January Rx Review

Question 1

defect in albinism

Answer 1

AR mutation in tyrosinase preventing converstion of tyrosine to DOPA in melanin production

Question 2

MOA of dantrolene

Answer 2

inhibits RyR Ca++ channels

Question 3

Most commonly injured ligament in ankle sprain

Answer 3

Anterior talofibular ligament on inversion

Question 4

Muscle cremaster is derived from

Answer 4

internal oblique

Question 5

Symptoms of common peroneal nerve damage

Answer 5

foot drop due to loss of dorsiflexion and loss of eversion. Pain and paresthesia in lateral leg and dorsum of foot

Question 6

Osteogenesis imperfecta mutation

Answer 6

Mutation in collagen I alpha gene that leads to errors in glycosylation, altering triple helix formation and causing defect in procollagen assembly

Question 7

Valgus and varus stress tets

Answer 7

valgus tests MCL; varus tests LCL

Question 8

nerve damage in posterior hip dislocation

Answer 8

injures inf gluteal nerve which innervates gluteus max. So patient has difficulty extending and laterally rotating thigh

Question 9

Alkaptonuria: pathophys and symptoms

Answer 9

Congenital defect in tyrosine degradation pathway. Dark urine and dark cartilage

Question 10

Nerve damage with fracture of surgical head of humerus

Answer 10

axillary nerve which innervates deltoid and teres minor

Question 11

Nerve damage with anterior shoulder dislocation

Answer 11

axillary nerve which innervates deltoid and teres minor

Question 12

Probenacid: use and MOA

Answer 12

used to treat chronic gout. Acts on kidney to inhibit uric acid reabsorption in the proximal collecting tubule

Question 13

Innervation and pharyngeal arch derivation of muscles of the larynx

Answer 13

Cricothryoid innervated by sup laryngeal and derived from fourth arch. All other muscles innervated by recurrent laryngeal and derived from sixth arch

Question 14

Only muscle derived from third pharygneal arch

Answer 14

Stylopharyngeus, which elevates the pharynx and larynx during swallowing

Question 15

Muscles innervated by radial nerve

Answer 15

BEST: brachioradialis, extensors of wrist and fingers, supinator, triceps

Question 16

Innervation of biceps

Answer 16

musculocutaneous nerve from lateral cord, C5-C6

Question 17

Tumor associated with myasthenia gravis

Answer 17

thymoma - mediastinal mass

Question 18

Side effect of bisphosphanates (plus two drug names)

Answer 18

Avascular necrosis of the jaw. Alendronate and risedronate

Question 19

Nerve damage as complication of mastectomy

Answer 19

Damage to long thoracic nerve resulting in shoulder blade that sticks out

Question 20

Anti-fungal that causes skin darkening

Answer 20

ketoconazole

Question 21

presentation of scaphoid fracture

Answer 21

most common carpal fracture. Can be missed on initial x-ray and then seen few weeks later as hypodensity of avascular necrosis

Question 22

Drugs that cause drug-induced lupus

Answer 22

HIPPES: hydralazine, INH, procainamide, phenytoin, etanercept, sulfas

Question 23

presentation of juvenile rheumatoid arthritis

Answer 23

joint pain, migratory rash, spking and remitting fevers, systemic symptoms

Question 24

MOA of isoniazid

Answer 24

decreases synthesis of mycolic acids of TB cell envelope

Question 25

side effect of fluoroquinolones

Answer 25

risk of tendon rupture

Question 26

1st pharyngeal arch

Answer 26

mandibular branch of trigeminal nerve; muscles of mastication

Question 27

2nd pharyngeal arch

Answer 27

facial nerve; muscles of facial expression + a few others

Question 28

3rd pharyngeal arch

Answer 28

CN IX; stylopharyngeus

Question 29

4th pharyngeal arch

Answer 29

CNX; muscles of palate and pharynx; crycothyroid

Question 30

6th pharyngeal arch

Answer 30

recurrent branch of CNX; laryngeal muscles

Question 31

characteristics of EBV

Answer 31

herpesvirus family; double stranded linear DNA

Question 32

lead poisoning treatment

Answer 32

adults: dimercaprol + EDTA
kids: succimer

Question 33

deferoxamine

Answer 33

chelator used to treat iron and aluminum toxicity

Question 34

MOA and use of 6-mercaptopurine

Answer 34

interferes with purine synthesis. Same mechanism as azathioprine which is converted to 6-mercaptopurine by hepatic metabolism. Used to treat kidney transplant patients and ffor glomerulonephritis and rheumatoid arthritis

Question 35

hemolytic uremic syndrome complication

Answer 35

microangiopathic hemolytic anemia in which RBCs forced through narrowed and obstructed microvasculature

Question 36

heparin-induced thrombocytopenia

Answer 36

immune reaction to heparin that produces antibodies that cross-react with platelets leading to activation and cluping

Question 37

vinca alkyloids names na dMOA

Answer 37

vincristine and vinblastine; inhibit microtubule function and spindle formation in mitosis

Question 38

paclitaxel MOA

Answer 38

reversibly binds tubulin and hyperstabilizes microtubules preventing spindle breakdown

Question 39

gray baby syndrome

Answer 39

side effect of chloramphenicol; some infants can’t conjugate and excrete the drug; abdominal distension, ashen-grey color, CV collapse

Question 40

two side effects of chloramphenicol

Answer 40

grey baby syndrome; aplastic anemia

Question 41

treatemtn of heparin induced thrombocytopenia

Answer 41

discontinue all heparin products and replace with direct thrombin inhibitor

Question 42

GERD drugs that affects CYP system

Answer 42

cimetidine (H2 antag) and PPIs are P450 inhibitors

Question 43

Ribavirin: MOA, use, side effect

Answer 43

Inhibits inosine monophosphate dehydrogenase, inhibiting nucleotide formation. Treats hep C. Can cause hemolytic anemia

Question 44

antiphospholipid antibody syndrome pathophys

Answer 44

Antibody binds to platelet phospholipids so that clotting factors can’t access. Affects both intrinsic and extrinsic pathway. PTT elevated paradoxically. Recurrent venous and arterial thrombi.

Question 45

treatment of warm hemolytic anemia

Answer 45

corticosteroids in kids; IVIG in adults; splenectomy if chronic or refractory