question

Possible causes of blood in stool include:

answer

Diverticular disease. Diverticula are small pouches that project from the colon wall. Usually diverticula don't cause problems, but sometimes they can bleed or become infected. Anal fissure . A small cut or tear in the tissue lining the anus similar to the cracks that occur in chapped lips or a paper cut. Fissures are often caused by passing a large, hard stool and can be painful. Colitis . Inflammation of the colon. Among the more common causes are infections or inflammatory bowel disease. Angiodysplasia. A condition in which fragile, abnormal blood vessels lead to bleeding. Peptic ulcers . An open sore in the lining of the stomach or duodenum, the upper end of the small intestine. Many peptic ulcers are caused by infection with a bacterium called Helicobacter pylori (H. pylori). Long-term use or high doses of anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen can also cause ulcers. Polyps or cancer . Polyps are benign growths that can grow, bleed, and become cancerous. Colorectal cancer is the third most common cancer in the U.S. It often causes bleeding that is not noticeable with the naked eye. Esophageal problems. Varicose veins of the esophagus or tears in the esophagus can lead to severe blood loss.

question

cigarette smoke leads to

answer

increased mucus production but low activity of cilia and machophage function.

question

morphine chronic use can be lethal due:

answer

metabolization of morphine leads to active metabolites that acumulate. (eg:Morphine-6-glucuronide (M6G) is a major active metabolite of morphine, and as such is the molecule responsible for much of the pain-relieving effects of morphine and heroin)

question

caution of chronic use of morphine in severe ill patients due:

answer

kidney impairment would result in accumulation of the kidney-excreted active agent M6G, leading to potentially fatal toxicity such as respiratory depression. The frequent use of morphine in critically ill patients, and the common occurrence of kidney failure in this group implied that M6G accumulation could be a common

question

Two major theories of opioid tolerance involve:

answer

changes in opioid receptors. One theory purports that receptors undergo changes that result in decreased receptor activation, or desensitization, with prolonged exposure to opioids. The other line of evidence suggests that opioid receptor down-regulation is at least partially responsible for the development of tolerance. more: http://www.medscape.com/viewarticle/562216_3

question

Lamelar bodies where do you find?

answer

Lungs! lamellar granules (otherwise known as membrane-coating granules (MCGs), lamellar bodies, keratinosomes or Odland bodies) are secretory organelles found in type II pneumocytes and keratinocytes. Lamellar granules fuse with the cell membrane and release pulmonary surfactant into the extracellular space. Epidermis!In the upper spinous layer and stratum granulosum layer of the epidermis, lamellar bodies are secreted from keratinocytes, resulting in the formation of an impermeable, lipid-containing membrane that serves as a water barrier and is required for correct skin barrier function. These granules release components that are required for skin shedding (desquamation) in the uppermost epidermal layer, the stratum corneum

question

what is the 5' untranslated region (5? UTR) ?

answer

(also known as a Leader Sequence or Leader RNA) is the region of an mRNA that is directly upstream from the initiation codon. This region is important for the regulation of translation of a transcript by differing mechanisms in viruses, prokaryotes and eukaryotes

question

The prokaryotic 5? UTR contains a ribosome binding site (RBS), also known as

answer

the Shine Dalgarno sequence (AGGAGGU), which is usually 3-10 base pairs upstream from the initiation codon.[5] In contrast, the eukaryotic 5? UTR contains the Kozak consensus sequence (ACCAUGG), which contains the initiation codon.[5]

question

Cap-independent translation of poliovirus mRNA is conferred by sequence elements within the

answer

5 UTR

question

which allows for translation initiation in an end-independent manner, as part of the greater process of protein synthesis?? In eukaryotic translation, initiation typically occurs at the 5' end of mRNA molecules, since 5' cap recognition is required for the assembly of the initiation complex.

answer

An internal ribosome entry site, abbreviated IRES, is a RNA element The location for IRES elements is often in the 5'UTR of Rna virus!, but can also occur elsewhere in mRNAs.

question

the diference in risk between exposed and unexposed groups or proportion (%) of disease ocurrences that are attributable to the EXPOSURE.

answer

treatment rate - control rate Ie-Ine (incidence of disease/effect.. in exposed to treatment - non exposed_) if the risk of lung cancer in smokers is 21% and risk in non smokers is 1%,then 20% of lunk cancer is attributable to smoking. AR (attributable Risk) also AR %: 100x(RR-1)/RR

question

the proportion of risk reduction attributable to the INTERVENTION as compared to control.

answer

if 2% of patients develop the flu,while 8% develop without vacine.then RR=2/8=.025 (Ie/Ine) and ...RRR= 1-RR= .75

question

the diference in risk (not proportion) atributable to the INTERVENTION as compared to control

answer

control rate - treatment rate. (Ine-Ie) ARR if 8% receive placebo vaccine develop flu X 2% receive flu vaccine develop flu 8%-2%=6%

question

presence og genetically distinct cell lines in the same individual. term and disease example

answer

Mosaicism Mccune Albright syndrome

question

mutation affecting G ptn signaling= unilateral cafe au lai spots polyostotic fibrous dysplasia,precocious puberty multiple endocrine abnormalities. lethal if mutation occur before fertilization (affecting all cells)

answer

Mccune albright syndrome features

question

mutations arise from mitotic errors after fertilization and propagates through multiple tissues and organs

answer

somatic mosaicism

question

mutation only in egg or sperm cells

answer

gonadal mosaicism

question

one gene contribute to different phenotype affecting multiple organ system

answer

pleiotropy (PKU)

question

2 hit hypothesis remember

answer

loss of heterozigozity

question

BRACA1 gene do not always result in breast ,ovarian cancer

answer

incomplete penetrance

question

presence of normal and mutated mtDNA resulting in variable expressivity of mitocondrial inherited disease

answer

heteroplasmy

question

phenotype varyes among individuasl with same phenotype (NF1)

answer

variable expressivity

question

mutations at different LOCI can produce similar phenotype mutations at same LOCI can produce similar phenotype

answer

LOCUS heterogeneity: albinism allelic heterogeneity: B thalassemia

question

can result is miscarriage,stillbirth and chromossomal imbalance (down,patau syndrome)

answer

unbalanced translocation

question

Translocations can be reciprocal (balanced or unbalanced) or nonreciprocal (robertsonian)(balanced or unbalanced). give examples?

answer

Reciprocal translocations are usually an exchange of material between nonhomologous chromosomes. are usually harmless and may be found through prenatal diagnosis. However, carriers of balanced reciprocal translocations have increased risks of creating gametes with unbalanced chromosome translocations, leading to miscarriages or children with abnormalities.

question

2 typer of chromossomal reciprocal translocations:

answer

chromosomal translocations occurring in gametogenesis, due to errors in meiosis, and translocations that occur in cellular division of somatic cells, due to errors in mitosis. The former results in a chromosomal abnormality featured in all cells of the offspring, as in translocation carriers. Somatic translocations, on the other hand, result in abnormalities featured only in the affected cell line, as in chronic myelogenous leukemia with the Philadelphia chromosome translocation.

question

Robertsonian translocation is a type of translocation caused by

answer

breaks at or near the centromeres of two acrocentric chromosomes(six acrocentric chromosomes: 13, 14, 15, 21, 22 and the Y chromosome). The reciprocal exchange of parts gives rise to one large metacentric chromosome and one extremely small chromosome that may be lost from the organism with little effect because it contains so few genes. The resulting karyotype in humans leaves only 45 chromosomes, since two chromosomes have fused together

question

diseases with congenital MICROscopic deletion of: short arm of 5 long arm of 7

answer

5: Cri du chat syndrome (46 XX or XY,5p-) 7:Williams syndrome

question

microcephaly with intelectual disability,epicantal folds,cardiac abnormalities(VSD),

answer

Cri du chat! cat like cry!

question

delected region gene of elastin, distinctive elfin fascies,intelec disab, hyper CALCEMIA (high sensitiity to vit D) WELL developed verbal skilss!!extreme friendliness with strangers! CV problems.

answer

williams!

question

-microdeletion of chromosome -deletion of chromosome: -codon deletion -single gene deletion

answer

-above - turner -CF - prader/angelman

question

GRAM + stain 3 divisions:

answer

Cocci rods(bacilli) branching filaments

question

cocci next

answer

catalase + staph -; coagulase -; + Aureus - novobiocin sens: epidermidis X saprophyticus - strep

question

rods: CCBL

answer

Clostridium,corynebacterium,bacillus(aerobe),listeria

question

Branching filaments

answer

Actinomyces (A naerobe,NOT acid fast) X Nocardia

question

GRAM - stain

answer

cocci (diplo) coccoid rods Rods curved rods

question

maltose fermenter

answer

N meningitis

question

coccoid rods HP BB

answer

haemophilus, pasteurela, Bordetella pertussis, Brucella

question

Rods begins with -

answer

lactose fermenter(pink color) fast: KEE CS Klebsiella,E.coli,enteroBACTER slow: citrobacter, serratia lactose non fermenter, use oxidase because is white/colourless!

question

oxidase - X +

answer

oxidase +: pseudomonas motile encapsuled or aeromonas hydrophila oxidase -: next TSI agar

question

TSI agar (triple sugar iron) produces H2S -Black ?bacterias

answer

spy! Salmonella proteus Yersinia do not produce: shiiiiiiigella

question

patient has burning abdominal pain that occurs 1-2 hours after patient eats. suspect:

answer

duodenal ulcer due arrival of acid food! usually the pain relieves when patient eats due release of pancreatic alkaline secretion

question

patient has burning abdominal pain worsening when eating! fear of eat!

answer

stomach ulcer due increased acid secreations released

question

patient wit 6 month history of burning abdominal pain that occurs 1 to 2 hours after he eats.he also has Black stools for 2 days! suspect:

answer

bleeding duodenal ulcer

question

high grade and low grade means:

answer

low and high differentiation

question

stage TNM

answer

high stage worst prognosis T: tumor size ,depth N:nodules (2 worst) M: metastasis (worst)

question

lactose fermenters grow which color on Mc conkey? which color in EMB agar and specifically E.coli ?

answer

Mc conkey: Lactose is key! -;pink colonies EMB(eosin methilene blue|) purple/Black colonies and e.coli grows with green sheen

question

which enzyme is responsible for the green color of pus and sputum in bacterial infection?

answer

myeloperoxidase

question

a blue green heme based enzyme released from neutrophil azurophilic granules and forms hydrochlorus acid( Bleach)

answer

myeloperoxidase

question

pigmanet producing bacteria: yellow (2) gree red

answer

Y: actinomyces israelli,S.aureus green: pseudomonas aeruginosa ( blue green) due production of pyocyanin Red: serratia marcescens

question

condition of urine containing white blood cells or pus. Defined as the presence of 6-10 or more neutrophils per high power field of unspun, voided mid-stream urine

answer

piuria

question

-Can be a sign of a bacterial urinary tract infection.

answer

piuria

question

urine which contains white blood cells while appearing sterile by standard culturing techniques.

answer

Sterile pyuria

question

sterile piuria It is often caused by:

answer

sexually transmitted infections, such as gonorrhea, or viruses which will not grow in bacterial cultures. Sterile pyuria is listed as a side effect from some medications such as paracetamol (acetaminophen). Its occurrence is also associated with certain disease processes, such as Kawasaki disease and genitourinary tuberculosis.[2] However, there are many known causes, including systemic or infectious disease, structural and physiological reasons, intrinsic kidney pathology, or drugs.[2]

question

use monoclonal antibody TNF blockers for: name of drugs:

answer

PAIR reumatoid arthritis names: Adalimu/inflixi/certolizu!

question

TNF decoy TNF a receptor blocker:

answer

Ertanecept

question

main indication of ertanecept in RA

answer

added to metotrexate to treat mod to severe RA when Metho failed

question

Sweating Shivering Headache Muscle aches Loss of appetite Dehydration General weakness

answer

fever symptoms (above 37 - 98.6F)

question

Hallucinations Confusion Irritability Convulsions Dehydration

answer

High fevers between 103 F (39.4 C) and 106 F (41.1 C) may cause:

question

diseases 1-liver and spleen enlargement,fibrosis and inflammation (portal hypertension) 2-chronic infection can lead to squamous cell carcinoma of the bladder and may cause KATAYAMA fever (fever,urticaria,angioedema,eosinophilia)

answer

1- S.mansoni (egg with lateral spine) Sjaponicum also cause intestinal disease: (diarrhea,abdominal pain,ulceration) 2-S.haematobium (egg with TERMINAL spine)

question

praziquantel to treat:

answer

intestinal Nematodes (round) no! give bendazoles! use praz! for: -cestodes(tapeworms) except: neurocist or echinococcus both albendazole!! -trematodes(flukes)

question

1.Cestodes(Tapeworms) give examples 3 2.trematodes

answer

1. - taenia solium -;intestinal infection (injestion of larva) X cisticercosis muscle(ingestion of eggs) or neurocisticercosis (give albendazol) -diphylobothrium latum - echinococcus granulosus give albendazole 2. schistosoma clonorchis sinensis paragommus westermani: live lung: chronic bronchitis/hemoptisis

question

1.diphylobothrium latumX 2.eccinococcus granulosus X 3.clonorchis sinensis

answer

1/2: cestode 3. trematode 1/3 from undercooked /raw fish 1.vit B12 deficiency 3.biliary tract inflammation-; pigmented stones, may cholangiocarcinoma 2. ngestion of eggs from dogs, goes lung and liver-; hydatid cysts in the liver causing anaphylaxis if antigens released

question

Nitrous oxide: blood and lipid solubility induction and potency: Isoflurane blood and lipid solubility induction and potency: relate: a) blood/gas partitition (or oil/gas) with onset of action, potency

answer

- Has low blood and lipid solubility and thus: - Fast Induction ; Low Potency Isoflurane - ? Lipid and Blood solubility and thus: - Slow Induction ; High Potency blood/gas is related with onset of action! and oil/gas is related to potency ? Blood solubility = ? Blood/Gas partition coefficient = ? solubility = ? Gas required to saturate blood = Slower onset of action.

question

blood/gas partitition is diretly oy indirectly proportional to onset of action and recuperation?

answer

indirectly

question

oil/gas partitition is diretly oy indirectly proportional of potency?

answer

directly

question

is there a tendency of anesthetics with greater oil/gas have greater blood/gas partition?

answer

yes! higher potency with slower onset of action.

question

give prophylatic penicillin daily to decrease patients´risk for infection by:

answer

encapsulated organisms (S.pneumo first!, H.Influenza)! due autosplenectomy (howell jolly bodies)

question

drugs which Concentration in plasma decreases linearly with time. rate of elimination is constant regardless of Cp (constant amount of drug eliminated per unit time)

answer

zero order elimination PEA phenytoin, ETHANOL,ASPIRIN

question

drugs witch decrease exponentially with time. rate of elimination is directly PROPORTIONAL to the drug concentration! is a flow dependent elimination. there a constant Proportion of drug elimined per unit time

answer

First Order elimination

question

if first order elimination in 2hours 12,5 mg decrease to 10mg, after 2 hours which will be the concentration?

answer

same proportion! 20% 8mg

question

bacteria mechanism of resistance for ATB 1. penicillinase in bacteria cleaves the blactam ring penicillins resistant b lactamases (oxa/methi,diclo,nafcillin)

answer

1. penicilli G,V amoxicillin, ampicillin(wider spectrum) Pipera/ticarcillin (anti pseudo) (may combine wit b lactamase inhibitors)

question

bacteria mechanism of resistance for ATB 2. structural change in penicillin binding ptns (transpeptidases)

answer

cephalosporins

question

bacteria mechanism of resistance for ATB 3. D ala D ala to D ala d LAC! (VRE)

answer

vancomycin

question

bacteria mechanism of resistance for ATB 4. bacterial transferase inactivate ATB by acetylation, phosphorilation or adenylation

answer

aminoglycosides

question

Bacteria mechanism of resistance for ATB 5. decrease or increase efflux out of the bacterial cells by plasmid encoded transport pump. production of a ptn that allows translation of bacteria to take place even when ATB is present within the bacteria.

answer

tetracycline

question

bacteria mechanism of resistance for ATB 6. plasmid encoded acetyltransferase inactivates the drug

answer

chloramphenicol

question

bacteria mechanism of resistance for ATB 7.point mutation of ribossomal RNA

answer

Linezolid

question

bacteria mechanism of resistance for ATB 8. methylation of 23 S rRna binding of 50s prevents binding of drug

answer

macrolides

question

bacteria mechanism of resistance for ATB 9.altered enzyme (bacterial dihydropteroate synthase),decreased uptake or PABA synthesis

answer

sulfonamides

question

mechanism of resistance of mycobacteria:: mutation reduces drug binding to RNA polymerase.(mutation in gene that codes for a DNA dependent RNA polymerase)

answer

Rifamycin monotherapy leads to resistance

question

mechanism of resistance of mycobacteria: mutation leading to underexpression of KatC

answer

Isoniazid KAT encodes catalase peroxidase needed to convert INH to active metabolite

question

mechanism of resistance of virus for antiviral 1. mutated (thymidine) viral kinase

answer

cyclovirs

question

mechanism of resistance of virus for antiviral 2.mutated (CMV) viral kinase

answer

ganciclovir

question

mechanism of resistance of virus for antiviral 3. mutated DNA polymerase

answer

Foscarnet does not require activation by viral kinase

question

characterized by acute noninflammatory encephalopathy (headache,coma) and fatty degenerative liver(hypoglycemia) decreased beta oxidation! due mitochondrial enzymes inhibition! liver failure after a viral illness, particularly an upper respiratory tract infection, influenza B, varicella, or gastroenteritis,

answer

Reye syndrome aspirin use!

question

H1 blockers! generation? names contains 1. en/ine or en/ate 2.adine

answer

1. DiphENhydramINE, DimENhydrATE, chlorphENiramINE 2. lorat/fexofenadine

question

H1 blockers clinical use 1generation 2generation

answer

both allergy! (second rhinitis! and less sedating due low penetration in CNS) but first motion sickness,sleep aid (disrupts), anaphylaxis after stabilization with epinephrine.

question

expectorants think 2!:

answer

-N acetylcysteine mucolytic!prophylaxis against induced nephropathy if preexisting renal disease. -Guaifenesin: EXPECTORANT-thin secretions

question

cough suppression:think

answer

-opioids:inhibits at CNS level (codeine) DEXTROmethorphan: antagonizes NMDA glutamate receptors), synthetic codeine analog! mild opioid effect if used in excess:constipation

question

nasal descongestionants

answer

pseudoephedrine and phenylephrine (alpha adrenergic agonists) pseu used to makje methamphetamine

question

AR disease: q square = prevalence q = allele frequency 2q = carrier frequency X-linked AR: Prevalence = allele frequency q square = q Carrier state for females = 2q

answer

the X link disease is seen in 1/100,000 males.which is the expected prevalenve of heterozygous females. Allele frequency (q) = the prevalence (q square) Thats why in this question q = 1/100000 Carrier state = 2q = 2/100000 = 1/50000

question

at the initial screening evidence of clamydia tracomatis infection is founf in 500 of 2500 student .one year later evidence of C tramotis is found in an additional 200 students which of the following is anual incidence of c tracomatis infection in this population of students

answer

B10 % here is no info about how much students have got the treatment, so consider like a chronic disease. take out people who had the disease in people at risk! those 500 who already have it aren't at risk anymore to get it. therefore 200/2000 is the correct answer

question

flow rate formula:

answer

- flow velocity X cross sectional area if fv:20cm/sec and cross area:2cm2 remember to convert units is L/Min

question

ohms law to calculate flow resistance formula:

answer

- U=R.i p1-p2=R.Q(flow) Q= p1-p2/R R= viscosity/radio4 so: Q=p1-p2 x r4 /viscosity

question

1. hyperproteinemia styates, polycythemia, hereditary spherocytios increases 2. anemia decreases

answer

viscosity

question

have highest total cross sectional area and lowest flow velocity

answer

capillaries

question

organ removal(nephrectomy) leads to

answer

increased TPR and decreased CO

question

cm 3

answer

1 ml or 10 -3 L

question

tanner scale I prepubertal childhood II 8-13 pubic hair ___________;breast buds________ III pubic hair _________;breast___________;penis increase________ IV penis increase__________;scrotal skin/glans, areola_; V adult; areola

answer

I prepubertal childhood II.pubic hair appears(pubarche);breast buds form (thelarche) III pubic hair: darkens/curly! ;breast enlarge;penis increase size/lengh IV penis increase width;scrotal skin/glans, areola raise V adult; areola are no loger raised

question

irregular mestrual periods 13/14, after menarche

answer

anovulatory cycles

question

how S pneumoniae ability to produce capsules (his major virulence factor)

answer

bhy transformation! SHN use this ability to take up fragments of Dna from environment (eg from cell lysis)

question

transduction generalized "a packaging" event by

answer

litic phage infecting bacterium!cleaves bacterial DNA and parts of both DNA are packaged together in viral capside to infect another bacteria.

question

transduction specialized is a "excision event" by:

answer

Lytic Phage! infects bacteria, its viral dna is incomporated in bacterial chromosome! when phage DNA is EXCISED, flanking bacterial genes may be excised with it, packaged into viral capside to infect another bacteria.

question

which bacteria toxins are encoded by lysogenic phage: ABCDE

answer

Shiga Botulinum cholera diphteria erythrogenci of st pyogenes

question

the condition may increase the risk for: Kidney obstruction - abnormal placement of ureter may lead to obstruction and dilation of the kidney. Kidney infections - associated with vesicoureteral reflux. Kidney stones - deviant orientation of kidneys combined with slow urine flow and kidney obstruction may lead to kidney stones. Kidney cancer - increased risk of renal cancer, especially Wilms' tumor, transitional cell carcinoma, and an occasional case report of carcinoid tumor.[3] Despite increased risk, the overall risk is still relatively low.

answer

While most cases of horseshoe kidneys are asymptomatic and discovered upon autops The prevalence of horseshoe kidneys in females with Turner Syndrome is about 15%. It can be associated with trisomy 18,13.[5]

question

whats the LH/FSH ratio in POS?

answer

high LH! stimulates theca cells to produce androgens

question

how insulin resistance increase androgens?

answer

stimulates theca cells to produce androgens

question

whats does high androgens lead?

answer

high conversion in periphery to estrone due aromatase!

question

androgens are converted to estradiolin granulosa cells?

answer

no, due low FSH!

question

what does sex binding hormones interfere in level of strogens/androgens in blood?

answer

they are in low quantitity due low production by the liver leading to higher free levels of androgens and estrogens in the blood

question

all are up less FSH

answer

POS

question

consequences: 1.high estrogen 2.high androgen

answer

1.amenorrhea/oligo, repeated anovulatory cycles-subfertility; higher risk of endometrial hyperplasia/cancer due unoposed estrogen. 2.hirsutism,acne

question

treat POS

answer

weight reduction OCP clomiphene ketokonazol spironolactone

question

why acute alcohol intake protects for acetaminophen intake liver injury and chronic alcohol intake worse live injury?

answer

by inhibiting or inducing P450 enzymes to make hepatotoxic metabolites!

question

oral or depot-injected contraceptive and also as the progestin component of menopausal hormone replacement therapy to prevent endometrial hyperplasia and cancer. is also used as a treatment for endometriosis, dysmenorrhea, and amenorrhea. decreases growth and increases vascularization of endometrium

answer

progestins (medroxyprogesterone)

question

adjuvant therapy for postmenopausal women with ER+ breast cancer

answer

exemestane/anastrozole (aromatase inhibitors)

question

selective estrogen receptor modulators

answer

clomiphene tamoxifen raloxifene

question

antagonist at estrogen receptor in hypothalamus 1 line of infertility due anovulation prevents normal feedback inhibition and increase release of LH and FSH, which stimulates ovulation. may cause Hot flashes,ovarian enlargement,multipole pregnancies.

answer

clomiphene

question

drug to prevent /treat breast cancer (ER+) (also agonist bone,uterus)

answer

tamoxifen

question

drug to prevent breast cancer and mainly prevent osteoporosis *agonist bone) but antagonist at uterus!

answer

Raloxifene

question

DX: men: Low back pain,dysuria,urgency,frequency

answer

prostatitis

question

CD56, chromogranin, synaptophysin, and neuron-specific enolase) markers from

answer

neuroendocrine origin

question

bacteria which causes prostatitis 35Y

answer

35: think UTI ( PEcKS proteus,E.COLI!!!,Klebsiella,Serratia and enterobacter

question

prostatitis treat:

answer

fluoroquinolones,levo for ;4 weeksor TMP/SMX

question

is an activator of the intrinsic coagulations cascade: Deficiency leads to increased:

answer

Kallikrein deficienct of kallikrein leads to defective intrinsic pathway which is measured with PTT ( is increased in dysfunction of the intrinsic pathway

question

B1 selective B antagonists A to M

answer

Acetabulol (partial agonist),atenolol,esmolol,metoprolol

question

Non selective B antagonist N to Z

answer

Nadolol,Pindolol(partial agonist),propranolol,Timolol

question

non selective B and alpha

answer

labetalol and carvedilol!

question

weak B1B2 agonis(partial) acts as antagonists

answer

acetabulol,pindolol to HTN patients with bradycardia

question

non seletive irreversible X reversible Alpha blockers

answer

irreversible (PHEnoxbensamine! to PHEochromocytoma reversible; give to patients using MAO eating tyramine foods

question

alpha 1 selective blockers (osin) to BPH

answer

praz,teraz,doxaz,tamsulosim

question

alpha 1 selective blockers (osin) to BPH which does not lower BP!give for normotense patients

answer

Tamsulosin (selective for Alpha 1 a on Prostate!) does not relax vascular Alpha 1 b receptors on vessels

question

alpha 2 agonist for ADHD, tourette syndrome cause CNS depression,bradycardia,hypootension,respiratory depression,miosis.

answer

clonidine

question

alpha 2 blocher for depression but becomes asleep, fat, hungry!

answer

mirtazapine

question

alpha 2 agonist for HTN in pregnancy diect coombs + hemolysis SLE like syndrome

answer

a methyldopa

question

name of zone I affected first by viral hepatitis, ingested toxins

answer

periportal zone

question

namoe of zone affected by yellow fever

answer

intermediate zone

question

name of zone affected by ISCHEMIA! (high demant of energy by Na/Katpase)contains P450!being most sensible to metabolic toxins! and alcohol!(alcoholic hepatitis)

answer

pericentral vein (centrilobular)

question

shows micro abscesses within the crypts and depletion of mucus from goblet cells,tenesmus and bloody diarrhea

answer

ulcerative colitis

question

which drug upregulate LPL(lipoprotein lipase) increasing blood TG clearance increased cholesterol bile secretion by decreasing bile acid formation (inhibition of cholesterol 7 hydroxilase)

answer

Fibrates (high risk of cholesterol gallstones0 Myopathy (high risk with statins)

question

which drug inhibits lipolysis (HSL) at adipose tissues and reduces hepatic VLDL synthesis? increases HDL perfect drug! but side effects:

answer

Vit B3 Niacin red,flushed face decreased by NSAIDS HyperGLYCEMIA!!:(URICEMIA:((

question

caution use with statins

answer

ezetimibe,Fibrates

question

arterial/venous supply above (superior rectum) under pectinate line (middle/inferior rectum)

answer

above: -superior RECTAl (a.)(v.) from IM(a.)(v.) under: -middle RECTAL (a.) from internal iliac (a.)(v.) directly! -inferior RECTAL (a.)(v.). from internal pudendal (a.) from internal iliac

question

A 57 year old man comes to the physician because of a 6 month history of progressive constipation and a feeling of rectal fullness. Digital rectal examination shows no papable lesion. Test of the stool for occult blood is positive. Colonoscopy shows a mass in the sigmoid colon. A biopsy specimen of the mass shows adenocarcinoma. Metastases from this mass will most likely spread via which of the following lymph nodes?

answer

A) Inferior mesenteric B) Internal iliac C) Left colic D) Pararectal E) Superficial inguinal

question

lymphatic drainage 1. above: (superior rectumXmiddle rectum) 2. under pectinate line

answer

1.above: -superior rectum: superior RECTAL nodes to IMesenteric -middle rectal nodes to internal iliac nodes 2. under -to superficial inguinal nodes

question

remembre effect of partial agonist in presence of full agonist

answer

antagonist effect

question

P450 inhibitors CRACK AMIGOS

answer

Cimetidine Rito NAVIR Alcohol use acute CIPROFLOXACIN KetoconaAZOLES(fluco/itra..) AMIODARONE Macrolides (EXCEP AZITRO!) Isoniazid GRAPE FRUIT juice Omeprazole SULFA Quinidine! gingko biloba

question

P 450 inducers

answer

Phenytoin Barbiturates Chronic alcohol GRISEOFULVIN RIFANPIN St johj green vegetables/ginseng

question

substrates for P450

answer

statins anti epilectics theophiline OCPs Ciclosporine/tacrolimus

question

rouworms by ingestion EATT

answer

enterobius,ascaris,toxocara, trichinella

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roundworms that penetrate skin (SANd)

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Strongylois, Ancylostoma/necator

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intestinal infection causing vomiting,diahhrea,epigastric pain(fell like peptic ulcer)

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strongyloides

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intestinal infection causing anemia by sucking blood from intestinal walls

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Ancylostoma/necator (hook worms)

question

At the cell surface, the binding of ligands such as hormones and neurotransmitters to a GPCR activates the receptor by causing a conformational change, which in turn activates the bound:

answer

G protein on the intracellular-side of the membrane. The activated receptor promotes the exchange of bound GDP for GTP

question

GTP binding changes the conformation of switch regions within the alpha subunit, which allows the bound trimeric G protein (inactive) to be released fromthe receptor, and to dissociate into

answer

active alpha subunit (GTP-bound) and beta/gamma dimer

question

the alpha subunit and the beta/gamma dimer go on to activate distinct downstream effectors, such:

answer

as adenylyl cyclase, phosphodiesterases, phospholipase C, and ion channels. These effectors in turn regulate the intracellular concentrations of secondary messengers, such as cAMP, diacylglycerol, sodium or calcium cations, which ultimately lead to a physiological response, usually via the downstream regulation of gene transcription

question

activated receptor promotes the exchange of bound GDP for GTP in which G ptn subunit?

answer

G protein alpha subunit.

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The cycle is completed by the hydrolysis of

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alpha subunit-bound GTP to GDP, resulting in the re-association of the alpha and beta/gamma subunits and their binding to the receptor

question

glucagon (fasting) activates which enzyme to get to gluconeogenesis

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high glucagon-;high cAMP-;high Ptn Kinase A which activates FBPase 2(fructose biphosphatase) which converts Fructose 2,6BP -;Fructose6P (less glycolysis),more gluconeogenesis.

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1.glucokinase inhibitor 2.hexokinase inhibitor 3.PFK1 inhibitor X stimuli 4.Pyruvate kinase inhibitorX stimuli 5.Fructose 1,6Bisphosphatase inhibX stimuli

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1.fructose 6P 2.glucose 6P 3.Citrate,ATP X Fructose 2,6B,AMP 4.Alanine,ATP X Fructose 1,6B 5. AMP,fructose 2,6BphosphateX AMP,ACETYL COa,Citrate

question

antiviral drug ciclovirs action.inhibits

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DNA polymerase

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viral kinase (HSV/VZV) phosphorilates drug and celullar kinase also forming triphosphate which acts:

answer

guanosine analogs (AFV) aci,fam,valacyclovir. actsinhibiting DNA polymerase

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drug which triphosphate is formed by CMV and host cellular kinases and also inhibits DNA polymerase. also a guanosine analog

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Ganciclovir by CMV!

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incidence of neutropenia increases with coadministration of ganciclovir with

answer

Zidovudine or SMT TMP

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does not require virus (viral kinmase) to be activated! has also DNA and RNA polymerase inhibition action! and HIV transcriptase inhibition

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Foscarnet! a pyrophosphate analog

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also inhibits DNA polymerase also does not require virus (viral kinmase) to be activated!

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cidofovir

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use is CMV retinitis in immunocompromissed,acyclovir resistant HSV

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foscarnet or cidofovir

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prostaglandins produced by COXs

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IDE PGI2,D2,E2 ( vasodilation,increased permeability) E2 also fever and pain

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Leukotrienes produced by 5 Lipoxygenases:

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B CDE! LTC4,D4,E4 (vaso CONSTRICTION,increased permeability also., and BRONCHOSPASM! LTB4 activate neutrophil

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systemic mycosis and treat:

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Histo/blasto/coccidio/paracocci itraconazole; flucytosine w/wit ampho B

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opportunistic

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candida/aspergilus/cryptoco/mucor/pneumocystis/sporothrix candida/crypto/sporot: fluconazole aspergilus: caspogungins

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cutaneous tineas 1.corporis/pedis/ungueal: 2.capitis

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1.topical terbinafine 2.oral

question

what are the Amino Acids, HC03, Phosphate and Glucose levels

answer

Everything decreased

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