Test 88: All Flashcards

(102 cards)

1
Q

Venous component of internal hemorrhoids drain where

A
  • Middle and superior rectal veins
  • internial iliac vein
  • inferior mesenteric vein
  • portal system
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2
Q

What is venous drainage for external hemorrhoid

A
  • Inferior rectal vein
  • internal pudendal vein
  • internal iliac vein
  • common iliac vein
  • IVC
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3
Q

Name drugs used for bipolar? which one is also used for seizure prophylaxis

A
  • lithium
  • valproate ( seizure prophylaxis)
  • carbamazepine
  • lamotrigine
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4
Q

Carbamazepine is first line treatment for what

A

trigeminal neuralgia

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5
Q

what is a common side effect for Carbamazepine

A

Agranulocytosis

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6
Q

What is a common side effect for valproate

A

hepatotoxicity

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7
Q

What is the side effect for Lamotrigine

A

Stevens-Johnson syndrome

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8
Q

What does Carbamazepine do to CYP450

A

inducer

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9
Q

Ethosuximide is the anticonvulsant choice for what type of seizure

A

absence seizures

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10
Q

Carbon tetrachloride causes what type of injury

A

free radical injury

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11
Q

carbon tetrachloride is oxidized by what system

A

P450

- creates free radicals

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12
Q

Furosemide is what drug

A

loop diuretic that works by inhibiting Na-K-2Cl simperers in loop on Henle

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13
Q

Furosemide stimulates the release of what

A

prostaglandin ( vasodilates afferent arteriole)

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14
Q

What goes wrong with concurrent use of NSAIDs and loop diuretics?

A

decrease diurectic response

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15
Q

role of endothelin

A

vasoconstrictor

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16
Q

Side effects of erythropoiesis-stimulating agents

A
  • thromboembolic events

- hypertension

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17
Q

MOA of Allopurinol

A
  • competitively inhibits xanthine oxidase
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18
Q

Allopruinol interacts with what drug and how

A
  • increases conversion of azathioprine to its active metabolic
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19
Q

MOW of Ganciclovir

A

competitively inhibits incorporation of deoxyguanosine triphosphate into viral DNA

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20
Q

MOA for trimethoprim

A

inhibits bacterial dihydrofolate reductase

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21
Q

Tetrahydrobiopterin (BH4) is a cofactor used for the synthesis of what

A

tyrosine
dopamine
serotonin

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22
Q

What is the hallmark of phenylketonuria

A

intellectual disability

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23
Q

What is elevated and depressed in phenylkeonuria

A
  • increased phenylalanemia

- decreased serotonin

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24
Q

Treatment for phenylketonuria

A
  • low phenylalanine diet

- BH4 supplementation

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25
Female patient comes in with abdominal pain, bloody vaginal discharge, orthostatic hypotension and a positive pregnancy test is highly concerning for
ectopic pregnancy
26
Why must the patient wait at least 2 weeks after discontinuing an MAO inhibitor before taking SSRI?
must allow enough time for MAO regeneration
27
MOA for Phenelzine
monoamine oxidase inhibitor
28
Name the Monoamine oxidase inhibitors
MAO Takes Pride In Shanghai - Tranylcypromine - Phenelzine - Isocarboxazid - Selegiline
29
Why is co-administration of an SSRI and an MAO inhibitor contraindicated
risk of serotonin syndrome
30
MOA for caspofungin
glucan component of the fungal cell wall
31
MOW for cyclosporine
immunosuppressant | - decrease synthesis of IL-2
32
MOA for Fucytosine
nucleotide analog that competitively inhibits RNA synthesis in fungal cells
33
Propanolol can treat what endocrine problem
- decreases peripheral conversion of T4 to T3
34
MOA for propylthiouracil and methimazole
inhibit thyroid peroxidase | - decrease thyroid hormone
35
What is the dose-limiting side effect of Vincristine therapy
neurotoxicity
36
Common side effect for cyclophosphamide
hemorrhagic cystitis
37
common side effect for doxorubicin
congestive heart failure
38
common side effect for bleomycin
- pulmonary fibrosis | - flagellate skin discoloration
39
Common adverse effect of highly-active antiretroviral therapy
lipoatrophy/lipodystrophy
40
How is fat redistributed in viral drugs
- lipoatrophy: loss of subcutaneous fat, from face, extremities and buttocks - central fat deposition on abdomen
41
What hormone increases the most after ovulation
Progresterone
42
Digoxin toxicity
- cardiac arrhythmias - nonspecific GI - neurological ( confusion/weakness) - visual symptoms
43
What serum level is a sign of digoxin toxicity
elevated potassium
44
mechanism behind the ACE inhibitor induced cough
- accumulation of bradykinin, substance P or prostaglandins
45
Do angiotensin receptor blockers have a side effect of cough
no
46
Role of ACE
degrades bradykinin
47
Nonnucleoside reverse transcriptase inhibitors (NNRTIs) do not require what
do not require activation via intracellular phosphorylation
48
Name the NNRTI's
Delavirdine Efavirenz ( common) Nevirapine ( common)
49
Common side effects for NNRTI
rash and hepatoxicity
50
Zidovudine and emtricitabine are what type of drugs
NRTI
51
MOA for Enfuvirtide
bind to HIV envelope gp41 and blocks fusion
52
MOA for Ritonavir
inhibitor of HIV protease that prevents assembly and maturation of the virus
53
Why should non-selective beta blockers should be given with cation to a diabetic mellitus patient
- drug exacerbates hypoglycemia | - masks its adrenergic symptoms mediated by norepinephrine and epinephrine
54
What is the sickle cell mutation
DNA point mutation of glutamic acid to valine at positive 6
55
Theophylline MOA
- adenosine receptor antagonist - indirect adrenergic agnet - phosphodiesterase inhibitor
56
Theophylline is metabolized by what
cytochrome P450
57
Amoxicillin and cephalexin MOA
beta-lactams that inhibit bacterial cell wall synthesis
58
NItrofurantion MAO
inactivates or alters bacterial ribosomal proteins
59
What is the drug interaction between Ciprofloxacin and theophylline
theophylline metabolized by CYP450, however Cipro increases [theophylline]
60
how does spinal stenosis present
- posture-dependent lower extremity pain, numbness/paresthesia and weakness
61
Most common causes of spinal stenosis
1. intervertebral disk herniation 2. ligamentum flavum hypertrophy 3. osteophyte formation
62
Aldosterone excess causes what
- hypertension - hypokalemia - metabolic alkalosis - depressed renin
63
Conn syndrome
Primary hyperaldosteronism
64
Treatment for Conn's syndrome
Spironolactone/Eplerenone
65
Cribiform plate
CN I olfactory bundles
66
Optic canal
CN II ophthalmic artery central retinal vein n
67
superior orbital fissure
CN III, IV, V1, VI ophthalmic vein sympathetic fibers
68
Foramen rotundum
CN V2 maxillary
69
Foramen ovale
CN V3 mandibular
70
Foramen spinosum
Middle meningeal artery and vein
71
Internal acoustic meatus
CN VII, VIII
72
Jugular foramen
CN IX, X, XI | Jugular vein
73
hypoglassal canal
CN XII
74
Foramen magnum
Spinal roots of CN XI brain stem vertebral arteries
75
What muscle opens the jaw
lateral pterygoid
76
Third ( mandibular) branch of trigeminal nerve innervates what
- muscles of mastication ( masseter, medial and lateral pterygoids, and temporals muscles)
77
How is PAH excreted from blood to tubules
via carrier protein-mediated process
78
Characterize giant cell arteritis
granulomatous inflammation of the media | - medium and small branches of carotid artery ( temporal artery)
79
treatment for giant cell
glucocorticoid therapy `
80
Elderly women with beaches, muscular pain, and a rapid response to glucocorticoid therapy
giant cell arteritis
81
What is tranmural inflammation of the arterial wall with fibrinoid necrosis
polyartertis nodosa
82
What anti-inflammatory agent does not impair platelet aggregation
Celecoxib
83
MOA for Celecoxib
reversibly inhibits cox-2
84
How is glucose moved across cell membrane
Facilitated diffusion
85
Where is GLUT 4 found
skeletal muscle and adipocytes
86
Role of GLUT 2
export of glucose from liver, small intestines, and kidneys into circulation
87
What enzyme inactivates 6-mercaptopurine
xanthine oxidase
88
6-MP requires activation by what
HGPRT | hypoxanthine-guanine phosphoribosyl transferase
89
Incidence of cancer in women, top 3
1. breast, lung, colon
90
extra renal manifestations of autosomal dominant polycystic kidney isease
- liver cyst | - intracranial aneurysm
91
Statins are metabolized by what? exception
P-450 3A4 | - pravastatin
92
Erythromycin and P450
inhibits P450
93
The presence of erythroid precursor cells in the liver and spleen indicative of what
extramedullary hematopoiesis
94
Extramedullary hematopoiesis is most frequently cause by severe
severe chronic hemolytic anemias
95
Niemann-Pick is deficiency in what
Sphingomyelinase
96
What accumulates in Niemann pcik
Sphingomyelin accumulaiton
97
Clinical findings for Niemann pick
- hepatosplenomegaly - neurologic regression - "cherry-red" on macula
98
Patient with alcohol use, epigastric pain , and steatorrhea likely has
chronic pancreatitis
99
Candida is normally located where
GI tract (oral cavity)
100
How does cleaning something with alcohol disinfect it
disorganizing lipid structure in membranes, causing them to be leaky, and by denaturing cellular proteins
101
Main mechanism of excess copper removal in healthy human body is
hepatic excretion into bile
102
How do you reduce the risk of wrong-site surgery
"dual identifies" | - nurse and physician independently confirm