Boards Boot Camp Comprehensive Flashcards: Segment 7

Front 1

What do the following have in common?
busulfan
bleomycin
amiodarone
radiation
chemical poison
pneumoconiosis

Back 1

potential to cause parenchymal disease resulting in restrictive lung disease

Front 2

pt presents with cor pulmonale (rt sided heart failure) and CXR shows honeycomb lung

Back 2

Interstitial fibrosis

Front 3

CHF, nephrotic sd, and hepatic cirrhosis cause ____________ effusions, while malignancy, pneumonia, radiation, and chylothorax cause ___________ effusions.

Back 3

transudate; exudate

Front 4

Pt presents with hemoptysis, iron deficiency, and proteinuria. Renal biopsy reveals linear anti-GBM IgG deposits. Tx?

Back 4

this is Goodpasture's
emergent steroids

Front 5

Pt presents with sinusitis, bloody nose, fever, and joint pain. What anti-body would confirm your dx?

Back 5

C ANCA anti-body
dx of Wegner's

Front 6

pt with a hx of asthma presents with fever, tachycardia, and signs of an MI (which are all systemic symptoms). What anti-body is highly sensitive to make the dx of Churg-Strauss?

Back 6

P ANCA
eosinophilia in lung and blood

Front 7

pt presents with SOB, cough, easy fatigue. CXR shows eggshell calcifications in hilar lymph nodes. What was his likely job?

Back 7

sand blaster
Silocosis

Front 8

the carotid bodies are the major sensors to __________.
the central chemoreceptors senors to _________.
The Hering-Breuner reflex acts to do what?
Peripheral chemoreceptors are the major mediator of compensatory __________ in the case of metabolic ___________.

Back 8

hypoxia (more sensitive than aortic bodies)
hypercapnia (high CO2)
Vagal response to terminate inspiration when the lung capacity reaches 1 L
hyperventilation; acidosis

Front 9

For the following, match the factor with its association with acute interstitial nephtitis or acute tubular necrosis:
aminoglycosides
contrast media
dirty brown casts
proteinuria, RBCs, WBCs, and WBC casts
penicillin, dilantin, infections, radiation
hypersensitivity response

Back 9

aminoglycosides - ATN
contrast media - ATN
dirty brown casts - ATN
proteinuria, RBCs, WBCs, and WBC casts - AIN
penicillin, dilantin, infections, radiation - AIN
hypersensitivity response - AIN

Front 10

A pt with a partial airway obstruction can compensate for an increased PCO2 by hyperventilating (central chemoreceptor response), but not a decreased PO2

Back 10

FACT

Front 11

prokaryotes are inhibited from dividing by blocking __________, which are done by drugs that block __________ _________.

Back 11

translation; protein synthesis inhibitors

Front 12

match the drugs that block translation at the 50s and 30s:
CEC
TA

Back 12

50s CEC - chloramphenicol, erythryomycin, clindamycin
30s TA - tetracycline, aminoglycosides

Front 13

this drug has a seriously weird pharm profile, name the drug based on the following:
photosensitivity
pseudotumor cerebri, exacerbated by isotretonin
stains teeth in kids under 8
CI in preggers
not to be taken within 2 hours of antacid, iron, calcium, or dairy products as they impair absorption

Back 13

tetracycline
pseudotumor cerebri - increased intracranial pressure in the absence of a tumor. Which is ironic bc tetracycline doesn't cross the BBB

Front 14

drug ID based on the following:
inhibits peptidyl transferase at 50s (same MOA for clindamycin)
inhibits P450
bone marrow toxicity-->fatal aplastic anemia
causes gray baby syndrome

Back 14

chloramphenicol
peptidyl transferase forms a peptide bond btw amino acids

Front 15

ID the drug based on the following:
blocks translocation of the peptide chain
DOC in penicillin allergic patients
DOC mycoplasma pneumoniae
increase the risk for QT interval prolongation-->torsades
risk of torsades is magnified by other drugs that also inhibit P450

Back 15

erythromycin

Front 16

Which bacterial toxin is a protein synthesis inhibitor in eukaryotes?

Back 16

diptheria toxin

Front 17

folate inhibitors are the DOC for what types of infections?

Back 17

toxoplasmosis
prophylaxis for toxoplasma and pneumocystis

Front 18

any drug that inhibits DNA synthesis cause what adverse effect?

Back 18

bone marrow supression

Front 19

ID the drug based on the following:
inhibits purine synthesis by being incorporated into RNA and DNA
used especially for the tx of ALL
hepatotoxic and caused bone marrow supression

Back 19

6-mercaptopurine

Front 20

ID the drug based on the following profile:
pyrimidine antagonist by incorporation into DNA
used especially for non-lymphocytic leukemia
caused bone marrow supression and is hepatotoxic
has its own "syndrome" marked by fever, malaise, bone pain, conjunctivitis, rash, and chest pain

Back 20

cytarbine

Front 21

ID the drug based on the following profile:
inhibits thymidine synthesis
special use in slow growing tumors (breast, colon, GI)
causes bone marrow depression

Back 21

5-fluorouracil (5-FU)

Front 22

antibiotic cytotoxins (actinomycin D, doxorubicin, bleomycin) are used in the treatment of?

Back 22

cancer

Front 23

Drug ID:
interferes with DNA-dependent RNA polymerase, at high does inhibits DNA synthesis
severe necrosis if escapes into tissue
CI in active chickenpox or shingles

Back 23

actinomycin D (dactinomycin)

Front 24

Drug ID:
creates radical oxygen species that causes DNA breaks between base pairs
causes bone marrow suppression
cardiotoxic and can cause cardiomyopathy
tissue necrosis if escapes from tissue

Back 24

doxorubicin (adrimycin)
"ruby red heart"

Front 25

Drug ID:
binds to DNA and creates radical oxygen species resulting in DNA breaks
nephrotoxic, hepatotoxic, skin toxic, and causes fibrosis of the lung

Back 25

bleomycin
"blows apart DNA"

Front 26

Drug ID:
effective against gram positive and negative
prolongs QT interval
risk of joint cartilage injury in the young
tendon rupture in the old, specifically the Achilles
also can cause false + on an opiate screen

Back 26

floroquinolones

Front 27

Drug ID:
transcription inhibitor
used to treat mycobacterium, leprosy, TB
prophylaxis for neisseria meningitis
significant hepatotoxicity, bone marrow supression, and thrombocytopenia

Back 27

rifampin

Front 28

Drug ID:
used to treat breast and lung cancer, ALL, and lymphoma
dose limiting alopecia, stomatitis, bone marrow suppression, immunosupression

Back 28

actinomycin D

Front 29

chemotherapeutic drug can cause hemorrhagic cystitis that may progress to bladder fibrosis

Back 29

cyclophosphamide

Front 30

chemo drug that can cause pulmonary fibrosis

Back 30

bleomycin

Front 31

chemo drug that can cause nephrotoxicity, ototoxicity, and peripheral neuropathy (parathesias and loss of proprioception)

Back 31

cisplatin

Front 32

How to differentiate if pulmonary edema is d/t ARDS or cardiogenic?

Back 32

capillary wedge pressure
<12 non-cardiogenic (ARDS)
>12 cardiogenic

Front 33

pt presents post-partum with dyspnea, tachypnea, tachycardia, and hemoptysis. CXR shows wedge shaped opacification at the distal edges (hamptons hump)

Back 33

PE
possible from amniotic exposure to maternal blood

Front 34

What are the severe adverse reactions when aminoglycosides are combined with:
neuromuscular blockers
loop diauretics

Back 34

enhanced blockade
ototoxicity

Front 35

What are the severe adverse affects when MAOIs are combined with:
levodopa
amphetamine

Back 35

hypertensive crisis
hypertensive crisis

Front 36

What two drugs can cause drug induced lupus?

Back 36

procainamide (antiarrhythmic)
hydralazine (hypertensive agent, relaxes smooth mm by limiting Ca++ release)

Front 37

What do the following drugs have in common:
penicillins
cephalosporins
aminoglycosides
vancomycin
quinolones

Back 37

all are bactericidal

Front 38

What do the following drugs have in common:
chloramphenicol
erythromycin
tetracyclines
sulfonamides
trimethoprim

Back 38

all are bacteriostatic

Front 39

Define the mechanism of resistance:
transmission of DNA from bacteriophage
uptake from environment
transmission from sex pili

Back 39

transduction
transformation
conjugation

Front 40

pt presents with cough, dyspnea, hemoptysis, and hoarsness. If lung cancer is suspected, what is the worst screening tool and will definitely get you laughed at.

Back 40

X-ray
only visible at 1 cm and by that point it has most likely metastized

Front 41

Type of lung cancer that can produce myasthenia gravis-like condition known as what? Mechanism?

Back 41

small cell carcinoma
Lambert-Eaton syndrome
d/t induction of abs to tumor that cross react with pre-synaptic Ca++ channel

Front 42

Renal cell carcinoma can metastasize to lung and secondarily cause polycythemia d/t what?

Back 42

overproduction of eythropoietin

Front 43

Type of lung cancer that presents in non-smokers, seen in lung periphery and sub-pleura. Arises from previous lung scar. CEA used to follow treatment. Characterized by mutated K-RAS oncogene

Back 43

Adenocarcinoma

Front 44

Lung cancer not related to smoking, seen in lung periphery, reacts with surfactant. Arises in Clara and type II pneumocytes

Back 44

broncoalveolar carcinoma

Front 45

Carcinoma in lung periphery, highly anaplastic, pleomorphic giant cells with leukocyte fragments in cytoplasm

Back 45

large cell carcinoma
giant cells = emperipolesis

Front 46

Central hilar mass in broncus, strong association with smoking, hypercalcemia d/t PTH like peptide, keratin pearls and intracellular bridges (desmosomes), masses for cavity

Back 46

small cell carcinoma

Front 47

Similar to small cell carcinoma, ACTH secretion and possibly ADH secretion-->SIADH. PN Kulchitsky cells (small, dark blue cells similar to lymphocytes

Back 47

small cell (oat cell) carcinoma

Front 48

Lung cancer that causes recurrent diarrhea, skin flushing, and wheezing. Also present Kulchitsky cells

Back 48

bronchial carcinoid tumor
tx with 5-HT antagonist

Front 49

Lung cancer that causes dyspnea, hemoptysis, and pneumothorax. Arises in smooth mm. Tend to obstruct

Back 49

lymphangioleiomyomatosis
seriously?

Front 50

Difference in apnea and central apnea?

Back 50

apnea - absent airflow despite breath despite effort
central - no attempt is made

Front 51

Syndrome of obstructive sleep apnea. Daytime sleepiness

Back 51

Pickwickian syndrome

Front 52

Definition of non-allergic asthma

Back 52

d/t a single high dose exposure to toxic material (MC chlorine). Pt develops asthma because of direct muscosal injury

Front 53

pt presents with fever, chills, lung infiltrates in CXR, leukocytosis, and dyspnea that has lasted 2 days. Chronic low level exposure to antigen leads to what?

Back 53

hypersensitivity pneumonitis
pulmonary fibrosis

Front 54

Exposure to this toxic inhalant produces granulomas and fibrosis, looks like sarcoidosis

Back 54

Beryllium

Front 55

PN for this inhalant are giant cells

Back 55

giant cell pneumonitis (cobalt exposure)