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Combank Q facts > Combank 2 > Flashcards

Combank 2 Flashcards

1
Q

The only anti-epileptic medication that is an inhibitor of cytochrome p450 enzymes

A

Valproic Acid

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2
Q

What class of drugs is Glyburide in and what does it treat?

A

sulfonylurea; treatment of diabetes

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3
Q

MOA of sulfonylureas

A

block ATP dependent potassium channels thus depolarizing pancreatic beta cells which leads to insulin release (release mediated by calcium influx)

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4
Q

Carbamazepine, oxcarbazepine and phenytoin are inducers or inhibitors of the CYP450 system?

A

Inducers

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5
Q

What is valproic acid commonly used to treat?

A

a common epileptic medication for tonic-clonic seizures; also used for partial seizures and absence seizures

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6
Q

What is the MOA of valproic acid?

A

inactivates Na+ channels and increases GABA concentration in the synapse

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7
Q

First line option for tonic clonic seizures

A

Carbamazepine

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8
Q

What is another use of Carbamazepine other than treating seizures?

A

Trigeminal neuralgia

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9
Q

Does phenobarbitol induce or inhibit CYP enzymes?

A

Induce

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10
Q

What is the first line prophylaxis for status epilepticus?

A

Phenytoin

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11
Q

How does erysipelas present?

A

A painful raised lesion with sharply demarcated borders

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12
Q

How is cellulitis different from erysipelas?

A

Cellulitis can also present with symptoms of pain, erythema and pruritis, but does NOT have a raised lesion with sharply demarcated borders

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13
Q

What is the major causative agent for both erysipelas and cellulitis?

A

Streptococcus pyogenes (Group A strep)

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14
Q

What is the drug of choice to treat streptococcal erysipelas?

A

Penicillin

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15
Q

Group B strep is also known as?

A

Strep agalactiae

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16
Q

Group A strep is also known as

A

Strep pyogenes

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17
Q

The viscerosomatic reflex for the head and neck correspond to what vertebral levels?

A

T1-T4

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18
Q

What type of hypersensitivity reaction is Guillain-Barre syndrome?

A

Type IV

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19
Q

How are type IV hypersensitivity reactions mediated?

A

T cells that come into contact with the antigen activate macrophages

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20
Q

Guillain-Barre can occur several days after an infection with what causative agents?

A

Campylobacter jejuni, CMV, or influenza

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21
Q

Goodpasture syndrome and rheumatic fever are examples of what type of hypersensitivity?

A

Type II, cytotoxic

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22
Q

Graves disease and myasthenia gravis are examples of what type of hypersensitivity?

A

Type II, noncytotoxic

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23
Q

Rheumatoid arthritis and polyarteritis nodosa are examples of what type of hypersensitivity?

A

Type III

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24
Q

Agranulocytosis and aplastic anemia are AEs of which AED medication that is first line for tonic clonic seizures and trigeminal neuralgia?

A

Carbamazepine

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25
Q

Gingival hyperplasia is a AE of which AED?

A

Phenytoin

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26
Q

This AED used to treat absence seizures works by depressing the nerve transmission in the motor cortex thereby increasing the threshold for seizures

A

Ethosuximide

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27
Q

Absence seizures can be treated with which two drugs?

A

Valproic acid or Ethosuximide

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28
Q

What other drug can be used to treat and prevent congenital syphilis in the case that the patient is allergic to penicillin?

A

Doxycycline

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29
Q

What is the first line treatment for syphillis in both pregnant mothers and the neonate?

A

Penicillin G

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30
Q

What type of drug is Alendronate and what is it used for?

A

It is a bisphosphonate that inhibits bone resorption (osteoclast activity) and is used to increase bone density in women with post menopausal osteoporosis

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31
Q

The description of lancet shaped bacteria points to …

A

strep pneumoniae

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32
Q

Name the causative agent - aerobic, gram positive, catalase negative, ALPHA HEMOLYTIC cocci, optochin sensitive

A

strep pneumoniae

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33
Q

Name the hepatitis virus - DNA genome, reverse transcriptase used to make DNA from viral RNA in the cytoplasm

A

Hepatitis B

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34
Q

How is hepatitis B transmitted?

A

blood contact, sexual contact

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35
Q

Name the hepatitis virus - picornavirus, spread through food, prevented by giving a vaccine before travel, self limiting

A

Hepatitis A

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36
Q

Name the hepatitis virus - RNA flavivirus, spread through blood, no vaccine available, most develop chronic hepatitis

A

Hepatitis C

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37
Q

Name the hepatitis virus - RNA delta virus, requires coinfection with hepatitis B

A

Hepatitis D

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38
Q

Name the hepatitis virus - RNA hepevirus, fecal oral spread, causes acute hepatitis, common in developing countries

A

Hepatitis E

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39
Q

How does hepatitis C infect hepatocytes?

A

HCV coats itself with low density and very low density lipoproteins

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40
Q

Which hepatitis virus is associated with high infant mortality when occuring in pregnant women?

A

Hepatitis E (no vaccine is available)

41
Q

What is the DOC for Loa Loa infection?

A

diethylcarbamazine

42
Q

Name the causative agent - transient migratory angiodema, pruritis, localized urticaria in the arms and legs (usually wrists, ankles), ocular symptoms

A

Loa Loa

43
Q

What is used to treat gram negative anaerobic rods?

A

metronidazole or clindamycin

44
Q

What is the first line treatment for mild persistent asthma?

A

start an inhaled steroid controller - ex beclomethasone

45
Q

An anticholinergic drug used as an alternative to albuterol in the treatment of acute asthma. MOA is blocking the M3 receptors found in the bronchi causing bronchodilation.

A

Ipratropium

46
Q

Where is Histoplasma capsulatum found?

A

Mississippi and Ohio River Valleys; located in caves

47
Q

How would Histoplasma capsulatum present on sputum microscopy?

A

small intracellular yeasts residing within macrophages

48
Q

Where is Coccidioides immitis found?

A

San Joaquin Valley of California and other areas of the southwestern US

49
Q

How does Coccidioides immitis present on sputum microscopy?

A

Presence of spherules within endospores

50
Q

Where is Blastomyces dermatitidis found?

A

Mississippi and Ohio River basins

51
Q

Where is Paracoccidioides brasiliensis found?

A

South and Central America

52
Q

How does Paracoccidioides brasiliensis present on sputum analysis?

A

one large mother cell produces multiple daughter cells that arise from multiple sites - resembles a “pilots wheel”

53
Q

What type of drug is furosemide and how does it work?

A

Loop diuretic; blocks Na/K/Cl pump in the thick ascending limb of the LOH

54
Q

What type of drug is Hydrochlorothiazide and how does it work?

A

Thiazide diuretic; blocks the sodium/chloride channel in the DCT

55
Q

How does Acetazolamide work?

A

Reversibly inhibits carbonic anhydrase resulting in reduction of hydrogen ion secretion at the renal tubule and an increased renal excretion of Na, K, HCO3 and H2O

56
Q

What are some common potassium sparing diuretics?

A

spironolactone, amiloride, triamterene

57
Q

How does Amiloride and triamterene work?

A

Inhibit the Na/K ATPase on the renal distal convoluted tubule which prevents sodium resorption from the lumen

58
Q

This condition results in upper respiratory symptoms, lower respiratory symptoms and renal symptoms; characterized by inflammation of small and medium sized blood vessels

A

Wegener’s granulomatosis

59
Q

Wegener’s granulomatosis is usually positive for what antibodies?

A

c-ANCA antibodies

60
Q

What are rales?

A

crackling sounds that result from small bronchioles and alveoli popping open due to fluid build up

61
Q

Name the causative agent - common cause of pneumonia in alcoholic or elderly, currant jelly sputum

A

Klebsiella pneumoniae

62
Q

Describe the lab profile of Klebsiella pneumoniae

A

gram negative lactose fermenting rod; indole negative (vs. E coli is indole positive)

63
Q

What type of drug is ketamine and how does it work?

A

intravenous anesthetic; rapid onset, short duration; interacts with NMDA receptors and stimulates sympathetic outflow causing tachycardia, HTN, increased CO; causes vivid dreams and hallucinations during recovery

64
Q

What is an isotonic contraction?

A

constact muscle tension as a muscle changes length - ex. push up

65
Q

MAO-A degrades …

A

NE and serotonin

66
Q

MAO-B degrades …

A

dopamine

67
Q

The frontal bone is a paired or unpaired bone?

A

paired

68
Q

This suture is present at birth and runs vertically through the center of the frontal bone separating the frontal bone into two halfs

A

Metopic suture

69
Q

A patient with suspected cervicitis should be treated with antibiotics that cover which two causative agents?

A

Neisseria gonorrhea and Chlamydia trachomatis

70
Q

Chandelier sign

A

cervical motion tenderness

71
Q

Chandelier sign is positive in what condition?

A

Pelvic inflammatory disease

72
Q

DOC for Chlamydia trachomatis

A

Azithromycin or doxycycline; azithromycin preferred due to single dose therapy vs. doxycycline’s 7 day dosing

73
Q

DOC for Neisseria gonorrhoeae

A

Ceftriaxone

74
Q

Erythromycin inhibits or induces P450 system?

A

inhibits

75
Q

Rifampin inhibits or induces P450 system?

A

induces

76
Q

What is a unique AE of rifampin?

A

red/orange color change that occurs in bodily fluids

77
Q

What type of mutation causes sickle cell anemia?

A

point mutation causing glutamic acid to be replaced by valine

78
Q

How does Clopidogrel work?

A

inhibits platelet aggregation by irreversibly blocking ADP receptors, which does not allow for GPIIb/IIIa expression thus inhibiting fibrinogen binding

79
Q

How does hydroxyurea work and what is it indicated for?

A

Anti-neoplastic agent; indicated for reducing the rate of painful occlusive attacks in patients with sickle cell disease; increases production of fetal hemoglobin

80
Q

What is a common cause of osteomyelitis in patients with sickle cell disease?

A

Salmonella

81
Q

Most common cause of osteomyelitis in general population (those w/o sickle cell disease)

A

Staph aureus

82
Q

What are the clinical manifestations of paroxysmal nocturnal hemoglobinuria?

A

hemolytic anemia, hypercoagulable state, diminished hematopoiesis

83
Q

What causes paroxysmal nocturnal hemoglobinuria?

A

genetic defect in red blood cell membrane anchor proteins; there is an absence of CD 59 and CD 55 which act to inhibit membrane lysis, thus there is un-inhibited complement mediated hemolysis

84
Q

Crohn’s disease most often affects what part of the GI tract?

A

terminal ileum

85
Q

How does Ezetimibe work?

A

impairs biliary and dietary cholesterol absorption at the intestinal brush border by inhibiting specific receptors at the border

86
Q

Name 3 bile acid sequestrants

A

cholestyramine, chlesevelam, colestipol

87
Q

How do bile sequestrants work?

A

bind bile acids in the intestine and prevent their absorption at the brush border

88
Q

What is the MOA of Niacin as a lipid lowering agent?

A

decreasing hepatic LDL and VLDL production as well as hepatic triglyceride esterification

89
Q

What is Sjogren syndrome?

A

chronic systemic inflammatory d/o characterized by lymphocytic infiltrates in exocrine organs

90
Q

Patient’s with Sjogren syndrome are at risk of developing what condition?

A

lymphoma

91
Q

What antibodies are positive in Sjogren syndrome?

A

Anti-Ro and Anti-La antibodies

92
Q

What antibodies are positive in CREST syndrome? (calcinosis, raynaud disease, esophageal dysmotility, sclerodactyly, telangiectasia

A

Anti-centromere antibodies

93
Q

What antibodies are positive in SLE?

A

Anti-ds DNA antibodies

94
Q

What antibodies are found in polymyositis/dermatomyositis?

A

Anti-Jo1 antibodies

95
Q

What antibodies are positive in scleroderma?

A

SCL 70 antibody

96
Q

What is the DOC for pregnant women with hyperthyroidism in the first trimester?

A

Propylthiouracil

97
Q

T4 analog used to treat hypothyroidism

A

Levothyroxine

98
Q

What medications are used to treat antipsychotic-induced EPS?

A

Benztropine, amantadine, diphenhydramine

Combank Q facts (11 decks)

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