Wed jul 15

Question 1

MOA of hydralazine?

Answer 1

anteriolar vasodilator

Question 2

metoprolol MOA

Answer 2

cardioselective beta blocker - blocks B1

Question 3

how long does it take for a drug metabolized by first order kinetics to reach steady state?

Answer 3

4-5 half lives

Question 4

what murmur is heard with an ASD?

Answer 4

fixed splitting of S2

Question 5

what murmur is heard with a VSD?

Answer 5

holosystolic murmur best heard at lower left sternal border

Question 6

which drug is used to treat malignant hyperthermia?

Answer 6

dantrolene

Question 7

MOA of dantrolene?

Answer 7

inhibits intracellular Ca release from the abnormal RYR receptor

Question 8

what is the osmolarity of the fluid in the PCT?

Answer 8

Isotonic with plasma - about 300mOsm/L

Question 9

in which part of the nephron is the fluid the most dilute?

Answer 9

DCT

Question 10

how hypertenoic may urine become in the presence of ADH?

Answer 10

up to 1200 mOsm/L - mediated by ADH causing water reapsorption in the CD

Question 11

which type of drugs follow the multicompartment model of distribution?

Answer 11

highly lipophilic drugs (such as propofol)

Question 12

how will drug concentrations that follow the multicompartment model of distribution change over time?

Answer 12

Following a bolus dose the drug will first be high in the central compartment (blood) but rapidly spread to well-perfused organs (brain, heart, lungs). Over time the drug redistributes to less-well perfused organs such as skeletal muscle, fat, bone etc.

Question 13

at which rib do the lungs end at the midclavicular line? Mixaxillary line? Paravertebral?

Answer 13

Midclavicular - 6th
Midaxillary - 8th
Paravertebral - 10th

Question 14

Where should paracentesis be performed at the midclavicular line? Mixaxillary line? Paravertebral?

Answer 14

Midclavicular - below the 6th rib
Midaxillary - below the 8th rib
Paravertebral - below the 10th rib

Question 15

atopic dermatitis is associated with loss of function mutations in…

Answer 15

filaggrin and other epidermal barrier proteins

Question 16

mutations in what protein are responsible for epidermolysis bullosa simplex?

Answer 16

keratin genes

Question 17

which pathogen causes linear ulcerations of hte esophagus?

Answer 17

CMV

Question 18

which pathogen causes punched out ulcerations of hte esophagus?

Answer 18

HSV

Question 19

what does the a wave in a JVP tracing represent?

Answer 19

atrial contraction

Question 20

Under which condition will the a wave of a JVP tracing be absent?

Answer 20

atrial fibrillation

Question 21

which specific mutation is responsible for sickle cell disease?

Answer 21

A point mutation on the beta globin gene that results in valine being replaced with glutamic acid

Question 22

ingestion of pesticides/insecticides (possibly through contaminated water) may lead to which type of poisoning?

Answer 22

arsenic poisoning

Question 23

which processes does arsenic poisoning disrupt?

Answer 23

binds to sulfhydryl groups on enzymes disrupting cellular respiration and gluconeogenesis

Question 24

acute arsenic poisoning presentation?

Answer 24

garlic breath, vomiting, watery diarhea, QT prolongation

Question 25

chronic arsenic poisoning presentation?

Answer 25

hyper/hypopigmentation, hyperkeratosis, stocking glove neuropathy

Question 26

treatment of arsenic poisoning?

Answer 26

dimercaprol or DMSA

Question 27

what chelating agent is used to treat iron overload?

Answer 27

deferoxamine

Question 28

which cells produce anti-mullerian hormone?

Answer 28

sertoli cells

Question 29

which cells produce testosterone?

Answer 29

leydig cells

Question 30

which gene codes for testes determining factor?

Answer 30

SRY on Y chromosome

Question 31

in the absence of the SRY gene, what will happen to gonads?

Answer 31

they will develop into ovaries

Question 32

which subtype of ovarian cancer is associated with increased CA-125?

Answer 32

epithelial ovarian cancer

Question 33

alpha fetoprotein may be increased with which types of cancer?

Answer 33

germ cell tumours of the ovaries and HCC

Question 34

coffee bean nulcei and call-exner bodies are characteristic of which ovarian cancer?

Answer 34

Granulosa cell tumours (stroma - sex cord)

Question 35

a mutatino of what may be implicatd in ALS?

Answer 35

copper-zinc superoxide dismustate 1 (SOD1)

Question 36

what causes a right shift of the oxy-hemoglobin curve?

Answer 36

Increased H (decreased pH) Increased 2,3BPG Increased temperature

Question 37

which enzyme is commonly deficient in homocystinuria?

Answer 37

cystathione beta-synthase

Question 38

what is the cofactor for cystathione beta-synthase

Answer 38

B6

Question 39

how does a transudative effusion compare to an exudative effusion?

Answer 39

it will have lower protein and lower LDH

Question 40

fibrates MOA?

Answer 40

fibrates activate PPARalpha which decreases VLDL production and increase LPL activity (which hydrolyzes triglycerides in chylomicrons and VLDL to release FFA for storage or use by the cells)

Question 41

how does cortisol exert its permissive effects on norepinephrine?

Answer 41

it upregulates alpha 1 receptors

Question 42

treatment for scabies?

Answer 42

permethrin

Question 43

CGG trinucleotide repeats are characteristic of which syndrome?

Answer 43

Fragile X syndrome

Question 44

pathophys of lytic bone lesions seen in multiple myeloma?

Answer 44

Multiple myeloma directly stimulates osteoCLASTS by production RANKL and destroying OPG (decoy receptor) and also secrete cytokines that inhibit osteoblasts