Practice DD exam 2

Question 1

Side effects of Dexamethasone

Answer 1

most of the undesirable effects of cortisol - GCC

inhibition of HPA

Question 2

Steroids are much more beneficial than NSAIDs in treatment of acute asthma exacerbation. This may be partially explained by the fact that compared with NSAIDs, steroids have additional mechanisms of activity by what?

Answer 2

Decreasing leukotrienes

• NSAIDS COX blockers.
  not including leukotrienes
• steroids blocks everything (top of the chain)
  PG, TXN, Prostacyclin, complement, leukotrienes

Question 3

Do glucocorticoids increase fat deposition centrally or peripherally?

Answer 3

central

Question 4

Long term use of glucocorticoids does what to your bones?

Answer 4

decrease osteoblast activity leading to osteoporosis

Question 5

In left heart failure and significant peripheral edema, which of the following is BEST representative of how the kidney is sensing intravascular volume?
A. Intravascular volume overload
B. Intravascular volume deplete

Answer 5

B Intravascular volume depletion

• kidney senses low intravascular volume due to heart not pumping out enough blood

Question 6

What effect does DIC have on platelets?

Answer 6

result in low platelet levels

-Platelets are consumed during DIC due to wide-spread thrombotic activity

Question 7

1. Describe how each of the following is involved in metastatic spread of cancer
   A. E-cadherin

Answer 7

E-cadherin is frequently downregulated to allow “loosening up” of cell-cell interactions, facilitating detachment from the primary tumor and invasion into the surrounding tissues.

Question 8

1. Describe how each of the following is involved in metastatic spread of cancer

B. SNAIL, TWIST and ZEB1/2

Answer 8

SNAIL, TWIST and ZEB1/2 are transcriptional repressors of E-cadherin that get UPREGULATED in some tumor cells. This is one mechanism of how E-cadherin expression may be downregulated in tumor cells.

Question 9

1. Describe how each of the following is involved in metastatic spread of cancer

C. Matrix metalloproteinases (MMPs)

Answer 9

MMPs are involved in degrading/remodeling the extracellular matrix (ECM), facilitating invasion of the tumor cells

Question 10

1. Describe how each of the following is involved in metastatic spread of cancer

D. Anoikis

Answer 10

Anoikis is a process whereby normal cells that have lost adhesion to extracellular matrix proteins undergo apoptosis. Many metastatic cells have lost this property, facilitating their survival during invasion and vascular dissemination.

Question 11

Describe the Ames test.

Answer 11

○ Testing a chemical proven to be carcinogenic to see if it’s a mutagen (+ test = mutagenic)

Generally, all mutagens are carcinogens, but not all carcinogens are mutagens.

Question 12

Which type of lung cancer is frequently associated with tumor cells trying to form primitive gland-like structures.

Answer 12

adenocarcinoma

Question 13

Rituximab

Answer 13

antibody that is antiCD20 - treat B cell tumors

Question 14

Which type of cancer has neuroendocrine characteristics

Answer 14

Small cell lung cancers are often associated with paraneoplastic syndromes (in this case ectopic production of ACTH) and

have a predilection to spread to the brain.

Question 15

Squamous cell cancer of lung

Answer 15

often found in bronchial tree
big, stains for keratin
peripheral or centrally

Question 16

adenocarcinoma

Answer 16

glandular
grows in septum of alveolar
stain for mucin
peripheral or centered

Question 17

large cell

Answer 17

high grade cancer
arise anywhere in lungs
highly undifferentiated, weird looking
do not produce keratin, mucin, or form glands

Question 18

“seed and soil” theory regarding why certain types of cancer show organ tropism

Answer 18

Cancer cells make chemokine receptors and the organs they prefer to go to express chemokines.

Question 19

Which lung cancer has the best prognosis?

Answer 19

Bronchioalveolar carcinoma

not linked w/ smoking