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Test reviews DEDICATED > thurs jul 30 > Flashcards

thurs jul 30 Flashcards

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1
Q

levadopa MOA

A

converted to dopamine by DOPA decarboxylase -> increased dopamine in parkinsons patients

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2
Q

peripheral S/E of increased dopamine?

A

GI distress (nausea, vomiting), arythmias, orthostatic hypotension

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3
Q

central S/E of incraesed dopamine?

A

psychiatric symptoms -anxiety, hallucinations, etc.

-chronic therapy also causes dyskinesia

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4
Q

what is the wearing off phenomon of levadopa therapy?

A

with chronic therapy akinesia and dyskinesia reemerge towards the end of each dose

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5
Q

what happens to the therapeutic window as parkinsons progresses?

A

becomes narrower

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6
Q

carbidopa MOA

A

peripheral DOPA decarboxylase inhibitor - prevents peripheral conversion of levadopa

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7
Q

tolcapone MOA

A

central and peripheral COMT inhibitor - inhibits breakdown, increasing bioavailability

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8
Q

entacapone MOA

A

peripheral COMT inhibitor - inhibits breakdown, increasing bioavailability

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9
Q

tolcapone A/E

A

hepatic failure

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10
Q

selegiline MOA

A

MOA-B inhibitor- increases dopamine in CNS

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11
Q

ropinirole MOA

A

D2 receptor agonist

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12
Q

pramipexole MOA

A

D3 receptor agonist

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13
Q

treatment of restless leg syndrome?

A

dopamine receptor agonists

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14
Q

A/E of dopamine receptor agonists?

A

impulsivity - gambling, hypersexuality, etc.

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15
Q

amantadine MOA

A

increases endogenous dopamine

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16
Q

what are benztropine and trihexyphenidal?

A

anti-muscarinics that improve tremor and rigidity in parkinsons (no effect on bradykinesia)

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17
Q

transmural fibrous thickening of aortic branches is seen in…

A

takayasu

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18
Q

treatment of kawasaki disease?

A

IV immunoglobulin and aspirin

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19
Q

presentation of kawasaki disease?

A

child with desquamative rash, oropharyngeal signs (strawberry tongue), adenopathy, chest pain

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20
Q

what is thromboangiitis obliterans?

A

beurgers disease

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21
Q

Polyarteris nodosa vessel findings

A

transmural inflammation with fibrinoid necrosis, in renal, coronary and mesenteric arteries
STRING OF PEARLS

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22
Q

which types of arteries does polyarteritis nodosa effect?

A

medium size - coronary, mesenteric, renal

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23
Q

patients with polyarteritis nodosa may be positive for what marker?

A

30% are positive for Hepatits B surface antigen

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24
Q

what presentations do henoch schlonlein purpura and cryoglobulinemic vasculitis have in common?

A

Hematuria
Palpable purpura
Arthralgia

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25
does henoch schlonlein purpura have GI pain?
yes
26
does cryoglobulinemic vasculitis have GI pain?
no
27
what deposits in henoch schlonlein purpura?
igA
28
what is cryoglobulinemic vasculitis associated with?
hepatitis C
29
what deposits in cryoglobulinemic vasculitis ?
cryoglobulin
30
treatment of cryoglobulinemic vasculitis ?
treat hep C
31
churg-strauss syndrome AKA
eosinophilic granulomatosis with polyangitis
32
churg-strauss is associated with a positive...
p-ANCA
33
presentation of churg-strauss
asthma/allergic rhinitis polyps (nasal) peripheral neuropathy igE
34
wegeners aka
granulomatosis with polyangitis
35
wegeners has a positive...
c-ANCA
36
what areas are involved in wegeners?
lungs kidney nasopharynx
37
microscopic angiitis has a positive...
p-ANCA
38
what areas are involved in microscopic angiitis?
lungs and kidneys - not NASOPHARNYX
39
Digeorge syndrome is caused by defective...
neural cell migration
40
which enzyme do fibrates inhibit?
cholesterol 7 alpha-hydroxlyase
41
why do fibrates increase your risk for gallstones?
by inhibting cholesterol 7 alpha-hydroxlyase, the rate limiting step of bile acid synthesis, there is decreased cholesterol solubility in the bile -> gallstones
42
why can H influenza grow on a blood culture, specifically in the presence of staph aureus?
H influenza requires factors V and X (hematin and NAD). | Staph aureus will secrete NAD and the beta hemolysis of S aureus releases hematin -allowing H influenza to grow
43
what is the yellow-brown pigment that may be found in the heart and liver of aging persons?
lipofuscin (this is normal)
44
how does lipofuscin form?
from free radical injury and lipid peroxidation
45
which ribs overlie the spleen?
left 9th 10th 11th
46
which ribs overlie the liver?
right 8th 9th 10th 11th
47
dermatomyositis muscle findings?
PERIMYSIAL inflammatory infiltrates and atrophy in skeletal muscle
48
describe an ecological study
a study that looks at populations as the sample rather than individuals (compares whole countries)
49
what are the benefits of injecting epinephrine along with a local anesthetic?
epinephrine will induce vasoconstriction which: - decreases local bleeding - increases duration of action because the anesthetic stays at the site - decreases systemic side effects due to less systemic absorption
50
diagnosis of P jirovecii?
silver stain
51
treatment of P jirovecii?
TMP-SMX
52
what activates tryspin?
enteropeptidase
53
location of enteropeptidase?
intestinal brush border
54
how may atheroembolic disease present?
days-weeks after a procedure that would have dislodged a plaque, with skin findings such as livedo reticularis and blue toe
55
are the artery pulses palpable in atheroembolic disease?
yes, the microemboli do not affect large arteries
56
what will tissue biopsy show of someone with atheroembolic disease?
needle shaped clefts
57
all opioids are coupled to which type of receptor?
g protein
58
MOA of mu opioid drugs (name both mechanisms)
1. On presynaptic neurons: decrease calcium influx thus decreasing NT release 2. On postsynaptic neurons: opens potassium channels leading to potassium efflux and hyperpolarization MEDIATED BY G PROTEIN BINDING
59
osteltamavir MOA
Neuraminidase inhibitor - prevents virion release
60
what is the best drug for lowering triglycerides?
fibrates
61
effects of niacin?
increased HDL and decreased LDL
62
how do uterine fibroids change as menopause approaches?
they regress
63
which drug is a risk factor for uterine sarcoma?
tamoxifen
64
leiomyoma =
uterine fibroid
65
what spreads babesiosis?
ixodes tick
66
is coal mining associated wiht asbestos?
no
67
is working with insulation assocaited with asbestos?
yes

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