Axon
07-08-2005, 02:44 PM
1516
Given a circle of the cell cycle, abcde, point to where griseofulvin acts...
a) Hundreds of questions can come from this concept. Griseofulvin acts in M phase. How?
1517
Given a choice of drugs, abcde, that you can use to reduce hyperthyroidism in pregnancy, which will you choose commonly?
A) PTU, propothiouracil.
1518
Just KNOW that vincristine acts in the M phase and methotrexate acts on the S phase. See a circle of the cell cycle....
1519
You are shown a descrip. of a Peptic Ulcer Dx. pt. You are told it is NOT due to NSAIDS. So what is the MOA of Sucralfate and Bismuth-Salicylate? (Similar properties). What bug?
a) Prostaglandin E 2 is activated in the mucosal lining and is protective. They also bathe the ulcer. H. pylori, give Clarithromycin, a component of drug combination therapy that effectively treats duodenal ulcer or gastric ulcer associated with H pylori infection. Inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest.
1520
After several endoscopies, you think you killed off the H pylori. But, in patients with gastric ulcers, documenting the eradication of H pylori with a urea breath test, rapid urease test, or histology studies on a biopsy sample is imperative. If H pylori is not eradicated, treatment should be repeated with another regimen. How can you demonstrate for SURE that the infection is GONE?
a) documenting the eradication of H pylori with a urea breath test, rapid urease test, or histology studies on a biopsy sample is imperative. If H pylori is not eradicated, treatment should be repeated with another regimen.
1521
I just watched Rob Roy, very good movie...OK, my vacation is running short. Here is a "lovely":
Pt. comes in from TROPICAL AFRICA. Friend gives him chloroquine, next he takes an OXIDANT nitrite drug, and washes it down with methylene blue. Hmmm... suddenly, he feels very weak and looks jaundiced. And you can feel his spleen.What is the inheritance pattern of the disease? (Hint: You can see "Heinz bodies" on a peripheral blood smear)
a) G6PD Def.
1522
Ok, this you have to KNOW cold. G6PD deficiency. Given ans. choices abcde, what is the pathophys going on?
(Hint: KNOW that the genetic lesion is a SUBSTITUTION)....
(Hint2: This gene persists cause it confers some protection against MALARIA)
a) The G6PD enzyme catalyzes the oxidation of glucose-6-phosphate to 6-phosphogluconate while concomitantly reducing the oxidized form of nicotinamide adenine dinucleotide phosphate (NADP+) to nicotinamide adenine dinucleotide phosphate (NADPH). NADPH, a required cofactor in many biosynthetic reactions, maintains glutathione in its reduced form. You have to KNOW that reduced glutathione acts as a scavenger for dangerous oxidative metabolites in the cell. With the help of the enzyme glutathione peroxidase, reduced glutathione also converts harmful hydrogen peroxide to water. Red blood cells rely heavily upon G-6-PD activity because it is the only source of NADPH that protects the cells against oxidative stresses; therefore, people deficient in G-6-PD are not prescribed oxidative drugs because their red blood cells undergo rapid hemolysis under this stress. That is why your friend looked yellow and jaundiced...
1523
KNOW in G6PD def. bilirubinemia occurs with excessive hemoglobin degradation.
KNOW also that serum haptoglobin levels serve as an index of hemolysis and will be decreased.
1524
Oh, also I heard that you need to KNOW that oxidative drugs like LASIX and DAPSONE can precipitate attacks of hemolytic anemia in G6PD def.
1525
You have to know how
quinidine, the popular antiarrythmic works…MOA please?
RISKS also??
Quinidine slows the Na+ rush into the heart cells and prolongs the QRS interval.
But there are a lot of risks. (oh, just know that they like to ask related anti arrhythmic drugs like..........)
Amiodarone, Beta blockers
Calcium Channel Blockers
Digoxin
Diltiazem
Disopyramide
Flecainide
Procainamide
Sotalol
Verapamil
KNOW all are antiarrythmics…
A2) Quinidine can provoke new lower chamber or ventricular arrhythmias of a particular type known as torsades de pointes. Torsades is a life-threatening arrhythmia and can result in fainting spells or cardiac arrest, or sudden death. Risk of torsades is increased in patients with slow heart rates who are deficient in electrolytes such as potassium with evidence of prior ventricular arrhythmia. A measurement on the electrocardiogram, the QT-interval, may help predict risk of this ventricular arrhythmia and needs to be monitored carefully in patients treated with quinidine and similar agents. The incidence of torsades in patients treated appropriately with quinidine is not known. The incidence appears to be higher in patients who have serious heart diseases, particularly those associated with congestive heart failure.
Quinidine may cause a variety of other adverse effects also. At times when patients with atrial fibrillation or flutter are treated with quinidine, it may slow the rate of activity within the atrium but speed up conduction across the AV node or electrical connection between the atrium and ventricles causing the ventricular rate or pulse to become more rapid. This may result in a life-threatening ventricular or lower chamber arrhythmia and produce a fall in blood pressure or symptoms such as lightheadedness or fainting. That is a LOT to know, but Boards need you to know all about drugs that can cause V-tach and sudden death and sudden bankruptcy...!
1526
You DO know the MOA of DANTROLENE right?
1527
Pt, 45 year old short woman with infertility comes to you with chronic hypertension, she is showing signs of osteoporosis. Given choices abcde. What is she likely to have problems in (which organ and WHAT?) What is the dx?
a) Pick the cardiac anomalies. This is Turner's Syn.
Bicuspid aortic valve ?
Coarctation of the aorta?
And REMIND HER of the deadliest one, AORTIC DISSECTION.... Go get 'em, tiger...and tigress !!
1528
She, or the Boards, asks what drugs/supplements she may need. What do you say?
a) Somatotropin?
Calcium and milk with vit D. Give her some anabolic steroids (unless she has hypertension or liver failure). She may also need some Thyroid hormone. Pick any antihypertensive (from the USMLE answer choices). She is going to need estrogen.
1529
Lastly, you may be asked..
There may be a question on pregnancy…she is likely infertile, but if with child, warn her the baby may also have Turner’s and Down’s syn. Also, she may have some learning disabilities as well.
1530
KNOW that Turner's babies are shown on Boards with pictures of lymphedema, particularly of the feet (looks like sausages)
Given a circle of the cell cycle, abcde, point to where griseofulvin acts...
a) Hundreds of questions can come from this concept. Griseofulvin acts in M phase. How?
1517
Given a choice of drugs, abcde, that you can use to reduce hyperthyroidism in pregnancy, which will you choose commonly?
A) PTU, propothiouracil.
1518
Just KNOW that vincristine acts in the M phase and methotrexate acts on the S phase. See a circle of the cell cycle....
1519
You are shown a descrip. of a Peptic Ulcer Dx. pt. You are told it is NOT due to NSAIDS. So what is the MOA of Sucralfate and Bismuth-Salicylate? (Similar properties). What bug?
a) Prostaglandin E 2 is activated in the mucosal lining and is protective. They also bathe the ulcer. H. pylori, give Clarithromycin, a component of drug combination therapy that effectively treats duodenal ulcer or gastric ulcer associated with H pylori infection. Inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest.
1520
After several endoscopies, you think you killed off the H pylori. But, in patients with gastric ulcers, documenting the eradication of H pylori with a urea breath test, rapid urease test, or histology studies on a biopsy sample is imperative. If H pylori is not eradicated, treatment should be repeated with another regimen. How can you demonstrate for SURE that the infection is GONE?
a) documenting the eradication of H pylori with a urea breath test, rapid urease test, or histology studies on a biopsy sample is imperative. If H pylori is not eradicated, treatment should be repeated with another regimen.
1521
I just watched Rob Roy, very good movie...OK, my vacation is running short. Here is a "lovely":
Pt. comes in from TROPICAL AFRICA. Friend gives him chloroquine, next he takes an OXIDANT nitrite drug, and washes it down with methylene blue. Hmmm... suddenly, he feels very weak and looks jaundiced. And you can feel his spleen.What is the inheritance pattern of the disease? (Hint: You can see "Heinz bodies" on a peripheral blood smear)
a) G6PD Def.
1522
Ok, this you have to KNOW cold. G6PD deficiency. Given ans. choices abcde, what is the pathophys going on?
(Hint: KNOW that the genetic lesion is a SUBSTITUTION)....
(Hint2: This gene persists cause it confers some protection against MALARIA)
a) The G6PD enzyme catalyzes the oxidation of glucose-6-phosphate to 6-phosphogluconate while concomitantly reducing the oxidized form of nicotinamide adenine dinucleotide phosphate (NADP+) to nicotinamide adenine dinucleotide phosphate (NADPH). NADPH, a required cofactor in many biosynthetic reactions, maintains glutathione in its reduced form. You have to KNOW that reduced glutathione acts as a scavenger for dangerous oxidative metabolites in the cell. With the help of the enzyme glutathione peroxidase, reduced glutathione also converts harmful hydrogen peroxide to water. Red blood cells rely heavily upon G-6-PD activity because it is the only source of NADPH that protects the cells against oxidative stresses; therefore, people deficient in G-6-PD are not prescribed oxidative drugs because their red blood cells undergo rapid hemolysis under this stress. That is why your friend looked yellow and jaundiced...
1523
KNOW in G6PD def. bilirubinemia occurs with excessive hemoglobin degradation.
KNOW also that serum haptoglobin levels serve as an index of hemolysis and will be decreased.
1524
Oh, also I heard that you need to KNOW that oxidative drugs like LASIX and DAPSONE can precipitate attacks of hemolytic anemia in G6PD def.
1525
You have to know how
quinidine, the popular antiarrythmic works…MOA please?
RISKS also??
Quinidine slows the Na+ rush into the heart cells and prolongs the QRS interval.
But there are a lot of risks. (oh, just know that they like to ask related anti arrhythmic drugs like..........)
Amiodarone, Beta blockers
Calcium Channel Blockers
Digoxin
Diltiazem
Disopyramide
Flecainide
Procainamide
Sotalol
Verapamil
KNOW all are antiarrythmics…
A2) Quinidine can provoke new lower chamber or ventricular arrhythmias of a particular type known as torsades de pointes. Torsades is a life-threatening arrhythmia and can result in fainting spells or cardiac arrest, or sudden death. Risk of torsades is increased in patients with slow heart rates who are deficient in electrolytes such as potassium with evidence of prior ventricular arrhythmia. A measurement on the electrocardiogram, the QT-interval, may help predict risk of this ventricular arrhythmia and needs to be monitored carefully in patients treated with quinidine and similar agents. The incidence of torsades in patients treated appropriately with quinidine is not known. The incidence appears to be higher in patients who have serious heart diseases, particularly those associated with congestive heart failure.
Quinidine may cause a variety of other adverse effects also. At times when patients with atrial fibrillation or flutter are treated with quinidine, it may slow the rate of activity within the atrium but speed up conduction across the AV node or electrical connection between the atrium and ventricles causing the ventricular rate or pulse to become more rapid. This may result in a life-threatening ventricular or lower chamber arrhythmia and produce a fall in blood pressure or symptoms such as lightheadedness or fainting. That is a LOT to know, but Boards need you to know all about drugs that can cause V-tach and sudden death and sudden bankruptcy...!
1526
You DO know the MOA of DANTROLENE right?
1527
Pt, 45 year old short woman with infertility comes to you with chronic hypertension, she is showing signs of osteoporosis. Given choices abcde. What is she likely to have problems in (which organ and WHAT?) What is the dx?
a) Pick the cardiac anomalies. This is Turner's Syn.
Bicuspid aortic valve ?
Coarctation of the aorta?
And REMIND HER of the deadliest one, AORTIC DISSECTION.... Go get 'em, tiger...and tigress !!
1528
She, or the Boards, asks what drugs/supplements she may need. What do you say?
a) Somatotropin?
Calcium and milk with vit D. Give her some anabolic steroids (unless she has hypertension or liver failure). She may also need some Thyroid hormone. Pick any antihypertensive (from the USMLE answer choices). She is going to need estrogen.
1529
Lastly, you may be asked..
There may be a question on pregnancy…she is likely infertile, but if with child, warn her the baby may also have Turner’s and Down’s syn. Also, she may have some learning disabilities as well.
1530
KNOW that Turner's babies are shown on Boards with pictures of lymphedema, particularly of the feet (looks like sausages)