Pharm

Question 1

Thiazide diuretics

Answer 1

Hydrochlorothiazide and Chlorthalidone

Inhibits resorption of sodium and chloride at the distal convoluted tubule

Question 2

Loop diuretics

Answer 2

Furosemide, Bumetanide, and Torsemide

Inhibits sodium and chloride resorption at the loop of Henle, and proximal and distal convoluted tubule

Question 3

Potassium-sparing diuretics

Answer 3

Spironolactone and Eplerenone

Antagonizes aldosterone-specific mineralocorticoid receptors (primarily in the distal convoluted tubule), decreasing sodium and water reabsorption and increasing potassium retention

Question 4

Lactulose MOA

Answer 4

Nonabsorbable disaccharide that decreases ammonia in the bloodstream by acidifying colonic contents

Can cause a nongap metabolic acidosis from large volume losses of bicarbonate.

Question 5

Beta blocker affects on Heart

Answer 5

Increases diastolic filling time by slowing the heart rate and therefore leads to decreased cardiac contractility

Question 6

Medical Management of diabetic peripheral neuropathy

Answer 6

1st line therapy:
Pregabalin
Gabapentin
Amitriptyline
Duloxetine 

2nd line- Venlafaxine

Question 7

Coumadin (Warfarin) MOA

Answer 7

anti-coagulant that has a mechanism of action by inhibiting vitamin K dependent clotting factors, which include II, VII, IX, X, and protein C and S.

Question 8

Ibuprofen MOA

Answer 8

Non-selective COX inhibitor; thus promoting anti-inflammatory action via COX-2

Question 9

Celebrex (celecoxib) MOA

Answer 9

Selective COX inhibitor that targets COX-2 and has no effect on COX-1 function

Inhibition of COX-2 allows anti-inflammatory action without the disruption of COX-1 (gastric mucosa, regulating renal blood flow, and platelet aggregation)

Question 10

Aspirin MOA

Answer 10

Aspirin irreversibly inhibits the formation of thromboxane A2, which is required for normal platelet aggregation.

Question 11

Plavix (clopidogrel) MOA

Answer 11

Inhibits platelet aggregation by irreversibly inhibiting an adenosine diphosphate (ADP) chemoreceptor on platelet cell membranes.

Question 12

Ginkgo biloba

Answer 12

Herbal supplement that is marketed for the treatment of dementia, memory impairment, and vascular disorders

Potential risk of bleeding due to inhibition of binding of platelet activating factor. (so don’t use with aspirin, NSIDS and anticoagulants)

Question 13

Unfractionated heparin

Answer 13

polysaccharide that binds to anti-thrombin III (AT III) and increases the rate of AT III inactivation of thrombin and Factor Xa

Only in hospital bc it’s given IV

Question 14

Low molecular weight heparins (LMWH), such as enoxaparin

Answer 14

LMWH actions preferentially inhibit factor Xa, with a longer effect than that of heparins. LMWH are administered subcutaneously, but require significant dose reductions with chronic kidney disease

Question 15

GPIIb/IIIa inhibitors

Answer 15

Abciximab (ReoPro), tirofiban (Aggrastat), and eptifibatide (Integrilin)

GPIIb/IIIa receptors are found on platelets. Activation of these receptors leads to platelet aggregation

Question 16

Aspirin

Answer 16

irreversibly inhibits COX-1 in platelets, blocking the conversion of arachidonic acid to thromboxane A2, which is responsible for platelet recruitment and aggregation

Question 17

Hunter Criteria for Diagnosing Serotonin Syndrome

Answer 17

Recent use of serotonergic
agent (usually in the past 5 weeks) PLUS
Any of the following:
Spontaneous clonus
Hyperreflexia AND tremor
Muscle rigidity AND hyperthermia (temp > 100.4°F) AND ocular or inducible clonus
Inducible clonus AND agitation OR diaphoresis
Ocular clonus AND agitation OR diaphoresis

Question 18

linezolid is a serotonergic medication

Answer 18

Serotonin syndrome typically develops within 12 hours of excess serotonergic agent administration
Hyperreflexia, clonus, hyperactive bowels, and autonomic instability help differentiate it from other differential diagnoses

Question 19

Lumbar puncture shows:

Extremely elevated cell count with decreased glucose

Answer 19

Bacterial meningitis

Question 20

Lumbar puncture shows:

Extremely elevated protein with lymphocytosis

Answer 20

TB meningitis

Question 21

Lumbar puncture shows:

Increased protein with a normal cell count

Answer 21

Guillain- Barre syndrome

Question 22

Lumbar puncture shows:

Normal protein and glucose with lymphocytosis

Answer 22

Viral meningitis

Question 23

Adult polycystic kidney disease (ADPKD)- Autosomal dominant

Answer 23

Linked to abnormalities on chromosomes 16 and 4

Patients with ADPKD should be evaluated for berry aneurysms with a CT angiogram of the head

Other associations include bicuspid aortic valve, mitral valve prolapse, and aortic dissection.

Question 24

Diagnostic Criteria for Diabetes Mellitus in Adults

Answer 24

Presence of symptoms of hyperglycemia: polydipsia, polyuria, weight loss, blurry vision + random blood glucose ≥ 200 mg/dL

Question 25

Diagnostic Criteria for Diabetes Mellitus in Adults that are asymptomatic

Answer 25

If the patient is asymptomatic:
Fasting plasma glucose ≥ 126 mg/dL
Two-hour plasma glucose values of ≥ 200 mg/dL during an oral glucose tolerance test
A1C values ≥ 6.5%

Question 26

Diagnosing Central vs Nepphrogenic DI

Answer 26

Diabetes insipidus (DI) is due to a deficiency in (central DI) or decreased effect of (nephrogenic DI) vasopressin, leading to polydipsia, polyuria, and hypernatremia. When given desmopressin, a synthetic analog of vasopressin, patients with central DI show improvement, while those with nephrogenic DI show no change. Nephrogenic DI is a well-documented side effect of lithium, which is used to treat bipolar disorder.

Question 27

Treatment for cocaine induced chest pain?

Answer 27

Benzodiazepines

Question 28

Phencyclidine toxicity treatment

Answer 28

Benzodiazepines

Question 29

Bisphosphonates

Answer 29

bind hydroxyapatite crystals in bone and inhibit osteoclast-mediated bone resorption