Practice 5

Front 1

Internalin
Listeriolysin O

Back 1

Listeria - internalin - endocytosis
listeriolysin O - pore forming toxin, escape from endosome

Front 2

Reservoir of HIV in:
1. CNS
2. periphery

Back 2

Macrophage
1. microglial
2. dendritic cell (lymph nodes)

Front 3

Bone side effect of Heparin

Back 3

ostetoporosis

Front 4

Aspirin effect on pH at high doses

Back 4

Stim resp drive --> resp alk
Accumulate --> met acidosis

Front 5

Treatment for Lyme

Back 5

doxycycline
penicillin-type abx

Front 6

What molecule does colchicine bind

Back 6

tubulin --> prevents polymerization into microtubules

Front 7

GpIIa/IIIb blockers (3)

Back 7

Eptifibatide
Abciximab
Tirofiban

Front 8

ADP receptor blockers

Back 8

Clopidogrel
Ticlodipine

Front 9

Direct thrombin inhibitors

Back 9

Lepirudin
Bivalirudin
Argatroban

Front 10

Which bisphosphonate doesn't cause reflux esophagitis? why?

Back 10

Zoledronate (IV)

Front 11

Uses of bisphosphonates

Back 11

Malignancy associated hypercalcemia
Paget's disease of bone
Postmenopausal osteoporosis

Front 12

Metabolism of isoniazid

Back 12

Acetylation
(Slow vs. fast acetylators --> diff t(1/2)

Front 13

What to give for acute diuresis in pulmonary edema

Back 13

Loop diuretics

Front 14

What to give to patient:
- DKA
- gestational diabetes

Back 14

regular insulin

Front 15

Nystatin: uses

Back 15

Swish and swallow - oral candidiasis
Diaber rash/vaginal candidiasis

Front 16

What fungus can cause endocarditis in IV drug abusers

Back 16

Candida

Front 17

How might a craniopharyngeoma cause hyperphagia

Back 17

Destruction of ventromedial area

Front 18

Metoclopramide

Back 18

D2 antagonist --> antiemetic
Accelerate gastric emptying, treat gastroparesis

Front 19

anti-histamines: side effects from diff receptors

Back 19

1st gen
- H1 - sedation
- 5-HT - inc appetite, weight gain
- M3 - vision, dry mouth, urinary retention,

2nd gen - doesn't cross BBB --> less sedating

Front 20

Treat hypoglycemia
- street
- ER

Back 20

street: IV glucagon
ER: IV dextrose

Front 21

Side effects of COX-2

Back 21

inc risk thrombosis
sulfa allergy

(no effect on platelet aggregation)

Front 22

NSAIDs (4)

Back 22

Ibuprofen
Naproxen
Indomethacin
Ketorolac

Front 23

Blood effect of NSAIDs

Back 23

aplastic anemia

Front 24

opioids used for diarrhea

Back 24

loperamide
diphenoxylate

mu receptors in gut --> dec GI motility

Front 25

Sulfalazine

Back 25

use for Chrons and UC
- sulfapyridine (antibacterial) plus ASA (a salycyclate - anti-inflammatory)

Front 26

Rx:
- Chron's
- UC

Back 26

Both - Sulfalazine, infliximab
Chrons - corticosteroids
UC - 6-mercaptopurine

Front 27

Rx: secretory diarrhea

Back 27

octreotide

Front 28

Why is methodone useful in opioid withdrawal

Back 28

long t(1/2) --> suppress withdrawal symptoms

Front 29

Main MOA of oral contraceptives

Back 29

suppress gonadotropins

Front 30

Into where does thiopental redistribute

Back 30

Adipose & skeletal muscle

Front 31

How does phenylephrine affect the heart

Back 31

constriction of vessels --> stim baroreceptors --> inc vagal tone --> dec HR

Front 32

How does a2 affect NE

Back 32

inhibits NE release

Front 33

Levidopa
1. on/off
2. wearing off

Back 33

1. unpredictable
2. progressive deterioration of nigrostriatal neurons

Front 34

Epileptic drug precipitating generalized lymphadenopathy

Back 34

Phenytoin

Front 35

EtOH withdrawal
1. MOA
2. 8-12 hours
3. Day 3
4. Treatment

Back 35

1. dec GABA receptors --> no inhibition
2. Autonomic hyperactivity - tachycardia, tremors, anxiety, seizures
2. psychotic symptoms - hallucinations, delusions
4. Benzos - subst for alcohol on GABA receptor
1st line - long acting - chlordiazepam, diazepam
2nd line - short acting - lorazepam, oxazepam

Front 36

Why does digoxin work for afib

Back 36

afib - ventricular contraction limited by AV refractory period
digoxin - slow it down

Front 37

Most common cause of hemolysis in G6PD deficiency

Back 37

infection

Front 38

How do B-blockers affect renin

Back 38

B1 = inc renin release
Block --> dec renin

Front 39

Effects of PDE inhibitors

Back 39

inc cAMP
- inc ionotropy in heart
- vasodilate in vasculature (ie. sildenafil)

Front 40

DA agonists for parkinson's

Back 40

Ergot - bromocriptine, pergolide
non-ergot - pramiprexole, ropinerole

Front 41

Cause of death from TCA toxicity

Back 41

- refractory hypotension
- cardiac arrhythmia

due to inhibition of fast sodium channels in cardiac myocytes

Treatment: NaHCO3

Front 42

Prophylaxis: angina pectoris, coronary syndrome

Back 42

Anti-platelet:
Clopidogrel
Aspirin

Front 43

MAC

Back 43

reflects conc of drug in all tissues (all equilibrate)
MAC = minimum concentration at which 50% of population is anesthetized --> corresponds with potency
Not dependent on ANYTHING except age and temp

Front 44

Diff in side effects between long and short acting antipsychotics

Back 44

Long acting/high potency
- DA antagonist --> EPS side effects

Short-acting/Low potency
- anti-a --> orthostatic hypotension
- anti-M --> blurry virion, dry mouth, constipation
- anti-H --> sedation, weight gain

Front 45

Ketamine

Back 45

dissociative, hallucination, bad dreams, hypersalivation
block NMDA
inc cerebral blood flow
cardiovascular stim

Front 46

Propofol

Back 46

potentiate GABA
less postoperative nausea
rapid, short procedures

Front 47

Esters and Amides preferentiatlly bind...

Back 47

activated Na+ channels - rapidly firing neurons
(inside membrane)

Front 48

Esters and amides are able to bind when...

Back 48

They penetrate the membrane as uncharged, and bind in charged form.
If acidic/infected tissue --> cannot penetrate the membrane --> must use more anesthetic

Front 49

Succeptibility to Malignant hyperthermia

Back 49

Defective ryanodine receptors --> release too much Ca2+ from SR after anesthetic is removed

Use dantrolene to inhibit ryanodine receptors from releasing Ca2+

Front 50

Rate limiting step
Pyrimidine synth
Purine synth

Back 50

Py - Carbamoyl Phosphate II
Pur - Glutamine PRPP Amidotransferase

Front 51

Rate limiting step:
1. Ketogenesis
2. Cholesterol synthesis

Back 51

1. HMG Co-A synthase
2. HMG-Co-A reductase

Front 52

What dopamine pathway do neuroleptics act on

Back 52

Mesolimbic-mesocortical
Regulates behavior

Front 53

how do babies with preductal coarctation supply body

Back 53

PDA --> rt to left shunt from lungs to systemic

Front 54

Pain:
1. angina
2. pericarditis

Back 54

1. substernal, constant, crushing
2. sharp, pleuritic, exacerbate by swallow, relieve by leaning forward

Front 55

schwannoma - uni? bi?

Back 55

bilateral

Front 56

See hypercoagulability, think:

Back 56

cancer

Front 57

Histo of oligodendrocytes in PML

Back 57

cytoplasmic inclyusions - JC virus

Front 58

Wernicke - last symptom to go

Korsakoff - what goes

Back 58

W - ataxia stays a while

K - damage to MD nucleus of thalamus, permanent memory loss

Front 59

Predispose to intimal tear:

sequela?

Back 59

1. HTN!!!
2. cystic medial necrosis

--> aortic dissection (aortic double ring sign)

Front 60

Hypercholesterolemia, Diabetes, smoking predispose to....

--> ?

Back 60

Intimal streak --> atherosclerosis

--> aortic aneurysm

Front 61

Pathophys of
- Troussou's syndrome
- marantic vegetations

Back 61

procoagulant effects of malignancy

Front 62

Aggregated protein:
1. Pick
2. Lewy body dementia

Back 62

1. tau protein
2. a-synuclein

Front 63

Age related aortic stiffening causes...

Back 63

Isolated systolic hypertension

Front 64

MAP =

Back 64

DBP + (1/3)(SBP-DBP)