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Question 1

What are the most common sx of a primary HSV infx?

Answer 1

Fever, vesiculoulcerative gingivostomatitis, cervical LAD

Question 2

What are the most common sx of reactivation of a latent HSV infx?

Answer 2

More limited than a primary infx: periorbal blisters aka cold sores

Question 3

What do multinucleated giat cells with intranuclear inclusions suggest?

Answer 3

HSV or VZV

Question 4

Fever, vesiculoulcerative gingivostomatitis, and cervical LAD are suggestive of what infx?

Answer 4

Primary HSV infection (secondary would show perioral cold sores)

Question 5

Where do HSV and VZV reside and reinfect from?

Answer 5

HSV: trigeminal ganglia
VZV: dorsal root ganglia

Question 6

What sx are seen in reactivation of endogenous, latent CMV?

Answer 6

Interstitial pneumonitis, retinitis, hepatitis, colitis, and/or generalized disease

Question 7

What lobe is affect in aspirations while standing? While supine?

Answer 7

Standing: basilar right lower lobe
Supine: posterior right upper lobe or superior right lower lobe

Question 8

What receptors does NE have the most effect on?

Answer 8

Alpha1 and Beta1

Question 9

What adrenergic receptor mediates vasoconstriction? Vasodilation?

Answer 9

Vasoconstriction: Alpha1
Vasodilation: Beta2

Question 10

Phenoxybenzamine MOA?

Answer 10

Non selective, irreversible a1 and a2 receptor antagonist

Question 11

Major use for Phenoxybenzamine?

Answer 11

Pheochromocytoma

Question 12

Labetalol MOA?

Answer 12

Reversible, competitive a1, b1, b2 adrenergic receptor antagonist

Question 13

For what sort of overdose would you give Labetalol?

Answer 13

Sympathomimetic overdose (e.g. cocaine)

Question 14

Phentolamine MOA?

Answer 14

Reversible, competitive, non specific alpha adrenergic antagonist

Question 15

When might you give phentolamine?

Answer 15

Management of catecholamine-induced hypertensive crises (pheochromocytoma, MAOI crisis, cocaine overdose)

Question 16

Propanolol MOA?

Answer 16

nonspecific beta adrenergic antagonist

Question 17

Atropine MOA?

Answer 17

Competitive muscarinic ACh R antagonist

Question 18

What drug is a non selective, irreversible a1, a2 receptor antagonist?

Answer 18

Phenoxybenzamine

Question 19

What drug is a reversible, competitive a1, b1, b2 receptor antagonist?

Answer 19

Labetalol

Question 20

What drug is a reversible, competitive, nonspecific alpha adrenergic antagonist?

Answer 20

Phentolamine

Question 21

What drug is a nonspecific beta adrenergic antagonist?

Answer 21

Propranolol

Question 22

What drug is a competitive muscarinic ACh R antagonist?

Answer 22

Atropine

Question 23

What class is Quinidine?

Answer 23

Class 1A

Question 24

What class is Lidocaine?

Answer 24

Class 1B

Question 25

What class is Flecainide?

Answer 25

Class 1C

Question 26

What class is verapamil?

Answer 26

Class 4

Question 27

What class is Esmolol?

Answer 27

Class 2

Question 28

Does amyloidosis cause restrictive or dilated cardiomyopathy?

Answer 28

Restrictive

Question 29

What are some causes of restrictive cardiomyopathy?

Answer 29

Amyloidosis, sarcoidosis, cancer, inborn metabolic errors

Question 30

Diastolic dysfunction = restrictive or dilated cardiomyopathy?

Answer 30

Restrictive

Question 31

Systolic dysfunction = restrictive or dilated cardiomyopathy?

Answer 31

Dilated

Question 32

What 3 characteristics primarily describes the histology of PSGN?

Answer 32

1. Enlarged, hypercellular glomeruli 2. "Lumpy bumpy" granular deposits of IgG and C3 3. Electron-dense deposits on the epithelial side of the basal membrane

Question 33

Homocystinuria due to cobalamin (B12) deficiency prevents synthesis of what?

Answer 33

Methionine

Question 34

What dopaminergic pathway connects the hypothalamus and the pituitary?

Answer 34

Tuberoinfundibular

Question 35

Classic galactosemia is due to deficiency of what enzyme?

Answer 35

Galactose-1-phosphate uridyl transferase

Question 36

What is the most important E. coli virulence factor?

Answer 36

Fimbriae (aka pili): type 1 fimbriae, P fimbriae (especially for UTI), S fimbriae For adhesion to epithelial cells and enterocytes

Question 37

What vitamin takes years to deplete?

Answer 37

B12 (cobalamin)

Question 38

Thiazolidinediones (TZD) MOA?

Answer 38

TZDs bind to peroxisome proliferator activating receptor gamma (PPAR-gamma), which regulates expression of adiponectine gene, decreasing insulin resistance

Question 39

Aminoglycosides MOA?

Answer 39

Inhibits bacterial 30S ribosomal subunit

Question 40

What is the typically elevated lab value in Gilbert syndrome?

Answer 40

Elevated unconjugated bilirubin (normal LFT, CBC, smear, retic) Familiar disorder of bilirubin glucuronidation

Question 41

CYP450 Inducers?

Answer 41

Rifampin, Carbamazepine, Phenobarbital, Phenytoin, Griseofulvin

Question 42

CYP450 Inhibitors?

Answer 42

Cimetidine, Ciprofloxacin, Erythromycin, Azole antifungals, grapefruit juice, Isoniazid, Ritonavir

Question 43

What parts of the spinal cord are affected in B12 deficiency?

Answer 43

Dorsal columns, lateral corticospinal tracts (leading to "subacute combined degeneration")

Question 44

What parts of the spinal cord are affected in syringomyelia?

Answer 44

Central portions including the lateral spinothalamic tracts and anterior horns

Question 45

What parts of the spinal cord are affected in tabes dorsalis? (Neurosyphilis)

Answer 45

Dorsal columns and dorsal roots

Question 46

What parts of the spinal cord are affected in ALS?

Answer 46

Upper and lower motor neuron lesions, lateral corticospinal tracts, anterior horn

Question 47

What parts of the spinal cord are affected in poliomyelitis?

Answer 47

Anterior horns