Test 59

Question 1

central event in pathogenesis of acute necrotizing pancreatitis

Answer 1

abnormal activation of trypsinogen to trypsin>

premature activation of zymogens and pancreatic autodigestion

Question 2

lower total cholesterol and LDL levels

most effective lipid lowering drugs for primary and secondary prevention of CVD events

Answer 2

statins

Question 3

manifests in infants w/ ACUTE RENAL FAILURE, microangiopathic hemolytic anemia and thrombocytopenia

decreased RBC
hematocrit
platelet count

Answer 3

HUS

increased bleeding time, LDH, BUN, Cr

Question 4

interferons a and B

Answer 4

produced in response to VIRAL infections

act on neighboring cells>
stimulate them to synthesize antiviral proteins that DEGRADE intracellular mRNA na dimpair protein syntehsis

Question 5

ifn y

Answer 5

NK and T cells

promotes Th1 differentiation, MHCII expression, activates mphages

Question 6

MCC of subungal splinter hemorrhages

Answer 6

microemboli from valvular vegetations of bacterial endocarditis

*may hear new onset regurgitant murmur

Question 7

used to treat MOST seizure types and are broad spectrum anticonfulsants

Answer 7

lamotrigine
levetiracetam
topiramate
valproic acid*

Question 8

JME

Answer 8

juvenile myoclonic epilepsy

myoclonic seizures that are a form of generalized epilepsy

Question 9

Baclofen

Answer 9

GABA-B agonist

x muscle spasticity

Question 10

Baclofen

Answer 10

GABA-B agonist

tx muscle spasticity

Question 11

Clonidene

Answer 11

alpha 2 receptor agonist

children w/ ADD who failed tx w/ stimulants

Question 12

Diazepam

Answer 12

used ACUTELY to tx PROLONGED seizures

Question 13

DA antagonist that can treat Tourettes

Answer 13

fluphenazine

Question 14

CO poisoning

Answer 14

1. binds Hb w/ more affinity than O2, and reduces number of heme binding sites available to O2–> decrease O2 content in blood
2. causes LEFT shift of Hb-O2 curve, reflecting decreased tendenccy of O2 to unload in tissues

**does NOT affect PaO2 (O2 dissolved in plasma) NORMAL

Question 15

Methemoglobinemia

Answer 15

drug exposures

Fe2 oxidized to Fe3

Question 16

recurrent veginal Candida infections
weight loss
diarrhea
generalized lymphadenopathy
thrush

Answer 16

HIV

Question 17

pts w/ AIDS have increased incidence of waht cancer

Answer 17

EBV assocaited lymphomas

Question 18

what vitamins are NOT present in breast milk

Answer 18

vits D and K

K supplemented by intramuscular injection at delivery to prevent hemorrhagid disease of newborn

vit D supplements hsould be given to prevent rickets d/t lack of sun exposure

Question 19

black pigment stones

Answer 19

chronic extravascular hemolysis

Question 20

what drug in combination w/ lisinopril is most likely to cause hyperkalemia

Answer 20

K sparing diuretics

Question 21

amiloride
triamterene
spironolactone

Answer 21

K sparing diuretics

Question 22

Ticlodopine SE

Answer 22

Neutropenia
fever and mouth ulcers

CBC should be monitored biweekly for tfirst three months

Question 23

used to control sxs of carcinoid syndrome

Answer 23

octreotide

synthetic STTT analog

Question 24

ondansetron

Answer 24

antiemetic used in pts undergoing chemo

5HT3 receptors

Question 25

ondansetron

Answer 25

antiemetic used in pts undergoing chemo 5HT3 receptors

Question 26

MCC of ca kidney stone disease

Answer 26

Idiopathic hypercalciuria NORMAL serum Ca levels and high leels of Ca excreted in urine

Question 27

HUS etiology

Answer 27

shiga toxin producing gbacteria E. coli shigella

Question 28

antecedent diarrheal illness (bloodY) hemolytic anemica w/ shistocytes thrombocytopenia acute kidney injury (red urine)

Answer 28

HUS toxins injure endothelium of preglomerular arterioles/capillaries leading to platelet activation and aggregation to form MICROTHROMBI

Question 29

IgA mediated vasculitis

Answer 29

HSP palpable purpura abdominal pain arthralgias acute glomerulopnephritis

Question 30

streptococcal Ag associated glomerular damage

Answer 30

1-3 weeks after infection

Question 31

vasculitis of medium arteries

Answer 31

kawasaki disease

Question 32

massive widespread activation of coagulation cascade

Answer 32

DIC d/t release of procoag substances by sepsis, malignancy, trauma

Question 33

hematogneous osteomyelitis

Answer 33

MC in children affects METAPHYSIS of long bones d/t slower blood aflow in region> chronic supprative osteomyelitis

Question 34

homogenous deposition of eosinophilic hyaline material in intima and media of small arteries and arterioles

Answer 34

hyaline arteriosclerosis d/t longstanding non malig HTN or diabetes

Question 35

resembles clinical presentation of Friedrich ataxia ataxia dysarthria loss of P/V sensation

Answer 35

severe vit E def degeneration of spinocerebellar tracts, dorsal column and peripheral nerves

Question 36

vaccination for Rubella

Answer 36

live attenuated rubella virus vaccine