MB 3 part 2

Question 1

clinical diagnosis of narcolepsy?

Answer 1

low CSF levels of hypocretin-1 (due to depletion of specific neuron in lateral hypothalamus responsible for maintaining wakefulness) and shortened REM sleep latency on polysomnography

Question 2

diagnosis of brief psychotic disorder

Answer 2

one or more positive psychotic symptoms are present for less than a month in the absence of another medical disorder or substance abuse

Question 3

diabetic ketoacidosis presentation

Answer 3

nausea/vomiting, abdominal pain, decreased mental status, fruity odor to breath

Question 4

diagnosis of DM

Answer 4

fasting glucose > 126 or random > 200, hg A1C >6.5%

Question 5

Type 1 DM sx

Answer 5

polyuria, polydipsia, polyphagia, fatigue, weight loss

Question 6

hyperthyroidism sx

Answer 6

weight loss, polyuria, palpitations, heat intolerance, excessive sweating

Question 7

opiate used in diarrhea

Answer 7

loperamide - slows motility

Question 8

octreotide

Answer 8

somatostatin analogue that decreases gut motility, blood flow, and endocrine and exocrine pancreatic function

Question 9

how do you correct pancreatic insufficiency in CF?

Answer 9

pancreatic enzyme supplementation

Question 10

if someone is having urinary retention issues, what type of drug would help activate the detrusor muscle?

Answer 10

a muscarinic agonist (bethanechol) or alpha-1 blocker

Question 11

finasteride

Answer 11

increase urination in setting of obstructed pathway with prostatic hypertrophy; inhibits 5a-reductase promoting shrinkage

Question 12

oxybutynin

Answer 12

anti-muscarinic used in urge incontinence by tightening sphincters

Question 13

imaprimine

Answer 13

anti-cholinergic activity

Question 14

efficacy

Answer 14

intrinsic ability of a drug to elicit an effect; maximum ceiling of activity (Emax). The max effect that can be achieved regardless of dose

Question 15

potency

Answer 15

the dose of drug that is required to produce a given effect; primarily affected by the affinity of the drug for its receptor and the amount of drug that is able to reach the target tissue

Question 16

the lower the ED50 of a drug, the more ____

Answer 16

potent it is

Question 17

what are the vitamin K dependent clotting factors inhibited by warfarin?

Answer 17

II, VII, IX, X

Question 18

causes of restrictive cardiomyopathy

Answer 18

idiopathic, infiltrative disease (amyloidosis, sarcoidosis, hemochromatosis), radiation fibrosis, endomyocardial fibrosis

Question 19

cardiac myxoma

Answer 19

primary heart tumor, mostly left atrium, can obstruct blood flow across mitral valve resulting in syncope and symptoms of heart fialure

Question 20

cardiac sarcoidosis

Answer 20

non-caseating granulomas containing giant cells

Question 21

chagas disease

Answer 21

secondary to trypanosoma cruzi, common cause of myopericarditis and dilated cardiomyopathy in latin america

Question 22

excessive iron deposition in myocardium

Answer 22

hemochromatosis, confirm with prussian blue stain

Question 23

complications for patients with psoriasis

Answer 23

psoriatic arthritis (can resemble RA, arthritis mutilans, seronegative spondyloarthropathy), nail changes (yellow-brown discoloration, pitting, thickening, or crumbling), inflammatory disorders of the eye: conjunctivitis, blepharitis, or uveitis

Question 24

what increases the chance of a patient with psoriatic skin lesions developing arthritic symptoms?

Answer 24

HLA-B27 positive

Question 25

rash in lupus

Answer 25

malar