Drug-Related Pathology:

1. Lung Damage:

• Risk factors:

• Age > 60

• Chronic lung disease (interstitial pneumonia)

• Decreased respiratory function

• History of lung resection

• Oxygen use

• Radiation exposure

• Kidney damage

• Smoking

• Drugs causing cardiogenic pulmonary edema:

• Diltiazem

• Propanolol

• Albumin

• Drugs causing non-cardiogenic pulmonary edema:

• Aspirin

• Methotrexate

• Methotrexate-induced lung damage:

• Risk factors: Diabetes, low albumin, older age, pulmonary lupus

• Mechanism: Allergy

2. Pulmonary Embolism:

• Risk factors:

• Estrogen-containing medications (contraceptives)

• Antipsychotics

3. Weakness due to increased CO2:

• Drugs causing weakness:

• Aminoglycosides (amikacin)

• Penicillin A

• Procainamide

4. Cough due to ACE inhibitors:

• Characteristics:

• More common in women > men

• Latency period up to 15 months

5. Pre-jaundice:

• Symptoms:

• Mild fever WITHOUT cold symptoms

• Flu-like

• Appears after 1 week

6. Jaundice:

• Symptoms:

• Increased jaundice, dark urine

• Fever subsides, fever disappears

• Appears after 2-6 weeks

7. Transmission route of hepatitis viruses:

• HAV: Oral-fecal route

• HBV, HCV, HDV: Blood, contact with mucous membranes, sexual intercourse, mother to child

• HEV: Fecal-oral route

8. Liver failure:

• Classification:

• Fulminant liver failure: <7 days

• Acute liver failure: 8-28 days

• Subacute liver failure: 4 weeks – 28 weeks

9. Hepatitis Tests:

• AST/ALT:

• Acute hepatitis: <1

• Cirrhosis: >1

• Alcoholic hepatitis: >2

• Hepatocellular failure syndrome:

• Sleep, digestive, coagulation disorders

• Jaundice, yellow eyes

• Spider nevi

• Erythema, palmar erythema

• Ankle edema

• Ascites

• Decreased albumin, cholesterol

• Increased globulin, bilirubin

• Portal hypertension syndrome:

• Ascites

• Splenomegaly

• Portal-systemic shunt

• Hemorrhoids

• Gastrointestinal bleeding

• Hypersplenism

10. Iron overload disease, copper overload disease:

• Iron: Skin pigmentation

• Copper: Wilson’s disease

11. Diagnosis of cirrhosis:

• Gold standard: Liver biopsy

12. Classification of hepatitis:

• By clinical and paraclinical symptoms: Hepatocellular failure, portal pressure

• By stage: Gastrointestinal bleeding, jaundice, ascites, hepatic encephalopathy (compensated – decompensated)

13. Urinalysis:

• Positive, false negative:

• False (+): Myoglobin in urine

• False (-): Urine containing ascorbic acid, nitrites, high protein, pH<5

• Sample collection: First urine of the morning, midstream

14. Proteinuria:

• No proteinuria: Minimal change glomerulonephritis

15. Dysmorphic red blood cells:

• Cause: Renal tuberculosis

16. Red urine:

• Cause: Bilirubin, porphyrins, myoglobin, hemoglobin

17. Important test in renal edema:

• Proteinuria

18. Classification of hypertension:

• Conditions: >=18 years old, primary chronic hypertension, not using blood pressure medication, no acute illness

19. Calcium channel blockers (Blood pressure):

• Use in elderly patients: Thiazide diuretics are also used

• Side effects: Flushing, palpitations, ankle edema, nocturia

20. Beta blockers:

• Cautions: Sudden discontinuation, bradycardia, asymptomatic hypoglycemia

21. Effective volume depletion:

• Cause: Heart failure, infection, ascites, acute pancreatitis, loss in the third space

22. True volume depletion:

• Cause: Diarrhoea, chronic diarrhea, excessive diuretic use, poor diet

23. Prevention of drug-induced nephrotoxicity from contrast media:

• Use the lowest dose possible, no additional imaging within 24-48 hours

• Do not use NSAIDs or diuretics for at least 24 hours

• Monitor kidney function for 24-48 hours

24. Acute tubular necrosis:

• Drugs causing necrosis: Aminoglycosides, amphotericin B

25. Drugs causing hemolysis:

• Drugs causing hemolysis: Colchicine, ciprofloxacin, paracetamol

26. Chronic interstitial nephritis:

• Risk factors: Using acetaminophen, aspirin >1g >2 years

27. Risk factors for acute kidney injury from contrast media:

• >60 years old

• Diabetes

• Heart failure

• Infection

• Decreased circulatory volume

• Underlying kidney disease >60ml/min

28. Prevention of drug-induced kidney injury:

• Measure drug levels

• Use alternative drugs if possible

• Adjust risk factors if possible

• Adequate fluid replacement before and during treatment

• Assess kidney function before treatment (MDRD)

• Monitor and adjust drug dose (Cockroft-Gault)

• Avoid combining nephrotoxic drugs

29. Drugs causing more severe hypertension:

• NSAIDs

• Erythropoietin

• Cyclosporine

• Ergotamine

• Estrogens

• Corticosteroids

• Alcohol

• Cocaine

• Anticholinergics

30. Risk factors for increased peptic ulcer disease in Hp-infected individuals:

• Infection with CagA & Vac A bacteria

• High salt diet

• Canned food consumption

• NOT a risk factor: Alcohol

31. Acute myocardial infarction:

• Classification:

• ST-segment elevation MI

• Non-ST-segment elevation MI

• Unstable angina

32. Causes of coronary artery disease:

• Atherosclerosis

• Takayasu’s disease, Kawasaki’s disease

• Hyperthyroidism

• Thrombosis, embolism

33. Risk factors for coronary artery disease:

• Increased LDL

• Decreased HDL

• HbA1c

• Systolic blood pressure

• Smoking

34. Classification of MI:

• 5 types:

• Type 1: Occurs spontaneously (primary)

• Type 2: Secondary MI due to myocardial oxygen imbalance

• Type 3: Sudden cardiac death MI

• Type 4a: MI related to intervention, procedures

• Type 4b: MI related to stent intervention

• Type 5: MI related to coronary artery bypass surgery

35. Optimal aspirin dose for coronary artery disease:

• 75-150mg

36. Most sensitive test for coronary artery disease:

• Exercise electrocardiogram

37. Drug groups that improve prognosis for patients with chronic CAD:

• Statins

• Aspirin

• ACEi, ARB

38. Drug groups that improve CAD symptoms:

• Beta blockers

• Calcium channel blockers

• Nitrates

39. Mechanism of diarrhea:

• Osmotic diarrhea

• Secretory diarrhea

• Inflammatory diarrhea (exudative diarrhea)

• Diarrhea due to intestinal motility disorders (diabetes, hyperthyroidism, adrenal insufficiency) -> Chronic diarrhea

40. Causes of acute diarrhea:

• Infection

• Chemical poisoning

• Diet, medication

41. Dysentery:

• Symptoms: Bloody and mucous diarrhea

• Classification:

• Amoebic dysentery – kst: No fever

• Bacillary dysentery – vk(shigella): Fever

42. Pathogenesis of constipation:

• Slow transit in the colon

• Defecation disorder

• Misinterpretation of bowel habits

43. Causes of constipation:

• Tumor, inflammation, irritable bowel syndrome

• Pregnancy

• Hypothyroidism

• Diabetes

• Hypokalemia

• Lead poisoning

44. Helicobacter pylori (Hp):

• Characteristics:

• Gram (-) spiral bacterium

• Has flagella

• Lies under the mucous layer of the mucosa

• Secretes urease enzyme that hydrolyzes urea into NH3 & CO2, neutralizes acid

• Classification:

• Toxic – moderately toxic – non-toxic

• Cag (+): Toxic

• Cag (-): Non-toxic

• pH >7 converts from spiral bacterium -> coccus (inactive form)

Note: This information is for reference purposes only and should not be considered a substitute for advice from a healthcare professional. Please contact your doctor for proper advice and treatment.