Andrew Shared "biochem 4-1" - 48 Picmonics

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biochem 4-1

Gout Disease
Acute Inflammatory Monoarthritis
Epidemiology
Primarily in Males
Pathophysiology
Precipitation of Monosodium Urate Crystals
Underexcretion of Uric Acid
Overproduction of Uric Acid
Negatively Birefringent, Needle-Shaped
Symptoms
Swollen, Red, Painful Joint
Asymmetric Joint Distribution
Podagra
Tophus
After Large Meal or Alcohol
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2 mins
Gout Treatment
Acute (Acute-angle)
NSAIDs
Glucocorticoids
Colchicine
Impairs Leukocyte Chemotaxis
Chronic Gout (Crone Goat)
Inhibit Xanthine Oxidase
Allopurinol
Febuxostat
Inhibit Reabsorption of Uric Acid
Probenecid
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1 min
Lesch-Nyhan Syndrome
X-linked Recessive
Absence of HGPRT
Hypoxanthine to IMP
Guanine to GMP
Excess uric acid
Gout
Retardation
Self-mutilation
Choreoathetosis
PRPP is increased
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2 mins
Trimethoprim
Mechanism of Action
Bacteriostatic
Inhibits Bacterial Dihydrofolate Reductase
Causes Sequential Block of Folate Synthesis
Used in Combination with Sulfamethoxazole
Combination Used For Recurrent Urinary Tract Infections
Indications
Shigella
Salmonella
Pneumocystis Jiroveci Pneumonia
Side Effects
Decrease in Red and White Blood Cells
Alleviated with Leucovorin Rescue
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2 mins
Vancomycin
Mechanism of Action
Inhibits Bacterial Cell Wall Synthesis
Indications
Serious Gram-Positive Infections
Side Effects
Nephrotoxicity
Ototoxicity
Red Man Syndrome
Thrombophlebitis
Nursing Considerations
Culture Samples First
Infuse IV Over 60 Minutes
Take Around the Clock
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Albumin Lab Value
3.5 - 5.0 g/dL
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Emphysema
Clinical Features
Pink Puffer
Exhale through Pursed Lips
Barrel Chest
Pathophysiology
Obstructive Lung Disease
Increased Lung Compliance
Types
Centriacinar
Panacinar
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2 mins
Wilson's Disease Pathophysiology
Autosomal Recessive
Mutation in ATP7B gene
Chromosome 13
Decrease in Ceruloplasmin
Inadequate copper excretion
Liver
Brain
Kidney
Cornea
Joints
Treat with Penicillamine
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2 mins
Wilson's Disease Symptoms
Cirrhosis
Hepatocellular Carcinoma
Basal Ganglia Degeneration
Dementia
Dyskinesia
Asterixis
Kayser-Fleischer Rings
Slit Lamp Exam
Hemolytic Anemia
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2 mins
Arsenic, Gold and Copper Antidotes
Toxic Metals
Arsenic
Gold
Copper
Antidotes
Penicillamine
Dimercaprol (BAL)
Succimer
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2 mins
Multiple Myeloma Pathophysiology
Pathophysiology
Monoclonal Plasma Cell Cancer
Clock Face Chromatin
Diagnosis
M Spike on Protein Electrophoresis
Increased IgG and IgA
Fried Egg Appearance (BM Biopsy)
Rouleaux Formation
Stacked RBC's
Bence Jones Protein
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Multiple Myeloma Signs and Symptoms
Signs and Symptoms
Increased Susceptibility to Infection
Back/Bone Pain
Punched Out Lytic Bone Lesions
Hypercalcemia
Primary Amyloidosis
Renal Insufficiency
Anemia
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2 mins
Normal Electrolyte Lab Values
Potassium (K+)
3.5 to 5.0 mEq/L
Calcium (Ca2+)
8.5 to 10.5 mg/dL
Phosphate (PO43–)
2.5 to 4.5 mg/dL
Magnesium (Mg2+)
1.5 to 2.5 mEq/L
Sodium (Na+)
135 to 145 mEq/L
Chloride (Cl)
95 to 105 mEq/L
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2 mins
Myocardial Infarction Interventions
MONA
Morphine
Oxygen
Nitrates
Aspirin
Thrombolytics (tPA)
Invasive Procedures
Cardiac Catheterization
Stent Placement
Angioplasty
Coronary Artery Bypass Grafting (CABG)
Considerations
Decrease Modifiable Risk Factors
Resuming Activity (Physical, Sexual)
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2 mins
Pancreatin, Pancrelipase (Pancreatic Enzymes)
Mechanism
Pancreatic Enzymes
Indications
Cystic Fibrosis
Pancreatic Insufficiency
Side Effects
GI Distress
Considerations
Inactivated by Gastric Acid
24 Hour Fat Excretion
Take with Every Meal and Snack
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2 mins
Acute Pancreatitis Assessment
Mechanism
Heavy Alcohol Use and Gallstones
Signs and Symptoms
Abdominal Pain
Nausea/Vomiting/Anorexia
Abdominal Rigidity/Guarding
Decreased or Absent Bowel Sounds
Hypotension and Tachycardia
Jaundice
Increased White Blood Cells
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2 mins
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 10-30 U/L
ALT: 10-40 U/L
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1 min
Cardiac Enzyme Evaluation: Troponin
Measures
Cardiac Muscle Injury
Time Ranges
Onset: 1 Hour
Peak: 10 - 24 Hours
Return to Normal: 5 - 14 Days
Considerations
Most Specific for Cardiac Muscle
Treated Aggressively
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2 mins
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
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1 min
Fluoroquinolones
End in "-floxacin"
Mechanism of Action
Bactericidal
Indications
Variety of Infections
Side Effects
GI Distress
Photosensitivity
Achilles Tendon Rupture
Contraindications
Pregnancy
Children
Myasthenia Gravis
Considerations
Avoid Milk Products or Antacids
Slow IV Infusion
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2 mins

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