sim ex 1

Question 1

Warfarin therapy started on atrial fib guy with GERD. What is contraindicated?

• aluminum hydroxide
• clarithromycin
• misoprostol
• nizatidine
• sucralfate

Answer 1

clarithromycin; it’s a CYP450 inhibitor

Question 2

half lives and percent of steady state

Answer 2

1- 50%
2- 75%
3- 87.5%
4- 93.75%

Question 3

filtration fraction =

Answer 3

GFR/RPF

Question 4

von Gierke enzyme defish?

Answer 4

glucose-6-phosphatase

can’t convert G6P to glucose in the liver, so fasting hypoglycemia (can –> seizures), hepatomegaly

Question 5

SCID enzyme defish?

Answer 5

adenosine deaminase

severe combined immunodeficiency

Question 6

Lesch Nyhan enzyme defish?

Answer 6

HGPRT
only seen in males
hyperuricemia and neurologic deficits

Question 7

phenylketonuria

Answer 7

deficiency of phenylalanine hydroxylase

mental retardation and decreased pigmentation of the skin

Question 8

hypertension in young healthy person, consider

Answer 8

fibromuscular dysplasia

renal artery

Question 9

first hepatitis B antigen to appear?

Answer 9

HBsAg

Question 10

chlamydophila psittaci transmitted how?

Answer 10

elementary body

obligate intracellular pathogen, treat with tetracycline or doxy

Question 11

morulae found in

Answer 11

patients with ehrlichiosis

febrile disease occuring in same gegraphic range as lyme disease, same tick vector

Question 12

abrupt withdrawal of steroids –>

Answer 12

hypotension

adrenal-pituitary-hypothalamic axis is suppressed

Question 13

treat organophosphate poisoning with what?

Answer 13

pralidoxime very shortly after poisoning

atropine in patients who have muscarinic symptoms

Question 14

diagnose rheumatoid arthritis how?

Answer 14

IgM antibodies against the patient’s own IgG (rheumatoid factor)

Question 15

antibodies against microsomal antigens are found in

Answer 15

Hashiimoto thyroiditis (and to thyroglobulin)

Question 16

the coronary sinus traverses the epicardium alongside the

Answer 16

circumflex artery

Question 17

decreased dopamine–>

Answer 17

parkinsonian effects

Question 18

decreased norepinephrine and serotonin

Answer 18

related to depression

Question 19

elevated norepinephrine

Answer 19

anxiety

Question 20

increased dopamine

Answer 20

schizophrenia

Question 21

Turner syndrome

Answer 21

45,X phenotype
failure of onset of puberty, short stature, webbed neck, wide nipples, lots of nevi, infertility

coarctation associated with it

Question 22

hypothyroid symptoms

Answer 22

decreased conversion of vitamin A–> yellow skin
bradycardia
decreased GFR
hypercholesterolemia

Question 23

treat wilson’s with?

Answer 23

penicillamine (chelates the copper, also treats cystinuria)

can be associated with lupus-like side effect

Question 24

treat myasthenia gravis with

Answer 24

pyridostigmine (AChE inhibitor)
or neostigmine

dx with edrophonium, short-acting

Question 25

in specialized transduction, the genes transferred by the virus to the new bacterium are

Answer 25

always the genes located closest to the insertion site of the virus

Question 26

buprenorphine and morphine

Answer 26

buprenorphine has less efficacy than morphine at mu receptors (partial agonist)

Question 27

Wolff Parkinson White

Answer 27

caused by 2 electrical pathways to the ventricle, one through the AV node and the other through the bundle of Kent

avoid drugs that slow AV node conduction

use procainamide

Question 28

thoracic duct

Answer 28

provides lymphatic drainage for hte upper left and bilateral lower extremities
courses through the diaphragmatic hiatus into the thorax, ascending just to the right of midline and eventually emptying into the central left internal jugular vein
Injury to the thoracic duct results in fluid wiht an extremely high concentration of triglycerides

Question 29

infectious mono

Answer 29

caused by EBV and CMV
positive heterophile antibodies indicate it’s EBV

atypical lymphocytes associated with EBV (Downey type II cells): T lymphocytes. Significantly increased.