March 27 2014

Question 1

cromolyn sodium and nedocromil

Answer 1

Mast Cell Stabilizers

act by stabilizing mast cell membranes and have anti-inflammatory prophylaxis which can only be used before onset of asthma symptoms

Question 2

Zileuton

Answer 2

5 lipoxygenase inhibitor

leukotriene receptor antagonist that blocks activity of leukotrienes involved in bronchospasm

Question 3

Side effects of Metformin

Answer 3

(GI) disturbance (nausea/vomiting and diarrhea) and lactic acidosis, especially in those with liver or renal failure.

Does NOT cause hypoglycemia

Question 4

chlorpropamide

Answer 4

1st generation sulfonylurea

inhibit the beta cell potassium-ATP channel

stimulates insulin release from beta-islet cells increase circulating insulin levels

CAN cause hypoglycemia

Question 5

Pioglitazone MOA

Answer 5

work on PPAR-γ transcription factors to decrease insulin resistance

Question 6

Pioglitazone side effects

Answer 6

heart failure, cholestatic hepatitis, hepatotoxicity and diabetic macular edema.

weight gain, edema, and increased HDL and LDL.

Question 7

Necrosis of the mammillary bodies in the periventricular region of the brain; progressive dementia, confusion, ataxia, and paralysis of the extraocular muscles

Answer 7

Wernicke encephalopathy

Question 8

A thought disorder that results in retrograde memory failure and confabulation

Answer 8

Korsakoff psychosis

Question 9

Confusion, ataxia, nystagmus, confabulation, and necrosis of the mammillary bodies.

Answer 9

Wernicke Korsakoff syndrome

Question 10

Common deficiency in chronic alcoholics

Answer 10

thiamine

Question 11

Supraspinatus muscle insertion site = ?

Answer 11

greater tubercle of the humerus

Question 12

Supraspinatus actions ?

Answer 12

abduction - first 15 degrees

external rotation (when shoulder abducted)
internal rotation (when shoulder flexed)

Question 13

Rotator cuff tears may be detected by

Answer 13

the drop arm test, Hawkins-Kennedy test, Apprehension test, or Neer impingement test.

Question 14

What is the Hawkins- Kennedy impingement test?

Answer 14

For rotator cuff injury

=Forward flexing the shoulder and elbow to 90 degrees while passively (by physician) internally rotating the shoulder. Pain indicates a positive test

Question 15

Surfactant is produced by ______ and has ___________ as its major component

Answer 15

type II pneumocytes and dipalmitoylphosphatidylcholine

Question 16

Do smaller or larger alveoli have a tendency to collapse more? What does this mean about the collapsing pressure?

Answer 16

Smaller are more prone to collapse

Smaller radius = larger collapsing pressure

Question 17

hyperprolactinemia is a side effect of first or second generation anti-psychotics?

Answer 17

first generation (typical)

ex) fluphenazine

Question 18

Name 3 potent D2 dopamine receptor agonists that function to inhibit the release of prolactin from the lactotrophic cells of the anterior pituitary

Answer 18

bromocriptine, cabergoline, and quinagolide

Question 19

cutaneous complication of ulcerative colitis

Answer 19

Pyoderma gangrenosum is a chronic slow healing or non-healing ulcer, most commonly seen on the lower legs

Question 20

Mutation in type IV collagen

Answer 20

Alport syndrome

Question 21

Mutation in type I collagen

Answer 21

osteogenesis imperfecta

Question 22

Long QT syndrome can be caused by a mutation in….

Answer 22

outward-rectifying potassium current gene

Question 23

erythromycin MOA

Answer 23

binds to the 50S ribosomal subunit

Question 24

Vitamine A toxicity symptoms

Answer 24

seizures, stroke, increased intracranial pressure, psychosis, liver damage, depression, and gastrointestinal upset

Question 25

MCC of atypical pneumonia?

Answer 25

mycoplasma pneumoniae

Question 26

MCC of typical pneumonia?

Answer 26

strep pneumonia

Question 27

DX of mycoplasma pneumonia

Answer 27

IgM | Cold agglutinin titer

Question 28

only type of thyroiditis to present with an enlarged, painful thryoid

Answer 28

subacute granulomatous thyroiditis

Question 29

what drug inhibits MTOR and stops T cell proliferation

Answer 29

sirolimus

Question 30

LSD can cause hypo or hyperthermia?

Answer 30

hyperthermia

Question 31

auto antibody associated with hashimoto thyroiditis

Answer 31

anti microsomal antibodies

Question 32

auto anitbody assc with CREST

Answer 32

anti centromere

Question 33

auto antibody with primary biliary cirrhosis

Answer 33

anti mitochondrial

Question 34

Why does anticipation occur in mytonic dystrophy?

Answer 34

instability during maternal meiosis

Question 35

mytonic dystrophy is due to _____ repeats

Answer 35

CTG

Question 36

symptoms of mytonic dystrophy

Answer 36

``` skeletal muscle weakness myotonia (slowed relaxation or prolonged contractions as seen in this patient's grip) cardiac conduction abnormalities cataracts testicular failure hypogammaglobulinemia impaired sleep insulin resistance excessive daytime sleepiness. ```

Question 37

The mechanism of action of low molecular weight heparin is

Answer 37

binding of antithrombin III, which inhibits thrombin and factor Xa

Question 38

erythema infectiosum (fifth disease) with a lacey rash worsening in sunlight is caused by _____

Answer 38

parvovirus B19