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Uworld > Test 89: All > Flashcards

Test 89: All Flashcards

1
Q

aphasia

A

lost of inability to understand or express speech

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2
Q

What are some unique features of herpes simplex virus type 1 encephalitis

A

aphasia and personality changes

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3
Q

Herpes simplex virus type 1 encephalitis impacts what part of the brain

A

temporal lobe

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4
Q

Post-mortem macroscopic brain examination of herpes simplex virus type 1 encephalitis?

A

edema and hemorrhagic necrosis of temporal lobe

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5
Q

What is the most common cause of viral meningitis in children

A

Enterovirus, group B coxsackievirus

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6
Q

Doxazosin, Prazosin, and Terazosin are what type of drugs

A

alpha 1 selective antagonists

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7
Q

Name the alpha 1 selective antagonists

A

Doxazosin
Prazosin
Terazosin

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8
Q

What is Doxazosin used to treat

A
  • Urinary symptoms of BPH

- hypertension

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9
Q

Patients with coronary artery disease and heart failure along with hypertension will benefit from what drug class

A
  • cardioselective beta-blockers
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10
Q

What is the first line-medication for the treatment of essential hypertension in the general population

A

Hydrochlorothiazide

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11
Q

Difference between amlodipine and dihydropyridine

A
  • amlodipine is selective for vascular smooth muscle
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12
Q

Trichomonal vaginitis and bacterial vaginosis is treated with what

A

Metronidazole

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13
Q

What is the adverse effect of metronidazole

A
  • disulfiram-like effects ( abdominal cramps, nausea, headache) when combined with alcohol
  • due to acetaldehyde accumulation
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14
Q

MOA for fluconazole

A

inhibits ergosterol synthesis in the P450 system of fungi

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15
Q

Hippocampal atrophy on MRI suggests what

A

Alzheimer’s disease

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16
Q

What is the drug of choice for oropharyngeal candidiasis on patients without advanced immunodeficiency?

A

Nystatin

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17
Q

MOA for Nystatin

A
  • binding to ergosterol in fungal cell membrane

- formation of pores and leakage of fungal cell contents

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18
Q

how is Nystatin administered

A
  • not absorbed from GI tract

- oral “swish and swallow” agent

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19
Q

MOA for Acyclovir

A
  • nucleoside analog
  • converted into acyclo-GTP in infected cells
  • inhibits viral DNA polymerase
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20
Q

MOA for Griseofulvin

A
  • inhibits fungal cell mitosis at metaphase
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21
Q

What is Terbinafine used to treat

A

dermatophytosis

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22
Q

how does Neisseria meningtitis get to the brain

A
  • Pharynx
  • blood
  • choroid plexus
  • meninges
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23
Q

Spread from pharynx, lymphatics, meningitis

A

Haemophilus influenzae

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24
Q

How does sunlight exposure catalyze vitamin D

A
  • converts 7-dehydrocholesterol to Cholecalciferol ( vitamine D3) in skin
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25
Q

What drug can be used to prevent cerebral vascular spasm following subarachnoid hemorrhage ?

A

Nimodipine

- calcium channel blocker

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26
Q

The autonomic nervous system utilizes what 3 types of signal pathways

A
  1. cAMP
  2. IP3
  3. ion channels
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27
Q

Nicotinic receptors use what signal pathway? what is the flow of the ion?

A
  • ligand-gated ion channels that open after binding acetylcholine
  • influx if Na and Ca into the cell
  • outflow of K from cell
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28
Q

binding of epinephrine to alpha1 adrenoceptors uses what signal system

A

IP3

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29
Q

Beta 1 and 2 adrenoceptors use what signaling

A

cAMP

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30
Q

M1 and M2 muscarinic receptors utilize what signal pathway

A

-Inositol triphosphate

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31
Q

M2 muscarinic receptor uses what pathay

A

cAMP

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32
Q

MOA for protease inhibitors

A
  • inhibit cleavage of polypeptide precursor into mature viral proteins
  • HIV antiretroviral medication
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33
Q

What are 3 side effects of Protease inhibitors

A
  1. Hyperglycemia
  2. lipodystrophy
  3. inhibits cytochrome P450
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34
Q

Atazanavir is what type of drug

A

protease inhibitor

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35
Q

Most important side effect for Acyclovir

A

renal toxicity

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36
Q

Side effects for Trimethoprim-sulfamethoxazole

A
  • megaloblastic anemia
  • Stevens-Johnson syndrome
  • toxic epidermal necrolysis
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37
Q

What type of drug is Zidovudine? MOA?

A
  • nucleoside reverse transcriptiase inhibitor (NRTI)

- suppressing DNA synthesis from viral RNA

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38
Q

common side effects of Zidovudine

A

bone marrow toxicity, resulting in anemia

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39
Q

Prostatectomy or injury to prostatic plexus can cause what other problem

A

erectile dysfunction

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40
Q

Injury to what muscle is responsible for erectile dysfunction

A

corpus cavernosa

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41
Q

The lesser and great cavernous nerves arise from what

A

prostatic plexus

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42
Q

Branches of pudendal nerve innervate what

A
  • external urethral and anal sphincters

- sensory to external genitalia

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43
Q

When is loss of cremasteric reflex commonly seen

A

testicular torsion or L1-L2 spinal injury

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44
Q

Contraction of the detrusor muscle is stimulated by what

A

muscarinic cholinergic agonists

45
Q

What is a good medication to use postoperative urinary retention

A

Bethanechol, muscarinic agonist

46
Q

MOA for Finasteride

A

5 alpha reductase inhibitor

47
Q

All hormone-containing contraceptives prevent pregnancy through the actions of wha

A

progestins

48
Q

How do progestins inhibit ovulation

A

decreasing FSH and LH

49
Q

Most common cause of retinitis in HIV-positive patients is what

A

CMV infection

50
Q

HIV patients with retinitis from CMV should be treated how

A

ganciclovir

51
Q

CMV retinitis is most frequently affects AIDS patients with what CD 4 count

A

less than 50

52
Q

What can be injured from a hysterectomy due to its close proximity to uterine structures

A

ureter

53
Q

How does the ureter pass in female reprdocutve

A

ureter passes inferior and lateral to the uterine artery at the level of the internal cervical os prior to entering the bladder

54
Q

What is the most important mediator of coronary vascular dilation in large arteries and pre-arteriolar vessels

A

Nitric oxide

55
Q

how do endothelial cells make NO

A

arginine and oxygen

56
Q

areflexic

A

absent reflexes

57
Q

subuxation

A

partial dislocation

58
Q

In rheumatoid arthritis, what is more prone to subluxation

A

atlantoaxial joint, cervical spine

59
Q

An endotracheal intubation with a person with severe rheumatoid arthritis can cause what problems

A
  • neurological deficits like areflexic paralysis

- b/c of vertebral subluxation

60
Q

What is the case of duchenne muscular dystrophy

A

deletion of dystrophin gene

61
Q

role of dystrophin

A

allows interaction between extracellular connective tissue and intracellular contraction apparatus

62
Q

Dystrophin is located on what chromosome

A

X p21

63
Q

Charcot-Marie-tooth disease , what is wrong

A

mutation of genes responsible for myelin synthesis

64
Q

Endoneural inflammatory infiltration is characteristic of what

A

Guillain-Barre syndrome

65
Q

difference between Duchenne and Becker mutations

A

Duchenne: frameshift mutation
Becker: non-framshift

66
Q

investing rat poison is similar to what type of toxicity

A

Warfarin toxicity

67
Q

how is rat poison treated

A

fresh frozen plasma in addition to vitamin K

68
Q

Protamine sulfate used to an overdose of what

A

heparin

69
Q

Desmopressin increases what in the clotting cascade

A
  • von Willebrand factor

- factor VIII

70
Q

Cryoprecipitate contains what

A
  • Factor VIII
  • Factor XIII
  • von Willebrand factor
  • fibrinogen
71
Q

What goes wrong in achondroplasia

A

gain-of-function mutation in FGFR3 gene

72
Q

Aminoglycosides inhibit what process

A
  • inhibit genetic code reading and protein synthesis by binding to prokaryotic 30S ribosomal subunit
73
Q

Adverse effect of aminoglycoside

A
  • nephrotoxicity
  • neuromuscular blockage
  • Ototoxicity
  • Teratogen
74
Q

Patients who receive the equivalent of more than one body blood volume of whole blood transfusions or packed red blood cells over a period of 24 hours my develop elevated plasma levels if what substance? what does this cause

A
  • citrate: chelates calcium and magnesium

- can cause paresthesias

75
Q

internuclear ophthalmoplegia is damage to what structure

A

medial longitudinal fasciculus

76
Q

Lesion to the right dorsal paramedian pons can disrupt what other structure and cause what

A
  • right MLF

- internuclear ophthalmoplegia

77
Q

Mu receptors bind to what type of receptor and what happens

A

G protein

  • increase potassium efflux
  • hyper polarization of postsynaptic neurons, blocking pain
78
Q

Naproxen

A

NSAID

79
Q

Adverse effects of TCA overdose

A
  • convulsions
  • coma
  • cardiotoxicity ( widened QRS interval or ventricular arrhythmias)
80
Q

how do TCAs create cardiotoxicity

A

block sodium channel on heart

81
Q

How do you treat arrhythmias in cardiotoxicity

A
  • sodium bicarbonate
82
Q

Classic presentation for benzodiazepine overdose

A

CNS depression with normal vital signs

83
Q

patient with pancreatitis and subsequent respiratory failure likely has what

A

acute respiratory distress syndrome

84
Q

what are causes of acute pancreatitis

A 
I GET SMASHED
Idiopathic
gallstones
ethanol
trauma
steroids
mumps
autimmune 
scorpion sting
hypercalceia/hypertriglyceridemia 
ERCP 
Drugs
85
Q

What are causes of acute respiratory distress syndrome

A 
Sepsis
Pancreatitis, pneumonia
Aspiration
uremia
trauma
amniotic fluid embolism 
shock
86
Q

pathology of acute respiratory distress syndrome

A
  • endothelial damage
  • increase alveolar capillary permeability
  • protein-rich leakage into alveoli
  • diffuse alveolar damage and noncardiogenic pulmonary edema
    intra-alveolar hyaline membranes
87
Q

autopsy of 78 year old man died of esophageal cancer and has small heart without significant coronary artery atherosclerosis. Myocardial cells show prominent intracytoplasmic granules that are tinged yellowish-brown. what is this in the heart?

A

lipid peroxidation

88
Q

what does monoamine oxidase do

A
  • degrades exces monoamine neurotransmitters in presynaptic nerve terminals
  • detoxifies dietary tyramine in GI tract
89
Q

What is a hypertensive emergency

A
  • severe hypertension
  • headache
  • blurry vision
90
Q

What are changes in Km and Vmax in competitive inhibitors

A

Km increased

Vmax is unchanged

91
Q

effect of Km on noncompetitive inhibitors

A

does not change

92
Q

how do you diagnose Mucro and Rhizopus

A
  • mucosal biopsy

- broad nonseptate hyphae with right-angle branching

93
Q

what is the difference between leading and lagging strand

A
  • lagging need more DNA ligase
94
Q

Everytime GFR halves, what happens to creatinine

A

doubles

95
Q

MOA for naloxone

A

pure opioid receptor antagonist

96
Q

MOA for cyanide toxicity

A
  • cyanide binds ferric ( Fe3+) iron

- inhibits cytochrome C oxidase in mitochondria

97
Q

What is the PE for cyanide poisoning

A

reddish skin discoloration

98
Q

laboratory studies for methemoglobin

A
  • lactic acidosis

- narrowing of the venous-arterial PO2 gradient

99
Q

edetate disodium calcium chelates what

A

lead

100
Q

what are the key cells involved delayed-type hypersensitivity reaction ( type IV)

A
  • marcrophages
  • CD4 helper T cells
  • CD8 cytotoxic T cells
101
Q

failure to generate a Type IV hypersensitivity is called

A

anergy

102
Q

Severe combined immunodeficiency is caused by what

A
  • genetic defect in T cell development,

- leading to loss of both cellular and humoral immunity

103
Q

What is a common clinical presentation for SCID

A
  • failure to thrive

- chronic diarrhea

104
Q

What is pernicious anemia

A
  • autoimmune disease characterized by CD4 mediated destruction of parietal cells
105
Q

What are 2 effects of having loss of parietal cell mass

A
  • megaloblastic anemia

- elevated intraluminal pH that stimulates gastrin secretion

106
Q

Location of indirect inguinal hernias

A

lateral to the inferior epigastric vessels

107
Q

Location of direct inguinal hernia

A

medially to the inferior epigastric vessels

108
Q

Which type of hernia protrudes into the scrotum

A

indirect inguinal hernia

109
Q

for the degree of overlap between healthy and diseased population curves, what effects sensitivity and specificity

A

chosen cutoff value

Uworld (63 decks)

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