Final exam quesitons

Question 1

what is cause of glomelular hyperfiltration in diabetes (2)

Answer 1

1. affertent arteriole dilatation

2. efferecnt arteriole constriction

Question 2

3 steps of T1DM nephropathy and targets

Answer 2

1. control glycemia (under 7)
2. treat hypertension (under 130/80)
3. ACE inhib or ARB

Question 3

4 steps to treat life threatening hyperkalemia

Answer 3

1. stabilize myocardium (Ca gluconate)
2. Shift K into cells (IV insulin)
3. K excretion (IV fluids plus diuretic or diarrhea)
4. Dialysis if others don’t work

Question 4

Name of all apo-proteins, their molecules and funciton

Answer 4

A1 - HDL, CM - activates LCAT
B - all low density - structure and non-exchangable
C2 - CM, VLDL, HDL - activates LPL and important for TG metabolism
C3 - CM, VLDL, HDL - inhibits LPL and common in diabetes
E - CM, VLDL, HDL - bind LDL r and LRP for clearance

Question 5

diff between 2 lipoprotein receptors

Answer 5

1. LDL-r - recognized B-100

2. LRP - recognizes E - only on CM and VLDL

Question 6

What are 7 primary risk factors in framingham

Answer 6

1. age
2. HDL
3. Total C
4. Systolic
5. diabetes
6. smoker
7. Gender

Question 7

addtional risk in framingham when choosing treatment

Answer 7

1. LDL
2. CRP
3. Family Hx

Question 8

Ursodeoxycholic acid (Ursodiol)

Answer 8

• TPN causes liver damage and low bile flow
• give to promote bile flow
• reduce risk of liver disease

Question 9

N‐acetylcysteine (Mucomyst)

Answer 9

• mucous thinner
• has been used to cystic fibrosis
• given to reduce inflammation in liver that is caused by lipids in TPN
• cycsteine
• Effectively gives enough co-factor for his detoxification enzymes to work properly in liver

Question 10

Dexlansoprazole (Dexilant)

Answer 10

• prn proton pump inhibitor

- eneteric coated to allow later release

Question 11

Domperidone

Answer 11

• D2 antagonist (peripheral)

-

Question 12

Prucalopride (Resotran) prn

Answer 12

• 5HT-4 agonist

- promotility

Question 13

Cycle of rifaximin (Xifaxan), metronidazole (Flagyl) & cefazolin (Ancef)

Answer 13

• anti-biotics for overgrowth

Question 14

measures in AG

Answer 14

Na - bicarb - Cl

Question 15

measured in OG

Answer 15

Osmolarity - ((2xNa) + Urea + gluc)

Question 16

what does AG indicate

Answer 16

1. toxin
2. ketoacid
3. lacticacid
4. renal failure

Question 17

what does OG > 10 indicate

Answer 17

presence of alc

Question 18

what does N-cysteine do

Answer 18

helps the glutathione pathway of conjugation

Question 19

what is hirschprungs

Answer 19

defect in the craniocaudal migration of neuroblasts originating from the neural crest that occurs during the first 12 weeks of gestation