Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

S4M1 > LAST SEM CONCEPTS > Flashcards

LAST SEM CONCEPTS Flashcards

1
Q

What NT is responsible for the negative effects of Benzos?

A

GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the first line pharmacotherapy for anxiety disorders?

A

SSRIs– fluoxetine, paroxetine, ec___, sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What melatonin agonist can be used safely in the elderly?

A

Ramelteon (for elderly & jetlag)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the MOA and TU of Mirtazapine?

A

a2 blocker –> increase 5HT & NE… adjunct anti-depressant. Decr sexual AE and blocks nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pt is taking MAO-I, but it’s not working. Switch him to a transdermal MAOI. What is the benefit?

A

Selegiline– doesn’t cause HTN crisis with tyramines (bypasses GI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anxious and depressed. How do you tx?

A

SSRI. If already on SSRI, give SNRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Partial generalized seizures. What first gen, narroow spec drug?

A

Phenytoin. AE = gingival hyperplasia,, hirsutism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pt is on Valproate. What second gen drug would you add to increase efficacy?

A

Lamotrigine– increased half-life because valproate will inhibit CYP450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the effects of Carbamazapine on P450s and what clinical effects will this have?

A

Induces P450s, therefore induces its own metabolism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Patient has tics…. What is the MOA of the drug that you prescribe?

A

Guanfacine— a2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vascular headache with gradual onset, photophobia. History of HTN and family hx of vascular problems. What kind of headache?

A

Migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Regular episodic severe unilateral headache in male. Eye-watering. Short in length.

A

Cluster headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Limbic signs, deja vu. Where is the seizure?

A

Medial temporal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Transient loss of vision.

A

Retinal artery occlusion due to microthrombi in the common carotid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pic of woman with 2 lights shining into eyes from side. Shadow indicates?

A

Shallow anterior chamber– acute angle closure glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Crescent shaped hematoma. Pre-existing cortical atrophy.

A

Subdural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Glasgow Coma scale. Midpoint pupils. what level?

A

Midbrain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an optional test used to determine brain death?

A

Cerebral Angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Weakness Face & Arm > Leg

A

MCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Timeline of nervous tissue reaction to injury

A

2 days only - red neuron.
2-3 days- PMNs
3-10 days- foamy macrophages & gemistocytes
11-4w- liquefaction, fibrillary astrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Infection of brain with ring-like lesions. Patient dies after seeming like she was recovering.

A

Abscess– rupture into ventricles. (s.pneumo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

HIstology of Alzheimers

A

Neurofibrillary triangles (PHFs, Tau), Senile Neuritic Plaques w/amyloid core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Person hits head. Seems fine, but dies.

A

Epidural hematoma–lucid phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

45 year old man running on treadmill. Gets headache. Rests against wall. Passes out 3 mins later and dies.

A

Berry aneurysm. (marfan, polycystic kidney, HTN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pallisading tumor.

A

Glioblastoma (large darker pink cirlcle-ish)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Homer Wright Rosettes

A

Medulloblastoma (purple rosette with pinkish stuff inside)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Proliferative retinopathy

A

VEGF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fixed, mid-sized pupil. increased SNS. asian.

A

Acute angle closure glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Person any age over 10y and still walking, family history of dystrophy. Pseudoatrophy of calves.

A

Beckers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

S/S Major Depressive Disorder

A

SIGECAPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Bipolar I vs II

A

I- manic; II - major dep + hypomania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Straight A med student sleeps 4h a day

A

Hypomania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Paranoid that in-law or friend is poisoning him

A

paranoid schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Sinusitis –> abscess- causitive agent

A

s.pneumo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Dx ketosis in hypoglycemic infant

A

urine strip for ketonuria, ketone breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Prostprandial physiologic changes in glucose metabolism.

A

decrease GH, increased glycogenolysis, decreased guconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

During thyroid surgery, mess up ligation of nerves @ right inferior thyroid artery. Woman wakes up with hoarse voice. What did you hit?

A

Right recurrent larygeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Overuse of somatotroph cells- what will you see (in terms of glucose levels?)

A

Hyperglycemia (somatotroph increases GH which increases glucose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Diabetic Ketoacidosis. Treatment?

A

Saline. Check potassium first. If normo- or hyperkalemic, give insulin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the mechanism of Atomoxetine?

A

Non-stimulant treatment of ADD– Norepi reuptake inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Treatment of Huntington’s Chorea?

A

Tetrabenazine- controls chorea by inhibiting VMAT –> dec. DA.
A/E include depression & prolonged QT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is an adverse effect of Sumatriptan

A

Coronary Vasospasm– angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How would you treat ALCOHOL WITHDRAWAL SX in the ELDERLY & those with LIVER DAMAGE?

A

INTERMEDIATE-acting benzo (elderly)– oxazepam, lorazepam, t—-pam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What MAO-I works in Parkinson’s and how?

A

Selegilin- transdermal patch. Low doses selectively inhibit MAO-B, thereby increasing levels of DA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What si the role of Carbidopa in combination with L-DOPA?

A

Blocks AADC in the periphery, preventing the metabolism of L-DOPA in the periphery, allowing more to reach the CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the MOA of Donepazil?

A

Cholinesterase inhibitor (2nd gen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the MOA and TU of Memantine?

A

NMDA receptor antagonist. For moderate-severe Alz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is an abnormal movment side-effect that occurs with chronic L-DOPA and carbidopa?

A

Dyskinesias— treat by reducing dose and adding AMANTADINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Schizophrenic. Has been taking a first generation drug for 30 years and has odd movements such as tongue flicking and jerking. Why? What is the drug?

A

TARDIVE DYSKINESIA!! From Haloperidol or Chlorapromazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Anti-psychotic. D2 and 5-HT1a partial agonist. No weight gain.

A

Aripiprazole. No muscarinic, 5HT2C or His antag–> lowest weight gain. Approved for teens. Also approved to treat irritability in autism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the most significant modifiable risk factor for stroke?

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Girl’s father has a stroke in front of her. Before she calls the ambulance, what should she give him?

A

Baby aspirin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are the CNS vascular complications of poorly controlled HTN?

A

Lacunar strokes –> internal capsule L = A = F

54
Q

S/S of acute confusional state

A

aka ICU/Toxic Psychosis aka Encephalopathy aka Delirium. NO CLEAR SENSORIUM.

55
Q

Patient comes in dehydrated and extremely confused. Tx?

A

Treat the underlying problem (rehydrate) and WAIT.

56
Q

65 year old man has 1 year onset of serious erratic behavior. What kind?

A

Pick’s. Same as frontotemporal except RAPID PROGRESSION (<2y)

57
Q

Pt has cogwheeling and shuffling gait. dx?

A

Parkinson’s

58
Q

Man comes in with serious behavior issues and jerky movements. dx?

A

Huntington’s

59
Q

Woman has problems blow-drying her hair and has ptosis. dx?

A

Myasthenia Gravis

60
Q

What is the pathogenesis of myasthenia gravis?

A

Autoantibodies against the ACh receptor

61
Q

What would you see clinically and in an MRI of Multiple Sclerosis?

A

MRI/gross: Focal demyelinated regions
S/S: UNILATERAL probs.
Dx: IgG oligoclonal bands @ spinal tap

62
Q

Nervous tissue damage. What would you see after 4 days?

A

> 12h-1day: Red neurons
Day 2: PMNs
Day 3-10: Macrophages, reactive astrocytes
Day 11-Week4: Macrophages, gemcistocytic & fibrillary astrocytes

63
Q

Arnold-Chiary II S/S

A 
Downward displacement of cerebellar vermis, tonsils, & medulla
Caused by shallow post. fossa
Causes Syringohydromyelia
Obstructive Hydrocephalus
Meningomyelocele
Brainstem beaking
64
Q

CNS infections in immunocompromised pts?

A

LISTERIA, or s. pneumoniae. Higher risk of sepsis.

65
Q

Alcohol is ruining this guy’s life. HE’S TRIED QUITTING, but failed. What is this?

A

DEPENDENCE.

66
Q

Tremors and hallucinations WITHIN 3 days of hospitalization.

A

DELERIUM TREMENS– coarse tremors of hands, tongue, N/V, hTN, disorientation.

Tx with Lorazepam or chlordiazepoxide with thiamine. DON’T GIVE ANTI-PSYCH OR DEXTROSE.

NOTE: alcohol hallucinosis w/in 2 days, withdrawal seizure w/in 3 days.

67
Q

What are the symptoms of PTSD?

A

Exposure to a traumatic experience. RE-EXPERIENCE. Avoidance of associated situations/Numbness. Increased arousal (cortisol- vigilance, startle, irritability).
>1mo

68
Q

Child has von Gierke. Mom wants to give juice to child, but wanted to ask first.

A

Intake of carbohydrates which must be converted to G6P to be utilized (e.g., galactose and fructose) should be minimized.

69
Q

Woman gave birth. Now has amenorrhea and inability to lactate. You find that TSH is low. What else should be low?

A

Prolactin. (Sheehan synd)

70
Q

Blood supply of adrenal gland.

A

aorta –> inf. phrenic –> sup. suprarenal aa.
aorta –> middle suprarenal aa
aorta –> renal aa –> inf. suprarenal aa.

R suprarenal v -> IVC
L suprarenal v -> L renal v. -> IVC

71
Q

Structure involved in hormone synthesis

A

Primary capillary plexus??

Hormones synth in pituitary, stored in unmyel. axons in HERRING BODIES containing secretory granules. Release into PCP @ median eminence

72
Q

What are Kussmaul respirations?

A

rapid, deep respirations characteristic of DKA, due to respiratory compensation for metabolic acidosis

73
Q

Patient on anti-psychotic. Must be have blood tests weekly. What drug & why?

A

CLOZAPINE is the most efficacious but causes AGRANULOCYTOSIS.

74
Q

Woman with schizophrenia has gained a lot of weight after starting treatment and wants to switch to a drug that won’t cause this AE.

A

Aripiprazole.

75
Q

What is the TU and AE of Lithium?

A

Bipolar disorder, esp with MANIA. Very narrow TI. Cannot be taken with NSAIDs (incr. Li+ levels), Diuretics (incr. Li+ levels), or ACE Inhibitors (Na+ depletion)

76
Q

Patient wants to quit smoking. You give them Nicotinic partial agonist.

A

Varenicline.

77
Q

What Z-Drug can be given on demand, in the middle of the night. Why?

A

Zaleplon– short half life

78
Q

Opioid abuser– you give them partial agonist with low abuse liability.

A

Buprenorphine. [partial ag @ mu, full @ K & d)

79
Q

What dopamine agonist is used as a rescue for freezing in late-stage Parkinson’s?

A

Apomorphine.

80
Q

Patient is diagnosed with Parkinson’s at age 67. tx?

A

Since he is >65, give L-DOPA +/- DA agonist. If he was <65, give DA agonist

81
Q

Patient has respiratory failure, pinpoint pupils, hTN. Dx & Tx

A

Opioid overdose. Give IV NALOXONE (for emergency use).

Naltrexone & Buprenorphine are used for quitting

82
Q

Patient is tense and irritable, high energy, low-appetite, agitated, mydriasis, cardiac arrythmias, whatever. Dx?

A

Cocaine overdose. (w/drawal would have depression, fatigue, inc appetite).

83
Q

Woman in 30s with blurred vision, difficulty walking (weakness & incoordination), parasthesias, fatigue, malaise, depression.

A

Multiple Sclerosis

84
Q

Patient is on corticosteroids. Get an infection. What do you do to prevent Acute Adrenal Crisis?

A

Decrease dose.

85
Q

S/S Conn syndrome

A 
Primary hyperaldosteronism:
\+ Chvotsek's sign
\+ Trusseau sign
HTN
Glycosuria
Edema
DECREASED RENIN
86
Q

S/S Hyperthyroidism in ELDERLY

A

APATHETIC HYPERTHYROIDISM: fatigue and weight loss mask symptoms of thyrotoxicosis

87
Q

What are the features of CONGENITAL hypothyroidism?

A

Thyroid agenesis/hypoplasia; TSH-R mutation, Dyshormonogenesis (Pendred synd).
S/S: Normal at birth, neonatal jaundice for >1mo, umbilical hernia, hoarse cry, poor feeding, hypotonia

88
Q

What are the features of Sheehan syndromE?

A

During pregnancy, pit doubles in size but doesn’t get double blood supply, so sensitive to ischemia. Any complication with birth (hemorrhage) will cause necrosis of the pituitary.

S/S: Amenorrhea, problem with lactation, weight loss, decreased pigmentation, hypogonadism

89
Q

What are the features of Acromegaly?

A

Prominent jaw, increased shoe size, secondary diabetes, arthritis.
*skeletal changes are permanent
Tx with Octreotide, Pegvisomant

90
Q

Management of diabetes- good range for HbA1c?

A

Keep close to 6, no more than 9.
6.5-7.5 = “Intensive montioring”
8-9 = “less intensive monitoring”

91
Q

What are the features of HONKS/HHS (Hyperosmolar hyperglycemic state)

A

confused, DRY mucus membranes, decreased skin turgor (dehydration), NO KETONES.

92
Q

What is the main issue behind diabetic foot complications?

A

Suppresion of Immune response

  • -PMNs and macrophage function is impaired
  • -T lymphocyte function depressed

Blood supply impaired due to vasculopathy

93
Q

Patient pale, HTN, raccoon eyes. What would show on Histo if good prognosis?

A

Pseudorosettes

Bad prognosis: >18mo, NSE, VMA-HVA low, N-myc

94
Q

Hashimoto Thyroiditis: Histo, Dx

A

Anti-thyroperoxidase antibodies –> hyperthyroidism.

Sheets of lymphocytes

95
Q

Histo of Medullary Carcinoma

A

Amyloid due to agg of pro-calcitonin B-pleated sheets.

FYI: 5HT inc -> panic, flushing
RET mutation

96
Q

Tumor with machine-like fluid inside. Where did it originate?

A

Rathke’s pouch remnant. (oral ectoderm)

97
Q

Clinicopathology of SIADH?

A

SMALL cell carcinoma

98
Q

Baby is born without PTH glands. What else would be missing?

A

Thymus (DiGeorge)

99
Q

Etiopathogenesis of Diabetic Retinopathy

A

non-enzyme glycosylation of collagen

100
Q

Pt with neurologic damage, but tests show nothing (no known cause)

A

Conversion disorder

101
Q

Schizoid Personality Disorder

A

Doesn’t care. indifferent to criticism & praise. Doesn’t want friends.

102
Q

D.nozzzzle comes in late to appt, demands to be seen immediately. Finally gets to see doctor, says employees are incompetent and he should fire them. “I hope you’re a good doctor since you’re going to be treating me”.

A

Narcissistic Personality.

103
Q

Woman with sprained ankle. “how bad does it hurt?” “It’s not that bad. If you have other patients to see, you can see them instead”.

A

Willingness to volunteer for unpleasant tasks to gain approval– Dependent PErsonality.

104
Q

What are the stages of Readiness for Change?

A

Precontemplation– don’t currr– educate them
Contemplation– no plan – ID barriers
Preparation– plan – realistic goals
Action — positive reinforcement
Maintenance– relapse prevention – encouragement

105
Q

How would you dx a virus that’s causing encephalitis?

A

PCR

106
Q

Immunocompromised. Pigeons.

A

Cryptococcal meningitis.

107
Q

Precocious puberty in boy. Increased 17a, normal salt levels

A

11a (11-DOC is functioning— makes mineralcorticoids)

108
Q

Gastroduodenal a and Inferior pancreaticoduodenal a supply what part of the pancreas?

A

Head

109
Q

Patient has cardiac arrhythmia. What opioid should you NOT give.

A

Meperidine (prolonged QT)

110
Q

What opiod is a partial mu agonist and full K antagonist?

Partial mu agonist and full K agonist?

A

Buprenorphine; Pentazocine

111
Q

What MS drug binds S1P-Receptor?

A

Fingolimod (oral)

112
Q

Higher MAC means what for a drug?

A

Higher MAC = lower potency.

113
Q

NHomeless person inhales something on the streets to get a high. Comes in with serious analgesia. What drug?

A

Nitrous Oxide

114
Q

Patient comes in with ischemic stroke. Temp is, say, 104. Tx?

A

Acetaminophen

115
Q

Drugs for SAIDH?

A

Conivaptin. V2-R, cAMP

116
Q

“My shoes are too smalllll!” Give PEgvisomant. MOA?

A

GH-R antagonist— competitive antagonist–> decr. IGF-1, GH remains high.

117
Q

Woman with hypothyroidism takes levothyroxine. becomes preg. what to do?

A

increase dose (pregnancy increases TBG)

118
Q

How to manage cardiac symptoms during thyroid storm.

A

Beta blocker: esmolol. (use PTU also, in general)

119
Q

Secondary obesity vs. primary

A

Secondary: Endocrine or pharm effects. Usually –> RAPID gain

120
Q

What is age-related cochlear degeneration called?

A

Presbycusis

121
Q

How to prevent osteoporosis in elderly?

A

Calcium, vit D

122
Q

Interviewing styles acronym

A 
OARS
Open-ended Qs
Affirmations
Reflective statements
Summarizing
123
Q

Boy goes swimming. Eyes start watering like crazy. blah blah pink eye. Causative agent?

A

Adenovirus

124
Q

Baby is born with meningitis. What is the most likely cause?

A

Strep agalactiae (B)

125
Q

Muscle glucose uptake during exercise

A

Insulin-independent.

Contraction incr Ca2+, incr GLUT4, Glucose moves in

126
Q

What is the role of glucocorticoid therapy in the treatment of CAH?

A

negative feedback on pituitary

127
Q

What drug binds PO4 to control Ca-P homeostasis in chronic renal disease?

A

Sevelamer. A/e: G/I probs

128
Q

Short-acting insuiin. When is it useful and what makes it effective?

A

Insulin lispro, aspart, glulisine
Short t1/2
Rapid absorption. 5-15min before meal.

129
Q

Patient knows how to recognize when he is hypoglycemic based on sx. What drug might a person be on that would mask these sx?

A

Esmolol (b-blockers blunt hypoglycemic sx)

130
Q

Girl is 18 and has arthritis, so she takes chronic glucocorticoids. Gets and infection– taking antibiotics. What should you do?

A

Lower dose of glucocorticoids, but DONT remove completely.

131
Q

Tx of hypercalcemia of malignancy

A 
First rehydrate with saline to restore renal fx.
Give Bisphosphonates (Zoledronic acid, Pamidronate) - ih GTPases imp in signaling cascades/osteoclast fx.

Give glucocorticoids to pt with myeloma, lymphoma, sarcoidosis.

S4M1 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions