Random

Question 1

AE of sildenafil (PDE5 inhibitor)

Answer 1

can inhibit PDE6 in the retina (color vision) –> bluish discoloration of vision

non-arteritic anterior ischemic optic neuropathy (sudden monocular vision loss)

Question 2

how do PDE5 inhibitors improve erectile dysfunction

Answer 2

nitric oxide –> induces formation of cGMP –> vascular smooth muscle relaxation –> end of erection

PDE5 inactivates cGMP (maintains erection)

Question 3

examples of PDE5 inhibitors

Answer 3

sildenafil, vardenafil, tadalafil, avanafil

Question 4

indications for PDE-5 inhibitors

Answer 4

erectile dysfunction

pulmonary hypertension

BPH (tadalafil only)

Question 5

cause of vasospastic (prinzmetal) angina

Answer 5

endothelial dysfunction and autonomic imbalance that lead to intermittent coronary vasospasm and myocardial ischemia

Question 6

compare primary ciliary dyskinesia and cystic fibrosis

Answer 6

both have chronic rhinosinusitis and nasal polyposis due to impaired mucociliary clearance

failure to thrive and weight loss are NOT associated with primary ciliary dyskinesia

Question 7

demographic most likely to get uterine fibroids

Answer 7

African american women

Question 8

symptoms of uterine fibroids

Answer 8

• heavy menses
• pressure symptoms (pelvic pain, constipation, urinary frequency)
• impaired fertility
• enlarged, irregular uterus

Question 9

what is the mechanism of radiation induced lung injury

Answer 9

affects alveolar-capillary barrier formed by alveolar epithelial cells and vascular endothelial cells

acutely –> impaired gas exchange and hyaline membrane formation

chronically –> fibrosis (TGF-B)

Question 10

“double bubble” sign on x-ray indicates

Answer 10

duodenal atresia

Question 11

thin, curvilinear areas of lucency that parallels the bowel wall lumen in an infant indicate what

Answer 11

pneumatosis intestinalis (air in the bowel wall)

can be caused by necrotizing enterocolitis

Question 12

layers to get through in a cricothyotomy

Answer 12

1) skin
2) superficial cervical fascia (including subcutaneous fat and platysma muscle)
3) pretracheal layers of deep cervical fascia
4) cricothyroid membrane

Question 13

MOA metronidazole

Answer 13

forms toxic free radical metabolites in bacterial cell that damage DNA

Question 14

MOA fidaxomicin

Answer 14

macrocyclic antibiotic that inhibits sigma subunit of RNA polymerase, leading to protein synthesis impairment and cell death

Question 15

indications fidaxomicin

Answer 15

c. diff infections

Question 16

antibiotics indicated in c. diff infections

Answer 16

oral vancomycin, metronidazole, fidaxomicin

Question 17

why do 25% of active TB patients have a false negative skin test

Answer 17

impaired lymphocytic response

Question 18

how does fibroblast growth factor 23 help regulate phosphate levels

Answer 18

it is secreted by osteocytes in response to hyperphosphatemia and binds to FGF23 receptor –> suppresses 1-hydroxylase (converts vitamin D to active form) –> decreases intestinal phosphate absorption and decreases renal phosphate reabsorption

Question 19

why does diverticulosis cause hematochezia

Answer 19

diverticula tend to form in areas where intraluminal colon wall lacks structural integrity, which is normally located where the vasa recta are –> weakened vessels can ulcerate and rupture

Question 20

treatment for juvenile myoclonic epilepsy

Answer 20

broad spectrum anticonvulsant (valproic acid, levetiracetam)

Question 21

clozapine MOA

Answer 21

second generation anti-psychotic

Question 22

what is the only medication that has consistently shown superior efficacy in treatment-resistance schizophrenia

Answer 22

clozapine

Question 23

most often cause of death in ALS patients

Answer 23

respiratory failure

decreased vital capacity

Question 24

inheritance of G6PD deficiency

Answer 24

x-linked recessive

Question 25

hemolytic anemia due to medication induce oxidative stress indicates what dz

Answer 25

G6PD deficiency

Question 26

BMI CUT OFF FOR ANOREXIA

Answer 26

18.5 NOT 17.5

Question 27

pathophysiology of MVP

Answer 27

myxomatous degeneration (pathologic deterioration of the connective tissue) affecting mitral valve leaflets and chordae tendinae

Question 28

enzyme deficient in classic galactosemia

Answer 28

galactose-1-phosphate uridyltransferase | galactose-1-phosphate --> glucose-1-phosphate

Question 29

most common manifestation in mild galactosemia

Answer 29

cataracts (due to galactitol)

Question 30

how does amyl nitrite work in cyanide poisoning

Answer 30

it oxidizes Fe2+ to Fe3+ which generates methemoglobin methemoglobin has high affinity for cyanide, so it binds and sequesters cyanide in the blood

Question 31

describe schizotypical personality disorder

Answer 31

magical thinking (superstitiousness, clairvoyance) and odd perceptual disturbances that are SUB-threshold for a psychotic disorder they DO NOT experience persistent, fixed delusions or frank hallucinations seen in schizophrenia they rarely sustain close relationships due to excessive social anxiety

Question 32

describe schizoaffective disorder

Answer 32

shares symptoms with schizophrenia and mood disorders >2 weeks of psychotic symptoms without manic or depressive episode

Question 33

burkoholderia cepacia: - gram stain? - catalase +? - lactose fermenting?

Answer 33

- gram negative - catalase positive - non-lactose fermenting

Question 34

is bordetella pertussis catalase positive?

Answer 34

yep

Question 35

is serrate catalase positive?

Answer 35

yep

Question 36

is pseudomonas catalase positive

Answer 36

yep

Question 37

how does systemic vascular resistance and pulmonary vascular resistance change during pregnancy

Answer 37

both decrease due to vasodilatory mechanisms that occur during pregnancy

Question 38

where do spinal nerves exit in the lumbar spine

Answer 38

BELOW the vertebral level L5 nerve root exits below L5 vertebrae

Question 39

why do patients need a nitrate-free interval every day when taking nitrates

Answer 39

to decrease tolerance around the clock nitrate administration rapidly results in development of tolerance to nitrates

Question 40

how does age change prognosis in PSGN

Answer 40

increased age worsens prognosis

Question 41

compare effects of raloxifene and tamoxifen

Answer 41

raloxifene: agonist on bone, antagonist on breast and uterus (no increased risk for breast or uterine cancer) tamoxifen: agonist on bone, antagonist on breast, agonist on uterus (increases risk of endometrial hyperplasia/cancer)

Question 42

what antibodies exist in grave's disease

Answer 42

thyrotrophic (TSH) receptor antibodies

Question 43

what antibodies exist in hashimoto thyroiditis

Answer 43

thyroid peroxidase antibodies

Question 44

pathogenesis of hemochromatosis

Answer 44

mutations in HFE protein HFE protein normally interacts with transferrin receptor to form complex that functions as a sensor of iron stores HFE mutation --> enterocytes and hepatocytes detect falsely low iron levels --> accumulation of iron

Question 45

brain tumor in the ventricles int most likely a

Answer 45

ependymoma

Question 46

symptoms of IgA nephropathy

Answer 46

painless hematuria within 5-7 days of a URI

Question 47

compare IgA nephropathy and hence schonlein purpura

Answer 47

IgA nephropathy: painless hematuria within 5-7 days of a URI HSP: IgA nephropathy with extra renal symptoms (abd pain, arthralgia, purport)

Question 48

pathogenesis of neuronal injury in DM

Answer 48

nonenzymatic glycosylation of tissue proteins resulting in hyalinization of endometrial arterioles --> narrowing of arteriole lumen --> ischemic nerve damage also intracellular hyperglycemia in peripheral nerves --> increased metabolism of glucose into sorbitol by aldose reductase --> accumulation of sorbitol --> oxidative stress in the nerve