- binding to ergosterol in fungal cell membrane - formation of pores and leakage of fungal cell contents

- nucleoside analog - converted into acyclo-GTP in infected cells - inhibits viral DNA polymerase

- inhibits fungal cell mitosis at metaphase

Test 89: All Flashcards by Bina Malapur

aphasia

lost of inability to understand or express speech

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What are some unique features of herpes simplex virus type 1 encephalitis

aphasia and personality changes

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Herpes simplex virus type 1 encephalitis impacts what part of the brain

temporal lobe

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Post-mortem macroscopic brain examination of herpes simplex virus type 1 encephalitis?

edema and hemorrhagic necrosis of temporal lobe

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What is the most common cause of viral meningitis in children

Enterovirus, group B coxsackievirus

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Doxazosin, Prazosin, and Terazosin are what type of drugs

alpha 1 selective antagonists

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Name the alpha 1 selective antagonists

Doxazosin
Prazosin
Terazosin

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What is Doxazosin used to treat

Urinary symptoms of BPH

- hypertension

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Patients with coronary artery disease and heart failure along with hypertension will benefit from what drug class

cardioselective beta-blockers

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What is the first line-medication for the treatment of essential hypertension in the general population

Hydrochlorothiazide

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Difference between amlodipine and dihydropyridine

amlodipine is selective for vascular smooth muscle

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Trichomonal vaginitis and bacterial vaginosis is treated with what

Metronidazole

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What is the adverse effect of metronidazole

disulfiram-like effects ( abdominal cramps, nausea, headache) when combined with alcohol
due to acetaldehyde accumulation

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MOA for fluconazole

inhibits ergosterol synthesis in the P450 system of fungi

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Hippocampal atrophy on MRI suggests what

Alzheimer’s disease

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What is the drug of choice for oropharyngeal candidiasis on patients without advanced immunodeficiency?

Nystatin

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MOA for Nystatin

binding to ergosterol in fungal cell membrane

- formation of pores and leakage of fungal cell contents

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how is Nystatin administered

not absorbed from GI tract

- oral “swish and swallow” agent

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MOA for Acyclovir

nucleoside analog
converted into acyclo-GTP in infected cells
inhibits viral DNA polymerase

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MOA for Griseofulvin

inhibits fungal cell mitosis at metaphase

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What is Terbinafine used to treat

dermatophytosis

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how does Neisseria meningtitis get to the brain

Pharynx
blood
choroid plexus
meninges

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Spread from pharynx, lymphatics, meningitis

Haemophilus influenzae

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How does sunlight exposure catalyze vitamin D

converts 7-dehydrocholesterol to Cholecalciferol ( vitamine D3) in skin

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What drug can be used to prevent cerebral vascular spasm following subarachnoid hemorrhage ?

Nimodipine | - calcium channel blocker

The autonomic nervous system utilizes what 3 types of signal pathways

1. cAMP 2. IP3 3. ion channels

Nicotinic receptors use what signal pathway? what is the flow of the ion?

- ligand-gated ion channels that open after binding acetylcholine - influx if Na and Ca into the cell - outflow of K from cell

binding of epinephrine to alpha1 adrenoceptors uses what signal system

IP3

Beta 1 and 2 adrenoceptors use what signaling

cAMP

M1 and M2 muscarinic receptors utilize what signal pathway

-Inositol triphosphate

M2 muscarinic receptor uses what pathay

cAMP

MOA for protease inhibitors

- inhibit cleavage of polypeptide precursor into mature viral proteins - HIV antiretroviral medication

What are 3 side effects of Protease inhibitors

1. Hyperglycemia 2. lipodystrophy 3. inhibits cytochrome P450

Atazanavir is what type of drug

protease inhibitor

Most important side effect for Acyclovir

renal toxicity

Side effects for Trimethoprim-sulfamethoxazole

- megaloblastic anemia - Stevens-Johnson syndrome - toxic epidermal necrolysis

What type of drug is Zidovudine? MOA?

- nucleoside reverse transcriptiase inhibitor (NRTI) | - suppressing DNA synthesis from viral RNA

common side effects of Zidovudine

bone marrow toxicity, resulting in anemia

Prostatectomy or injury to prostatic plexus can cause what other problem

erectile dysfunction

Injury to what muscle is responsible for erectile dysfunction

corpus cavernosa

The lesser and great cavernous nerves arise from what

prostatic plexus

Branches of pudendal nerve innervate what

- external urethral and anal sphincters | - sensory to external genitalia

When is loss of cremasteric reflex commonly seen

testicular torsion or L1-L2 spinal injury

Contraction of the detrusor muscle is stimulated by what

muscarinic cholinergic agonists

What is a good medication to use postoperative urinary retention

Bethanechol, muscarinic agonist

MOA for Finasteride

5 alpha reductase inhibitor

All hormone-containing contraceptives prevent pregnancy through the actions of wha

progestins

How do progestins inhibit ovulation

decreasing FSH and LH

Most common cause of retinitis in HIV-positive patients is what

CMV infection

HIV patients with retinitis from CMV should be treated how

ganciclovir

CMV retinitis is most frequently affects AIDS patients with what CD 4 count

less than 50

What can be injured from a hysterectomy due to its close proximity to uterine structures

ureter

How does the ureter pass in female reprdocutve

ureter passes inferior and lateral to the uterine artery at the level of the internal cervical os prior to entering the bladder

What is the most important mediator of coronary vascular dilation in large arteries and pre-arteriolar vessels

Nitric oxide

how do endothelial cells make NO

arginine and oxygen

areflexic

absent reflexes

subuxation

partial dislocation

In rheumatoid arthritis, what is more prone to subluxation

atlantoaxial joint, cervical spine

An endotracheal intubation with a person with severe rheumatoid arthritis can cause what problems

- neurological deficits like areflexic paralysis | - b/c of vertebral subluxation

What is the case of duchenne muscular dystrophy

deletion of dystrophin gene

role of dystrophin

allows interaction between extracellular connective tissue and intracellular contraction apparatus

Dystrophin is located on what chromosome

X p21

Charcot-Marie-tooth disease , what is wrong

mutation of genes responsible for myelin synthesis

Endoneural inflammatory infiltration is characteristic of what

Guillain-Barre syndrome

difference between Duchenne and Becker mutations

Duchenne: frameshift mutation Becker: non-framshift

investing rat poison is similar to what type of toxicity

Warfarin toxicity

how is rat poison treated

fresh frozen plasma in addition to vitamin K

Protamine sulfate used to an overdose of what

heparin

Desmopressin increases what in the clotting cascade

- von Willebrand factor | - factor VIII

Cryoprecipitate contains what

- Factor VIII - Factor XIII - von Willebrand factor - fibrinogen

What goes wrong in achondroplasia

gain-of-function mutation in FGFR3 gene

Aminoglycosides inhibit what process

- inhibit genetic code reading and protein synthesis by binding to prokaryotic 30S ribosomal subunit

Adverse effect of aminoglycoside

- nephrotoxicity - neuromuscular blockage - Ototoxicity - Teratogen

Patients who receive the equivalent of more than one body blood volume of whole blood transfusions or packed red blood cells over a period of 24 hours my develop elevated plasma levels if what substance? what does this cause

- citrate: chelates calcium and magnesium | - can cause paresthesias

internuclear ophthalmoplegia is damage to what structure

medial longitudinal fasciculus

Lesion to the right dorsal paramedian pons can disrupt what other structure and cause what

- right MLF | - internuclear ophthalmoplegia

Mu receptors bind to what type of receptor and what happens

G protein - increase potassium efflux - hyper polarization of postsynaptic neurons, blocking pain

Naproxen

NSAID

Adverse effects of TCA overdose

- convulsions - coma - cardiotoxicity ( widened QRS interval or ventricular arrhythmias)

how do TCAs create cardiotoxicity

block sodium channel on heart

How do you treat arrhythmias in cardiotoxicity

- sodium bicarbonate

Classic presentation for benzodiazepine overdose

CNS depression with normal vital signs

patient with pancreatitis and subsequent respiratory failure likely has what

acute respiratory distress syndrome

what are causes of acute pancreatitis

``` I GET SMASHED Idiopathic gallstones ethanol trauma steroids mumps autimmune scorpion sting hypercalceia/hypertriglyceridemia ERCP Drugs ```

What are causes of acute respiratory distress syndrome

``` Sepsis Pancreatitis, pneumonia Aspiration uremia trauma amniotic fluid embolism shock ```

pathology of acute respiratory distress syndrome

- endothelial damage - increase alveolar capillary permeability - protein-rich leakage into alveoli - diffuse alveolar damage and noncardiogenic pulmonary edema intra-alveolar hyaline membranes

autopsy of 78 year old man died of esophageal cancer and has small heart without significant coronary artery atherosclerosis. Myocardial cells show prominent intracytoplasmic granules that are tinged yellowish-brown. what is this in the heart?

lipid peroxidation

what does monoamine oxidase do

- degrades exces monoamine neurotransmitters in presynaptic nerve terminals - detoxifies dietary tyramine in GI tract

What is a hypertensive emergency

- severe hypertension - headache - blurry vision

What are changes in Km and Vmax in competitive inhibitors

Km increased | Vmax is unchanged

effect of Km on noncompetitive inhibitors

does not change

how do you diagnose Mucro and Rhizopus

- mucosal biopsy | - broad nonseptate hyphae with right-angle branching

what is the difference between leading and lagging strand

- lagging need more DNA ligase

Everytime GFR halves, what happens to creatinine

doubles

MOA for naloxone

pure opioid receptor antagonist

MOA for cyanide toxicity

- cyanide binds ferric ( Fe3+) iron | - inhibits cytochrome C oxidase in mitochondria

What is the PE for cyanide poisoning

reddish skin discoloration

laboratory studies for methemoglobin

- lactic acidosis | - narrowing of the venous-arterial PO2 gradient

edetate disodium calcium chelates what

lead

what are the key cells involved delayed-type hypersensitivity reaction ( type IV)

- marcrophages - CD4 helper T cells - CD8 cytotoxic T cells

failure to generate a Type IV hypersensitivity is called

anergy

Severe combined immunodeficiency is caused by what

- genetic defect in T cell development, | - leading to loss of both cellular and humoral immunity

What is a common clinical presentation for SCID

- failure to thrive | - chronic diarrhea

What is pernicious anemia

- autoimmune disease characterized by CD4 mediated destruction of parietal cells

What are 2 effects of having loss of parietal cell mass

- megaloblastic anemia | - elevated intraluminal pH that stimulates gastrin secretion

Location of indirect inguinal hernias

lateral to the inferior epigastric vessels

Location of direct inguinal hernia

medially to the inferior epigastric vessels

Which type of hernia protrudes into the scrotum

indirect inguinal hernia

for the degree of overlap between healthy and diseased population curves, what effects sensitivity and specificity

chosen cutoff value

Test 89: All Flashcards

(109 cards)