The backbone of the cell; gives the cell its actual structure
The outside of the endoplasmic reticulum
Where proteins are translated from mRna.
Where ATP is generated
Small and lipid soluble (white)
Characteristics of drugs that allow them to pass through the blood brain barrier
An example of a drug that passes through the blood brain barrier. Also, what killed Michael Jackson.
A brain disease.
What type of disease is smoking?
Atrophy, hypertrophy, hyperplasia, and metaplasia.
What are adaptive changes of cells?
Which adaptive change occurs mostly in skeletal muscle & is caused by not using the muscle?
Which adaptive change is defined by enlargement of the cells?
The adaptive change in which cells multiply due to an increased rate of cell division
Atypical hyperplasia... abnormal changes in size, shape, and organization of cells.
Reversible replacement of one mature cell by another less differentiated type.
The adaptive cellular change that pregnant women and body builders undergo.
An adaptive cellular change that can be compensatory (callus, liver regeneration) or hormonal (breast enlargement before menstruation)
An abnormal cellular change that may, for example, occur in the cervix prior to the development of cervical cancer.
The reversible adaptive cellular change that occurs when bronchial columnar epithelial cells are replaced with stratified squamous epithelial cells due to smoking.
1. ATP depletion
2. Oxygen derived free radicals
3. Calcium alterations (influx of calcium into the cell)
4. Defects in membrane permeability that may allow bacteria to get in & cause infection
The 4 common biochemical themes in cell injury/death
A form of hypoxic cell injury caused by a rush of oxygen coming back & generation of free radicals. Avoid this type of injury by increasing blood supply gradually.
Gradual, reduced blood supply. Caused by atherosclerosis or thrombosis.
No blood supply so no oxygenation. Total lack of oxygen. Caused by a sudden obstruction or embolus.
An example of a free radical that is used in refrigerants, fire extinguishers, and dry cleaning.
Which enzyme is responsible for converting a a drug into its active metabolite form?
A very bad metabolite that causes fatty liver. It is formed when cytochrome p450 converts CCl4.
A contusion of the brain that is caused when you are hit in the front of the head.
A contusion of the brain that is caused when you fall onto the back of your head. The brain first hits the back of the head and then rebounds to the front of the brain, resulting in 2 bruises.
Nuclear dissolution and chromatin lysis from the action of hydrolytic enzymes
Clumping of the nucleus; nucleus shrinks to a dense, small mass of genetic material
Fragmentation of the nucleus into smaller particles or "nuclear dust"
cellular self-digestion or autodigestion
programmed cell death. Normally occurs throughout the lifespan as a controlled process in normal development that determines size, patterning, and function of many tissues.
Pathologic programmed cell death that occurs as the result of intracellular events or adverse exogenous stimuli. Also caused by enzyme deficiencies and in liver cells infected with Hep C.
Absence of apoptosis
Pathologic gene mutation that gives cellular signal to proliferate & not die. Lymphocyte accumulation leads to lymph node enlargement into the blood.
Type of necrosis that occurs most commonly in the kidneys, heart, and adrenal glands. Results from hypoxia and protein denaturation.
Type of necrosis in which hydrolytic enzyme of the brain digest dead brain cells causing soft brain tissue which is walled off from healthy tissue, forming cysts. Caused by bacterial infection.
Type of necrosis caused by Tb pulmonary infection & is a combination of coagulative and liquefactive necrosis
Type of necrosis that occurs in the breasts, pancreas, and other abdominal organs. Lipase action causes it, causing release of free fatty acids that combine with soaps. Opaque & chalk-white
Type of gangrene that results from coagulative necrosis. Skin is dry & shrunken with wrinkles and dark brown/black color.
Type of gangrene resulting from liquefactive necrosis, usually in internal organs, causing a cold, black, swollen site with a foul odor.
Type of gangrene caused by clostridium or other anaerobic bacterial infection of injured tissue.
The nitrogenous base A is always attached to...
The nitrogenous base C is always attached to...
In RNA, thymine is replaced by
Where is DNA formed and replicated?
Where does protein synthesis take place?
An ordered display of chromosomes
True/False: Deletion of chromosomes is worse than addition.
True/False: A triploidy or tetraploidy fetus may survive.
True/False: A fetus with trisomy may survive.
A cell containing three copies of one chromosome.
A zygote with three copies of each chromosome, so with a total of 69 chromosomes.
The best known example of aneuploidy. Trisomy 21. Affected individuals may be mentally retarded, have a low nasal bridge, epicanthal folds, protruding tongue, and poor muscle tone.
Sex chromosome aneuploidy in which a female has only one X chromosome.
Sex chromosome aneuplody in which an individual has at least two X's and one Y chromosome. XXY or XXXY
Cri du chat
An example of chromosomal deletion in which the short arm of chromosome 5 is deleted. Simean crease is a sign
When two breaks on a chromosome occur, causing reversal of the gene order.
The interchanging of material between nonhomologous chromosomes; Chromosomes breaking and attaching to different ones.
A type of translocation that occurs with the long arms of two nonhomologous chromosomes fuse at the centromere, forming a single chromosome. Confined to chromosomes 13, 14, 15, 21, and 22. A precursor for Down Syndrome.
Areas on chromosomes that develop distinctive breaks or gaps when cells are cultured
Fragile X Syndrome
Fragile site located on the long arm of the X chromosome; associated with mental retardation. Higher incidence in males because they have only one X chromosome. more than 50 repeats of CGG
the person who has the disease
Two people have the same disorder, but one has more mental retardation than the other. This is an example of a difference in what?
The area of pharmacology that looks at how the drug dissolves in the body.
Which area of pharmacology looks at what the body does to the drug?
The area of pharmacology that looks what what the drug does to the body
The clinical use of drugs to prevent and treat diseases
The metabolism of a drug and its passage from the liver into the circulation. reduces the bioavailability of a drug to less than 100%
Which organ do drugs pass through to be converted into an active form?
If a large proportion of the drug is processed into inactive metabolites in the liver, then a much smaller amount of the drug will pass into circulation (i.e., be bioavailable.) Is this a high or low first-pass effect?
True/False: A drug given PO has a high first-pass effect.
True/False: A drug given sublingually bypasses the first-pass effect.
True/False: A drug given IV has a high first-pass effect.
A drug given via this route avoids the first-pass effect of the liver but has erratic and unreliable systemic absorption. For this reason, drugs given this way are normally used for local effects.
Low levels of what protein can increase the risk for drug toxicity?
What protein carries drugs from the blood stream to its site of action?
True/False: Drugs are rapidly distributed to the muscle, skin, and fat.
The heart, liver, kidneys, and brains are areas of which speed of distribution: rapid or slow?
A huge classification of enzymes. A lot of drugs depend on the metabolism of it. It controls a variety of reactions that aid in medication metabolism
What type of medication cannot be given with grapefruit because of the cytochrome 450 effect?
Type of therapy that treats Tb and causes orange urine as a side effect
The time it takes for one half of the original amount of a drug to be removed from the body (if a 24 hour drug, then this time is about 12 hours)
The physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose. A physiologic plateau.
How long does it take to hit the steady state of a drug?
The time it takes for the drug to elicit a therapeutic response
The time it takes for a drug to reach its maximum therapeutic response
The time a drug concentration is sufficient to elicit a therapeutic response
A drug that you need to draw peak and trough blood levels for. A potent antibiotic that can be toxic if given too much.
If peak and trough levels are ordered for a drug, which dose do you get them at? (Like first, second, third...)
A patient in the end stage of cancer is receiving high doses of opioid analgesics. They are receiving which type of therapy?
Getting vaccines before traveling to a 3rd world country to prevent illness is an example of what type of therapy?
Receiving antibiotics before undergoing surgery is an example of what type of therapy?
A patient who is taking BP medications to treat chronic hypertension is receiving what type of therapy?
Diabetic patients taking insulin are an example of what type of therapy?
What type of therapy is used to achieve immediate action, often to sustain life or treat disease? Ex: Vasopressors for BP and CO after open heart surgery or intensive chemotherapy for a pt with newly diagnosed cancer
The ratio of a drug's toxic level to the level that provides therapeutic benefits
What drug treats arrhythmias and has a very narrow therapeutic index of <2.0?
An 80 year old with low albumin has a digoxin level of 1.8 (within the therapeutic index) and is complaining of nausea and vomiting. Is she toxic?
True/False: Low serum albumin in patients can cause toxicity even if the drug level is within the therapeutic index
Type of drug interaction in which one drug enhances the other; 1+1=more than 2
True/False: All drugs are compatible with IV saline.
An adverse drug effect for all statin medications
What can be given to treat the adverse effects of statins?
A type of adverse drug reaction that is not the result of a known pharmacologic property of a drug or of a pt. allergy and occurs unexpectedly in a particular patient. This type of reaction is genetically determined.
A drug-related effect that results in structural defects of the fetus
The hormone that regulates water balance
What type of relationship do Potassium (K) and Magnesium (Mg) have?
What type of relationship do Cl and Na have?
What type of relationship do Ca and P have?
What type of relationship do Cl and bicarbonate have?
1.8-2.4 is the normal range of which electrolyte? (abbr.)
2.5-5 is the normal range of which electrolyte? (whole word)
3.5-4.5 is the normal range of which electrolyte? (abbr.)
The normal range of this electrolyte is about 8-10 (abbr.)
The normal range of this electrolyte is 24-28 (whole word)
The normal range of this electrolyte is 135-145 (abbr.)
5-20 is the normal range for this waste product
0.7-1.3 is the normal range for this waste product
Too much of this electrolyte can cause kidney stones, muscle weakness, cardiac arrest, and constipation.
Low sodium always affects the...
If a patient is taking a medication that inhibits aldosterone, what should the nurse assess for?
Increased heart rate
What is always the body's first response?
What is the normal pO2 range?
What is the normal pH range?
What is the normal CO2 range?
What is the normal HCO3 range?
If the pH is less than 7.35 or more than 7.45, we call it what?
If the CO2 is 48, what do we call it?
If the HCO3 is 20, what do we call it?
Deficiency in which electrolyte causes arrhythmias, lethargy, confusion, decreased reflexses, seizure, coma
Too much of which electrolyte causes the cells to be unable to repolarize -> muscle weakness -> loss of muscle tone -> paralysis
A pt. comes into the ER complaining of chest pain radiating to the left arm. Which coronary artery is occluded?
If there is ST elevation in the anterior leads, which coronary artery is affected?
Pt. complaining of chest pain and pressure in the back. Which coronary artery is affected?
You know the pt. is having an inferior MI (RCA affected) when there is elevation in the leads that are located where?
Which node is the pacemaker of the heart?
Which node becomes the pacemaker if the SA node fails or is blocked?
What is the best way to cure an elderly patient with sick sino syndrome (sick sinoatrium -> HR drops)?
Which coronary artery is affected in a pt. complaining of jaw pains and feeling like there's an elephant sitting on his chest?
Vitamin B3 is also known as...
What type of medication was found to reduce risk of stroke almost 50% in the Jupiter Trial that there is now a move to put in the water since it is so helpful?
Constantly elevated levels of C-Reactive Protein (CRP) indicates that what is going on?
What type of smoke (secondary or tertiary) are you exposed to when it is on your clothes?
Do you give nitrates if a pt. has really high BP?
What do you give to a patient with really high BP to drop the BP gently?
Impotence is an important side effect for men to know of which class of cardiovascular drugs?
Calcium channel blockers
Peripheral edema is a side effect of which class of cardiovascular drugs?
Gynecomastia is a side effect of what medication?
Tinnitus is a side effect of what medication?
Rhabdomyolysis is a bad side effect of what type of medication?
What medication given to regulate cholesterol can cause flushing?
What class of drugs can cause a constant cough if not tolerated well?
What type of medication is clopidogrel (Plavix)?
HMG Co A Reductase Inhibitors
What class of medication are statins (like simvastatin)?
Calcium channel blocker
What type of medication is nifidipine (-pine)
What class of medication ends in -pril?
What is the drug of choice for A-fib?
What is elevated when you have an MI?
What is elevated in heart failure patients?
A patient who has a wet cough, crackles, frothy pink suptum has heart failure on which side of the heart?
A patient with distended jugulars, engorged liver, and peripheral edema has heart failure on which side of the heart?
True/False: BADD is the gold standard treatment for heart failure.
A patient is taking carvedilol, losinopril, and lasix. What does the patient have?
What levels should you draw before using heparin?
PT/INR levels should be checked before using what medications?
Abnormal breathing pattern that occurs before death and characterized by breathing that is very rapid and alternates between deep and shallow with short periods of apnea.
An increase in CO2 levels because it is not being removed properly due to hypoventiliaton
CO2 levels decrease because it's removed faster than it's produced because of hyperventilation
Coughing up of blood or bloody sputum. Indicates infection or inflammation that is damaging the bronchi or lung parenchyma
A patient turned blue from the legs up and passed out and died. What happened to him?
Type of oxygen mask that is capable of delivering 100% oxygen and is indicated for acute medical emergencies
A symptom of pulmonary disease where the patient experiences sharp and stabbing pain upon inspiration
A symptom of pulmonary disease where the patient experiences chest pain after coughing. Hard to differentiate from cardiac pain.
Reduced oxygenation of cells in tissues
Reduced oxygenation of arterial blood caused by respiratory alterations
Movement of air
In a patient who has a blood clot, is ventilation good or bad?
In a patient with emphysema, is ventilation good or bad?
Acute Respiratory Failure
Direct injury to the lungs, airway, or chest wall or indirect injury to the brain or spinal cord may cause what?
Pink frothy sputum is a symptom of what?
The collapse of lung tissue
The type of atelectasis that is caused by external pressure from a tumor, fluid or air in the pleural space or by abdominal distention
Dyspnea, cough, fever, and leukocytes are signs and symptoms of what pulmonary condition that tends to occur after surgery?
A patient who is coughing up tons (cupfuls) of purulent sputum and has decreased vital capacity and expiratory flow rates has what pulmonary condition?
Pleural abnormality characterized by presence of air or gas in the pleural space caused by a rupture
Type of pneumothorax in which air can move in during inspiration but cannot move out during expiration. Bad & life-threatening
The presence of fluid in the pleural space
A patient with pus in the pleural space after developing pneumonia with tachycardia, fever, and cough. What is their diagnosis?
Instability of the chest wall so there is movement when breathing, caused by having several fractures in the ribs. A sign is unequal chest expansion.
Lymphatic fluid from thoracic duct into pleural space. caused by traumatic injury to the neck or a tumor invading the thoracic duct.
An asthmatic patient has CO2 over 70mmHg and no audible air movement (silent chest). What is this very bad, life-threatening condition?
A chronic inflammatory disorder of the airways characterized by inspiratory and expiratory wheezing
A short acting beta2 agonist that is administered during nebulizer treatment & causes increased heart rate as a side effect
What is a sign of toxicity in patients taking theophylline (an old bronchodilator)?
Leukotriene antagonists like Montelukast are anti- what?
Is salmeterol a long or short action beta2 agonist?
Thrush is a side effect of what type of respiratory medication?
True/False: Oral steroids commonly cause weight loss.
What genetic cause is there for COPD in non-smoking patients?
Inflammation of the bronchi and bronchioles caused by chronic exposure to irritants, especially tobacco smoke
Severe form of COPD characterized by loss of lung elasticity and hyperinflation of the lungs.
Specific medication with a side effect of becoming moon-faced.
A side effect of antitussives
Guaifenesin is what type of medication?
A side effect of leukotriene receptor antagonists
What type of diuretic is Mannitol?
Which class of diuretics is the strongest?
Supplements of which electrolyte would you expect to be given with loop diuretics?
A side effect of loop diuretics
________ diuretics are a more gentle class of diuretics.
A renal failure patient has a potassium level of 5.8. Should you give them an ace inhibitor?
Which electrolyte do ace inhibitors cause retention of?
True/False: Upper urinary tract obstructions indicate bladder dysfunction.
What is a bad side effect of quinolone antibiotics like levofloxacin?
Patients with upper urinary tract obstructions should decrease dietary intake of foods high in what?
True/False: Urine must be supersaturated continuously for a stone to grow.
Do calcium stones precipitate in alkaline or acidic urine?
Kidney stones made up of ______ are the most common type.
A general term for bladder dysfunction caused by neurologic disorders.
What is a common symptom of lower urinary tract obstruction?
Is renal colic a clinical manifestation of upper or lower urinary tract obstruction?
A rubber or silicone device designed to compensate for vaginal wall prolapse.
Which class of antibiotics is used most commonly to treat UTI's?
Infection of the bladder
What is the best indicator of kidney function? (abbr.)
True/False: Normal GFR is under 90
Would you expect a patient with glomerular disease to have decreased or elevated BUN?
The negative ionic charge barrier of the glomerular capillary membrane prevents what from passing into the urine?
Nephritic sediment consists of what in the urine?
Lipids and _______ are found in nephrotic sediment in the urine.
Acute tubular necrosis is the most common cause of ________ acute renal failure.
Which type of acute renal failure is caused by decreased renal blood flow?
What vitamin decreases in renal failure?
Chronic renal failure
The irreversible loss of renal function that affects nearly all organ systems
A patient in renal failure is receiving phosphate binding drugs to increase his levels of what?
True/False: Heart failure is always caused by heart attack.
If a patient has 90% occlusion of the LAD, they will probably have an angioplasty and get a _____.
If all 3 major heart vessels are 90% occluded, the patient will be treated surgically by getting a ______.
A patient with 30% occlusion of the LAD and 40% occlusion of the RCA can be treated with _______.
The town in Massachusetts with a heart study named after it that coined the term "risk factor" & found that smoking was a risk factor for heart disease.
True/False: If there is too much fat, adiponectin levels are lower, increasing C-reactive protein levels & inflammation.
What drug subclass should be the initial drug therapy for most hypertensive patients?
True/False: DASH is short for "Daily Approaches to Stop Hyperventilating"
The specific drug most commonly used for patients who have had a coronary stint