Set 1

Question 1

What is the first-line treatment for a patient with erectile dysfunction?

Answer 1

SildenaFIL
VardenaFIL
TadalaFIL
(“fill the penis”)
*If hypogonadal try testosterone replacement

Question 2

MOA: drugs for erectile dysfunction?

Answer 2

(Sildenafil, vardenafil, tadalafil) inhibit phosphodiesterase causing an increase in GMP, smooth muscle relaxation in the corpus cavernosum, increased blood flood and penile erection

Question 3

A patient with Crohn disease fails traditional therapy (5-ASA, steroids, and immunosuppressants). What other drugs are used to treat Crohn disease that target TNF-α?

Answer 3

Infliximab (remicade), Adalimumab, Certolizumab

Question 4

With what physical exam finding must you presume a scaphoid fracture despite a normal initial x-ray? What might result in a proximal fracture of the scaphoid if left untreated?

Answer 4

• Tenderness in anatomical snuffbox

- Avascular necrosis in the proximal fragment (blood is supplied distal to proximal)

Question 5

What is a cholesteatoma, and how does it present?

Answer 5

Overgrowth of desquamated keratin debris in the middle ear space that can erode the ossicles in the middle ear and the external auditory canal and lead to hearing loss

Presents as chronic middle ear infections, gray/white pearly lesion BEHIND the TM, conducting hearing loss and vertigo

Question 6

During what week of fetal development will the fetus reach the following landmarks:

implantation
organogenesis
heart begins to beat
can distinguish male or female genitalia
gastrulation
formation of primitive streak and neural plate

Answer 6

implantation 1 week
organogenesis 3-8 weeks
heart begins to beat 4 weeks
can distinguish male or female genitalia 10 weeks
gastrulation within three weeks
formation of primitive streak and neural plate by week four

Question 7

What is the initial medical treatment for the arrhythmia known as torsades de pointes?

Answer 7

IV Magnesium sulfate

Question 8

Drugs that can cause a prolonged QT?

Answer 8

Some Risky Meds Can Prolonged QT
Sotalol
Risperidone (antipsychotics)
Macrolides
Chloroquine
Protease inhibitors (-navir)
Quinidine (class 1a, also class III)
Thiazides

Question 9

What are the adverse reactions of exogenous testosterone in males?

Answer 9

• premature puberty in children
• premature closure of epiphyseal place (growth restriction)
• erythrocytosis
• worsening of sleep apnea
• suppression of spermatogenesis
• increase in LDL, decrease HDL

Question 10

What structures give rise to the blood brain barrier?

Answer 10

• Tight junctions between nonfenestrated capillary endothelial cells
• BM
• Astrocytes foot processes

Question 11

Which diuretics are most appropriate for patients with hyperaldosteronism? What are their important side effects?

Answer 11

K+ sparing diuretics: spironolactone and eplerenone (comp aldosterone receptor antagonists in the CCT), triamtrene and amiloride (block Na+ channels in the CCT, decrease Na+ exchange)
“The K+ STAys”

SE: hyperkalemias (leading to arrhythmias), endocrine effects w/ spironolactone (gynecomastia, anti-androgen effects, menstrual irregularities)