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Test reviews DEDICATED > Test 1 June 21 > Flashcards

Test 1 June 21 Flashcards

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1
Q

first line treatment for acute gouty arthritis?

A

NSAIDs, but contraindicated if patient has peptic ulcer history

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2
Q

What does colchicine bind?

A

tubulin, blocking polymerization of microtubules

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3
Q

how does tolerance to alpha adrenergic decongestants commonly occur?

A

receptor internalization

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4
Q

Patau syndrome AKA

A

trisomy 13

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5
Q

What defect causes patau syndrome?

A

meiotic nondisjunction leads to trisomy 13 which results in a defect in the fusion of the prechordal mesoderm

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6
Q

presentation of patau syndrome?

A

Most babies will die in utero, but of those who do not:
Midline defects:
holoprosencephaly, cleft lip/palate, microphthalmia, microcephaly, omphalocele, cutis aplasia and polydactyly

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7
Q

edwards syndrome AKA

A

trisomy 18

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8
Q

presentation of edwards syndrome

A

fetal growth retardation, hypertonia, micrognathia, congenital heart defects, clenched hands with overlapping fingers, meckels diverticulum, malrotation

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9
Q

Presentation of williams syndrome

A

Elfie facies, supravalvular stenosis, and extroverted personality

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10
Q

Patients receiving anti-complement therapy are at risk for which infection?

A

Neisseria meningitis (complement is important for killing gram - bacteria, especially neisseria)

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11
Q

how do you prevent a patient on anticomplement therapy from getting N meningitis?

A

immunization and antibiotic prophylaxis

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12
Q

how is paroxysmal nocturnal hemoglobinuria treated?

A

monoclonal antibody to complement protein C5 (eculizimab)

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13
Q

How do nitrites cause poisoning?

A

They convert Fe 2+ to Fe 3+ (methemoglobin) which cannot bind oxygen

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14
Q

what does the partial pressure of oxygen in blood represent?

A

the amount of oxygen dissolved in plasma

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15
Q

is the partial pressure of ox in blood changed in nitrite poisoning?

A

no

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16
Q

presentation of methemoglobin?

A

dusky colour to skin (similar to cyanosis), and functional anemia

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17
Q

What is projection?

A

attributing one’s feelings to another

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18
Q

what is identification?

A

modelling ones behaviour after someone who is believed to be more powerful or prestigious. EX: abused son abuses his own kids

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19
Q

What is the pentose phosphate pathway (HMP shunt)?

A

pathway that generates NADPH and ribose-5-phosphate for use in reductive reactions and synthesis of nucleotides, respectively

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20
Q

When there is excess ribose-5-phosphate, which enzymes convert it to the intermediates glyceraldehyde-3-P and fructose-6-phosphate for ATP generation?

A

transketolase and transaldolase (these also work in the reverse direction when ribose-5-phosphate is needed)

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21
Q

cardiac output formula?

A

SV x HR

rate of O2 consumption/arteriovenous O2 content difference

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22
Q

What typically causes atrial flutter? where is this abnormality found?

A

A large reentry circuit. Found transversing the the cavotricuspid isthmus (between the inferior vena cava and triscuspid valve annulus)

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23
Q

Patients on metronidazole may develop what when drinking alcohol?

A

disulfuram-like-reaction

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24
Q

when you perform an emergency cricothyrotomy, what layers do you cut through?

A

skin, superior cerival fascia, investing/pretracheal layers of the deep cervical fascia and the cricothyroid MEMBRANE

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25
Where is locus ceruleus located?
rostral pons, floor of 4th ventricle
26
What does the locus ceruleus produce?
norepinephrine
27
where are histamine and orexin produced?
the posterior hypothalamus
28
statins MOA
inhibit HMG-Coa reduction, leading to decreased hepatic cholesterol synthesisis. LDL receptor upregulation occurs and decreased LDL from the blood
29
how do penicillians and cephalosporins work?
irreversibly bind to penicillin-binding proteins such as transpeptidase
30
how does vancomycin work?
binds D-alanine on cell wall GLYCOPROTEINS which inhibits transpeptidases from forming cross links
31
what cells do the cutaneous neurofibromas in NF1 derive from?
Schwann cells (which are from the neural crest)
32
is the initial lesion of chancroid painful?
yes
33
What causes lymphogranuloma venerum?
Chlamydia trachomatis
34
What is the presentation of lymphogranuloma venerum?
Multiple, small painless ulcers | Then large and painful inguinal lymph nodes (buboes)
35
which serotypes of chlamydia cause lymphogranuloma venerum?
L1-L3
36
how may you treat achalaisa?
botulinum toxin
37
what are the side effects of bile acid sequesterants?
GI upset, impaired absorption, increased triglycerides
38
MOA of ezetimide?
inhibits intestinal absorption of cholesterol -> lower LDL
39
Fibrates MOA?
inhibit hepatic production of triglycerides
40
what is the first line treatment for hypertriglyceridemia?
fibrates
41
using topical decongestants for more than 3 days may result in what?
Rebound rhinorhea -nasal congestion without cough, sneeze or postnasal drip, due to tachypylaxis
42
What causes chronic granulomatous disease?
X linked deficiency of NADPH oxidase (lack of respiratory burst)
43
a myeloperoxidase deficiency may result in recurrent infections with what?
candida
44
how does one get infected with schistosoma species?
swimming in freshwater contaminated with snails (sub saharan africa or east asia)
45
presentation of schistosoma infection?
most patients are asymptomatic but it can cause hepatosplenomegaly, liver fibrosis and portal hypertension, diarheaa/pain, intestional ulceration with iron deficiency anemia, hematuria, pyelonephritis, SCC of bladder
46
is eosinophilia present with malaria infection?
no
47
is eosinophilia present with infection from schistosoma?
yes
48
what is the name of the disorder that presents the same as schizophrenia but lasts <6 mo?
schizophreniform disorder
49
What is schizoaffective disorder?
Major depressive or manic episodes with concurrent symptoms of schizophrenia, PLUS delusions or hallucinations in absence of the manic/depressive episodes lasting > 2 weeks
50
what is the difference between schizoaffective disorder and bipolar/major depressive disorder with psychotic features?
with schizoaffective disorder, psychotic features have been present without the episode of mania/depression, whereas with bipolar or major depressive disorder with psychotic features, the psychotic features occur EXCUSIVELY during the episode
51
agranulocytosis is a complication of which thyroid drugs?
PTU and methimazole
52
which thyroid drug is associated with hepatotoxicity?
PTU
53
excess thyroid hormone results in the increased expression of which type of receptors?
Beta adrenergic -> hyperadrenergic state
54
which type of receptors are PTH (ca sensing) receptors?
G protein coupled (Gq)
55
EPO, growth hormone and prolactin have which kind of receptors?
JAK/STAT
56
which enzyme is deficient in acute intermittent porypheria?
porphobilinogen deaminase
57
AIP attacks result in accumulation of which two substances?
ALA and PBG
58
how do you treat an attack of AIP?
glucose and heme
59
how does glucose and heme work to treat AIP?
they have negative feedback on ALA synthase, the first and rate limiting step in the pathway preventing build up of ALA and PBG
60
which drugs may cause an attack of AIP?
any drugs that induce CYP 450s, including smoking and alcohol use - (these induce ALA synthase)
61
In addition to cat feces, toxoplasmosis can be transmitted how?
contaminated food
62
name 3 examples of cancers that spread hematogenously?
sarcomas renal cell carcinomas hepatocellular carcinomas
63
MOA of finasteride? how does it help BPH?
5 alpha reducatse inhibitor, prevents conversion of testosterone to DHT thus decreasing prostate size over time
64
how does tamsulosin and terazosin work to treat BPH?
these are alpha adrenergic antagonists that relax SM
65
how do glucocorticoids cause antiinflammatory effects?
inhibit phospholipase A2 - decreases leukotriene and prostaglandin production -also suppress transcription of cytokines and proteins for adhesion, decreasing leukocyte recruitment and activation

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