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Uworld > Test 88: All > Flashcards

Test 88: All Flashcards

1
Q

Venous component of internal hemorrhoids drain where

A
  • Middle and superior rectal veins
  • internial iliac vein
  • inferior mesenteric vein
  • portal system
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2
Q

What is venous drainage for external hemorrhoid

A
  • Inferior rectal vein
  • internal pudendal vein
  • internal iliac vein
  • common iliac vein
  • IVC
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3
Q

Name drugs used for bipolar? which one is also used for seizure prophylaxis

A
  • lithium
  • valproate ( seizure prophylaxis)
  • carbamazepine
  • lamotrigine
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4
Q

Carbamazepine is first line treatment for what

A

trigeminal neuralgia

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5
Q

what is a common side effect for Carbamazepine

A

Agranulocytosis

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6
Q

What is a common side effect for valproate

A

hepatotoxicity

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7
Q

What is the side effect for Lamotrigine

A

Stevens-Johnson syndrome

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8
Q

What does Carbamazepine do to CYP450

A

inducer

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9
Q

Ethosuximide is the anticonvulsant choice for what type of seizure

A

absence seizures

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10
Q

Carbon tetrachloride causes what type of injury

A

free radical injury

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11
Q

carbon tetrachloride is oxidized by what system

A

P450

- creates free radicals

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12
Q

Furosemide is what drug

A

loop diuretic that works by inhibiting Na-K-2Cl simperers in loop on Henle

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13
Q

Furosemide stimulates the release of what

A

prostaglandin ( vasodilates afferent arteriole)

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14
Q

What goes wrong with concurrent use of NSAIDs and loop diuretics?

A

decrease diurectic response

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15
Q

role of endothelin

A

vasoconstrictor

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16
Q

Side effects of erythropoiesis-stimulating agents

A
  • thromboembolic events

- hypertension

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17
Q

MOA of Allopurinol

A
  • competitively inhibits xanthine oxidase
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18
Q

Allopruinol interacts with what drug and how

A
  • increases conversion of azathioprine to its active metabolic
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19
Q

MOW of Ganciclovir

A

competitively inhibits incorporation of deoxyguanosine triphosphate into viral DNA

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20
Q

MOA for trimethoprim

A

inhibits bacterial dihydrofolate reductase

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21
Q

Tetrahydrobiopterin (BH4) is a cofactor used for the synthesis of what

A

tyrosine
dopamine
serotonin

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22
Q

What is the hallmark of phenylketonuria

A

intellectual disability

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23
Q

What is elevated and depressed in phenylkeonuria

A
  • increased phenylalanemia

- decreased serotonin

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24
Q

Treatment for phenylketonuria

A
  • low phenylalanine diet

- BH4 supplementation

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25
Q

Female patient comes in with abdominal pain, bloody vaginal discharge, orthostatic hypotension and a positive pregnancy test is highly concerning for

A

ectopic pregnancy

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26
Q

Why must the patient wait at least 2 weeks after discontinuing an MAO inhibitor before taking SSRI?

A

must allow enough time for MAO regeneration

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27
Q

MOA for Phenelzine

A

monoamine oxidase inhibitor

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28
Q

Name the Monoamine oxidase inhibitors

A

MAO Takes Pride In Shanghai

  • Tranylcypromine
  • Phenelzine
  • Isocarboxazid
  • Selegiline
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29
Q

Why is co-administration of an SSRI and an MAO inhibitor contraindicated

A

risk of serotonin syndrome

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30
Q

MOA for caspofungin

A

glucan component of the fungal cell wall

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31
Q

MOW for cyclosporine

A

immunosuppressant

- decrease synthesis of IL-2

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32
Q

MOA for Fucytosine

A

nucleotide analog that competitively inhibits RNA synthesis in fungal cells

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33
Q

Propanolol can treat what endocrine problem

A
  • decreases peripheral conversion of T4 to T3
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34
Q

MOA for propylthiouracil and methimazole

A

inhibit thyroid peroxidase

- decrease thyroid hormone

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35
Q

What is the dose-limiting side effect of Vincristine therapy

A

neurotoxicity

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36
Q

Common side effect for cyclophosphamide

A

hemorrhagic cystitis

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37
Q

common side effect for doxorubicin

A

congestive heart failure

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38
Q

common side effect for bleomycin

A
  • pulmonary fibrosis

- flagellate skin discoloration

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39
Q

Common adverse effect of highly-active antiretroviral therapy

A

lipoatrophy/lipodystrophy

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40
Q

How is fat redistributed in viral drugs

A
  • lipoatrophy: loss of subcutaneous fat, from face, extremities and buttocks
  • central fat deposition on abdomen
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41
Q

What hormone increases the most after ovulation

A

Progresterone

42
Q

Digoxin toxicity

A
  • cardiac arrhythmias
  • nonspecific GI
  • neurological ( confusion/weakness)
  • visual symptoms
43
Q

What serum level is a sign of digoxin toxicity

A

elevated potassium

44
Q

mechanism behind the ACE inhibitor induced cough

A
  • accumulation of bradykinin, substance P or prostaglandins
45
Q

Do angiotensin receptor blockers have a side effect of cough

A

no

46
Q

Role of ACE

A

degrades bradykinin

47
Q

Nonnucleoside reverse transcriptase inhibitors (NNRTIs) do not require what

A

do not require activation via intracellular phosphorylation

48
Q

Name the NNRTI’s

A

Delavirdine
Efavirenz ( common)
Nevirapine ( common)

49
Q

Common side effects for NNRTI

A

rash and hepatoxicity

50
Q

Zidovudine and emtricitabine are what type of drugs

A

NRTI

51
Q

MOA for Enfuvirtide

A

bind to HIV envelope gp41 and blocks fusion

52
Q

MOA for Ritonavir

A

inhibitor of HIV protease that prevents assembly and maturation of the virus

53
Q

Why should non-selective beta blockers should be given with cation to a diabetic mellitus patient

A
  • drug exacerbates hypoglycemia

- masks its adrenergic symptoms mediated by norepinephrine and epinephrine

54
Q

What is the sickle cell mutation

A

DNA point mutation of glutamic acid to valine at positive 6

55
Q

Theophylline MOA

A
  • adenosine receptor antagonist
  • indirect adrenergic agnet
  • phosphodiesterase inhibitor
56
Q

Theophylline is metabolized by what

A

cytochrome P450

57
Q

Amoxicillin and cephalexin MOA

A

beta-lactams that inhibit bacterial cell wall synthesis

58
Q

NItrofurantion MAO

A

inactivates or alters bacterial ribosomal proteins

59
Q

What is the drug interaction between Ciprofloxacin and theophylline

A

theophylline metabolized by CYP450, however Cipro increases [theophylline]

60
Q

how does spinal stenosis present

A
  • posture-dependent lower extremity pain, numbness/paresthesia and weakness
61
Q

Most common causes of spinal stenosis

A
  1. intervertebral disk herniation
  2. ligamentum flavum hypertrophy
  3. osteophyte formation
62
Q

Aldosterone excess causes what

A
  • hypertension
  • hypokalemia
  • metabolic alkalosis
  • depressed renin
63
Q

Conn syndrome

A

Primary hyperaldosteronism

64
Q

Treatment for Conn’s syndrome

A

Spironolactone/Eplerenone

65
Q

Cribiform plate

A

CN I olfactory bundles

66
Q

Optic canal

A

CN II
ophthalmic artery
central retinal vein n

67
Q

superior orbital fissure

A

CN III, IV, V1, VI
ophthalmic vein
sympathetic fibers

68
Q

Foramen rotundum

A

CN V2 maxillary

69
Q

Foramen ovale

A

CN V3 mandibular

70
Q

Foramen spinosum

A

Middle meningeal artery and vein

71
Q

Internal acoustic meatus

A

CN VII, VIII

72
Q

Jugular foramen

A

CN IX, X, XI

Jugular vein

73
Q

hypoglassal canal

A

CN XII

74
Q

Foramen magnum

A

Spinal roots of CN XI
brain stem
vertebral arteries

75
Q

What muscle opens the jaw

A

lateral pterygoid

76
Q

Third ( mandibular) branch of trigeminal nerve innervates what

A
  • muscles of mastication ( masseter, medial and lateral pterygoids, and temporals muscles)
77
Q

How is PAH excreted from blood to tubules

A

via carrier protein-mediated process

78
Q

Characterize giant cell arteritis

A

granulomatous inflammation of the media

- medium and small branches of carotid artery ( temporal artery)

79
Q

treatment for giant cell

A

glucocorticoid therapy `

80
Q

Elderly women with beaches, muscular pain, and a rapid response to glucocorticoid therapy

A

giant cell arteritis

81
Q

What is tranmural inflammation of the arterial wall with fibrinoid necrosis

A

polyartertis nodosa

82
Q

What anti-inflammatory agent does not impair platelet aggregation

A

Celecoxib

83
Q

MOA for Celecoxib

A

reversibly inhibits cox-2

84
Q

How is glucose moved across cell membrane

A

Facilitated diffusion

85
Q

Where is GLUT 4 found

A

skeletal muscle and adipocytes

86
Q

Role of GLUT 2

A

export of glucose from liver, small intestines, and kidneys into circulation

87
Q

What enzyme inactivates 6-mercaptopurine

A

xanthine oxidase

88
Q

6-MP requires activation by what

A

HGPRT

hypoxanthine-guanine phosphoribosyl transferase

89
Q

Incidence of cancer in women, top 3

A
  1. breast, lung, colon
90
Q

extra renal manifestations of autosomal dominant polycystic kidney isease

A
  • liver cyst

- intracranial aneurysm

91
Q

Statins are metabolized by what? exception

A

P-450 3A4

- pravastatin

92
Q

Erythromycin and P450

A

inhibits P450

93
Q

The presence of erythroid precursor cells in the liver and spleen indicative of what

A

extramedullary hematopoiesis

94
Q

Extramedullary hematopoiesis is most frequently cause by severe

A

severe chronic hemolytic anemias

95
Q

Niemann-Pick is deficiency in what

A

Sphingomyelinase

96
Q

What accumulates in Niemann pcik

A

Sphingomyelin accumulaiton

97
Q

Clinical findings for Niemann pick

A
  • hepatosplenomegaly
  • neurologic regression
  • “cherry-red” on macula
98
Q

Patient with alcohol use, epigastric pain , and steatorrhea likely has

A

chronic pancreatitis

99
Q

Candida is normally located where

A

GI tract (oral cavity)

100
Q

How does cleaning something with alcohol disinfect it

A

disorganizing lipid structure in membranes, causing them to be leaky, and by denaturing cellular proteins

101
Q

Main mechanism of excess copper removal in healthy human body is

A

hepatic excretion into bile

102
Q

How do you reduce the risk of wrong-site surgery

A

“dual identifies”

- nurse and physician independently confirm

Uworld (63 decks)

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