NBME 6 section 2

Question 1

A woman is taking leuprolide for breast cancer treatment. What is leuprolide?

Answer 1

GnRH analog

Question 2

How does leuprolide work?

Answer 2

interrupts pulsatile concentrations of GnRH, downregulating LH and FSH production and therefore lowering estrogen (and testosterone) production.

Question 3

What is diphenhydramine?

Answer 3

benadryl - antihistamine and anti-cholinergic

Question 4

What kind of a drug is midazolam? Name 3 indications for its use. *Bonus: Under what tradename is it sold in Israel?

Answer 4

benzodiazepine seizures, insomnia, sedation/amnesia *Dormicum

Question 5

What kind of a drug is thiopental?

Answer 5

barbiturate

Question 6

What kind of a drug is vecuronium? What other drugs is it related to?

Answer 6

competitive cholinergic antagonist; curare, pancuronium, tubocurarine

Question 7

What cardiotoxicity should you associate w/ atropine?

Answer 7

V-tach, including Torsade de Pointes.

Question 8

What is the pharmacological tx for Torsade de Pointes?

Answer 8

Mg++

Question 9

How do you identify most of the anti-muscarinic drugs by name? Can you name one for Parkinson’s? What Sx does it Tx?

Answer 9

“-tropi-“; Benztropine - resting tremor

Question 10

Name an anti-muscarinic used topically to dilate pupils.

Answer 10

Tropicamide

Question 11

Name an anti-muscarinic used to treat asthma and COPD.

Answer 11

ipraTROPIum

Question 12

Name an anti-muscarinic used for motion sickness.

Answer 12

scopolamine

Question 13

Name another anti-muscarinic used for Parkinson’s.

Answer 13

trihexyphenidyl

Question 14

Which hematopoietic growth factor may cause dyspnea, myalgia, nausea, and hypotension with the first dose? When would you use this drug?

Answer 14

Sargramostim (GM-CSF)

Used after bone marrow transplant and after Tx for AML.

Question 15

What is an opiod antagonist used to treat overdose? What is its main disadvantage?

Answer 15

Naloxone. short half-life

Question 16

What is cimetidine?

Answer 16

H2 antagonist used to treat heartburn and peptic ulcers.

Question 17

Calculate the incidence of autosomal recessive disease X in population Y if the carrier frequency in population y is 1/10.

Answer 17

(1/10)(1/10) = 1/100

(1/100)(1/4) = 1/400

1/400

Question 18

What is the feature of Borrelia recurrentis that allows it to cause a relapsing fever (Tick-borne relapsing fever)?

Answer 18

variation of surface Ag