Phenytoin anticonvulsant works by___________

Blocking Na influx/channels

What are the side effects of phenytoin?

Gingival hyperplasia

Hirsutism

Osteomalacia (interferes with vitD met)

Anemia (folic acid decr)

What is the mechanism of action of Valproic acid?

decrease GABA transaminases

block T type Ca²⁺ channels

block Na channels

What are the side effects of VALPROIC ACID?

''vALPRoATe''

Anemia

Liver toxicity

Pancreatitis

Allopecia

Teratogenic, tremors

Drugs that cause steven johnsons syndrome are_________

What is the drug used to tx Malgnant hyperthermia and its MOA?

Dantrolene

It blocks ca²⁺ release from the sarcoplasmic reticulum

Mechanism of action of opioids ___________

At presynaptic: decrease ca²⁺ influx.

At post synaptic: increase k⁺ efflux

Organisms not covered by cephalosporins are_________

'' LAME''

Listeria monocytogens

Atypicals (chlamydia, mycoplasma)

MRSA

Enterococi

___________ is a drug always given with Imepenem to prevent renal toxicity from its metabolites.

Cilastatin

_______ is the drug of choice for treatment of lyme disease and rickettsia (both caused by ticks)

tetracycline

'' tets for ticks''

Which medication has the same intracellular target as trimethoprim (in bact cell) in its mechanism of action?

Methotraxate (In human cells)

Pyrimethamine (in protozoa)

_______is an Antifungal medication that inhibits cytochrome p450 enzymes.

Azoles

Empiric treatment of Entamoeba hystolytica requires a 2-phase approach:

Tissue agent (eg, metronidazole) is administered first to kill trophozoites.

Intraluminal agent (eg, paromomycin) is given to eliminate intraintestinal cysts to prevent reinfection.

Penicillin is given together with clavulanic acid to_______

decrease hydrolysis of the beta-lactam ring of penicillin (prevent cleavage of penicilin by bact cells)

Examples of beta lactamase inhibitors include___________

Clavulanic acid

Tazobactam

Sulbactam

What is the mechanism of resistance of aminoglycosides?

Antibiotic-modifying enzymes. These enzymes add chemical groups (eg, acetyl, adenyl, phosphate) to the antibiotic, which diminishes its ability to bind to the 16S ribosomal RNA within the 30s ribosomal subunit.

______________is a common adverse effect of trimethoprim-sulfamethoxazole due to the trimethoprim-induced blockade of the sodium channels in the collecting duct, which prevents sodium-potassium exchange and reduces renal excretion of potassium (similar to the action of amiloride).

Hyperkalemia

___________________is the most common benign liver tumor.

Cavernous hemangioma

Damage to the anterior and posterior vagal trunks (of vagus) during fundoplication procedure causes _________

Delayed gastric emptying (gastroparesis) and gastric hypochlorhydria

_________ is derived from a zymogen produced by pancreatic acinar cells and activated by trypsin in the duodenum; levels correlate with pancreatic exocrine activity. ie low levels = pancreatic insufficiency.

Elastase (fecal elastase)

A drug that is non absorbabble antibiotic that is used to lower ammonia by modulating the bact that produces it in the GI tract

Rifaximin

Acute hemolysis following exposure to oxidative insults ie infection,oxidizing foods and meds (eg flouroquinolones) occurs in ________

Glucose 6 phosphste dehydrogenase deficiency

Patient without spleen have what kind of impairment?

Systemic bacteria clearance

Autosomal recessive disorder involving lack of homogentisic acid dioxygenase(metabolise tyrosine) leading to accumulation of homogentisic acid is called_______

Alkaptonuria

Clinical features of alkaptonuria are __________

Black urine when exposed to air

Blue black pigmentation on the face

Orchinosis (hyperpigmentaton in ear or eye sclera)

Arthritis in joint

What is the role of hCG therapy in a pt with PCOS receiving ovulation induction therapy with gonadotropins?

hCG mimic LH and act as ovulation trigger.

___________ is a fungalorganism that replicates within macrophages and spreads from lungs to the reticuloendothelial system through pulmonary lymphatics.

Histoplasma capsulatam

__________ IS A/W URIC ACID FORMATION IN POST KIDNEY TRANS??

Cyclosporin

What causes aplastic anemia?

autoimmune destruction of multipotent hematologic stem cells due to alterations in their surface antigen leading to cytotoxic Tcell responce and release of interferon gamma hence apoptosis.

Whats the commonest cause of type1 DM?

Autoimmune insulitis (islet leukocytic infiltration) with progressive beta cell loss.

Didanosine (ART used in HIV) causes_______________

Pancreatisis (''pancreaDIDis'')

Eg of encapsulated organism

Salmonella

H.influenza

E.coli

Strep. pneumoniae

C1 esterase inhibitor def

Angioedema, laryngospasm

Pseudocholinesterase def

Failure to breathe after fast acting anaesthesia eg succinylcholine or mivacurian are administered

Disruption of heme synthesis via inhibition of aminolevulinate dehydratase is caused by

Lead toxicity

Lead toxicity findings

Lead lines on gingivae

Encephalopathy, erythrocyte basophilic stippling

Abdominal colic , sideroblastic anemia

Drops- wrist and foot

Renal artery stenosis is commonly due to ________

Atherosclerosis

Fibromascular dysplasia

prolonged exposure to noise

damage to organ of corti

test to do before starting eternacept (tnf alpha inh)

tb

finasteride acts on what part of the prostate?

on epithlial cells and smooth muscle

Ethambutol (arabinosyl transfarase inhibition) causes__________

optic neuritis

What is the mechanism of action of Bisacodyl?

Activates enteric nerves in colonic myoplexus to stimulate peristalsis.

cause of gestational diabetes is due to

human placental lactogen

Examples of common immunosuppressants and mechanisms........

During anaphylactic reaction what is likely to be elevated in the serum?

Histamine

Tryptase (specific marker of histamine)

NB:both result from mast cell and basophil degranulation

The immunoglobulin most abundant in the blood is ____________

IgG

Immunoglobulin found in tears, saliva and breast milk is__________

IgA

Which immunoglobulin is responsible of immediate response to antigen?

IgM

NB: IgG is a/w chronic response

Interferons α and β are produced by most human cells in response to viral infections. Their function is___________

Stop protein synthesis in infected cells

Promote apoptosis

What is the mechanism of vancomycin infusion reaction ?

Direct mast cell activation by the drug due to rapid infusion.

ie: Red man syndrome (not allergic rxn)

Hereditary angioedema is caused by deficiency of what enzyme?

C1 esterase inhibitor deficiency (leading to over activation of the complement system.)

What is serum sickness?

Immune complex–mediated type III hypersensitivity reaction that typically forms 5-14 days after exposure to foreign proteins in an antitoxin, antivenom, monoclonal antibody, or vaccine.

Patients typically develop fever, urticarial rash, and arthralgia that resolve spontaneously over days as the immune complexes are cleared by the mononuclear phagocyte system

The specific surface marker for monocyte-macrophage lineage cells is________

CD14

Whats the mechanism of action of glucocorticoids?

Reduces inflammation by binding to a cytosolic receptor, translocating into the nucleus, and inhibiting proinflammatory transcription factors eg nuclear factor-kappa-B (NF-κB).

Drug of choice in treatment of anaphylactic shock is _________________

Epinephrine

Disorders of innate immunity are____________

What is mechanism of action of rituximab?

Depletion of B cells (binds CD20 of B cells inducing cytotoxicity and phagocytosis)

The mediator released from macrophages and one of the most important during systemic inflammation in sepsis is___________

TNF alpha

others: IL1, IL6

Fluticasone MOA is__________

Promote apoptosis of eosinophils

NB: Glucocorticoids inhibit transcription of proinflammatory mediators and promote apoptosis of eosinophils, T cells, and monocytes.

venous congestion causes expansion of which part iof the spleen?

red pulp

__________ is an enzyme that plays a crucial role in purine metabolism, to prevent accumulation of toxic metabolites(lymphocytotoxic).

__________inhibitors lead to destruction of the cell due to accumulation of metabolites.

Adenosine deaminase (ADA)

ADA inhbitors eg ( Medications that block ADA are used to treat lymphocyte-derived cancers )

Hyperacute rejection during transplant is due to recipient's preformed antibodies which are____________

Anti ABO blood group

Anti HLA antibodies

Hereditary angioedema is characterized by recurrent episodes of cutaneous and/or mucosal swelling due to__________ deficiency. C4 levels are low due to uninhibited cleavage of C4 by excess activated C1.

C1 inhibitor deficiency

What is the difference between pneumococcal conjugate and polysaccharide vaccine?

Pneumococcal conjugate vaccines are strongly immunogenic in infancy due to both B and T cell recruitment. They provide higher, longer-lasting antibody titers

The pneumococcal polysaccharide vaccine is poorly immunogenic in infants due to their relatively immature humoral antibody response. recommended for ages >65 and btn 2-65 with certain med condition eg DM

________________destroy parasite via antibody-dependent cell-mediated cytotoxicity with enzymes from their cytoplasmic granules. Another function is regulation of type I hypersensitivity reactions.

Eosinophils

_____________is the primary treatment for anaphylaxis as it decreases further mast cell release of inflammatory mediators and counteracts existing systemic inflammatory effects (eg, shock, bronchoconstriction).

Epinephrine

MECONIUM ILEUS IS ALMOST ALWAYS A/W _______

CF

DEEP INGUINAL RING AND SUPERFICIAL INGUINAL RING CAN BE DIFFERENTIATED BY ____________

INFERIOTR EPIGASTRIC VEIN

INCREASE P

OXANDROLONE

Many types of cancers evade immunodetection by increasing expression of _____________on their surface. Monoclonal antibodies against PD-1 upregulate the T-cell response and promote tumor cell apoptosis

PD-L1

_____________stimulates neutrophil migration to sites of inflammation. Other important chemotactic agents include 5-HETE (leukotriene precursor), C5a, and IL-8.

Leukotriene B₄

Topical corticosteroids are the first-line therapy for atopic dermatitis. Their mechanism of action is __________

Decreasing tissue production of proinflammatory prostaglandins and leukotrienes through the inhibition of phospholipase A₂

TESTESTERONE HAS EFFECT ON HB

INCREASES ERYTHROPOIETIC CAISING POLYCYTHEMIA

PERMETRIN

TO TX SCABIES

The only antibody that can cross the placenta______________

IgG

Chronic lung transplant rejection is due primarily to progressive scarring of the____________, leading to bronchiolitis obliterans. (months or years after transplantation and include obstructive lung disease (eg, reduced FEV1) with dyspnea and dry cough)

Small airways

The most important opsonins (coating proteins that enhance phagocytosis) are___________

IgG

C3b

metabolic syndr

olanzapine and second gen antipsychotics

Drug of choice foe panic attacks

SSRI

benzos foe immediate relief

long standing RA can lead to

vertebral sublaxation

nerve likely to be injured during cardiac catheter ablations

phrenic nerve

commoon infe in burn pt

pseudomonas aureginosa

Key Th2 cytokines that trigger acute inflammation in atopic dermatitis are _____

IL-4 and IL-13

____________is a type IV hypersensitivity reaction caused by drugs (eg, anticonvulsants, antibiotics) or their metabolites that typically occurs 5-21 days following drug initiation

Pt with auto immune thyroiditis are at risk of developing which thyroid ca?

Thyroid lymphoma

There is decreased responsiveness to __________ in old age making it hard to cope with critical illness eg sev burns

Adrenergic response

Mechanismof action of botulinum toxin

Blocks presynaptic exocytosis of Ach

Benzodiazepine withdrawal

Anxiety

Tremors

Insomnia

Sympathetic hyperactivity eg diaphoresis

Psychotic features eg hallucinations

Mitochondria DNA

In eukaryotic cells is in mitochondria

Sugar that is metabolized fast than others ?

Fructose 1 phosphate

The most common outcome of hep c infection without tx is_______

Life long infection

Methadone is an opioid agonist that prevents opioid withdrawal by its _______

Long half life

Damage to the pterion cause damage to which vessel?

Middle meningeal artery branch of maxillary artery

Spinal stenosis

Ligamentum flavin hypertrophy

Role of hcg(secreted by placental syncytiotrophoblast)in preg

Maintenance of corpus luteum(maintain pregnancy)

Drug of choice of listeria

Ampicillin

Posterior cerebral artery stroke

Contralateral hemianopia??

Peripheral acting mu opioid receptor antagonist for treating constipation (doesn't induce withdrawal symptoms; doesn't cross BBB)

Methylnaltrexone

Discolouration of skin due to station dermatitis (chronic venous insufficiency)

Hemosiderin deposit

Halogenated inhaled anesthesia can cause

Hepatocellular liver injury

(Have incr ast and prolonged PT)

Tx of priapism may involve penile injection with which medication?

Alpha adrenergic agonist (eg phenylephrin)

Breakdown of dipeptide and tripeptide to free amino acids takes place where in the GI

Intestinal mucosa

Needle shaped Crystal in gout are due to

Urate.

Diuretic drug that improve survival rate in heart failure with reduced EF_____

Spironolactone

Lithium interact with _______ to cause toxicity symptoms

NSAIDS

ACE inhibitors

Thiazides diuretics

Renal cell carcinoma classic sings include______

Hematuria

And mass

Flank pain

Weight loss

Patients with cleft palate are at increased risk of ear infection due to dysfunction of

Ani palatini muscles

Best intial treatment of distal symmetrical polyneuropathy due to uncontrolled DM is

Amitriptyline

Function of golgi tendon is to _______

Maintains muscle tone

Opioid can generate pseudoallergic reaction by directly acting on ___________

Mast cells and cause degranulation

First line tx for trigeminal neuralgia is

Carbamazepine

Prolonged seizures,crush injuries can predispose to?

Rhabdomyolysis

Aldolase b deficiency

Sucrose or fructose should be avoided

Buzz words for PCP (Phencyclidine)

Agitation

Nystagmus

Ataxia

• Mechanismof ace inhibitors post MI

Prevent remodeling and reduce LV dysfunction/dilatation

Tramadol can interact with ssri to cause ___

Serotonin syndrome

After 12 months of amenorrhea _______ confirms menopause in 50+ yr old women

Increased FSH

Patient with hyperuricemia have def of _______

Hypoxanthine guanine phosphoribotransferase

Treatment of malaria with primaquine is for _______

Treating exoerythrocytic parasite (Intrahepatic)

NB chloroquine treats parasite circulating in blood but will not treat liver hypnozoites

Mefloquine is a schizonticide that actively
destroys replicating parasites within red blood
cells. However, it is inactivated in the liver and
has no efficacy against hepatic (exoerythrocytic
tissue) schizonts. Because P falciparum
schizonts mature in the liver over 8-30 days,
travelers must take mefloquine
chemoprophylaxis for 4 weeks upon returning
from malaria-endemic areas to ensure that
schizonts released from the liver are destroyed
when they infect red blood cells.

Severe self limited watery diarrhea in immunocompromised pt is due to

Cryptosporidiosis

Atrophy of mammillary bodies is classically seen in ______

Wernicke Korsakoff syndrome

How does Phenytoin and antiepileptic drug cause decrease in VIT d ?

Inducing cyp24 which convert vit d to inactive form

Subacute thyroiditis usually follows viral infection and patient may show __________ on investigation

Low radioactive iodine uptake

Mesothelioma histologically shows__________

NB: asbestos exposure is the primary risk factor

Spindle cells positive for cytokeratin

Before fertilization oocyte is arrested at what stage ?

Metaphase of meiosis ii

Tx of ADHD

Ovarian torsion usually involve

Ovarian torsion usually involves

Twisting if infundibulopelvic ligament

Hepatocellular carcinoma can be caused by viruses _______

Hep B and hep C

Mitochondrial damage leading to impaired fatty acid metabolism is seen in ________

Reye syndrome

Neonatal respiratory distress syndrome

Diffuse atelectasis is seen on x-ray as ground glass opacities and air brinchogram

Epiglottis

Inspiratory stridor

Hypercalcemia In_________ is caused by PTH independent VIT d activation by macrophages

Sarcoidosis

Drugs that are given rectally avoid _______

First pass metabolism by going directly into the circulation

Agammaglobulinemia is characterized by _________

Low or absent circulating mature Bcell CD19,CD20

Vocal cord nodule in immunocompromised is usually a resiult of_______

HPV

Hypersplenism (as seen in liver cirrhosis or portal htn) is associated with __________

Pancytopenia

Formation of non caseating granuloma due to type IV hypersensitivity reaction to an unknown antigen is seen in_________

Sarcoidosis

NB: a/w uveitis, erythema nodosum

Malignant hyperthermia is caused by genetic defect in____________

Ryanodine receptor

nb symptoms occur when pt is exposed to inhaled anaesthetics

Neomycin mechanism of action?

kills gut flora hence reducing ammonia production

How do you differentiate between kaposis sarcoma and bacillary angiomatosis (Bartonella spp)?

Biopsy: Kaposi's sarcoma will show lymphocytic infiltrates in the sample while angiomatosis will show neutrophilic infiltrates.

Medulla of the adrenal gland is stimulated by

Acetylcholine

Drugs that don't require dose adjustment in hepatic or renal conditions

Monoclonal antibodies

Drug used for bulimia nervosa________

Fluoxetine(ssri)

Drug of choice for ADHD is___________

Methylphenidate (A drug that increase availability of norepinephrine and dopamine)

_________Is a polypeptide hormones that binds to transmembrane receptor along plasma membrane

Prolactin

NB:other hormones are intracellular

Proliferating spindle cells forming slit like spaces filled with blood is seen in ________

Kaposi sarcoma

Cytokine involved in class switching of immunoglobulin

IL4

IL13

Angiodysplasia of ascending colon is common disorder in old age and usually present with ________

Bleeding

First line treatment for claudication ?

Cilostazol

In hypersensitive type I mast cell secrete histamine in immediate phase and then secret ______ in late phase.

Prostaglandins

Circulation in lungs

Bronchial circulation

Pulmonary circulation

Rituximab moa

Lymphocytes mediated release of cytokines

Maple syrup disease is caused by ____________

Branched chain alpha keto acid dehydrogenase

Phenylketonuria (PKU) is an autosomal recessive disease caused by mutation of the gene that codes for____________________

Phenylalanine hydroxylase

Earliest response to bleeding injury is caused by_________

Secretion of Endothelin

What hormone increase during pre prandial period and declines after a meal ?

Ghrelin

Impaired binding of testosterone to it's receptors can be caused by __________

Spironolactone (cause gynecomastia)

Role of dextrose in ORS is_________

To enhance sodium absorption

The IV drug that causes arterial vasodilation and improve renal perfusion __________

Fenoldepam

What cells can't use ketones as a form of energy

Erythrocytes

Liver cells

Increased TGF-β activity is responsible for ___________________

Hypertrophic/keloid scar

(Also fibrosis of the lung, liver, and kidney that occur with chronic inflammation)

Following ischemic to cardiac muscle after how long does contractility stop when ATP starts to decline?

Within 60 seconds after ATP starts to decline

Side effects of succinylcholine _____________?

Malignant hyperthermia

Severe hyperkalemia

Bradycardia

What's the mechanism of HUS due to shiga toxin?

Microthrombi in small blood vessels formation

Effect of UV light on the skin ?

Endonuclease nicking of the damaged DNA strand

Which component of cardiovascular system is more susceptible to nitrates

Large veins

H influenza protection/ vaccination MOA?

Antibodies against hemagglutinin

Lesions in syphilis

Primary - chancre

Secondary - condylomata lata

Tertiary - gummas

Mechanism of vit D in treatment of psoriasis

Inhibit T-cell and keratinocyte proliferation and stimulate keratinocyte differentiation

A topical drug that acts like a toll like receptor to increase antiviral cytokine production and upregulate NFkB is called ______________

Imiquimod

Neck /head of femur is supplied by

Medial circumflex arteries

Antilipid drug that impairs excretion of statins

Fibrates

External branch of superior laryngeal nerve can be injured in thyroidectomy. The nerve supplies which muscle?

Cricothyroid muscle

Conversion of norepinephrine to epinephrine is facilitated by the_________

PNMT

___________ is found in adipose tissue, where it functions to drive the breakdown of stored triglycerides into free fatty acids and glycerol. During times of starvation, this enzyme provides substrates for hepatic gluconeogenesis and ketone body formation.

Hormone-sensitive lipase

Patients with turners syndr can be treated with growth hormone that stimulates the __________

JAC-STAT pathway

(this induce prod of IGF-1)

Whats the function of cholecytokinin (CCK)?

Causes contraction of the gallbladder to release bile

Side effects of tamoxifen (that are not caused by Raloxifene)

Endometrial hyperplasia

Endometrial carcinoma

Uterine sarcoma

1^o hyperparathyroidism causes hypercalcemia which causes constipation by __________________

Inhibit nerve depolarization leading to reduced colonic motility and impaired smooth muscle contraction.

PT with crohn disease are prone to get kidney stones due to _______

Reduced intestinal calcium oxalate formation

Vitamin necessary fo RBC membrane integrity ______

Vit E

(Def causes acanthocytes and hemolysis)

A carrier protein that transport both T4 and vit A is called

Transthyretin

Coadministration of levothyroxine with other medications can impair its absorption, these include

Iron

Calcium

Antiacids

(Also foods like soy products)

Treatment of generalized anxiety disorder is

Ssri/snri (Citalopram )

An oral macrolide antibiotic that inhibits the sigma subunit of RNA polymerase is _______

Fidaxomicin

(TX of c defficile)

Fracture of the 12th rib is likely to cause injury to which structure?

Kidney

The precursor for serotonin synthesis is ________

Tryptophan

Non stimulant drugs for ADHD __________

Atomoxetine

Alpha 2 adrenergic agonists

___________should be monitored in tx with olanzapine and other 2nd gen antipsychotics

Fasting glucose and lipid panel

Common side effects of SSRI is _______

Sexual dysfunction

Drug induced parkinsonism is treated with

Benztropine

Generalized anxiety disorder treatment with no risk of dependence

Buspirone

Turner syndrome is associated with what cardiovascular abnormality?

Bicuspid aorta

The vessel with highest O2 saturation in a fetus is

Umbilical vein that drains directly into IVC

Cancer cells usually have increased __________ activity that prevent chromosomal shortening

Telomerase

For maximum tensile strength collagen requires hydroxylation of proline and lysine this occurs in ________

Rough endoplasmic reticulum

NB: vit C is used as a cofactor in the reaction

Enzyme that removes short RNA fragment(RNA primers) that are base paired to DNA template

DNA polymerase l

Crohn's dse affects commonly the terminal ileum impairing bile reabsorption causing _______

Gall stones

Duodenal atresia is due to ____________ while intestinal atresia of midgut (jejunum, ileum, prox colon) is due to _______________

Failure of lumen to recanalize

Vascular occlusion

P falciparum ability to be more infectious/achieve higher parasitemia is because ______

Can infect erythrocytes of all ages

Cells that increase in COPD

Neutrophils

Macrophages

• CD8 T lymphocytes

CD8 t lymphocytes present antigen to MHC I which comprises of ________

Heavy chain and B2 microglobulin

Slow abnormal rise of Bhcg is seen in _________

Ectopic pregnancy

__________ targets tumor cells and virally infected cells that lack MHC I expression.

Natural Killer cells

Severe nodulocystic acne is treated with_____________

Oral Isotretinoin

Chronic use of glucocorticoids (glucocorticoids induced osteoporosis) predisposes to fractures of ________

Vertebral

usually asymptomatic

What represents apoptosis in the hepatocytes (seen in both acute and chronic hepatitis)?

council man bodies

Function of proteosome inhibitors chemotherapy (eg. Bortezomib)is to______________

Induce apoptosis of neoplastic cells

Oocyte remain in __________ till ovulation. And after maturation they arrest in _________ till its fertilized.

Prophase of meiosis I

Metaphase II

Whats the mechanism of acetazolamide in pt with increased ICP?

Decrease CSF production by choroid plexus

Cisplatin chemotherapy causes damage to dorsal root ganglia which would cause____________

Peripheral sensory neuropathy

Hyporeflexia

Complications of neostigmine (in tx of myesthenia gravis) can cause ______

Desensitization of nicotinic receptors due to prolonged exposure to acetylcholine

Tx: Atropine

Mechanism of action of protease inhibitors.

Prevents formation of mature viral core.

Damage to the lateral horn of spinal cord (intermediate horn) in c8-t2 level causes_______

Horner syndrome

Melanocytes are dendritic cells that are derived from _____________

Neural crest cells

Squamous cell carcinoma of the esophagus can be differentiated from adenocarcinoma of esophagus by?

Squamous cell carcinoma forms a foci of keratin.

Iron deficiency anemia presents with _________

Hypochromic microcytic RBCs

Locations of chambers on CT scans________

Multiple myeloma is what type of neoplasm?

B lymphocyte neoplasm

Bacteria infection that can mimic appendicitis is__________________

Yersinia Enterocolitica

Remodelling of a scar during wound healing is mediated by?

Matrix Metalloproteinases (collagen breakdown)

Large AV fistulas increase__________ and decrease______________.

Preload

Afterload

nb: eventually leads to high output cardiac failure

Thiazolidinediones (glitazones) and fibrates have a similar receptors where they act. this is____________

PPAR-gamma (peroxisomes proliferator acticated receptor gamma)

Glitazones increase insulin sensitivity

In leukocyte function polymerization of actin filaments allows ____________

Phagocytosis

Renal age related changes include ________?

Decreased response to ADH

Side effects of beta2 receptor agonists (eg.albuterol) include?

Tremors

Hypokalemia

Hyperglycemia

Tachycardia

Htn

Headache

Topical antibiotic ointment given to neonates to prevent STIs _______________

Erythromycin

NB: inhibit protein synthesis by binding to 50s subunit of bact ribosome

Substance P is the cause of peripheral neuropathy in pts with diabetic neuropathy. Treatment is by______________.

Capsaicin cream ( stimulates substance P release till its depleted causing pain relief)

What happens to systole and diastole in sinus tachycardia?

Diastole is shortened more than systole

When SVC is obstructed the blood returns to the heart via __________

Internal mammary and intercoastal veins

Drug that antagonize NMDA ____________

Ketamine

Dextromethorphan

Function of paclitaxel in stents is _________________

To prevent smooth muscle formation over stent

Seizures from which lobe are usually partial?

Frontal lobe

One pound of body fat has how many calories?

3500 calories

Mechanism of action of albendazole and mebendazole

They bind to tubulin and prevent microtubule polymerization

Elevated alpha fetal protein and acetylcholinesterase in aminocentesis suggest

Neural tube defect

Trendelenburg sign/gait is seen in injury to which nerve?

Superior gluteal nerve

NB:weak gluteus medius or minimus

Hippocampal sclerosis is a common cause of _____________

Temporal lobe epilepsy

NB: astrocyte proliferation

Anti lipid that acts in the intestinal lumen to prevent cholesterol absorption

Ezetimibe

Women get quickly intoxicated with alcohol compared to men. Why?

Women have lower proportion of total body water hence decreased alcohol dehydrogenase activity

Silicosis is an interstitial lung disease that presents with silicosis nodule that are characterized by__________________

Central area of hyaline core consisting of collagen fibers

When accessing the left atrium care should be taken not to damage the AV node which is located at____________________

Posteroinferior region above the opening of the coronary sinus

Effect of cortisol in arteries........

Upregulates alpha receptors (increase effect of norepinephrine)

Lymphatic spread is a characteristic of______________

Carcinomas

The primary treatment for diphtheria is the urgent administration of _____________

Diphtheria antitoxin

NB: contains preformed, neutralizing antibodies that binds and inactivates circulating toxin

A drug that inhibits platelets aggregation and is also a direct arterial vasodilator

Cilostazol

what happens to systemic vascular resistance during exercise

It reduces due to vasodilation in the skeletal muscles

Common cause of progression from paroxysmal AF to persistent AF is__________

Atrial remodeling

The most important cells against invasive candida infection are __________

Neutrophils

Commonest site of diverticulosis is _________

Sigmoid colon

Use of _____________ can induce the formation of antidrug antibodies (ADAs)

Adalimumab

NB: ADAs preventing the drug from functioning and leading to more rapid drug clearance.

Medications that block Adenosine deaminase (ADA) (converts of adenosine to inosine) is used to treat __________

Lymphocyte derived cancers e.g. Hairy cell leukemia

nb: Adenosine deaminase (ADA) inhibition/absence is highly lymphocytotoxic

What is the difference in DI caused by damage to posterior pituitary vs caused by damage to hypothalamic nuclei?

DI due to posterior pituitary damage usually resolves

DI due to hypothalamic nuclei is permanent.

Bone marrow features of MM include:

The bone marrow aspirate in MM shows numerous plasma cells, which are identified by their abundant basophilic cytoplasm, perinuclear paleness (due to a large Golgi apparatus), and nuclei with "clock-face" chromatin.

Constipation in pregnancy is a result of which hormone ?

Progesterone

NB: it reduces colonic smooth muscle activity

In DM pt on insulin they can experience episodes of hypoglycemia despite no changes in insulin dose due to ______________

Kidney dse (CKD)

NB: Insulin has renal and hepatic clearance. Decreased clearance can cause hypoglycemia

A hormone secreted by the hepatic parenchymal cells that controls Iron homeostasis

Hepcidin

Connective tissues found infants in supraclavicular area and around major blood vessels and abdominal organs that regulate heat

Brown adipose cells

Area of ablation in pt with A. flutter is _________

Area btn tricuspid valve and IVF in the right atrium

NB: For A.fib its pulmonary ostia in the left atrium

What is the difference between nitrates and nitroprussides ?

Nitrates are predominantly venous dilators with nitroprussides dilate both arteries and veins.

Long term treatment of social anxiety disorder

Serotonin reuptake inhibitors

Hep C treatment with sofosbuvir and ledipasvir is as aimed at?

Inhibiting viral genome replication and assembly

-sofosbuvir is RNA-dependent RNA polymerase inhibitors

-Ledipasvir is NS5A inhibitors