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STEP Flash Cards > PT2 > Flashcards

PT2 Flashcards

1
Q

MOA for INH

A

Inhibits mycolic acid synthesis - requires mycobacterial catalase-peroxidase for the drug to be activated

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2
Q

MOA for Streptomycin & how does resistance occur

A

Streptomycin = aminoglycoside that inhibits mycobacterial protein synthesis by disabling bacterial ribosomal 30S subunit; resistance via modification of 30S protein structure

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3
Q

Pyrazinamide MOA, indications, resistance

A

Used for TB; lowers pH in susceptible strains of tuberculosis; must be converted into an active form by bacterial pyrazinamidase - resistance via modification of that enzyme to make it structurally ineffective

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4
Q

Polyarteritis nodosa (PAN) presentation

A

fever, abdominal pain, peripheral neuropathy, weight loss; associated with hepatitis B infection - you see transmural inflammation with fibrinoid necrosis - see little aneurysms within the vessels looks like ROSARY BEADS ON STRING (classic sign)

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5
Q

How to measure potency of an inhaled anesthetic

A

MAC (minimum alveolar concentration) - refers to the concentration of inhalation anesthetic in the gas mixture that renders 50% of patients unresponsive to painful stimuli - corresponds to Ed50

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6
Q

Krukenberg tumor

A

Malignancy in ovary (usually bilateral) that has metastisized - classically from GI Tract (gastric adenocarcinoma) - characterized by mucin-producing signet cells

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7
Q

Minimal change disease is a highly or poorly selective disease?

A

HIGHLY selective - mostly low-molecular weight proteins (albumin & transferrin) are excreted

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8
Q

Global cerebral ischemia

A

aka ischemic-hypoxic encephalopathy; long lasting hypoperfusion can lead to this - see it in the watershed areas and they appear as bilateral, wedge-shaped bands of necrosis over the cerebral convexity, just lateral to the interhemispheric fissure

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9
Q

Purpose of cholinergic agonists

A

stim. peristalsis in postoperative ileus; treat NON-obstructive urinary retention (aka atonic bladder); lower intraocular pressure in glaucoma

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10
Q

Classes of dopamine agonists

A
  1. ergot compounds (bromocriptine and pergolide) 2. non-ergot compounds (pramipexole and ropinerole) - work by stim. dopamine receptors
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11
Q

MOA for selegiline

A

MAO-B inhib; prevents degradation of dopamine in the brain (central dopamine degradation)

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12
Q

COMT inhib & DDI MOA

A

decrease breakdown of levodopa in peripheral tissues - thus increasing amt of levodopa available to cross BBB

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13
Q

Where do ACE-I’s work?

A

Dilate efferent arteriole of kidney

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14
Q

Complication of neonatal respiratory distress syndrome (relating to eyes)

A

to treat respiratory distress, give oxygen supplementation - at high concentrations, this can cause retinal damage - inc. factors VEGF and cause neovascularization & possible retinal detachment!

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15
Q

Churg-Strauss

A

see anti-neutrophil myeloperoxidase antibodies (aka p-ANCA) - suggest polyangiitis; see mononeuropathy, asthma, eosinophilia

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16
Q

Trigeminal neuralgia treatment

A

Carbamazepine - pain reduction; inhib neuronal high-frequency firing (reduces ability of sodium channels to recover from inactivation)

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17
Q

Side effect of carbamazepine

A

aplastic anemia & agranulocytosis (order CBC frequently)

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18
Q

Indications for Haloperidol

A

neuroleptic; chizophrenia, acute psychoses, Tourettes

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19
Q

Phenobarbital indications

A

generalized tonic-clonic seizures

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20
Q

Histo for lactase-deficient patients

A

Normal…

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21
Q

Histo for celiac disease

A

Marked atrophy of intestinal villi

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22
Q

Histo for Whipple’s disease

A

Distended macrophages in intestinal lamina propria

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23
Q

Histo for UC

A

collections of neutrophils within crypt lumina

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24
Q

Histo for GI lymphoma

A

massive infiltration of intestinal lamina propria with atypical lymphocytes

25
Q

Drugs that classically inhibit warfarin metabolism

A

Cimetidine, amiodarone, TMP=SMX, metronidazole

26
Q

Drugs classically enhance warfarin metabolism - thus decreasing its efficacy

A

Rifampin, phenobarbital, phenytoin (universal P-450 enhancers)

27
Q

S-100 marker

A

neuroendocrine origin - ex: schwannoma

28
Q

Sarcoidosis associated with…

A

high serum calcitriol (active form of vitamin D) - leading to increased serum calcium levels

29
Q

AFP associated with

A

hepatocellular carcinoma

30
Q

CA-125 marker for

A

ovarian cancer

31
Q

CEA marker for

A

CRC

32
Q

Acid phosphatase marker for

A

prostate tumor; also in patients undergoing active osteoclast-initiated bone resorption

33
Q

Treatment for mucormycosis

A

Amphotericin B

34
Q

Side effects from drug used to treat mucormycosis

A

Renal toxicity (causes renal vasoconstriction & reduction in GFR) - hypokalemia & hypomagnesemia are 2 most serious disturbances

35
Q

Abetalipoproteinemia is…

A

autosomal recessive; malabsorption, neuro deficiencies (ataxia), retinitis pigmentosa - impaired apoB synthesis (a lipid transport protein that coats chylomicrons) = inability to transport lipids from intestine - foamy cytoplasm of intestinal epi cells - serum lipid levels LOW - see acanthocytes in periph blood (def. of lipids in RBC membranes)

36
Q

Blunting of villi indicates…

A

Celiac!

37
Q

PAS+ distended macrophages w/ rod-shaped bacteria equals…

A

Whipple disease

38
Q

Chron’s characteristics

A

inflammation of ALL layers of intestinal walls, non-caseating granulomas, crypt abscesses

39
Q

Impetigo

A

honey-colored crust; strep and staph generally responsible

40
Q

Kawasaki

A

swollen lymph nodes, red eyes, high fevers, strawberry tongue, perioral erythema, fissuring, periungual desquamation

41
Q

Henoch-Schonlein purpura (HSP)

A

most common small vessel vasculitis in children; often preceded by viral or strep URI; characterized by: abd pain, bloody diarrhea, hematemesis, bloody urine, palpable purpura on butt, joint pain

42
Q

Progesterone & bile acid relationship

A

reduces gallbladder motility/emptying

43
Q

Alpha-1 antitrypsin deficiency

A

Primarily produced in liver - many develop panacinar emphysema (hyperlucency of lung fields) & also liver disease (jaundice) - suspect this if you have premature onset of lung problems in non-smokers; hx of neonatal hepatitis also suspicious

44
Q

Dubin Johnson & Rotor syndrome

A

fairly mild course; both cause inc. CONJUGATED bilirubin levels; asymp. for most

45
Q

Pathogenesis for alcohol-induced hepatic steatosis

A

triglyceride accum. in liver with DECREASED FFA oxidation & excess NADH production & impaired lipoprotein assembly

46
Q

Amlodipine mechanism and side fx

A

calcium-channel blocker & can cause peripheral edema & cutaneous flushing - used to treat HTN

47
Q

G6PD def. periph smear results

A

“bite cells”

48
Q

Opiod withdrawal Sx and treatment

A

pupillary dilatation, rhinorrhea, sneezing, nasal stuffiness, vomiting, chills, myoclonic jerks, seizure - treat neonates with opium solution (tincture of opium)

49
Q

Phenytoin side fx

A

gingival hyperplasia (increased PDGF expression), inducer of P-450, megaloblastic anemia (interferes with folic acid metab), ataxia, nystagmus

50
Q

MOA and indications for phenytoin

A

anticonvulsant - treat tonic-clonic seizures, and status epilepticus; blocks voltage-gated Na channels in neurons; narrow TI

51
Q

Glomangioma

A

benign glomus tumor (under nail bed) - tender, red/blue lesion - originates from modified smooth muscle that controls thermoregulatory functions

52
Q

What produces Sx of cachexia

A

TNF-alpha - suppresses appetite in humans

53
Q

Where is aq. humor produced?

A

epithelial cells of the cliiary body - then excreted into posterior eye chamber and through pupil into anterior chamber then trabecular meshwork through schlemm’s canal and into veins

54
Q

timolol & glaucoma mechanism

A

works to decrease secretion via ciliary epithelium

55
Q

Meniere disease

A

inc volume of endolymph due to defective resorption; triad of 1. tinnitus 2. vertigo 3. sensorineural hearing loss (rinne test shows AC > BC - normal but weber will lateralize to healthy side)

56
Q

Repeated sickle cell crises manifestations in spleen

A

fibrosis & atrophy - causes autosplenectomy in many

57
Q

consequence of splenectomy

A

predisposed to infections with encapsulated bacteria (h. influ, s. pneumo, n. meningitidis, s. typhi)

58
Q

folic acid relationship with sickle cell

A

pts with sickle cell more likely to have folic acid deficiency due to high RBC turnover - which can cause megaloblastic anemia (high MCV and high reticulocyte count)

STEP Flash Cards (14 decks)

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