M 5/29

Question 1

What does the dorsal pancreatic bud become?

Answer 1

The pancreatic body, tail, most of head, accessory duct

Question 2

What does the ventral pancreatic bud become?

Answer 2

Uncinate process, portion of head, proximal portion of main duct

Question 3

What cells express HLA I?

Answer 3

All nucleated cells

Question 4

What cells express HLA II?

Answer 4

Antigen presenting cells

Question 5

What do HLA I present?

Answer 5

Endogenous peptides to CD8

Question 6

What do HLA II present?

Answer 6

Foreign antigens to CD4

Question 7

What mutation is associated with MODY?

Answer 7

Glucokinase

Question 8

What enzyme functions as a glucose sensor in B cells?

Answer 8

Glucokinase

Question 9

What is insulin release stimulated by?

Answer 9

Inc in ATP

Question 10

What does bradykinin do?

Answer 10

Dilates blood vessels

Question 11

What occurs in C1 esterase inhibitor deficiency?

Answer 11

Unregulated kallikrein leads to an inc in bradykining; hereditary angioedema

Question 12

What drugs are contraindicated in C1INH def

Answer 12

ACEI

Question 13

What enzyme degrades bradykinin?

Answer 13

ACE

Question 14

What is the mechanism of action of hydralazine

Answer 14

Inc cGMP –> sm m relaxation; arterioles > veins

Question 15

What effect does hydralazine have on afterload?

Answer 15

Dec

Question 16

What is hydralazine used for?

Answer 16

Severe/acute HTN

Question 17

Hydralazine has a mortality benefit in HF when combined with what?

Answer 17

Nitrate

Question 18

Is hydralazine safe in pregnancy?

Answer 18

Yes

Question 19

How do you prevent reflex tachy w hydralazine?

Answer 19

Administer w a B blocker

Question 20

How do the glitazones work?

Answer 20

Bind PPAR-g nuclear receptor; inc adiponectin; inc insulin sensitivity, FA oxidation, GLUT4 in peripheral tissues, inc TG storage/dec serum TG

Question 21

What are the adverse effects of glitazones?

Answer 21

weight gain, edema, hepatoxicity, HF, inc risk of fx

Question 22

V1 vasopressin rec

Answer 22

Gq - vasoconstriction, inc BP

Question 23

V2 vasopressin rec

Answer 23

Gs - CD - H20 permeability (aquaporin) and reabs; vascular endothelium - vwF, F8 release

Question 24

How do you calculate FF?

Answer 24

FF = GFR/RPF (N = 20%)

Question 25

Cr clearance =

Answer 25

GFR

Question 26

PAH clearance =

Answer 26

RPF

Question 27

What is indomethacin used for?

Answer 27

Close PDA, acute gout, nephrogenic DI

Question 28

How do you keep a PDA open?

Answer 28

PGE analogs

Question 29

What is the inheritance of Peutz-Jeghers

Answer 29

AD

Question 30

What are the features of Peutz-Jeghers?

Answer 30

Hamartomatous GI polyps, hyperpigmentation of hands/mouth/feet/genitals

Question 31

What are Charcot-Bouchard microaneurysms associated with? Where do they occur?

Answer 31

Chronic HTN, small vessels (basal ganglia, thalamus)

Question 32

What are the features NMS?

Answer 32

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia

Question 33

How do you treat NMS?

Answer 33

Dantroline, D2 agonist (bromocriptine)

Question 34

What drugs cause NMS?

Answer 34

Antipsychotics

Question 35

What does Fanconi anemia often progress to?

Answer 35

AML