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Kaplan 9

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zomovefa's version from 2018-03-12 15:35

Schistosomiasis

Question Answer
FishDiphyllobothrium latum -> B12 Deficiency
SnailHematuria, Thickened bladder wall -> Schistosomiasis
Schistosomiasis JaponicumAsia -> Portal Hypertension, Hepatomegaly
Schistosomiasis MansoniAfrica, Carribean, South America -> Intestinal ulceration -> Iron deficiency
Schistosomiasis HaematobiumAfrica, Middle east -> Urinary hematuria, dysuria, frequent urination, Hydronephrosis, pyelonephritis -> Squamous cell carcinoma of bladder
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Pharmacology

Question Answer
TNF-a leads to insulin resistance viaSerine & threonine residue phosphorylation
Cocaine vs Opiod(Heroin) withdrawal sxIncreased appetite, sleep and psychomotor retardation VS Dilated pupils, yawning, piloerection, lacrimation hyperactive bowel sounds
Dizziness SxCalcium blocker and Beta Blocker
Repaglinide, Nateglinide(Meglitinides)Membrane Ion channels -> Inhibit atp dependent K channel -> Increase Insulin release. Sx -> Weight Gain *Note - work the same way as sulfonylureas
Desmopressin(ADH)Decreases urea clearance by activating V2 receptors at the medullary collecting duct
Unfractionated Heparin stored in mast cell granulesUsed to prevent and breakdown clots in hip surgery pts by binding to antithrombin III
Prostate treatment pt presents with gynecomastia should've been treated withTamoxifen(estrogen receptor modulator)
Glucagon give to a pt that took insulin but skipped meal ended up unconsciousnessGlucagon increases serum glucose by Liver Glycogenolysis
Zidovudine MOALacks 3"-OH group making 3"-5" phosphodiester bond formation inhibition
Aspirin & Ibuprofen not used inHyperthyroidism pts
BortezomibProteasome inhibitors(Cell apoptosis) Tx Multiple Myeloma
Methimazole VS PTUTeratogenic/ Non-Hepatotoxic VS Non-Teratogenic/Hepatotoxic
ChlorthalidoneThiazide diuretics(hyperGLUC- Glycemia, Lipidemia, Uricemia, Calcemia), Hyponatremia, Hypokalemia
Isoniazid resistanceMutation of KatG(BACTERIAL Catalase peroxidase) needed to activate isoniazid OR Modification of the protein target binding site
T3 administration causesTSH -decrease, T3 -Increase, ReverseT3 - decrease, T4 DEREASE
K-RAS binds toGTP
Calcium sensing receptorsMembrane bound receptor coupled with a G-protein
ACE & TZD sxDO NOT GIVE -> Hypotension
Atypical depression -> Monoamine inhibitorsAffects monoamine degradation
High serum creatinine -> lactic acidosisMetformin contraindicated also SULFA Drug
HPV vaccine covers6, 11 genital warts / 16, 18 cervical cancer
Hepatic FailureSulfonylurea contraindicated
Tetanus toxoid containing vaccine given onlyPt has not received his 3 vaccination or has been more than 10 years
Magnesium hydroxide sxHyporeflexia
Heart failure or hepaticTZD contraindicated
Supraventricular tachycardias due to atrial fibrillationFlecainide, Propafenone -> No change
Metrondiazole use to treat GET GAP(Trichmonas vaginitis) SXDO not drink alcohol when taking this drug (Disulfiram like effect)
Venous Return decreased, Cardiac output decreased(High TPR)Epinephrine/Phenylephrine
Which drug causes asthma symptomsAspirin -> Cyclooxygenase inhibitor
Prinzmetal angina responds tonitroglycerine, calcium channel blockers, vasodilators
Insulin activatesPFK 1 & UDP gluco-phosphorylase
Seizures drugs with folate deficiency side effect?Phenytoin & Valproic acid
Hepatic AdenomaCommon in high estrogen such contraceptive use or pregnant women. Complication- Rupture
Adenylate cyclase coupled receptorBreceptors, TSH, calcitonin, glucagon, ACTH, HCG
Nitroprusside MOAVeno + Arterial vasodilator -> Decrease volume and pressure
Diffuse muscle rigidity WITHOUT CLONUS, high fever, Hypertension, tachycardia, altered sensorium, Elevated Creatine KinaseDantrolene -> Inhibition of calcium ion release from sarcoplasmic reticulum of skeletal muscle-> Ryanodine receptors
Diabetic Ketoacidosis txIV normal saline & Insulin -> Increase Serum Bicarbonate & Sodium, Decrease glucose, osmolarity & Potassium
DTP vaccination boostersArtificial active
Glucose oral vs IVOral produces more insulin because Ingested glucose increases duodenal secretion of GIP which stimulates insulin release
Reverse respiratory depression by fentanyl, propofol, midazolamNaloxone & Flumazenil only because propofol redistributes to the body
Pt who had MI is started on fibrinolytic drugs to break down clot and then later went into comatose, asymmetric pupils& irregular breathing Intracerebral bleedingAlteplase, Tenecteplase SX Hemorrhage
Amiodarone SxThyroiditis, Hyperthyroidism, Hypothyroidism
Ganciclovir + Trimethoprim-sulfamethoxazole SXNeutropenia due to bone marrow suppression
Expect an hypertension pt on Thiazide diuretics to have labs ofLow serum Na & PTH & High Calcium(Due to the fact Hydrochlorothiazide excretes Na and reabsorbs Ca hence why good drug to use for osteoporosis pt)
Colchicine MoaInhibits microtubules -> Leukocyte migration and phagocytosis -> reduced inflammation
Teen found unconscious at house and then when IV tx is given the pt regains consciousness and wants to go home right awayOpioid overdose treated with Naloxone for MU receptor
Macrolides areInducers - erythromycin & clarithomycin EXCEPT for Azithromycin
Drug sx hepatotoxicity, pancreatitis, thrombocytopenia, alopecia, teratogenValproic acid
MAO inhibitors+ SSRIContraindicated due to increase serotonin in the presynaptic -> Serotonin Syndrome-> Give SSRI 2 weeks so MAO A&B can be formed to BREAK DOWN too much serotonin from SSRI
Infection-> High fever -> High body temperature -> Seizures txAcetaminophen
Foscarnet SxHYPOcalcemia, HYPOkalemia, HYPOmagnesemia, HYPOphosphatemia
Black box warning of a drug isPHASE IV after the drug is in the market
Unfractionated Heparin VS Low molecular heparin(Enoxaparin)Heparin binds to Xa & Thrombin VS Enoxaparin only binds to Xa
Intramuscular GlucagonNon-clinical setting tx for glucose
Adenosine vs NOVasodilation small arteries VS large arteries
Beta agonist(Ritodrine, Terbutaline)Decrease Uterine contractions
Polysaccharide vaccineProtects against wide range of serotypes, antibody declines over time, ages 2-64
IP3(inositol triphosphate) produces effect byIncrease Calcium -> Activates protein Kinase C
Calcium binds to troponin for contraction inSkeletal Muscle
Oral glucose increase Insulin throughGlucagon like peptide-1
CHF Drug of choice with long term control of hypertension, post MI-cardiac remodelingACE Inhibitors(Lisinopril)
Gp160 splits and makes Gp120 & Gp41Function of these two proteins are virion attachment to the target cells
Neisseria Gonorrhea & ChlamydiaThird generation cephalosporins & Macrolide
Myocytes during contraction occur viaVoltage dependent calcium channels with the help of ryanodine receptors
Ach Receptors(Neuromuscular)Nicotinic (Sympathetic,NA/Ca influx & K efflux ligand gated, CNS), Muscarinic(Parasympathetic, 2nd messenger)
Ca efflux in myocytes during relaxation occur viaNa+/Ca2+ exchange mechanism
Depolarization of cardiac myocytesNa Ca exchanger
Tinkering sound in the GIObstruction Do not give metoclopramide
DNA taken up by organisms like h.influenzae, h pylori, streptooccus with a virus helpSpecialized transduction
DNA released from dead cells is taken up by recombination -> Bacteria that is now with high virulence or drug resistanceNatural transformation
Non Pathogenic C.Diphtheriae -> Pathogenic C.DiphtheriaePhage conversion permitting exotoxin production
Carbon Monoxide vs CyanideCyanosis vs NO Cyanosis
IV DextroseHospital setting tx for low glucose
P2Y12 inhibitors adenosine di-phosphate receptor MOAPrevents formation of new clots formation
Protein responsible for relieving TpA actionFibrin
Protein responsible for targeting by TpA actionPlasminogen
MOA Fibrates, Niacin, Fish oilReduce hepatic VLDL RECEPTOR DEGRADATION
Corynebacterium diphtheria best treatment in orderDiphtheria Antitoxin(Passive immunization) -> Best for the prognosis, Penicillin or erythromycin(Antibiotics), DPT Vaccine
Ampicillin, b-lactam antibiotics cause what kind of kidney infectionAcute Interstitial nephritis -> Renal Interstitium affected
Oral contraceptive method of treating HirsutismSuppress pituitary -> decreased ovarian androgen production
Antidepressants can cause what side effect with bipolar history?Mania -> SSRI aka sertraline NOT LITHIUM
Raloxifene OR Tamoxifen Contraindication or complicationHot Flashes, Venous thromboembolism
Decreases heart rate but NO effect on contractility or relaxation of myocytesIvabradine -> Inhibit funny Na channels during phase 4
DOC for psoriasisCalcipotriene -> Activates nuclear transcription factor -> Inhibit keratinocyte proliferation and promotes differentiation
Drug A isolates of the pathogen growing in culture quickly becomes less resistant to decoloration with an acid-alcohol agent and stop proliferatingIsoniazid also Pyrazinamide
Drug that is active form of Vitamin DCalcitriol -> Dx Primary Hypoparathyroidism
Blocks HIV gp120 attachment and preventing viral entryMaraviroc -> Sx - Hypotension & Hepatotoxicity
Blocks HIV gp41 attachment and preventing viral entryEnfuvirtide
A CHF pt on hydralazine and isosorbide dinitrate. ContraindicationSildenafil
24yr old M with nasal congestion, discharge, and sneezing. Happen each spring Which drugs is most effective in relieving these sx in the SHORT TERM?Alpha-adrenergic agonist(Phenylephrine, Midodrine, Epinephrine)
What breaks down incretin?Dipeptidyl peptidase -> Inhibit by giving Sitagliptin,vildagliptin
Estrogen + breast carcinoma infoGood prognosis & respond good to hormonal therapy with tamoxifen(Estrogen receptor antagonist)
Non Selective antagonist blocks a1 & b-adrenoceptorsLabetalol Dx - Hypertension
Alkylates guanine which leads to DNA cross linkingCyclophosphamide OR Ifosfamide
DNA intercalation and inhibits replicationBleomycin
BuspironeAnxiety treatment. Slow onset of action 2weeks similar to SSRI Drugs
Herpes pt viral strain lacks viral phosphorylating enzymeCidofovir, Tenofovir
Thiazide complicationNa and CL excreted leading to decrease volume -> Body turns on RAS system -> Aldosterone causes Na and Cl reabsorption and wasting of K
Phenotypic mixingTwo virus particles "share" coat proteins, therefore each has a similar assortment of identifying surface proteins, while having different genetic material
ThionamidesMethimazole MOA - Coupling of Iodotyrosine - inhibit thyroid peroxidase(Same as PTU but conversion of t4 to t3)
ADHD DocAmphetamines -> Methylphenidate -> Increase availability of norepinephrine and dopamine
Influenza vaccineInhibition of virus into cell
Liddle syndromeHypertension, Hypokalemia, metabolic alkalosis, Low aldosterone Amiloride -> K sparring diuritic that blocks ENaC
Genetic driftMinor antigenic change -> Yearly vaccination
S.pyogenes txPenicillin -> Bactericidal inhibits cell wall mucopeptide synthesis
Persistent tender, reddish purple nodules in both armpits with discharging pusHidradenitis suppurativa Lithium tends to cause this
Hospital Pneumonia(Klebsiella) risk factorOmeprazole or any drug decreasing acid in GI
A fib treatmentAmiodarone treat a fib aka supraventricular tachycardia -> Warfarin is given to prevent clots from A fib -> Amiodarone is inhibitor meaning warfarin levels increase causing GI bleeding, hematuria, easy bruising
Poultry working pt presenting with 3-day history of severe headache, dry cough, fever, high fever, diffuse rales scattered infiltrate with elevated liver enzymesC.Psittacosis -> Tetracycline Pistachio comes from bird poop
Phosphorus VS Calcium in kidneyPCT VS Distal tubule
NorepinephrinecAMP increases in cardiac myocytes
Digoxin + Furosemide(athacrynic acid or torsemide) causesIncreased Hypokalemia & Hypomagnesemia -> Increased Toxicity of Digoxin -> Vision Yellow
Anticholinergic sx of diphenhydramine that affects the eye is due to blockade of what mediators?Acetylcholine
Anticholinergic sx of diphenhydramine that causes drowsy & cognitive symptoms is due to blockade of what mediators?Histamine
Aspirin Induced asthma attack is due toInhibition of Cyclooxygenase pathway leading to decreased prostaglandin bronchodilators to leukotriene constrictors
Aminoglycoside resistance MOAEnzymatic inactivation by drug acetylation
Antagonist of Muscarinic which increases parasympathetic causesIncrease HR Carotid Occlusion MOA
TMP(bacteria), Methotrexate(humans), Pyrimethamine(protozoa) MOA SAMEInhibit Dihydrofolate reductase
TMP concomitantly used withSulfamethoxazole
SpironolactoneSpare K and hydrogen ions
Neprilysn InhibitorsSacubitril -> Prevents breakdown of ANP -> Used in Heart failure pts
Pt with hypertension presents to ER "obtunded and bradycardia"Beta blocker overdose -> Treat with Glucagon -> Increase cAMP in cardiac myocytes
Pt having incontinence due to detrusor instability. DOCGO -> Glycopyrrolate & Oxybutynin -> Antagonism of Muscarinic Cholinergic receptors
Pt nausea resistant to ondansetron and is given a new drugNeurokinin 1 antagonists -> Aprepitant, Fosaprepitant
Immediate treatment for bleedingFresh Frozen Plasma(Contains blood clotting factors and proteins) Dx- Warfarin Overdose or Rodent poisoning Vitamin K is NOT Immediate treatment
AmitriptylineNerve Pain & Anti-depressants
Gardnella VaginosisMetrondiazole OR Clindamycin
Trastuzumab -> Human epidermal growth factor receptor 2 monoclonal antibodyTyrosine kinase receptor
Denosumab for bone cancerReceptor activator of nuclear factor kappa-B ligand
Long term treatment for cystic fibrosisPancreatic Lipases -> Prevent ARDS -> DEATH
A adrenergic agonist(Phenylephrine,methoxamine)Increase BP & Reflexive LOW HR due -> Stimulation of baroreceptors of carotid sinus & aortic arch leading to a vagal stimulation of heart
pt who is started on isoniazid with pyridoxine presents with fever, anorexia, nausea with mild abdominal discomfort is have a Sx DUE TOHepatocyte damage due to Isonazid
Amphetamines - ADHDDecreased appetite & weight loss & insomnia
Drug induced parkinson txBenztropine -> Anti-muscarnic
Most important factor in preventing influenza infectionAntibodies to Hemagglutinin(Humoral)
Fever, mouth ulcers, low hemoglobin, low platelets, low leukocytesMethotrexate antidote-> Folinic acid
MOA of Xa inhibitor apiXabanProlong ptt & pt BUT not thrombin time
Steroid hormones, thyroid hormones, vitamin DIntracellular receptor with DNA binding protein
Milrinone txCardiogenic shock & Acute Heart Failure
Milrinone MOAPDE 3 inhibitor -> Moa increase cAMP in platelets and decreases platelet aggregation
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