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UWorld > Set 11 (CNS and Endocrine) > Flashcards

Set 11 (CNS and Endocrine) Flashcards

1
Q

Tremor
Worsens while particular posture is being maintained
Improve w/ alcohol consumption

A

Essential tremor

AD

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2
Q

DOC for essential tremor

A

Propranolol

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3
Q

Benztropine

A

Anticholinergic

Tx: PD, counteract neuroleptic drug extrapyramidal A/E

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4
Q

Clozapine

A

Atypical antipsychotic (block 5HT2 receptor)

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5
Q

C peptide

A

Formed from proinsulin in Golgi
Packaged along w/ insulin in secretory granules
Secreted together w/ insulin

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6
Q

Inhibit NTms reuptake in adrenergic synapses

A

Cocaine

TCA

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7
Q

Mucosal atrophy, partial septum destruction

A

Cocaine abuse

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8
Q

Reserpine

A

Block NT entry into presynaptic vesicles

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9
Q

Agitation
Dramatic symmetric pupillary DILATION that remains RESPONSIVE to light
Tachycardia
Increased BP

A

Cocaine intoxication

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10
Q

Allow patients to serve as their own control

A

x-over trials

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11
Q

HYPOgonadism
Eunuchoid habitus
Small firm testis

A

Klinefelter (47, XXY)

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12
Q

LH normal
FSH elevated
Testosterone normal, low sperm count

A

Cryptorchidism

seminiferous tubule damaged, leydig cell preserved

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13
Q

Carpal tunnel syndrome is a/w?

A

Hypothryoidism
DM
RA
Dialysis-associated amyloidosis

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14
Q

Responsible for many of the toxic effects observed in meningitis and meningococcemia?

A

Meningococcal lipo-oligosaccharide (LOS)

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15
Q

Hirsutism: tx

A

Spironolactone (Aldo receptor antagonist)
Flutamide (inhibit testosterone binding to receptor)
Finasteride (5-alpha reductase inhibitor)

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16
Q

Clomiphene

A

Anti-estrogen for tx of infertility

inhibit negative feedback of estrogen on CNS –> increasing synthesis of GnRH –> gonadotrophins

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17
Q

m/c finding of PCA stroke

A

CONTRAlateral homonymous hemianopia w/ macula sparing

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18
Q

Thyroid peroxidase responsible for?

A

Oxidation of inorganic iodine
Formation of mono/di-iodotyrosine
Coupling tha tforms T3 and T4

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19
Q

Morphine: MOA

A

Binds mu receptor –> GPCR –> activation of K+ conductance, inhibition of Ca2+ conductance, inhibition of AC, inhibition of NT release

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20
Q

High GH

Low IGF-1

A

Larson dwarfism

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21
Q

GH acts through what pathway?

A

JAK-STAT pathway

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22
Q

Loss of gag reflex (afferent limb)

A

Glossopharyngeal n.

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23
Q

Loss of sensation in:
Upper pharynx, posterior tongue, tonsils
Middle ear cavity
Loss of taste form posterior 1/3

A

Glossopharyngeal n. lesion

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24
Q

Fixed segmental loss of UE pain and temperature
UE LMN signs
LE UMN signs
Scoliosis

A

Syringomyelia

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25
Q

Botulism toxin

A

Prevent release of acetylcholine from nerve terminals in NMJ (–> flaccid paralysis)

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26
Q

Diplopia
Dysphagia
Dysphonia
w/i 12-46hrs of consumption of food

A

Botulinum

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27
Q

Typical HIGH potency anti-psychotics

A 
MORE likely to cause extrapyramidal sx
LESS likely to cause anticholinergic/antihistamine A/E
Haloperidol
Fluphenazine
Pimozide
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28
Q

Typical LOW potency anti-psychotics

A

Chlorpromazine

Thioridazine

29
Q

Atypical antipsychotics

A

Clozapine
Risperidone
Olanzapine
Quetiapine

30
Q

Neonate:
Pupillary dilatation
Rhinorrhea, sneezing, nasal stuffiness
Diarrhea, N, V

A

Acute neonatal narcotic withdrawal

Tx: diluted tincture of opium

31
Q

Flumazenil

A

Benzo receptor ANTAGONIST

for: benzo reversal

32
Q

Naloxone

A

PURE opioid receptor ANTAgonist

33
Q

Ketamine

A

NMDA receptor blocker

34
Q

Morphine tolerance: MOA

A

Activation of NMDA receptors of glutamate (Increased phosphorylation of opioid receptors, Increased NO levels)
Increased AC activity

35
Q

Organophosphates stimulate?

A

BOTH muscarinic and nicotinic receptors

36
Q

the ONLY med that reverses BOTH muscarinic and nicotinic effects of organophosphate?

A

Pralidoxime

regenerate cholinesterate

37
Q

Somatostatinomas

A

HYPERglycemia OR HYPOglycemia
Steatorrhea
Gallbladder stones

38
Q

Pentazocine

A

Partial agonist AND weak antagonist at mu receptor
(analgesia w/o abuse potential)
(do NOT combine w/ morphine: withdrawal sx)

39
Q

Ptosis and “down and out” gaze

Light reflex normal

A

CN III neuropathy

40
Q

Lacunar strokes manifest w?

A

Pure motor
or
Pure sensory

41
Q

Most sedating 1st gen H1 receptor blockers

A

Dephenyhydramine
Promethazine
Hydroxyzine
Chlorpheniramine

42
Q

Loratadine

A

2nd gen antihistamine (blocks PERIPHERAL H1 histamine receptors)

43
Q

Chlorthalidone

A

Thiazide diuretic

44
Q

Exclusively ketogenic a.a. (would NOT increase blood lactate in patients w/ Pyruvate dehydrogenase deficiency)

A

Lysine (essential a.a)

Leucine

45
Q

Neisseria meningitidis: route of colonization

A

Pharynx –> Blood –> Choroid plexus –> Meninges

46
Q

H. influenzae: route of colonization

A

Pharynx –> Lymphatics –> Meninges

47
Q

Decrease blood sugar by activation of PPAR gamma

A

Thiazolidinediones (TZDs)

48
Q

Insulin receptor

A

Tyrosine kinase

49
Q

Leads to insulin resistance (cell biology)

A

Aberrent serine and threonine residue phosphorylation

TNF-alpha, catecholamines, glucocorticoids, glucagon

50
Q

Phenytoin toxicity

A

Cerebellum/vestibular system: ataxia, nystagmus
Gingival hyperplasia (via PDGF)
Megaloblastic anemia
Induce CYP450
Fetal hydrantoin syndrome (pregnant women)

51
Q

Phenytoin: MOA

A

Block VG-Na+ channel

52
Q

Lithium: A/E

A

NMJ excitability
Nephrogenic DI
Hypothyroidism
Cardiac conduction defects

53
Q

Clozapine: A/E

(Atypical antipsychotic for negative sx0

A

Agranulocytosis

Seizures

54
Q

Failure of GnRH secreting neurons to migrate from OLFACTORY lobes to hypothalamus

A

Kallman’s syndrome

55
Q

Parafollicular C-cells: embryological origin

A

Ultimobranchial bodies

56
Q

Drug induced parkinsonism: DOC

A

Benztropine
Amantadine
(Levodopa and dopamine agonist are CONTRAINDICATED in antipsychotic-induced parkinsonism)

57
Q

Drug induced Parkinsonism is caused by?

A

D2 receptor blockage in Nigrostriatal pathway

58
Q

Anticholinergics should be avoided in?

A

Elderly patients: esp w/:
BPH
Angle-closure glaucoma

59
Q

Schizophreniform

A

Psychotic sx that interfere w/ patient’s functional status for 1-6months
(>6= schizophrenia)
(<1 = brief psychotic disorder)

60
Q

Fragile X is caused by?

A

Increased # of CGG repeats –> hypermethylation of FMR1 gene –> gene inactivation

61
Q

Chromosome instability disorders

A 
Xeroderma pigmentosum
Ataxia-telangeictasia
Fanconi's anemia
Bloom syndrome
(defects in DNA repair enzymes)
62
Q

Utilize tyrosine kinase-associated receptors and JAK/STAT pathway

A

Colony stimulating factors
Prolactin
Growth hormones
Cytokines

63
Q

Receptor tyrosine kinase + MAP kinase pathway

A

Growth factor receptors (EGF, PDGF, FGF, Insulin)

64
Q

Flutamide

A

Non-steroid anti-androgen (compete w/ testosterone and DHT for testosterone receptors)
(use combined w/ GnRH agonists)

65
Q

Anti-Yo
Anti-P/Q
Anti-Hu

A

Paraneoplastic cerebellar degeneration antibodies

66
Q 
Rapidly progressive dementia and myoclonic jerks
Spongiform encephalopathy (vacuoles in gray matter)
A

Creutzfeldt-Jakob disease (prion)

67
Q

Cerebellar ataxia
Telangiectasias
Increased risk of sinopulmonary infections (IgA deficiency)

A 
Ataxia telangiectasias
(AR, ATM gene in DNA break repair)
68
Q

Lesch-Nyhan syndrome

A

X-linked recessive

HGPRT defect: defective purine catabolism

69
Q

Severe hyperuricemia/gout, mental retardation, choreoathetoid movements, spasticity, self mutilating behavior

A

Lesch-Nyhan syndrome

X-linked recessive, HGPRT defect

UWorld (17 decks)

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