Set 17

Question 1

What synthetic agent is used both as a pituitary hormone analog and as a treatment for von Willebrand disease?

Answer 1

Desmopressin (DDAVP) synthetic analog of ADH

Question 2

What agent can be given as an inhaled drug to loosen mucus plugs, can be given orally to treat acetaminophen overdose, and can be given orally as prophylaxis against IV contrast-induced nephropathy in those with preexisting renal disease?

Answer 2

N-acetylcysteine (replenished glutathione)

Question 3

Which type of diabetes mellitus fits the following descriptions?

Associated with obesity
May cause ketoacidosis
Strong genetic predisposition
Associated with HLA DR 3 & 4

Answer 3

Associated with obesity - 2
May cause ketoacidosis - 1, rarely 2
Strong genetic predisposition - 2
Associated with HLA DR 3 & 4 - 1

Question 4

What viral illness is associated with Burkitt lymphoma? Is Burkitt lymphoma a neoplasm of mature T- or B-cells? Where are T-cells found in the spleen? Where are B-cells found in the spleen?

Answer 4

EBV
Neoplasm of mature B cells

T cells are found in the periarterial lymphatic sheath within the white pulp of the spleen
B cells are found in the follicles within the white pulp of the spleen

Question 5

In which lobes of the brain would you find the following brain functions?

Broca’s area (motor speech)
Wernicke’s area (speech understanding)
Primary auditory cortex
Principal visual cortex
Primary sensory cortex
Primary motor cortex
Premotor cortex

Answer 5

Broca’s area (motor speech) - Frontal (inferior frontal gyrus)
Wernicke’s area (speech understanding) - Temporal (posterior part of superior temporal gyrus)
Primary auditory cortex - Temporal
Principal visual cortex - Occipital
Primary sensory cortex - Parietal (most anterior part, posterior to central sulcus)
Primary motor cortex - Frontal (just anterior to central sulcus)
Premotor cortex - Frontal (anterior to primary motor cortex)

Question 6

When is a fetus most susceptible to damage from teratogens? What drug used in the treatment of hypertension is a teratogen? What effect does this have on the fetus?

Answer 6

Most susceptible in 3rd-8th week (embryonic period - organogenesis)
ACE inhibitors (-pril) and ARBs ( -sartan)
Renal damage to the fetus

Question 7

How is the body affected by a prolonged stay in space at zero gravity?

Answer 7

Decrease in blood volume, RBC mass, muscle strength and work capacity, max CO
Loss of calcium and phosphate from the bones —> loss of bone mass

Question 8

What is the most common gynecologic neoplasm? What is the typical histological pattern? Is it benign or malignant?

Answer 8

Leiomyoma (uterine fibroid): most common tumor in females. Often presents with multiple discrete tumors. Whorled pattern of smooth muscle bundles with well-demarcated borders. Benign smooth muscle tumor. Does not progress to leiomyosarcoma. May be asymptomatic, cause abnormal uterine bleeding, or result in miscarriage.

Question 9

Describe how the following diuretics affect the nephron function.

Acetazolamide

Answer 9

Carbonic anhydrase inhibitor. Causes self-limited NaHCO3 diuresis and decreases total-body HCO3 stores.

Question 10

Describe how the following diuretics affect the nephron function.

Mannitol

Answer 10

Osmotic diuretic. Increases tubular fluid osmolarity, producing increased urine flow and decreased intracranial/intraocular pressure

Question 11

Describe how the following diuretics affect the nephron function.

Furosemide

Answer 11

Sulfonamide loop diuretic. Inhibits cotransport system (Na+/K+/2Cl-) of thick ascending loop of Henle. Abolishes hypertonicity of medulla, preventing concentration of the urine. Stimulates PGE release (vasodilatory effect on afferent arteriole); inhibited by NSAIDs. Increased calcium excretion (loops lose calcium)

Question 12

Describe how the following diuretics affect the nephron function.

Hydrochlorothiazide (thiazides)

Answer 12

Inhibits NaCl reabsorption in early distal tubule. Decreases diluting capacity of the nephron. Decreased calcium excretion.

Question 13

Describe how the following diuretics affect the nephron function.

Potassium sparing

Answer 13

Spironolactone and eplerenone are competitive aldosterone receptor antagonists in the cortical collecting tubule. Triamterene and amiloride act at the same part of the tubule by blocking Na+ channels in the CCT

Question 14

Describe how the following diuretics affect the nephron function.

ADH antagonists

Answer 14

Blocks the action of ADH receptors — >diuresis

Question 15

How are the following relative component levels in the blood of a polycythemia vera patient different from normal: plasma volume, RBC mass, O2 saturation, and endogenous erythropoietin?

Answer 15

Plasma volume: increased
RBC mass: increased
O2 sat: unchanged
EPO levels: decreased