Thurs Jul 16

Question 1

Is misoprostol commonly prescribed for GERD?

Answer 1

No - its used for NSAID induced ulcers but is not that helpful for GERD and also causes uterine contractions (prostaglandin E1 analog)

Question 2

which cells activate macrophages in a TB infection?

Answer 2

CD4 t cells - by secreting IFNgamma

Question 3

what is pramipexole?

Answer 3

A dopamine agonist - directly binds dopamine receptors

Question 4

what is ropinirole?

Answer 4

A dopamine agonist - directly binds dopamine receptors

Question 5

what is bromocriptine?

Answer 5

A dopamine agonist - directly binds dopamine receptors

Question 6

what is a field defect?

Answer 6

multiple malformations that occur secondary to an embryonic disturbance in adjoining groups of cells

Question 7

holoprosencephaly is an example of which type of defect?

Answer 7

field defect

Question 8

vit E deficiency presentation?

Answer 8

hemolysis and neurological defects (similar to B12 deficiency)

Question 9

how far down in the lungs do the respiratory cilia go?

Answer 9

Down to the respiratory bronchioles

Question 10

how are particles that lodge beyond the respiratory bronchioles cleared?

Answer 10

alveolar macrophages

Question 11

blood findings in someone with reduced cortisol?

Answer 11

low sodium, high potassium, normocytic anemia, eosinophilia

Question 12

findings on brain MRI of someone with JC virus

Answer 12

asymmetric white matter lesions with no mass effect or enhancement

Question 13

which cells are attacked by JC virus leading to progressive multifocal leukoencephalopathy?

Answer 13

oligodendrocytes

Question 14

which nerve provides sensory innervation to the cornea of the eye?

Answer 14

trigeminal nerve (Va)

Question 15

which 3 enzymes of the citric acid cycle require niacin (NAD) as a cofactor?

Answer 15

isocitrate dehydrogenase
alpha keto acid dehydrogenase
malate dehydrogenase

Question 16

is aspergillus dimorphic?

Answer 16

NO - only mold

Question 17

presentation of tension pneumothorax?

Answer 17

SOB, chest pain
decreased breath sounds unilaterally
Subcutaneous crepitus
Hypotension, tachycardia and tracheal deviation

Question 18

which substances in the lungs are vasoconstrictive and proproliferative?

Answer 18

endothelin, TXA2

Question 19

which substances in the lungs are vasodilative and antiproliferative?

Answer 19

NO, prostacyclin

Question 20

what are the relative levels of endothelin, TXA2 and prostacylin in someone with pulmonary arterial hypertension?

Answer 20

increased endothelin
increased TXA2
decreased prostacyclin

Question 21

SGLT2 inhibitors MOA?

Answer 21

inhibit glucose reapsorption in the PCT

Question 22

how do SLGT2 inhibitors lead to decreased BP?

Answer 22

osmotic diuresis

Question 23

classic presentation of Rett syndrome?

Answer 23

normal development until 6-18 months when regression occurs

• stereotypical hand movements
• decelarated head growth

Question 24

how will increased estrogen effect the levels of T3 and T4?

Answer 24

Increasing estrogen raises circulating TBG (which binds T3 and T4) - more bound T3/T4 means less free T3/T4 and a subsequent raise in TSH –> this increases the TOTAL T3/T4

Question 25

presentation of typhoid fever (salmonella typhi)

Answer 25

``` Week 1: -Escalating fever -Bacteremia -Bradycardia Week 2: -Formation of rose spots on abdomen/chest -Abdominal pain Week 3: -Hepatosplenomegaly -Hemorhagic enteritis and possible bowel perforation ```

Question 26

how does salmonella typhi spread?

Answer 26

fecal-oral route by ingestion of food/water with human feces

Question 27

pathophys of salmonella typhi?

Answer 27

Invades intestinal mucosa and is engulged by macrophages but prevents oxidative burst via capsular antigen. Replicates in macrophages and spreads through the lypmh and reticuloendothelial system

Question 28

how is pneumocystis jirovecii stained?

Answer 28

methanamine silver stain