Pharm+Patho 0423Q

Question 1

histology of eczematous dermatitis

Answer 1

spongiosis: epidermal accum. of edematous fluid in intercellular spaces

Question 2

effects of corticosteroids on CBC

Answer 2

1. increased neutrophil count (de-margination from vessel wall)
2. decreased lymphocyte, monocyte, basophil, eosinophil - typical suppression of immune response by glucocorticoids

Question 3

which cholesterol drugs have increased risk of gallstone formation?

Answer 3

1. gemfibrozil
2. cholestyramine

both increase chol excretion by liver (in bile)

Question 4

acute acalculous cholecystitis

Answer 4

acute inflamm of GB in the absence of gallstones. most commonly seen in hospitalized and severely ill.

Question 5

what do doxazosin, prazosin, terazosin treat?

Answer 5

[alpha1 blockers]

BPH AND HTN.

Question 6

tx of HTN in pts with CAD and CHF

Answer 6

cardioselective beta blockers

Question 7

first line med for essential HTN in gen pop

Answer 7

HCTZ

Question 8

common location of CRC

Answer 8

1. rectosigmoid colon: obstructing sx (altered BM, constipation, abd distention, N/V)
2. ascending colon: bulkier masses that protrude into lumen, likely to bleed and cause iron-def anemia

Question 9

part of brain affected in huntington disease

Answer 9

loss of neurons in caudate nucleus and putamen

Question 10

which chemotherapeutic agents inhibit thymidylate formation?

Answer 10

methotrexate and 5-FU.

MTX effect is OVERCOME by N5-formyl-tetrahydrofolate supp (folinic acid or leucovorin).

Question 11

aplastic anemia

Answer 11

pancytopenia - decreased RBC, WBC, plts.

due to suppression of stem cell fx in BM.

Question 12

which abx can cause aplastic anemia?

Answer 12

CHLORAMPHENICOL. suppresses bact protein synthesis by inhibiting peptidyl transferase. can cause dose-dependent and dose-independent (irreversible) pancytopenia.

Question 13

what happens when metronidazole is taken with alcohol?

Answer 13

disulfiram-like rxn

Question 14

what is significant side effect of vancomycin?

Answer 14

rapid admin lead to histamine release - RED MAN SYNDROME (flushing).

also cause dose-related ototoxicity.

Question 15

what are the most common causes of ischemic stroke?

Answer 15

carotid artery atherosclerosis.

cardiac embolism.

Question 16

which cytokine induces cachexia?

Answer 16

TNF alpha - by suppressing appetite, inhibiting lipoprotein lipase, increasing insulin resistance in peripheral tissues.

nickname: cachectin

Question 17

main mech of combination OCP

Answer 17

suppress LH and FSH synthesis in ant pituitary, thus inhibiting ovulation (no LH surge)

minor effects: thicken cervical mucus. prevent endometrial growth needed for implantation (progesterone effect)

Question 18

what drug is used for pts allergic to TMP-SMX?

Answer 18

dapsone

Question 19

iron absorption occurs where?

Answer 19

duodenum and prox jejunum

Question 20

how does desmopressin (DDAVP) treat vWf disease?

Answer 20

induces endothelial procoag protein release, including vWf.

also increases stability of factor VIII (vWf binds VIII) - controls bleeding in hemophilia A.

Question 21

what immuno cell is involved with Crohns disease?

Answer 21

TH1 helper cells - mediate delayed hypersensitivity and non-caseating granuloma formation.

also produce IL-2 and IFN-g. activate macrophages to produce TNF.

TH2 involved with ULCERATIVE COLITIS.

Question 22

what happens with EPO in aplastic (and most other) anemias?

Answer 22

compensatory increase in EPO secretion by interstitial cells of renal cortex (if normal renal fx)

Question 23

what does bruising not assoc. with trauma indicate?

Answer 23

thrombocytopenia or coagulopathy

Question 24

what does high lipid content in BM suggest?

Answer 24

hematopoietic cell aplasia or hypoplasia

Question 25

lab values of intravascular hemolytic anemias

Answer 25

decreased serum haptoglobin. | increased Hb, LDH, bilirubin.

Question 26

haptoglobin

Answer 26

serum prot that binds free Hb and promotes its uptake by RES

Question 27

trazodone

Answer 27

indication: sedating effects = used with fluoxetine to treat pts with depression and accompanying insomnia SE: priapism (contraindicated in adolescent boys)

Question 28

mycobacterial resistance to INH

Answer 28

via non-expression of catalase-peroxidase enzyme OR through genetic modification of INH binding site on mycolic acid synthesis enzyme

Question 29

serious but rare complication of ticlopidine

Answer 29

NEUTROPENIA - presents with fever and mouth ulcers. monitor CBC biweekly for first 3 mos.

Question 30

leuprolide (GnRH analog) effects

Answer 30

continuous GnRH activity initially increases gonadotropin levels ("start up flare") with subsequent increase in testosterone and DHT. once the flare burns out, both T and DHT are suppressed to castrate levels.

Question 31

role of estrogen in gallstone formation

Answer 31

estrogen increases hepatic HMG-CoA reductase activity

Question 32

decreased enz activity predisposing to gallstones

Answer 32

7alpha-hydroxylase suppressed by meds (fibrates). decreased conversion of chol to bile acids, thus excess chol secretion in bile.

Question 33

hemiparesis with ARM affected more than leg

Answer 33

occlusion of middle cerebral artery. | if occluded MCA is in dominant (left) hemisphere, aphasia may also occur.

Question 34

benzodiazepine side effect

Answer 34

daytime drowsiness "hangover". increased falls in old peeps. severity of side effect depends on half life.

Question 35

long acting benzos

Answer 35

more severe drowsiness. | LESS addicting.

Question 36

medullary thyroid cancer

Answer 36

from parafollicular calcitonin-secreting C cells. RET proto-oncogene mutation. uniform polygonal or spindle-shaped cells with extracellular amyloid deposits.

Question 37

abetalipoproteinemia

Answer 37

lipids accumulate in int epithelium. | lack of lipids in cell membranes = abn RBCs (acanthocytes) and neuro deficits.

Question 38

chronic prednisone/corticosteroid use

Answer 38

promotes osteoporosis and pathologic fractures

Question 39

key feature of minimal change disease

Answer 39

rapid response to corticosteroid therapy

Question 40

conditions assoc. with MCD

Answer 40

resp infx immunization atopic d/o

Question 41

tx of active TB

Answer 41

NEVER with drug monotherapy due to rapid emergence of Abx resistance in M.tuberculosis. INH monotherapy may be used for pts with positive PPD and NEGATIVE CXR.

Question 42

Reid index

Answer 42

ratio of thickness of mucous gland layer in bronchial wall submucosa TO thickness of bronchial wall between resp epithelium and bronchial cartilage. measures mucus gland enlargement in chronic bronchitis.

Question 43

hematogenous osteomyelitis

Answer 43

affects metaphyses of long bones - rich vascularization and capillary fenestrae