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Step 1 Rx > Deck 10 > Flashcards

Deck 10 Flashcards

1
Q

What flu (A & B) prophylaxis can you give to at risk populations?

A

Neuramidase inhibitors: Oseltamavir, zanamivir. Prevent release of viral progeny from cells. Both A & B Tx and prophylaxis

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2
Q

What condition is type III collagen mutation?

A

Ehlers-Danlos. Joint hypermobility, skin fragility, berry aneurysms (spontaneous rupture) -> SAH

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3
Q

Muscles from what branchial arch are innervated by recurrent laryngeal?

A

6th. Cricothyroid is from 4th arch (superior laryngeal N)

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4
Q

What are the dumbbelss symptoms from increased acetylcholine?

A

Diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, lacrimation, sweating, salivation

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5
Q

Describe Job syndrome? What isn’t being made?

A

Hyper IgE syndrome: Failure of helper Th17 cells to make IFN-gamma -> impaired recruitment of neutrophils. Recurrent staph abscess, pruritic eczema, coarse facies, retained primary teeth, high serum eosinophils

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6
Q

Phenytoin (anti-seizure) blocks absorption of what nutrient?

A

Folate

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7
Q

What dz is caused by GAA repeat?

A

Friedrich ataxia

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8
Q

What inheritance/ chromosone is Wermers syndrome (MEN1)?

A

Autosomal dominant- chr 11

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9
Q

What enzyme is deficient in Lesch Nyhan? What does this do?

A

HGPRT; inactivates purine salvage pathway- guanine and hypoxanthine are lost in urine

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10
Q

Symptoms of Lesch Nyhan? What cell on CBC?

A

Yellow orange granules, self mutilation, dystonia; Hypersegmented neutrophils- since ^ are being lost, use B12 and folate for de novo purine synthesis

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11
Q

What structure runs on top of spermatocord?

A

Ilioinguinal nerve (from L1)

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12
Q

What does cyanide inhibit?

A

Last step in oxidative phosphorylation- modifies iron in cytochrome oxidase

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13
Q

Chediak-Higashi is inherited how? Failure of what?

A

Autosomal recessive- failure of phagolysosome formation (microtubule dysfunction impairing fusion). Recurrent staph and strep infections

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14
Q

What condition has CTG repeat?

A

Myotonic dystrophy

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15
Q

CGG repeat?

A

Fragile x

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16
Q

What dangerous compound is produced from sodium nitroprusside in malignant hypertension? What should you also give to prevent this?

A

Cyanide; Sodium thiosulfate

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17
Q

Aspirin toxicity?

A

hyperventilation, nausea, TINNITUS, sweating, abd pain, dizziness, cerebral edema, seizures, metabolic acidosis, respiratory alk….. Give sodium bicarb

18
Q

What should you give in TCAD overdose?

A

Sodium bicarb- TCAD in neutral form so less likely to cause arrythmia or cardiac toxicity. Also increases extracellular H gradient attenuating TCA induced blockade of cardiac rapid Na channels

19
Q

Side effects of acyclovir?

A

Neurotoxicity (confusion, tremor, delirium, seizures) and renal toxicity

20
Q

What are positively charged amino acids found in histones?

A

Arginine and Lysine - FA pg. 92

21
Q

What chromosone is the globin locus (thalassemia) found on?

A

Chr. 11

22
Q

Tx for walking pneumonia?

A

Macrolides (bind 23s ribosomal RNA of 50s ribosome) or tetracyclines

23
Q

What does a macrophage and T cell secrete to eachother to kill intracellular pathogens?

A

Mx secretes IL-12 for naïve t cell to differentiate into Th1. T cell secretes IFN-gamma to increase antigen presenting and lysosome production

24
Q

Side effects of tuberculosis meds?

A

Isoniazid: B6 deficiency (parasthesias, ataxia, mental status). Ehtambutol: optic neuropathy (visual acuity, or color blindness). Rifampin: GI, CNS, dermatologic, hematologic (thrombocytopen, hemolytic anemia). Pyrazinamide: hepatotoxicity, gout

25
Q

What is the rate limiting step of glycolysis? What inhibits this enzyme?

A

PFK- inhibited by citrate

26
Q

What are the mediators in anaphylactic shock?

A

C3a & C51 bind to IgE causing histamine to release. C3a & C5a circulate and cause anaphylaxis

27
Q

Protuberant abdomen, palmar erythema, gynecomastia make you think of what disease?

A

Liver disease

28
Q

Hepatic encephalopathy results from build up of what?

A

Ammonia

29
Q

What is the process for elimination of ammonia?

A

Transferred onto a-ketoglutarate forming glutamic acid. In all tissues except muscles, glutamic acid is turned to glutamine by adding another ammonia (glutamine synthetase)= non toxic carrier. Glutamine is turned to glutamate in liver + ammonia which enter urea cycle.

30
Q

What causes defect in type 1 collagen? Characteristics?

A

Osteogenesis imperfecta= injuries from minor trauma, discolored teeth, osteopenia, blue sclera, short, progressive hearing loss

31
Q

What is the deficiency with a-ketoacid dehydrogenase?

A

MSUD

32
Q

What is the deficiency with Cystathione synthase?

A

Homocystinuria

33
Q

What is the deficiency with Homogentisic acid oxidase?

A

Alkaptonuria

34
Q

What is the deficiency with Phenylalanine hydroxylase?

A

PKU

35
Q

In someone with manic-depression (type II), what mood stabilizer would you give/ what SE?

A

Lithium: side effect = nephrogenic diabetes (Doesn’t respond to ADH and can’t concentrate urine). Could also give valproate/ carbamazepine

36
Q

Diagnosis of a kid with hypocalcemia and frequent viral/ fungal infections?

A

DiGeorge: failure of 3rd/4th pharyngeal pouch (absent PTH and thymus)

37
Q

Symptoms of pellagra? What enzyme is deficient? What amino acid is precursor?

A

Dermatitis, Diarrhea, CNS Disturbances. Deficient in niacin. Tryptophan is precursor

38
Q

Condition results in inability to reabsorb neutral amino acids?

A

Hartnup dz

39
Q

What ratio is elevated in liver dz? What metabolic effects does this have?

A

NADH:NAD+ . Inhibits gluconeogenesis (Pyruvate is diverted to citrate, OA is diverted to malate) and fatty changes in liver

40
Q

What meds can decrease effectiveness of ‘conazoles?

A

PPIs- decreasing stomach acid reduces absorption

41
Q

What part of optic tract is damaged with someone who can’t recognize faces?

A

Damage to fusiform nucleus- inferior temporal lobe&raquo_space; meyers loop

42
Q

What nerve - pulls tympanic membrane medially?

A

CN V (tensor tympani) vs stapedius of CN VII

Step 1 Rx (10 decks)

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