RACP 2020 Flashcards
PARP inhibitors MOA and example
Inhibits PA-CRP1. PARP1 usually repairs single stranded breaks in DNA. By not repairing these single stranded breaks, they turn into double stranded breaks and inhibits cancerous growth
E.g olaparib
What receptor does frusemide act at
Na-K-Cl co-transporter at ascending loop of henle
Most common mutation in HFE gene causing hereditary haemochromatosis
C282Y. H63D less common than C282Y
Most common CF mutation
F508del
BK nephropathy Mx
Mainstay is to reduce immunosuppression
- If pt is on tac (calcineurin inhibitor), MMF (anti-metabolite) + pred, would reduce MMF first by half, then cease if no decrease in viral load
- Could also reduce calcineurin inhibitor followed by anti-metabolite
No antiviral agents avail for treatment
Accumulation of which substance in ACEi induced angioedema
Bradykinin
What is agnosia
Inability to recognise objects, people, smells, sounds
What is apraxia
Inability to perform learned movements
What is abulia
Lack of initiative, will, drive for action, speech, thought
Which cranial nerves carry parasympathetic outflow fibers through outside the cranium
CN III, VII, IX, X
Tranexamic acid MOA
Binds lysine binding site on plasminogen
In a box plot what does the line in the middle of the box represent
Median of the IQR
Mechanism of emphysema in alpha-1-antitrypsin
Imbalance between neutrophil elastase and elastase inhibitor AAT
Denosumab MOA
Monoclonal antibody that binds to RANKL
Blocks osteoclast maturation, function and survival
Which co-receptor binds with CD4 in early HIV infection
CCR5 in early
CXCR5 in later HIV infection
What antidepressant has the most anti-cholinergic effect
TCA
Which immunological structure is beta-2-microglobulin a part of
MHC class I
How to prevent dialysis related amyloidosis
High flux membranes
Beta-2 globulin absorber
Preservation of residual kidney function
Early kidney transplant
What vitamin deficiency do you get with metformin
Vitamin B12 deficiency
What happens to B cells in germinal centres?
Antigen-activated B cells diversify their immunoglobulins by somatic hypermutation to generate high-affinity immunoglobulins
Toxic metabolite of paracetamol
NAPQI
How does NAC work in paracetamol poisoning
Acts as a glutathione donor to prevent NAPQI accumulation
Amyloidosis cardiac and renal involvement
AA - kidneys
AL - kidneys and restrictive cardiomyopathy
ATTR - cardiac
What type of breast cancer derives most benefit from CDK inhibitors
Hormone positive, HER negative
Fulvestrant MOA
Selective oestrogen down regulator
Use in metastatic hormone positive postmenopausal pts in combo with AI or CDK inhibitor
Population attributable fraction
PAF = { F(RR-1) / [1 + F(RR-1)] } x 100
F is the prevalence or exposure in the population
Type B nerve fibres function
Visceral afferent fibres
Preganglionic nerve fibres of autonomic nervous system
Moderately myelinated - less myelinated than type A nerve fibres
Type A motor nerve fibres function
Alpha - skeletal muscle fibre innervation
Gamma - intrafusal muscle fibre innervation
Type A sensory nerve fibres function
Ia - proprioception
Ib - golgi tendon organ
II - secondary receptors of muscle spindle, cutanoues mechanoreceptors
III - touch and pressure, nociceptors of neospinothalamic tract, cold thermoreceptors
IV - nociceptors of paleospinothalamic tract, warm receptors
Type C nerve fibres
Unmyelinated, small diameter, low conduction velocity
Responsible for burning pain, warmth, itch
Metaraminol MOA
Stimulates alpha-1 receptors to cause peripheral vasoconstriction and increase BP
Terlipressin MOA
Splanchnic and extrarenal vasoconstriction by stimulating V1 receptors (found in smooth muscle of splanchnic arteries)
Sulfasalazine in which type of SpA
Good for peripheral SpA, not for axial
Applies for MTX as welll
Carbapenamase MOA
Hydrolysis beta-lactam ring
By what mechanism does clozapine cause myocarditis
Myocytes shows eosinophilic infiltration suggesting IgE mediated acute hypersensitivity reaction
Cytokines that drive Familial Mediterranean Fever
IL-1 and IL-18
What non-malignant cause increases CEA
Smoking Infections IBD Pancreatitis Liver cirrhosis
