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Maddy - NMSP Exam I - psych pharm > Random > Flashcards

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1
Q

AE of sildenafil (PDE5 inhibitor)

A

can inhibit PDE6 in the retina (color vision) –> bluish discoloration of vision

non-arteritic anterior ischemic optic neuropathy (sudden monocular vision loss)

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2
Q

how do PDE5 inhibitors improve erectile dysfunction

A

nitric oxide –> induces formation of cGMP –> vascular smooth muscle relaxation –> end of erection

PDE5 inactivates cGMP (maintains erection)

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3
Q

examples of PDE5 inhibitors

A

sildenafil, vardenafil, tadalafil, avanafil

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4
Q

indications for PDE-5 inhibitors

A

erectile dysfunction

pulmonary hypertension

BPH (tadalafil only)

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5
Q

cause of vasospastic (prinzmetal) angina

A

endothelial dysfunction and autonomic imbalance that lead to intermittent coronary vasospasm and myocardial ischemia

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6
Q

compare primary ciliary dyskinesia and cystic fibrosis

A

both have chronic rhinosinusitis and nasal polyposis due to impaired mucociliary clearance

failure to thrive and weight loss are NOT associated with primary ciliary dyskinesia

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7
Q

demographic most likely to get uterine fibroids

A

African american women

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8
Q

symptoms of uterine fibroids

A
  • heavy menses
  • pressure symptoms (pelvic pain, constipation, urinary frequency)
  • impaired fertility
  • enlarged, irregular uterus
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9
Q

what is the mechanism of radiation induced lung injury

A

affects alveolar-capillary barrier formed by alveolar epithelial cells and vascular endothelial cells

acutely –> impaired gas exchange and hyaline membrane formation

chronically –> fibrosis (TGF-B)

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10
Q

“double bubble” sign on x-ray indicates

A

duodenal atresia

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11
Q

thin, curvilinear areas of lucency that parallels the bowel wall lumen in an infant indicate what

A

pneumatosis intestinalis (air in the bowel wall)

can be caused by necrotizing enterocolitis

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12
Q

layers to get through in a cricothyotomy

A

1) skin
2) superficial cervical fascia (including subcutaneous fat and platysma muscle)
3) pretracheal layers of deep cervical fascia
4) cricothyroid membrane

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13
Q

MOA metronidazole

A

forms toxic free radical metabolites in bacterial cell that damage DNA

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14
Q

MOA fidaxomicin

A

macrocyclic antibiotic that inhibits sigma subunit of RNA polymerase, leading to protein synthesis impairment and cell death

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15
Q

indications fidaxomicin

A

c. diff infections

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16
Q

antibiotics indicated in c. diff infections

A

oral vancomycin, metronidazole, fidaxomicin

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17
Q

why do 25% of active TB patients have a false negative skin test

A

impaired lymphocytic response

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18
Q

how does fibroblast growth factor 23 help regulate phosphate levels

A

it is secreted by osteocytes in response to hyperphosphatemia and binds to FGF23 receptor –> suppresses 1-hydroxylase (converts vitamin D to active form) –> decreases intestinal phosphate absorption and decreases renal phosphate reabsorption

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19
Q

why does diverticulosis cause hematochezia

A

diverticula tend to form in areas where intraluminal colon wall lacks structural integrity, which is normally located where the vasa recta are –> weakened vessels can ulcerate and rupture

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20
Q

treatment for juvenile myoclonic epilepsy

A

broad spectrum anticonvulsant (valproic acid, levetiracetam)

21
Q

clozapine MOA

A

second generation anti-psychotic

22
Q

what is the only medication that has consistently shown superior efficacy in treatment-resistance schizophrenia

A

clozapine

23
Q

most often cause of death in ALS patients

A

respiratory failure

decreased vital capacity

24
Q

inheritance of G6PD deficiency

A

x-linked recessive

25
Q

hemolytic anemia due to medication induce oxidative stress indicates what dz

A

G6PD deficiency

26
Q

BMI CUT OFF FOR ANOREXIA

A

18.5 NOT 17.5

27
Q

pathophysiology of MVP

A

myxomatous degeneration (pathologic deterioration of the connective tissue) affecting mitral valve leaflets and chordae tendinae

28
Q

enzyme deficient in classic galactosemia

A

galactose-1-phosphate uridyltransferase

galactose-1-phosphate –> glucose-1-phosphate

29
Q

most common manifestation in mild galactosemia

A

cataracts (due to galactitol)

30
Q

how does amyl nitrite work in cyanide poisoning

A

it oxidizes Fe2+ to Fe3+ which generates methemoglobin

methemoglobin has high affinity for cyanide, so it binds and sequesters cyanide in the blood

31
Q

describe schizotypical personality disorder

A

magical thinking (superstitiousness, clairvoyance) and odd perceptual disturbances that are SUB-threshold for a psychotic disorder

they DO NOT experience persistent, fixed delusions or frank hallucinations seen in schizophrenia

they rarely sustain close relationships due to excessive social anxiety

32
Q

describe schizoaffective disorder

A

shares symptoms with schizophrenia and mood disorders

> 2 weeks of psychotic symptoms without manic or depressive episode

33
Q

burkoholderia cepacia:

  • gram stain?
  • catalase +?
  • lactose fermenting?
A
  • gram negative
  • catalase positive
  • non-lactose fermenting
34
Q

is bordetella pertussis catalase positive?

A

yep

35
Q

is serrate catalase positive?

A

yep

36
Q

is pseudomonas catalase positive

A

yep

37
Q

how does systemic vascular resistance and pulmonary vascular resistance change during pregnancy

A

both decrease due to vasodilatory mechanisms that occur during pregnancy

38
Q

where do spinal nerves exit in the lumbar spine

A

BELOW the vertebral level

L5 nerve root exits below L5 vertebrae

39
Q

why do patients need a nitrate-free interval every day when taking nitrates

A

to decrease tolerance

around the clock nitrate administration rapidly results in development of tolerance to nitrates

40
Q

how does age change prognosis in PSGN

A

increased age worsens prognosis

41
Q

compare effects of raloxifene and tamoxifen

A

raloxifene:
agonist on bone, antagonist on breast and uterus (no increased risk for breast or uterine cancer)

tamoxifen:
agonist on bone, antagonist on breast, agonist on uterus (increases risk of endometrial hyperplasia/cancer)

42
Q

what antibodies exist in grave’s disease

A

thyrotrophic (TSH) receptor antibodies

43
Q

what antibodies exist in hashimoto thyroiditis

A

thyroid peroxidase antibodies

44
Q

pathogenesis of hemochromatosis

A

mutations in HFE protein

HFE protein normally interacts with transferrin receptor to form complex that functions as a sensor of iron stores

HFE mutation –> enterocytes and hepatocytes detect falsely low iron levels –> accumulation of iron

45
Q

brain tumor in the ventricles int most likely a

A

ependymoma

46
Q

symptoms of IgA nephropathy

A

painless hematuria within 5-7 days of a URI

47
Q

compare IgA nephropathy and hence schonlein purpura

A

IgA nephropathy: painless hematuria within 5-7 days of a URI

HSP: IgA nephropathy with extra renal symptoms (abd pain, arthralgia, purport)

48
Q

pathogenesis of neuronal injury in DM

A

nonenzymatic glycosylation of tissue proteins resulting in hyalinization of endometrial arterioles –> narrowing of arteriole lumen –> ischemic nerve damage

also

intracellular hyperglycemia in peripheral nerves –> increased metabolism of glucose into sorbitol by aldose reductase –> accumulation of sorbitol –> oxidative stress in the nerve

Maddy - NMSP Exam I - psych pharm (23 decks)

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