Mix14

Question 1

Side effect of abrupt discontinuation of benzo:

Answer 1

seizure (be aware of short half life of benzo)

Question 2

What drug class is alprazolam?

Answer 2

benzo

Question 3

drug class of bupropion:

Answer 3

NE/Dopa reuptake i

Question 4

MOA of mirtazapine:

Answer 4

serotonin modulator (alpha 2 AR blocker)

Question 5

Requirements for chorioamnionitis:

Answer 5

maternal fever + 1 of the following:

• Fetal tachy (>160)
• Maternal leukocytosis
• Purulent amniotic fluid
• maternal tachy (>110)
• uterine fundal tenderness

Question 6

What’s the pathophys behind sturge weber syndrome?

Answer 6

leptomeningeal capillary venous malformation. May present with seizure +/- hemiparesis, intellectual disability and visual field deficits

Question 7

Complications of excess oxytocin?

Answer 7

Tachysystole (abnormally frequent uterine contractions), hypotension, and hyponatremia.

Oxytocin is a uterotonic agent

Question 8

Lesch Nyhan syndrome is due to deficiency of ___ and results in accumulation of toxic levels of ___

Answer 8

HGPRT, uric acid. Characterized by self mutilation, mental retardation, and EPS.

Question 9

Tinea versicolor is due to ____ infection:

Answer 9

malassezia globosoa (NOT dermatophyte). Tinea versicolor is the only tinea infection not caused by dermatophytes (which require keratin for growth).

Tinea corporis/pedis/cruris etc all use dermatophyte

Question 10

Rx for tinea versicolor:

Answer 10

topical ketoconazole, terbinafine, or selenium sulfide

Question 11

multiple, diffuse nodulocystic masses with a cyclic premenstrual tenderness in a young woman is suggestive of:

Answer 11

fibrocystic changes. NSAID or OCP for relief

*Fibroadenoma = single/solitary well circumscribed mass

Question 12

call exner bodies (cells in rosette pattern) in adnexal mass:

Answer 12

Granulosa-Theca cell tumor (sex cord stromal tumor)

Question 13

Relation of granulosa cell tumor and endometrial cancer:

Answer 13

Granulosa cell tumors increase available estrogen (via conversion of testosterone via aromatase) and secrete inhibin (which prevents FSH release). Leads to unopposed estrogen&raquo_space; endometrial hyperplasia and post menopausal bleeding. Due to assoc with endometrial cancer, need to do endometrial biopsy for staging before starting cancer treatment. Use inhibin levels to monitor for disease progression or recurrence.

Question 14

Neurocutaneous syndromes of café au lait macules, ash leaf spots, and port wine stains are characteristic of these diseases:

Answer 14

neurofibromatosis, tuberous sclerosis, sturge weber

Question 15

Painful third trimester bleeding with sudden onset. Firm, distended, and tender uterus. Cause?

Answer 15

Placental abruption. Premature detachment of placenta from uterus due to rupture of maternal decidual vessels. Bleeding&raquo_space; dissection of placenta off decidua. Uterus becomes distended, tender, and vaginal bleeding is prominent. Puts Pt at shock for DIC and hypovolemic shock and may cause fetal hypoxia (loss of variability). Rx = Immediate C/S

Question 16

Maternal AFP and estriol decreased. Inhibin A and HCG increased. Indicates:

Answer 16

Down’s

Question 17

Follow up steps for abnormal quad test results:

Answer 17

Cell free DNA testing, U/S to assess fetal abnormalities

Question 18

Encephalopathy, oculomotor dysfunction (horizontal nystagmus, bilateral abducens palsy), and postural/gait ataxia:

Answer 18

Wernicke’s encephalopathy (thiamine B1 def). Look out for alcoholics and pregnant women w/hyperemesis gravidarum

Question 19

Tamsulosin vs finasteride

Answer 19

Tamsulosin = alpha blocker

finasteride = 5 a reductase i

Question 20

Rx for antiphospholipid syndrome in pregnancy:

Answer 20

Prophylaxis with low dose aspirin and LMWH are used to prevent pregnancy losses. Thrombocytopenia and prolonged PTT are common in these patients.

Question 21

How does nephrotic syndrome increase the risk for MI and stroke?

Answer 21

Nephrotic syndrome&raquo_space; increased risk for atherosclerosis (due to hyperlipidemia) and AV thrombus (due to loss of AT III). Atherosclerosis and hypercoagulability increase risk for stroke and MI