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USMLE > Immuno pharm > Flashcards

Immuno pharm Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the major adverse effect of calcineurin inhibitors (Tacrolimus and Cyclosporine)

A

highly nephrotoxic

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2
Q

How do Calcineurin inhibitors (Tacrolimus F506 and Cyclosporine) function?

A

Shut down T cell response by inhibiting production of IL-2 by sequestering Calcineurin

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3
Q

Adverse effects of Cyclosporine

A

Nephrotoxicity, hypertension, hyperlipidemia, neurotoxicity, gingival hyperplasia, hirsuitism

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4
Q

Adverse effects of Tacrolimus

A

Nephrotoxic, neurotoxic, gingival hyperplasia, increased risk of diabetes

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5
Q

Which two immunosuppressants bind FKBP

A

Tacrolimus and Rapamycin (Sirolimus)

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6
Q

Mechanism of Sirolimus (Rapamycin)

A

binds FKBP to block T cell activaiton and B cell differentiation by preventing response to IL-2

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7
Q

Major uses for Cyclosporine

A

Transplant rejection prophylaxis, psoriasis, RA

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8
Q

Major uses for Tacrolimus

A

Transplant rejection prophylaxis

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9
Q

Major use for Rapamycin (Sirolimus)

A

Kidney transplant rejection prophylaxis

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10
Q

Adverse effects of Rapamycin (Sirolimus)

A

Pancytopenia, insulin resistance, hyperlipidemia

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11
Q

Side effects of Daclizumab and Basiliximab

A

hypertension, edema, tremore

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12
Q

Use and function of daclizumab, basiliximab

A

Monoclonal antibodies to IL-2R, kidney transplant rejection prophylaxis

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13
Q

Which immuno suppressant is a precursor for 6-mercaptopurine and inhibits purine synthesis by inhibiting PRPP amiodotransferase?

A

Azathioprine

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14
Q

Uses for Azathioprine

A

Transplant rejection prophylaxis, RA, Crohn, glomerulonephritis

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15
Q

Side effects of Azathioprine

A

Leukopenia, anemia, thrombocytopenia

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16
Q

Which immunosuppressant is associated with invasive CMV infection

A

Mycophenalate mofetil

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17
Q

Mechanism of Mycophenolate mofetil

A

reversibly inhibit IMP dehydrogenase; halt purine synthesis of B and T cells

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18
Q

Clinical use of Mycophenolate mofetil

A

Transplant rejection prophylaxis, lupus nephritis

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19
Q

Adverse effects of mycophenolate mofetil

A

GI upset, pancytopenia, hypertension, hyperglycemia. Less nephro and neurotoxic

20
Q

Mechanism of corticosteroids

A

Inhibit NFkappaB and suppress both B and T cell function by decreasing transcription of cytokines. Induce apoptosis of T lymphocytes

21
Q

Filgrastim and Sargramostim use

A

Bone marrow recovery

22
Q

Romiplostim, eltrombopag and Oprelvekin (IL-11) use

A

Thrombocytopenia

23
Q

Interferon-beta use

A

Multiple sclerosis

24
Q

Use of Traztuzumab

A

HER2/neu Antibody; breast cancer

25
Q

Rituximab use

A

CD20 antibody; B cell lymphomas, CLL, RA, ITP

26
Q

Cetuximab use

A

EGFR antibody; stage IV colorectal cancer, head and neck cancer

27
Q

Bevacizumab use

A

VEGF antibody; colorectal cancer, renal cell carcinoma

28
Q

Adalimumab, Certolizumab, Infliximab use

A

soluble TNF-alpha; IBD, RA, ankylosing spondylitis, psoriasis

29
Q

Eculizumab use

A

target is C5; PNH

30
Q

Natalizumab use

A

alpha4-integrin; MS, Crohn (can cause PML–demyelination– in pts with JC)

31
Q

Abciximab use

A

gpIIb/IIIa; antiplatelet agent

32
Q

Denosumab use

A

RANKL antibody; Osteoporosis

33
Q

Palivizumab

A

RSV prophylaxis for high-risk infants

34
Q

Ranibizumab, bevacizumab use

A

VEGF antibody; neovascular age-related macular degeneration

35
Q

How can high-doses of corticosteroids cause neutrophilia and induced psychosis?

A

Cause demargination of neutrophils from blood vessel walls, leading to an increase in circulating neutrophils

36
Q

Mechanism of Bortezomib (treatment for mulitple myeloma)

A

Inhibit 26s proteosome, allow buildup of pro-apoptotic factors that induce apoptosis in neoplastic cells

37
Q

Mycophenolate mechanism

A

Selectively targets B and T cell proliferation, promotes T cell apoptosis by inhibiting IMP dehydrogenase (stops purine synthesis)

38
Q

Used to treat CMV retinitis

A

Cidofovir

39
Q

Cidofovir side effect

A

Nephrotoxicity manifesting as proteinuria or elevated creatinine

40
Q

Inhibits nonstructural protein 5B (NS5B) an RNA-dependent RNA polymerase needed for Hep C

A

Sofosbuvir

41
Q

Used in ganciclovir-resistant CMV and associated with severe neutropenia

A

Valganciclovir

42
Q

Aprepitant is a ___ receptor antagonist used to treat chemotherapy-induced emesis

A

Neurokinin-1 receptor antagonist

43
Q

Fosaprepitant is a ____ receptor antagonist used to treat chemotherapy-induced emesis

A

Neurokinin 1

44
Q

Ondansetron and Granisetron are ____ receptor antagonists used to treat chemotherapy-induced emesis

A

5-HT3

45
Q

Scopolamine is a ____ used to to treat motion sickness

A

antimuscarinic

46
Q

Diphenhydramine, Meclizine and Promethazine are ___ used to treat motion sickness

A

Antihistamines

47
Q

How do calineurin inhibitors (Tacrolimus or Cyclosporine) cause renal failure?

A

Lead to afferent and efferent arteriolar vasoconstriction in kidneys, leading to obligerative vasculopathy and scarring

USMLE (36 decks)

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