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Test reviews DEDICATED > thurs jul 30 > Flashcards

thurs jul 30 Flashcards

1
Q

levadopa MOA

A

converted to dopamine by DOPA decarboxylase -> increased dopamine in parkinsons patients

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2
Q

peripheral S/E of increased dopamine?

A

GI distress (nausea, vomiting), arythmias, orthostatic hypotension

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3
Q

central S/E of incraesed dopamine?

A

psychiatric symptoms -anxiety, hallucinations, etc.

-chronic therapy also causes dyskinesia

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4
Q

what is the wearing off phenomon of levadopa therapy?

A

with chronic therapy akinesia and dyskinesia reemerge towards the end of each dose

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5
Q

what happens to the therapeutic window as parkinsons progresses?

A

becomes narrower

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6
Q

carbidopa MOA

A

peripheral DOPA decarboxylase inhibitor - prevents peripheral conversion of levadopa

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7
Q

tolcapone MOA

A

central and peripheral COMT inhibitor - inhibits breakdown, increasing bioavailability

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8
Q

entacapone MOA

A

peripheral COMT inhibitor - inhibits breakdown, increasing bioavailability

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9
Q

tolcapone A/E

A

hepatic failure

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10
Q

selegiline MOA

A

MOA-B inhibitor- increases dopamine in CNS

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11
Q

ropinirole MOA

A

D2 receptor agonist

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12
Q

pramipexole MOA

A

D3 receptor agonist

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13
Q

treatment of restless leg syndrome?

A

dopamine receptor agonists

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14
Q

A/E of dopamine receptor agonists?

A

impulsivity - gambling, hypersexuality, etc.

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15
Q

amantadine MOA

A

increases endogenous dopamine

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16
Q

what are benztropine and trihexyphenidal?

A

anti-muscarinics that improve tremor and rigidity in parkinsons (no effect on bradykinesia)

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17
Q

transmural fibrous thickening of aortic branches is seen in…

A

takayasu

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18
Q

treatment of kawasaki disease?

A

IV immunoglobulin and aspirin

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19
Q

presentation of kawasaki disease?

A

child with desquamative rash, oropharyngeal signs (strawberry tongue), adenopathy, chest pain

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20
Q

what is thromboangiitis obliterans?

A

beurgers disease

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21
Q

Polyarteris nodosa vessel findings

A

transmural inflammation with fibrinoid necrosis, in renal, coronary and mesenteric arteries
STRING OF PEARLS

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22
Q

which types of arteries does polyarteritis nodosa effect?

A

medium size - coronary, mesenteric, renal

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23
Q

patients with polyarteritis nodosa may be positive for what marker?

A

30% are positive for Hepatits B surface antigen

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24
Q

what presentations do henoch schlonlein purpura and cryoglobulinemic vasculitis have in common?

A

Hematuria
Palpable purpura
Arthralgia

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25
Q

does henoch schlonlein purpura have GI pain?

A

yes

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26
Q

does cryoglobulinemic vasculitis have GI pain?

A

no

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27
Q

what deposits in henoch schlonlein purpura?

A

igA

28
Q

what is cryoglobulinemic vasculitis associated with?

A

hepatitis C

29
Q

what deposits in cryoglobulinemic vasculitis ?

A

cryoglobulin

30
Q

treatment of cryoglobulinemic vasculitis ?

A

treat hep C

31
Q

churg-strauss syndrome AKA

A

eosinophilic granulomatosis with polyangitis

32
Q

churg-strauss is associated with a positive…

A

p-ANCA

33
Q

presentation of churg-strauss

A

asthma/allergic rhinitis
polyps (nasal)
peripheral neuropathy
igE

34
Q

wegeners aka

A

granulomatosis with polyangitis

35
Q

wegeners has a positive…

A

c-ANCA

36
Q

what areas are involved in wegeners?

A

lungs
kidney
nasopharynx

37
Q

microscopic angiitis has a positive…

A

p-ANCA

38
Q

what areas are involved in microscopic angiitis?

A

lungs and kidneys - not NASOPHARNYX

39
Q

Digeorge syndrome is caused by defective…

A

neural cell migration

40
Q

which enzyme do fibrates inhibit?

A

cholesterol 7 alpha-hydroxlyase

41
Q

why do fibrates increase your risk for gallstones?

A

by inhibting cholesterol 7 alpha-hydroxlyase, the rate limiting step of bile acid synthesis, there is decreased cholesterol solubility in the bile -> gallstones

42
Q

why can H influenza grow on a blood culture, specifically in the presence of staph aureus?

A

H influenza requires factors V and X (hematin and NAD).

Staph aureus will secrete NAD and the beta hemolysis of S aureus releases hematin -allowing H influenza to grow

43
Q

what is the yellow-brown pigment that may be found in the heart and liver of aging persons?

A

lipofuscin (this is normal)

44
Q

how does lipofuscin form?

A

from free radical injury and lipid peroxidation

45
Q

which ribs overlie the spleen?

A

left 9th 10th 11th

46
Q

which ribs overlie the liver?

A

right 8th 9th 10th 11th

47
Q

dermatomyositis muscle findings?

A

PERIMYSIAL inflammatory infiltrates and atrophy in skeletal muscle

48
Q

describe an ecological study

A

a study that looks at populations as the sample rather than individuals (compares whole countries)

49
Q

what are the benefits of injecting epinephrine along with a local anesthetic?

A

epinephrine will induce vasoconstriction which:

  • decreases local bleeding
  • increases duration of action because the anesthetic stays at the site
  • decreases systemic side effects due to less systemic absorption
50
Q

diagnosis of P jirovecii?

A

silver stain

51
Q

treatment of P jirovecii?

A

TMP-SMX

52
Q

what activates tryspin?

A

enteropeptidase

53
Q

location of enteropeptidase?

A

intestinal brush border

54
Q

how may atheroembolic disease present?

A

days-weeks after a procedure that would have dislodged a plaque, with skin findings such as livedo reticularis and blue toe

55
Q

are the artery pulses palpable in atheroembolic disease?

A

yes, the microemboli do not affect large arteries

56
Q

what will tissue biopsy show of someone with atheroembolic disease?

A

needle shaped clefts

57
Q

all opioids are coupled to which type of receptor?

A

g protein

58
Q

MOA of mu opioid drugs (name both mechanisms)

A
  1. On presynaptic neurons: decrease calcium influx thus decreasing NT release
  2. On postsynaptic neurons: opens potassium channels leading to potassium efflux and hyperpolarization

MEDIATED BY G PROTEIN BINDING

59
Q

osteltamavir MOA

A

Neuraminidase inhibitor - prevents virion release

60
Q

what is the best drug for lowering triglycerides?

A

fibrates

61
Q

effects of niacin?

A

increased HDL and decreased LDL

62
Q

how do uterine fibroids change as menopause approaches?

A

they regress

63
Q

which drug is a risk factor for uterine sarcoma?

A

tamoxifen

64
Q

leiomyoma =

A

uterine fibroid

65
Q

what spreads babesiosis?

A

ixodes tick

66
Q

is coal mining associated wiht asbestos?

A

no

67
Q

is working with insulation assocaited with asbestos?

A

yes

Test reviews DEDICATED (70 decks)

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