CBSSA 11

Question 1

Trace path of uterine artery from Femoral

Answer 1

Uterine artery comes off internal iliac.

So, go up femoral, into external iliac, down into the internal iliac, and then branch = uterine!

Question 2

Man with chronic bronchitis (severe) what will his arterial blood gas values be when breathing room air?

Answer 2

Chronic bronchitis: blue bloaters - you get hypertrophy of mucus secreting glands in bronchi; inc. RV, dec. FVC, way dec. FEV1/FVC ratio; V/Q mismatch

LOW pH (acidotic)
HIGH pCO2 (due to the fact that he probably has difficulty exhaling all the air out of his lungs which keeps CO2 trapped)
LOW pO2

Question 3

Patient whose brother had anemia and now he has anemia with hypochromic microcytic erythrocytes and target cells - how to confirm diagnosis?

Answer 3

Target cells - THINK THALASSEMIA - especially because man is African American

How to test for thalassemia? Hb Electrophoresis

Question 4

Metoclopramide MOA

Answer 4

Dopamine (D2) receptor ANTAGONIST:
Promotes gastric emptying
Anti emetic
Relieves nausea

Question 5

Metoclopramide vs. Ondansetron

Answer 5

Ondansetron is NOT a gastrokinetic agent - only used to prevent vomiting

Question 6

Which cells are involved in re-epithelization of blisters?

Answer 6

Basal layer keratinocytes - that’s essentially the stem cells of skin

Question 7

Glucagon role in lipolysis

Answer 7

In extended starvation mode - glucagon binds to receptor and causes stim. of adenylate cyclase - leads to inc. cAMP levels which activates hormone-sensitive lipase

Question 8

Location of lesion for syringomyelia

Answer 8

Anterior white commissure of the cervical spinal cord - cape-like distribution with bilateral decreased sensation to pain & temperature

Question 9

Paroxysmal barking cough

Answer 9

Indicates bordatella pertussis (whooping cough) infection vs. croup (usually caused by parainfluenza virus)

Question 10

MOA bordatella pertussis infection

Answer 10

Pertussis toxin: overactivates adenylate cyclase by disabling Gi - increases cAMP - impairs phagocytosis of microbe

Will impair neutrophil chemotaxis & oxidative metabolism

Question 11

Cisplatin/Carboplatin toxicity

Answer 11

acoustic nerve damage & nephrotoxicity

Question 12

Vincristine tox

Answer 12

peripheral neuropathy

Question 13

Bleomycin, Busulfan tox

Answer 13

pulmonary fibrosis

Question 14

Doxorubicin/Daunorubicin tox

Answer 14

cardiotox

Question 15

Trastuzumab tox

Answer 15

cardiotox

Question 16

cyclophosphamide tox

Answer 16

hemorrhagic cystitis

Question 17

5FU tox

Answer 17

myelosuppression

Question 18

6MP tox

Answer 18

myelosuppression

Question 19

Methotrexate tox

Answer 19

myelosuppression

Question 20

HIV protease inhib MOA

Answer 20

prevent maturation of new virus - inhib. pol gene (protease) from cleaving polypeptide products of HIV mRNA into functional parts

Ex: all end in “-navir” - Lopinavir, Saquinavir, Ritonavir etc.

Question 21

Nucleotide reverse transcriptase inhibitors (NRTI’s) MOA

Answer 21

Competitively inhibit nucleotide binding to RT and terminate DNA chain (they lack the 3’ -OH)

All need to be phosphorylated to be activated because they are actually nucleoSIDE analogs EXCEPT Tenofovir (which is a nucleoTIDE analog)

Ex: Tenofovir, Lamivudine, Zidovudine

Question 22

HIV Prophylaxis

Answer 22

ZDV (formerly AZT) - NRTI - Zidovudine

Question 23

NNRTIs

Answer 23

Bind to reverse transcriptase at site different from NRTI - don’t require phosphorylation to be active

Ex: Nevirapine, Efavirenz, Delavirdine

Question 24

Raltegravir MOA

Answer 24

Inhib. HIV integration into host cell by reversibly inhib. HIV integrase

Question 25

Ritonavir & effect on P450

Answer 25

P450 INHIB. - boost other drub concentrations