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STEP Flash Cards > PT3 > Flashcards

PT3 Flashcards

1
Q

What drug directly dilates arteries AND inhibits platelet aggregation?

A

Cilostazol: they dec. activity of platelet phosphodiesterase as well as directly vasodilate arteries - used to treat peripheral artery disease & intermittent claudication

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2
Q

Ticlopidine MOA

A

block platelet ADP receptor, therefore disallowing GP IIb/IIIa receptors to work properly

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3
Q

Abciximab MOA

A

monoclonal antibody that inhibits platelet aggregation by targeting platelet IIb/IIIa receptor

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4
Q

Jaundice, inc. LDH, anemia, inc. total & direct bilirubin and + osmotic fragility test SUGGESTS?

A

Spherocytosis (you have hemolytic anemia) - pigmented gallstones are a complication of this

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5
Q

What enzyme breaks down/metabolizes 6-MP

A

Xanthine oxidase - so if a pt is on allopurinol (XA inhibitor) then you have to dramatically reduce your 6-MP dosage to account for decreased metabolism!

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6
Q

What drugs inhibit topoisomerase II

A

Etoposide, Teniposide, Dauxorubicin

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7
Q

How does Wilson’s disease present

A

Neuro: ataxia, parkinson-tremor, slurred speech
Liver: asymptomatic liver function abnormalities,
Eyes: look for Kayser-Fleischer rings (use slit lamp test)

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8
Q

Which one is proven to decrease mortality rates: beta blocker or digoxin?

A

beta blocker - digoxin not proven to decrease mortality, just morbidity

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9
Q

3 wks after untreated sore throat, develops holocystolic murmur, swelling in joints and ASO titer is 400 - what does she have and what would be the cause of death if she died in the hospital?

A

She has ARF (acute rheumatic fever) after pharyngitis (post strep infection) = will probably die of severe myocarditis

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10
Q

Danger of following up an MAOI with SSRI

A

MAOI will cause inc. serotonin levels and SSRI will further increase those levels so to avoid serotonin syndrome, wait some time before starting the SSRI to allow for MAO to regenerate and do its usual activity of degrading monoamines (serotonin, NE, etc.)

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11
Q

Class 1A antiarrhythmics

A

Disopyramide, Quinidine, Procainamide (double quarter pounder) - intermediate inhib. of phase 0 depolarization and prolonged effect on AP

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12
Q

Class 1B antiarrhythmics

A

Lidocaine, Tocainide, Mexiletine (Lettuce, tomato, mayo) - weak inhib of phase 0 and shortened effect on AP

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13
Q

Class 1C antiarrhythmics

A

Moricizine, Flecainide, Propafenone (more fries please) Strong phase 0 inhibition and no change on length of AP

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14
Q

Propanolol mechanism as antiarrhythmic

A

slows AV node conduction and prolongs phase 4 depolarization in cardiac pacemaker cells - does not affect ventricular myocyte AP

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15
Q

Diltiazem mechanism and class

A

Class 4- calcium channel blocker; acts primarily on AV node and on pacemaker cells (not on ventricular myocyte AP0

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16
Q

Thiazide diuretics MOA and examples

A

block Na-Cl symporter in the distal convoluted tubules - causing enhanced Na, Cl, and water excretion - work on the DCT - may cause HYPERcalcemia (increases luminal calcium absorption in distal tubule which is already increased due to inc. reabs from proximal tubule due to volume depletion)

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17
Q

What increases peripheral metabolism of levodopa

A

Vitamin B6

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18
Q

Synaptophysin stains for cells of _________ origin

A

Neural

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19
Q

Granulosa theca cell tumors secrete

A

Estrogen

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20
Q

What is the most frequent CNS tumor in immunosuppressed patients

A

Primary CNS lymphoma - appear as uniform aggregates of atypical lymphoid cells & majority arise from B-cells

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21
Q

Type of cancer EBV associated with

A

Primary CNS lymphomas

22
Q

Bosentan MOA

A

Endothelin-1 receptor antagonist; decreaes pulmonary vascular resistance and used to treat PRIMARY (idiopathic) pulmonary arterial hypertension - useful to use on pt. waiting for lung transplant for this condition

23
Q

If you see a liver cyst that has been resected (maybe from a person of Mediterranean, Australian, South American descent) - what do you think?

A

Echinococcus granulosus - tapeworm - most common cause of hydatid cysts in humans

24
Q

Main risk from this cyst?

A

Anaphylactic shock if cyst contents are spilled within the periotneum

25
Q

First line of treatment for Streptococcus

A

Beta-lactam antibiotics (ex: penicillin)

26
Q

First line of treatment for Legionella

A

Erythromycin (inactivates bacterial 50S subunit and prevents protein synthesis) - Legionella produces beta-lactamase (so those antibiotics are ineffective)

27
Q

First line of treatment for Treponema

A

penicillin

28
Q

First line of treatment for Mycoplasma

A

CANNOT use cell wall inhibitors (doesn’t have a cell wall!) use erythromycin or tetracycline (inhibit protein synth by blocking 50S and 30S, respectively)

29
Q

How does N-acetyl cysteine (NAC) work in acetaminophen toxicity?

A

Acts as a glutathione substitute - this helps to soak up the toxic metabolites produced by acetaminophen - it uses SULFHYDRYL GROUPS to enhance non-toxic elimination of acetaminophen

30
Q

Role of protein C in coagulation cascade

A

Anticoagulant - degrades factors Va and VIIIa

31
Q

MOA for benzos

A

Allosterically binds to GABA(a) receptor and stimulates influx of chloride ions - facilitates inhibitory action of GABA by increasing the FREQUENCY of ion channel opening

32
Q

GABA(a) receptors: location, structure, and effect of stimulation

A

Location: Brain
Structure: Ion channel
Effect: CL- influx

33
Q

GABA(b) location, structure, effect

A

Location: Brain
Structure: G-portein
Effect: K+ efflux, decreased Calcium influx, inhibits adenylyl cyclase

34
Q

GABA(c) location, structure, effect

A

Location: retina
Structure: ion channel
Effect: Cl- influx

35
Q

What would a D&C on a uterus with ectopic pregnancy reveal

A

Even though fetus isn’t implanted in uterus, the uterus is still under influence of pregnancy hormones so you’d see decidualized stroma WITHOUT embryonic tissue or chorionic villi

36
Q

Decidualization of uterus under hormonal influence of:

A

Progesterone

37
Q

Binge drinking can lead to which GI problem?

A

Acute pancreatitis

38
Q

Complication from acute pancreatitis and describe the histologic tissue seen

A

Pseudocyst formation (most commonly in the lesser sac) - occurs when pancreatic enzymes disrupt walls of pancreatic ducts and leak into peripancreatic space - this induces inflammation and a capsule is formed around it: GRANULATION TISSUE AND FIBROUS TISSUE encapsulates the fluid

39
Q

True vs. pseudocyst

A

True cyst: encapsulated walls of epithelial cells

Pseudo: lined by granulation tissue (no epithelial cells)

40
Q

What cell expresses receptors for MHC II and IL-2?

A

CD4+ T-helper lymphocytes

41
Q

What antigen is required for proper function of T-cell receptors?

A

CD3

42
Q

CD20 seen on

A

B-lymphocytes

43
Q

Rituximab MOA

A

Monoclonal antibodies against CD20 - used to treat B-cell lymphomas and autoimmune diseases (like RA)

44
Q

Cetuximab MOA

A

Anti EGFR (epidermal growth factor receptor) - used to treat NSCC, colorectal, pancreatic, SCC

45
Q

Bevacizumab MOA

A

Anti VEGF (vascular endothelial growth factor) - used to treat metastatic colon, NSCC, renal cell carcinoma, and glioblastoma multiforme

46
Q

How to differentiate pilocytic astrocytoma from medulloblastoma via HISTO

A

Pilocytic: see astrocytes and rosenthal fibers; benign tumor = little mitotic figures and fairly well differentiation
Medullo: sheets of primitive cells, blue, hyperchromatic nuclei, scant cytoplasm, high mitotic figures, malignant

47
Q

How to differentiate pilocytic astrocytoma from medulloblastoma via IMAGING

A

Pilo: has a cystic & solid component - will see solid (white) part and cystic (black) part on scan
Medullo: all solid (white)

48
Q

Subacute thyroiditis aka…

A

de Quervain’s - hypothyroidism following flu-like illness; see granulomatous inflammation on histologic exam (mixed, cellular infiltration with occasional multinucleate giant cells) - get VERY tender thyroid

49
Q

Describe histo for renal cell carcinoma

A

Arises from PROXIMAL renal tubules - clear cell carcinoma is the most common type of RCC and you see cuboidal/polygonal cells with clear abundant cytoplasm

50
Q

Hypertrophic cardiomyopathy

A

get hypertrophy of the IV septum - main cause of sudden death in young adults (asymptomatic) - you get LV outflow tract obstruction which causes harsh systolic ejection murmur

STEP Flash Cards (14 decks)

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