0528

Question 1

intermittent muscle pain caused by exercise, relieved by rest

Answer 1

claudication (ischemic muscle pain)

Question 2

cause of claudication

Answer 2

atherosclerosis of larger arteries- fixed stenotic lesions produced by atheromas obstruct blood flow.

Question 3

carotid sinus massage results in?

Answer 3

1. increased baroreceptor firing.
2. increased parasymp influence on heart and vessels.
3. prolonged AV node refractory period.

Question 4

what can cause portal HTN but no histologic changes to hepatic parenchyma?

Answer 4

portal vein thrombosis-
with splenomegaly, varices.
NO ASCITES.

Question 5

acute effects of corticosteroids on CBC

Answer 5

increase neutrophil count.

decrease lympho, mono, baso, eosino.

Question 6

median n. runs between which forearm mm?

Answer 6

flexor digitorum superficialis

and flexor digitorum profundus

Question 7

CO poisoning affects…

Answer 7

O2 binding to Hb and O2 unloading to tissues.

decreases O2 content but does NOT affect PaO2 (dissolved).

Question 8

response to pressure overload in heart

Answer 8

concentric hypertrophy (in parallel)-
vent wall thickening.
chamber size decreases.

Question 9

response to volume overload in heart

Answer 9

eccentric hypertrophy (in series)- 
chamber dilation.
increase EDV (preload).

Question 10

polycythemia with normal RBC mass

Answer 10

RELATIVE erythrocytosis due to decrease in plasma volume (dehydration, excessive diuresis)

Question 11

another name for TSH

Answer 11

thyrotrophin

Question 12

physostigmine

Answer 12

tertiary amine.
can cross BBB.
inhibits ACh-esterase.

reverses both CNS and peripheral sx of severe atropine tox.

Question 13

what is different about physostigmine vs. neostigmine and edrophonium?

Answer 13

all are anti-ACh-esterase drugs but neostigmine/edrophonium are quaternary amines and have limited CNS penetration

Question 14

what is an essential protein in the activation of IL-2 for promotion of T cell growth/differentiation?

Answer 14

calcineurin

Question 15

PNMT

Answer 15

phenylethanolamine-N-methyltransferase.

responsible for synth of epinephrine from NE.
CORTISOL (high in adrenal medulla due to venous drainage from cortex) increases transcription of enzyme.
80% epi, 20% NE.

Question 16

Tx of acute C.diphtheriae infx

Answer 16

in order:
1. diphtheria antitoxin (PASSIVE immunization- inactivate all circulating toxin).

2. penicillin or erythromycin (kill bact, prevent new toxin release).
3. DPT vaccine (ACTIVE immunization- against future infx).

Question 17

gene mutations in early-onset familial Alzheimer’s

Answer 17

1. APP (chromo 21).
2. presenilin 1 (14).
3. presenilin 2 (1).

Question 18

gene mutations in late-onset familial Alzheimer’s

Answer 18

apo E4

Question 19

TX of loss of consciousness due to severe hypoglycemia

Answer 19

non-med setting: IM glucagon.

med setting: IV dextrose.

Question 20

DX of tetanus based on…?

Answer 20

clinical suspicion, good H&P

Question 21

short acting benzos

Answer 21

< 10 hrs:
Triazolam.
Oxazepam.
Midazolam.
Alprazolam.

Question 22

long acting benzos

Answer 22

for days:
Chlordiazepoxide.
Clorazepate.
Diazepam.
Flurazepam.

Question 23

complication of hyperprolactinemia

Answer 23

HYPOgonadism–

low estrogen increases risk for accelerated bone loss.

Question 24

POMC

Answer 24

polypeptide precursor that is cleaved into:

beta-endorphins (endogenous opioid).
ACTH.
MSH.

Question 25

CN III palsy

Answer 25

1. PTOSIS due to loss of levator palpebrae.
2. DOWN AND OUT GAZE due to unopposed lateral rectus (CN VI) and superior oblique (CN IV).
3. DILATED PUPIL and LOSS OF ACCOMODATION due to paralysis of iris sphincter and ciliary muscle.

Question 26

prolonged exposure to loud noises causes hearing loss due to damage to?

Answer 26

stereociliated hair cells of organ of Corti

Question 27

what freq is lost first with hearing loss?

Answer 27

high frequency

Question 28

clinical use of botulinum toxin

Answer 28

local injxs into muscle to treat focal dystonias, achalasia, spasms

Question 29

how does clostridium botulinum release its neurotoxins?

Answer 29

autolysis

Question 30

radial head subluxation

Answer 30

where humerus articulates with head of radius- can damage deep branch of radial n. and cause weakness of forearm + hand extensors with no sensory deficits

Question 31

jaw pain that starts in the middle of meal

Answer 31

temporal arteritis

Question 32

hyperpyrexia

Answer 32

body temp > 40 C.

requires emergent heat loss (fans, cold blankets, etc).

Question 33

interferons (alpha and beta) in viral infx

Answer 33

act as cytokines on neighboring cels, stimulating their synth of antiviral proteins that impair viral protein synth

Question 34

neurofibromas are tumors of what cells?

Answer 34

Schwann cells

Question 35

what do carbidopa and COMT-inhibitors have in common?

Answer 35

both increase levodopa availability to brain.

carbidopa: peripheral DOPA decarboxylase inhibitor.
entacapone: peripheral COMT inhibitor.

Question 36

flutamide

Answer 36

non-steroid antiandrogen that competes with T and DHT for receptors on target cells.

used alone: cause gradual increase in blood T due to neg feedback mech (reduce this by co-admin with GnRH agonists).

Question 37

atropine and glaucoma

Answer 37

atropine side effect: increased IOP- precipitate closed-angle glaucoma in susceptible individuals.

*potential complication when atropine is used to treat bradycardia by decreasing vagal influence on SA and AV nodes