Comlex

Front 1

A 60 year old women
Diabetes
High BP
UA positive albumin
Best initial drug

Back 1

ACE inhibitors - Catopril
Slows progression of diabetic nephropathy

Front 2

Paget's disease of the breast

Back 2

Requires investigation for ductal carcinoma

Front 3

Baby of diabetes mother

Back 3

Baby may rather large due to infusion of insulin
Hypoglycemic episodes immediately after birth

Front 4

ACE inhibitors are not prescribed to pregnant women
Or to those considering pregnancy due to RENAL AGENESIS

Back 4

Week 3-8 of pregnancy are referred to embryonic period during which neural tube is formed and closes

Front 5

5 year old, fever, painful skin rash on arms and trunk
Skin erythematous, with large blisters, serous fluid exudate
Splitting of epidermis at stratum granulosum

Back 5

Staph aureus. Scaled-skin syndrome is a toxin-mediated. It causes painful blistering due to splitting the epidermis at stratum granulosum

Front 6

Furosemide - loop diuretics
Common side effects

Back 6

Hypokalemic metabolic alkalosis
Ototoxicity
Hyperuricemia
Hypomagnesemia
Allergic reactions
Hypercalciuria

Front 7

Patient with exacerbation of heart failure.

Back 7

Loop diuretics such as furosemide are preferred agents in the treatment of symptomatic heart failure

Front 8

Fisherman, fever, chills, cellulitis with bullae on his hands

Back 8

Vibrio Vulnificus

Cellulitis on hands of salt-water shellfish handlers

Front 9

5 year old child, to clinic with 3 weeks hx of impetigo, and recent onset of dark colored urine

Back 9

Post streptococcal glumerulonephritis - is a glomerular immune complex disease induced by specific nephritogenic strains of group A beta-hemolytic streptococcus
- This response occur due to impetigo or tonsillopharyngitis infection
-Acute Rheumatic fever: only preceded by group A streptococcal tonsillopharyngitis

Front 10

Post-streptococcal Glomerulonephritis

Back 10

Type III hypersensitivity

Front 11

Lithium - DOC for bipolar disorder
Valproic acid and Carbamazepine also can be used

Back 11

Antidepressants - can cause manic phase if bipolar disorder is misdiagnosed as depression

Front 12

47 year old, DM II
Initiate on oral medication
Drug lowers her blood glucose
Decrease gluconeogenesis
Increasing glycolysis
Also act to sensitive to Insulin's response. Adverse effect of this drug:

Back 12

Lactic Acidosis
Metformin (Biguanide) is oral hypoglycemic medication that can lead to lactic acidosis

Front 13

27 year old female
Increased Urinary Frequency
Dysuria for the last four days
Positive Leukocyte Esterase
Positive Nitrates and WBC

Back 13

Tx with Trimethoprim/Sulfamethoxazole

Front 14

Mechanism of Trimethoprim/Sulfamethoxazole?

Back 14

Prevention of synthesis of dihydrofolic acid
( a substrate for tetrahydrofolic acid)

Front 15

Mechanism of Cipro?

Back 15

Ciprofloxacin and other fluoroquinolones
- inhibiting bacterial DNA topoisomerase II

Front 16

Streptococcus mutans - a gram positive bacteria in oral cavity

Back 16

Enters compromised gums and may cause vegetative growth on the heart's valves, leading to murmurs

Front 17

33 year old lanscaper, itchy watery eyes, nasal congestion, rash on flexor surface of extremitis
Symptoms get worse, difficult catching his breath
Most appropriate initial therapy?

Back 17

Loratadine - second generation anti-histamine.
First generation anti-histamines (diphenydramine, dimenhydrinate, chlopheniramine, and hydroxyzine) are more sedating than 2nd generation

Front 18

Second generation anti-histamine:

Back 18

Loratadine
Fexofenadine
Desloratadine
Cetirizine

Front 19

Patient spill parathion on himself
Parathion acts like a cholinesterase inhibitor

Back 19

- patient have suymptoms of:
Diarrhea, Urination
Miosis (pin point pupil,) bronchospasm, bradycardia, excitation of skeletal muscles and CNS
Lacrimation, Sweating, Salivation

Front 20

Panic disorder - associated with fear of closed spaces

Back 20

DOC for panic attack is benzodiazepine - such as alprazolam

Front 21

Overdose of benzodiazepines can be managed with

Back 21

Flumazenil.

Front 22

MOA of benzodiazepines

Back 22

Binds to GABA receptor and increase the frequency of its open channel state

Front 23

Fluconazole

Back 23

Treat systemic fungal infection
Inhibits synthesis of ergosterol (a steroid found in fungal cell membranes)
Cause gynecomastia and inhibits P 450

Front 24

Rifampin

Back 24

Tx Mycobacterium tuberculosis, disrupting mRNA synthesis
-Inhibits DNA-dependent RNA polymerase

Front 25

Side effect of Rifampin

Back 25

Red/Orange color change that occurs in body fluids
-May cause hepatotoxicity
-May cause drug-drug interactions due to its activation of cytochrome P450

Front 26

Doxycycline

Back 26

Tetracycline - inhibits protein synthesis, binds to 30S subunit
-Prevent attachment of aminoacyl-tRNA (responsible for elongation allowing peptide chains to grow)

Front 27

Doxycycline is CI in

Back 27

-Pregnant women and young children due to its potential to disrupt bone growth and
-Discoloration of tooth enemel
-No affect on P450

Front 28

Erythromycin -

Back 28

Macrolide useful in tx of gram positive cocci infections, Mycoplasma, Legionella, Chlamydia, Neiserria
-Binds to 50S subunit
-Inhibits translocation

Front 29

Side effect of erythromycin

Back 29

GI upset
Acute cholexttic hepatitis
Inhibits P450

Front 30

Gentamycin

Back 30

Aminoglycoside
Inhits protein synthesis
Bind to 30S ribosomal subunit
-Aminoglycosides prevent formation of initiation complex for protein synthesis, cause misreading of mRNA

Front 31

Gentamicin

Back 31

Aminoglycoside = ototoxicity, which cause hearing loss, a common side effect
CI in pregnancy
NO affect in P450

Front 32

Common side effect of Gentamicin

Back 32

- Ototoxicity
-Hearing loss, a common side effect
- No affect on P-450

Front 33

Rifampin

Back 33

tx Mycobacterium tuberculosis
disrupting mRNA synthesis
-Inducers of P450

Front 34

55 yo man, dull epigastric pain
2 hrs worsens 2hr after meals

Back 34

- Stool is positive
- Antacids: slightly improve his symptoms
- Chronic use of corticosteroids can cause peptic ulcers or worsen existing ulcers.

Front 35

Thirty minutes after taking her medicine, a 45-year-old type II diabetic complains of sweating, dizziness, heart palpitations and tremor

Back 35

responsible for her symptoms
- hypoglycemia
- sulfonylureas which includes glyburide

Front 36

A 55-year-old female doubled her dose of furosemide because she forgot to take it yesterday. She presents with lightheadedness and weakness. Blood pressure is 70/50.

Back 36

- High renin activity
- Hypotension stimulates baroreceptors causing tachycardia and activation of the renin-angiotensin system leading to salt and water retention.

Front 37

Hear voices, talk to himself, rampling speech, does not make sense, sloppy clothes that are too big

Back 37

Disorganized schizophrenia is characterized by disorganized speech, inappropriate affect, inappropriate laughter, poor hygiene and sloppy appearance.

Front 38

This infant most likely has Erb-Duchenne palsy, the most common brachial plexus injury during delivery, especially when traction is used.

Back 38

Erb-Duchenne palsy is the most common brachial plexus injury during delivery. It manifests as inability to abduct the shoulder.

Front 39

A positive linear correlation between two variables (in this case anti-DNA antibody levels and glomerulonephritis severity) means that when one variable increases or decreases the other also increases or decreases respectively. This is stated in choice

Back 39

A positive linear correlation between two variables means that when one variable increases or decreases the other also increases or decreases respectively.

Front 40

This patient has classic Alzheimer dementia, and the affected tissue is the brain, through the proposed mechanism of decreased acetylcholine neurotransmission and the buildup of amyloid plaques and neurofibrillary tangles. The ectoderm is the origin for the nervous system, melanocytes and the skin.

Back 40

Skin, nerves, and melanocytes stem from the ectoderm germ layer.