for endometriosis?
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Chemotherapy
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What is a red flag for endometriosis?
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Pelvic pain
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What is the most accurate diagnostic screening test to determine presence of uterine cancer?
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Endometrial sampling (biopsy)
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All of the following are risk factors for the development of uterine cancer in women except
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Progesterone replacement therapy
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The cardinal sign of uterine cancer is
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Abnormal uterine bleeding
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Which of the following is an appropriate recommendation for physical therapists regarding uterine cancer?
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For a patient with many risk factors, an exercise program can be prescribed to reduce risk
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PCOS is one of the common causes of what in women?
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Infertility
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What should all women diagnosed with PCOS be screened for?
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Glucose intolerance
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What characteristic of the ovarian cyst contributes most to whether or not a person feels symptoms or not?
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Size and location
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Relating to physical therapy, it may be extra important to ask a female patient about any menstrual dysfunctions if she presents with a complaint of what body part?
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Low back or sacral pain
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Which of these activities should you avoid doing with the patients with a history of pelvic organ prolapse?
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Lifting heavy objects
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Which of these increase the risk of POP?
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Multiple vaginal births
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Signs and symptoms of POP may include
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Low back pain or ache
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What type of surgical procedure can be used in place of performing a hysterectomy to fix a prolapsed uterus?
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Sacrohysteropexy
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Which of the following is a treatment option for fibrocystic breast disease?
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Fine-needle aspiration
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Which of these is least likely to be related to the possible development of fibrocystic breast disease?
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Post-menopausal women >60 years old not on hormone replacement therapy
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Common clinical manifestations of fibrocystic breast disease may include all of the following except
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Painful breast sores or ulcers
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What is the most common benign solid tumor in the female breast?
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Fibroadenoma
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What structure occurs in various neuroleptic drugs and antihistaminic drugs?
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Phenothiazine
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What does the term "phenothiazines" describe?
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The largest of 5 main classes of neuroleptic antipsychotic drugs.
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What are the beneficial effects of phenothiazines?
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Antipsychotic and often antiemetic properties Inodilators in CHF In ER to treat migraine and other intractable headaches
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What are side effects of phenothiazines?
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Extrapyramidal symptoms, hyperprolactinaemia, and rarely fatal neuroleptic malignant syndrome, weight gain
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How do phenothiazines work on CHF?
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Act on type 1 Ca calmoudulin-dependent phosphodiesterase
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What 3 groups are phenothiazines categorized based on substitute on nitrogen?
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Aliphatic compounds, piperidines, piperazines
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What is butyrophenone?
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Chemical compound to treat psychiatric disorders such as schizophrenia as well as acting as antiemetics
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What are drugs that cause Parkinsonism?
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Phenothiazines, butyrophenone, risperidone, SSRIs, amiodarone, diltiazem, metoclopramide, valproic acid
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What are extrapyramidal symptoms associated with Parkinson's disease but also occur with Parkinsonism?
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Tremor, rigidity, bradykinesia, postural instability, gait dysfunction, micrographia, hypophonia, lack of facial expression
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Describe 3 types of pharmacological treatment for Parkinson's
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1. Drugs that work directly or indirectly to increase levels of dopamine in the brain (precursors and agonists) 2. Drugs that affect other neurotransmitters (anticholinergics) 3. Drugs that help control the non-motor symptoms (antidepressants)
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Describe how levodopa causes increase in dopamine and where. How are peripheral side effects modulated or decreased?
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Converts to dopamine (precursor). Side effects blocked in periphery by antagonist carbidopa
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Define which drug is used for tremor and the potential side effects
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Anticholinergics. Heat exhaustion/stroke
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Describe the mechanisms of action for COMT and MAO-B inhibitors
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*COMT: blocks catecholamine metabolism and enhances bioavailability of levodopa *MAO B:
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Describe the pharmacological agents used in treatment of Alzheimer's including side effects
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*Cholinesterase inhibitors block degradation. Airway constriction, vasodilation, increased sweat, bradycardia, syncope, pupil constriction *NMDA receptor antagonists. HTN, tachycardia, dizziness, HA, hallucinations, confusion, urinary incontinence
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Describe the 3 reasons for pharm intervention for MS
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Inflammation, demyelination, gliosis (scarring)
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Describe the significant side effects of the disease modifying drugs for MS
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HA, flu-like symptoms, muscle pain, chest pain, fatigue, injection site redness, skin breakdown
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List indications for benzos
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Acute and short term management of anxiety, agitation, panic, withdrawal from CNS depressant, with SSRIs, insomnia. Long term management of generalized anxiety and social anxiety disorder
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List non psych uses of benzos. Side effects for PT?
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Muscle relaxants, seizure control, pre op adjunct to anesthesia. Side effects are drowsiness, sedation, cognitive effects, motor effects
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Describe which neurotransmitters are most commonly affected by antidepressants
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Serotonin, NE, dopamine
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Describe the common side effects of TCAs. Most serious?
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*Anticholinergics: dry mouth, blurry vision, constipation, urinary retention *Antihistiminic: sedation, weight gain *Alpha-adrenergic: orthostatic hypotension
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Describe the common side effects of SSRIs
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*5HT 2: agitation, akathisia, anxiety, insomnia, sexual dysfunction *5HT 3: nausea, GI upset, diarrhea, HA *Other: tremor, sweating, dry mouth, weight gain, asthenia, discontinuation syndrome
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Describe the side effects of MAOIs
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Combining with tyramine containing foods or certain drugs may result in fatal hypertensive encephalopathy, sedation, orthostatic hypotension
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Describe how traditional neuroleptic work
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Dopamine blockade to treat positive symptoms
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Describe atypical antipsychotics basic MOA
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Blockade of dopamine and serotonin
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Describe neuroleptic malignant syndrome and the drugs with which drug it is associated
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Muscle rigidity, ANS instability, elevated temp, delirium
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Describe how H2 blockers work.
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90% inhibition of vagal and gastric-stimulated acid secretion. Near complete inhibition of nocturnal acid secretion possible as well.
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What is the issue with cimetidine?
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High doses may cause sedation
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Compare and contrast H2 blockers and PPIs
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PPIs inhibit gastric acid secretion. Also better tolerated
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Describe the condition that H pylori causes and how is it managed pharmacologically?
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Causes chronic gastric inflammation. Treated with antibiotics and PPIs for several weeks
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Describe the mainstay pharmacological treatments for inflammatory bowel disease
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Anticholinergics/spasmodics, bulk fiber laxatives, lubiprostone, 5-HT3 receptor antagonist
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Describe the medication used to treat gallstones
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Dissolve radiolucent non-calcified gallstones. Suppresses hepatic synthesis, cholesterol secretion, inhibits intestinal absorption of cholesterol
