Drug

Question 1

Rivaroxaban
Apixaban
Edoxaban

Answer 1

Factor Xa Inhibitors

• Don’t need monitoring
• No antidote!

Question 2

Warfarin

Answer 2

Anti-coagulant

Blocks synthesis of Vita K dependent clotting factors

Question 3

Vitamin K

Phytonadione

Answer 3

Coagulants

Anti-warfarin!

Question 4

Fondaparinux
UFH/HMW Heparin
LMW Heparin

Answer 4

Anti-coagulants
Indirect Thrombin inhibitors
Bind Antithrombin (ATIII)

Question 5

Protamine

Answer 5

Coagulant
Heparin Antagonist
[binds, inactivates heparin]

Question 6

Dibigitran etexylate
Argatroban
Bivalirudin

Answer 6

Anti-coagulants

Direct Thrombin Inhibitors [Binds thrombin]

Question 7

Aspirin

Answer 7

Anti-platelet

Acetylsalicylate/TXA Inhibitor

Question 8

Clopidogrel
Prosugrel
Ticlopidine

Answer 8

Anti-platelets

ADP Receptor Antagonists (on platelets

Question 9

Abciximab
Eptifibatide
Tirofiban

Answer 9

Anti-platelet

GPIIb/IIIa receptor inhibitors

Question 10

Dipyridamole

Answer 10

Anti-platelet
Phosphodiesterase Inhibitor
[Inc. cAMP, inhib. platelets]

Question 11

Streptokinase

Answer 11

Fibrinolytic Drug

Promotes plasmin formation

Question 12

Urokinase

Answer 12

Fibrinolytic Drug

Kidney enzyme that converts plasminogen –> plasmin

Question 13

Alteplase
Reteplase
Tenecteplase

Answer 13

Fibrinolytic Drug
tPA (tissue plasminogen activators)
“Selective” activation of fibrin-bound plasminogen
Dissolves thrombi [stroke!]

Question 14

Aminocaproic Acid

Answer 14

Fibrinolytic INHIBITOR

Blocks plasmin’s actions

Question 15

Maraviroc

Answer 15

CCR5 Antagonist - Binds specifically and selectively to host CCR5. Patients might have CXCR4 only or both which means drug resistance.
Side effects: Pyrexia, rash, postural dizziness

Question 16

Enfuvirtide

Answer 16

Fusion Inhibitor - binds p41 on HIV and prevents conformational change
Side effects: local rxns (common), systemic hypersensitivity (rare)
-SubQ admin - twice daily
-Recently approved, not first line, used when resistant to other drugs

Question 17

NRTIs

Answer 17

Competitively inhibit reverse transcriptase
Nucleoside: Require phosphorylation by cellular enzymes :
–Zidovudine (Azidothymidine or AZT)
–Lamivudine (best tolerated - Hep B)
–Abacavir
–Emtricitabine (best tolerated - Hep B)
Nucleotide: Have one phosphate but same an nuceloside:
–Tenofovir

Question 18

Side effects of NRTIs:

Answer 18

Potentially fatal syndrome of lactic acidosis with hepatic steatosis (due to mitochondrial toxicity), Hyperlipidemia, fat redisribution

Question 19

Side effects of Zidovudine (AZT)

Answer 19

Granulocytopenia & Anemia, CNS disturbances

Question 20

Side effects Abacavir:

Answer 20

Hypersensitivity

Question 21

Side effects Tenofovir:

Answer 21

Nausea, vomiting, diarrhea, renal failure

Question 22

NNRTIs

Answer 22

Bind directly to reverse transcriptase as site distinct from that of the NRTI. Prevents production of viral DNA. Don’t need phosphorylation.
Etravirine - SE: (rash, nausea, peripheral neuropathy)
Efavirenz - once daily, SE: CNS (dreams, hallucination)

Question 23

Raltegravir

Answer 23

Integrase Inhibitor.

• Binds integrase, inhibits strand transfer, final step of provirus integration
• Fewer drug interactions than PI or NNRTIs

Question 24

Protease Inhibitors

Answer 24

Atazanavir + Ritonavir
Darunavir + Ritonavir
-Prevent protease action required for maturation of fully assembled virus.
-SE: GI disturbances, hepatotoxicity, hyperglycemia, etc.
-Ritonavir: used at low dose to inc. concentration of other PIs. It inhibits CYP3A4 which metabolizes PIs and decreases their effectiveness

Question 25

What condition is bleeding time prolonged in?

Answer 25

Von Willebrand’s Disease

Question 26

How do you test for Factor V Leiden?

Answer 26

Genetic testing!

-In this condition, it’s hard to turn OFF factor V, so you can’t do a clotting cascade test

Question 27

What does LDH measure?

Answer 27

Blood cell/tissue destruction!

It can be elevated in hemolytic anemias!

Question 28

What disease?

• RDW normal
• Slightly high number RBC
• low hemoglobin
• low MCV

Answer 28

Thalassemia

Question 29

Your patient has an elevated neutrophil count. The blood smear shows lots of unusual-looking neutrophils; some have abundant, dark-purple cytoplasmic granules, and others have lots of vacuoles in the cytoplasm. Which of the following disorders is the most likely cause of these findings?

Answer 29

E. coli Sepsis

Question 30

Which of the following disorders may show the highest lymphocytosis,with lymphocyte counts as high as 100,000?

Answer 30

Infectious Lymphocytosis

Question 31

Which is the most useful in differentiating between chronic lymphocytic leukemia and a benign lymphocytosis due to infectious lymphocytosis?

Answer 31

Patient Age

Question 32

Of the following, which is the most useful in differentiating between chronic myeloid leukemia and a benign neutrophilia with a left shift?

Answer 32

Cytogenetic Studies

Question 33

The following molecule will act as a cofactor for the Factor I cleavage of C3b:

Answer 33

Factor H

Question 34

Which virus has structural elements that protect its genome from degradation by the host cells’ Dicer/RISC complex?

Answer 34

Colorado Tick Fever Virus

Question 35

In a patient with infectious mononucleosis caused by EBV, fever results from the production of __________ in the hypothalamus.

Answer 35

Prostaglandin E2

Question 36

Epstein Barr Virus encodes two viral oncogenes, LMP-1 and LMP-2. What is the result of LMP-1 and LMP-2 expression in infected B cells?

Answer 36

Antigen and T Cell Independent B Cell Proliferation