Algorithmic Complexity

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Questions and Answers

Why do proton pump inhibitors (PPIs) have a long duration of action?

  • They are rapidly metabolized by CYP enzymes.
  • They are quickly absorbed in the small intestine.
  • They increase gastric acid secretion.
  • They selectively and irreversibly bind to proton pumps. (correct)

Which of the following is a potential side effect associated with the use of proton pump inhibitors (PPIs)?

  • Pseudomembranous colitis
  • Hypomagnesemia (correct)
  • Increased absorption of antacids
  • Hypermagnesemia

When is the optimum time to administer antacids in relation to food intake?

  • On an empty stomach.
  • During food consumption.
  • Immediately before food.
  • 1-3 hours after food. (correct)

Why should sucralfate be administered on an empty stomach?

<p>To allow it to form a protective layer on the stomach wall. (D)</p> Signup and view all the answers

What is the primary use of carbenoxolone?

<p>Treatment of gastric and duodenal ulcers. (B)</p> Signup and view all the answers

Which of the following best describes the mechanism of action of paraffin as a laxative?

<p>Lubricating the fecal mass. (D)</p> Signup and view all the answers

Magnesium sulfate (Epsom salt) exerts its laxative effect through which mechanism?

<p>Osmotic action. (B)</p> Signup and view all the answers

Which of the following is a contraindication for the use of psyllium husk?

<p>Gallstones. (A)</p> Signup and view all the answers

Lactulose is classified as what type of laxative?

<p>Osmotic (D)</p> Signup and view all the answers

What causes Barrett's esophagus?

<p>Acid reflux. (B)</p> Signup and view all the answers

Which medication is typically used in the treatment of esophageal varices?

<p>Propranolol (D)</p> Signup and view all the answers

What is a contraindication for using metoclopramide?

<p>Parkinsonism (B)</p> Signup and view all the answers

Why is domperidone preferred over metoclopramide in patients with Parkinson's disease?

<p>Domperidone does not cross the blood-brain barrier to a significant extent. (D)</p> Signup and view all the answers

In which patient population are diphenoxylate and loperamide contraindicated?

<p>Children (C)</p> Signup and view all the answers

What is the primary consequence of gallbladder removal on fat digestion?

<p>Decreased fat emulsification. (C)</p> Signup and view all the answers

Lansoprazole binds to the H+/K+-ATPase enzyme via what type of bond?

<p>Covalent bond (C)</p> Signup and view all the answers

Cirrhosis is characterized by what pathological process in the liver?

<p>Progressive fibrosis and scarring (A)</p> Signup and view all the answers

Ranitidine reduces gastric acid secretion by blocking which receptor?

<p>H2-receptor (D)</p> Signup and view all the answers

Simethicone is used for gas relief because it contains:

<p>Silicon (A)</p> Signup and view all the answers

Which cells in the stomach secrete hydrochloric acid (HCl)?

<p>Parietal cells (B)</p> Signup and view all the answers

Docusate sodium is primarily used for what purpose during pregnancy?

<p>Stool softener (C)</p> Signup and view all the answers

Golimumab is used in the treatment of ulcerative colitis and is considered effective if it shows improvement within what timeframe?

<p>6 weeks (B)</p> Signup and view all the answers

What is the primary mechanism by which antacids decrease the absorption of PPIs?

<p>By altering gastric pH (D)</p> Signup and view all the answers

A patient with a history of opioid-induced constipation is prescribed a laxative. Which of the following is most appropriate based on the given information?

<p>Senna (B)</p> Signup and view all the answers

Which of the following is a disaccharide that contributes to the osmotic laxative effect of lactulose?

<p>Fructose (C)</p> Signup and view all the answers

A patient undergoing treatment with omeprazole develops a vitamin B12 deficiency. What is the most likely mechanism for this deficiency?

<p>Decreased gastric acid production affecting B12 release from food. (A)</p> Signup and view all the answers

A patient with cirrhosis develops hepatic encephalopathy. Which of the following medications would be most appropriate to manage this condition based on the provided information?

<p>Lactulose (D)</p> Signup and view all the answers

How does blocking the H2 receptor with ranitidine lead to reduced gastric acid secretion?

<p>By preventing histamine from stimulating parietal cells (A)</p> Signup and view all the answers

Which best describes the role of parietal cells?

<p>Secreting intrinsic factor (B)</p> Signup and view all the answers

What is the primary mechanism of action of docusate sodium?

<p>Softening stool (C)</p> Signup and view all the answers

A patient with ulcerative colitis is started on golimumab. After 8 weeks, there is no significant improvement in their symptoms. What is the most appropriate course of action?

<p>Discontinue golimumab and consider alternative treatments (C)</p> Signup and view all the answers

Which of the following laxatives is LEAST likely to cause dependence with prolonged use?

<p>Psyllium husk (B)</p> Signup and view all the answers

A patient taking a PPI develops community-acquired pneumonia. What is the most likely reason for this increased susceptibility?

<p>PPI-induced decrease in gastric acid production, allowing for bacterial overgrowth. (C)</p> Signup and view all the answers

Which of the following best explains why antacids should be avoided when taking sucralfate?

<p>Antacids raise gastric pH, interfering with sucralfate's binding to the ulcer base. (A)</p> Signup and view all the answers

Which of the following is a potential side effect of carbenoxolone that necessitates careful monitoring during its use?

<p>Hypokalemia (D)</p> Signup and view all the answers

A patient reports chronic flatulence as a side effect while using docusate sodium. What is the MOST likely reason for this?

<p>Increased bacterial fermentation of unabsorbed carbohydrates (D)</p> Signup and view all the answers

A patient with a history of alcohol abuse develops esophageal varices. What is the primary mechanism by which propranolol helps prevent bleeding in this patient?

<p>Decreased hepatic blood flow and portal pressure (A)</p> Signup and view all the answers

Flashcards

Celiac disease

Inability of the small intestines to absorb gluten.

PPIs mechanism

Selectively and irreversibly bind to proton pumps, inhibiting gastric acid secretion.

PPIs and CYP enzymes

They can differ in their effects on CYP enzymes.

Hypomagnesemia

Side effect of PPIs, such as esomeprazole.

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Antacids interaction with PPIs

They decrease PPI absorption; take PPIs 1-3 hours after food.

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Antacids on pH

Raise the pH from 1-2 to 3.5.

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Sucralfate use

Used for peptic ulcers on empty stomach, as a protective layer.

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Sulfasalazine

Poor absorption leads to use in ulcerative colitis treatment.

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Carbenoxolone

Derivative used in gastric/duodenal ulcer treatment; aldosterone-like effects.

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Al(OH)3 + Mg(OH)2

Given hourly for duodenal ulcers.

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Senna as a laxative

Stimulant laxative used for opioid constipation.

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Paraffin action

Lubricates the fecal mass.

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Magnesium Sulfate

Epsom salt; it is an osmotic laxative.

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Polyethylene Glycol

Osmotic laxative.

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Barrett's esophagus cause

Can cause inflamed esophagus.

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Esophageal varices treatment

Enlarged veins in the esophagus; treat with propranolol.

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Metoclopramide

Decreases ulcer contact; contraindicated with parkinsonism.

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Gallbladder removal

Fats will not be emulsified.

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Ranitidine action

Blocks H2-receptor; decreases gastric acid.

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Docusate sodium

Stool softener used in pregnancy.

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Omeprazole use case

Used for breastfeeding mothers when antacids/ranitidine don't work.

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Stimulant laxatives

Stimulate bowel contractions, may cause dependence with prolonged use.

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Magnesium sulfate & citrate

Osmotic laxative; magnesium hydroxide works as a chemical antacid.

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Lactulose

An osmotic laxative.

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Lansoprazole action

It forms a covalent bond with the H+/K+-ATPase enzyme.

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Cirrhosis

Progressive fibrosis and scarring of the liver.

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Simethicone

Contains silicon; used as a GIT agent for gas relief.

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Parietal cells

Epithelial cells in the stomach that secrete HCl and intrinsic factor.

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Golimumab for UC

Effective within 6 weeks for treatment of ulcerative colitis; continue treatment.

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Diphenoxylate & Loperamide

Used for acute, uncomplicated diarrhea; contraindicated in children.

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Constipation treatment

Calcium Polycarbophil is for this condition.

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Intestinal Irritants

Phenolphthalein and castor oil act as these.

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Metoclopramide's contraindication

Blocks dopamine receptors, unlike Domperidone which doesn't cross BBB.

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Psyllium husk

Gentle fiber, bulk-forming laxative; contraindicated with gallstones.

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Study Notes

Algorithmic Complexity

  • Measures how time and space resources grow with input size.
  • Time Complexity: Measures the time an algorithm needs as a function of input size.
  • Space Complexity: Measures the space an algorithm needs as a function of input size.
  • It is important to write faster and more efficient code.

Measuring Time Complexity

1. Benchmarking

  • Measures the actual runtime of an algorithm.
  • This method has problems as different computers and different times on the same computer will yield different results.
  • This makes comparing algorithms difficult with this method.

2. Counting Instructions

  • Counts the number of instructions an algorithm executes.
  • Problems are that different instructions' execution times vary, tracking all instructions is difficult, and it is still computer-dependent to some extent.

3. Asymptotic Analysis

  • Analyzes the algorithm as the input size approaches infinity.
  • Big O Notation: Used to describe performance or complexity of an algorithm.
    • $O(n)$: Linear Time
    • $O(1)$: Constant Time
    • $O(log n)$: Logarithmic Time
    • $O(n^2)$: Quadratic Time
    • $O(2^n)$: Exponential Time

Big O Notation Details

  • Describes the upper limit of an algorithm's time complexity, and how time/space resources grow with input size.
  • Only the most significant term matters.
    • $O(n^2 + n) = O(n^2)$
    • $O(n + log n) = O(n)$
  • Constant factors can be ignored.
    • $O(2n) = O(n)$
    • $O(n/2) = O(n)$

Common Complexities

Name Big O Notation Example
Constant $O(1)$ Accessing Array Element
Logarithmic $O(log n)$ Binary Search
Linear $O(n)$ Searching an Array
Log-Linear $O(n log n)$ Merge Sort
Quadratic $O(n^2)$ Insertion Sort
Cubic $O(n^3)$ Matrix Multiplication
Exponential $O(2^n)$ Tower of Hanoi
Factorial $O(n!)$ Generating Permutations

Examples with Code

1. Constant Time - $O(1)$

  • Example code:
def get_first_element(list):
    return list
  • The function always takes the same time, regardless of input size.

2. Linear Time - $O(n)$

  • Example code:
def print_all_elements(list):
    for element in list:
        print(element)
  • Function's runtime is directly proportional to list size.

3. Quadratic Time - $O(n^2)$

  • Example code:
def print_all_pairs(list):
    for i in list:
        for j in list:
            print(i, j)
  • Iterates through the entire list for every element in the list.

Space Complexity Explained

  • Measures algorithm's memory needs relative to input size, including input size and auxiliary space.
  • Uses same principles as time complexity: Big O notation, dominant term, ignoring constants.

Space Complexity Examples

  • Example code:
def sum_array(arr):
    sum = 0
    for num in arr:
        sum += num
    return sum
  • $O(1)$: Constant extra space is used.
  • Example code:
def double_array(arr):
    new_arr =  * len(arr)
    for i in range(len(arr)):
        new_arr[i] = arr[i] * 2
    return new_arr
  • $O(n)$: A new array the same size as the input is created.

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