1. Metaphyseal dysplasia due to single gene disorder caused my mutation in PTH receptor gene. Phenotype is "similar to that of acquired hyperparathyroidism." Mechanism?
Haploinsufficiency - wrong
Dominant Negative
Gain of function
Pleiotropy
Anticipation
2. So aripiprazole has what action compared to haloperidol on the dopamine receptors?
Reversible antagonism - wrong - didn't feel to good about it
Agonism
antagonism
inverse agonism
irreversible antagonist
partial agonism
3. Why is there reduced tactile fremitus in asthma kid?
4. Chronic peripheral neuropathy; enzyme histochemical staining shows fiber grouping. Most likely cause?
Altered trophic substance form innervating neuron - wrong
Altered muscle enzyme exprerssion due to damaged nerve fibers - correct?
Regeneration of muscle fibers
Re innervation of muscle fibers by regenerating axons
Selective loss of nerve fibers to type II muscle fibers
5. 73 year old w/ BPH, UTI +fever + chills +pain in flank + WBC + 100,000 colonies of gram + what is the causal organism?
Staphyloccus aureus - wrong
Streptococcus pyogenes
Enterococcus faecalis - would need a fistula and you'd see lots of other nasty stuff yea?
6. Lady with TIA's, cannot tolerate aspirin. Appropriate alternative?
Dipyramidal - wrong
Clopidogrel? -these were the two i narrowed
Acetaminophen
Ibuprofen
Tissue plasminogen activator
7. Lady gets to 10,000 ft ski resort. Dizzy, nausea, headache. Acetazolamide helps, how?
Stimulation of ion pumps in BBB - wrong
Direct action on resp centers, depressing ventilation
Direct action on resp centers, stimulate ventilation
Induction of metabolic acidosis, stimulate ventilation
Induction of metabolic alkalosis, depress ventilation
Stimulation of EPO
This one kid of bothered me. So her initial problem is alkalosis due to major reduction in PO2 at altitiude and subsequent increased RR blowing off CO2 = alkaline. Acetazolamide will help by creating some metabolic acidosis, but then what? Stimulating further respiration would be counter productive right? EPO would take a while. Direct action seemed a bit off to me. So i was left with ion pumps; I dunno.
8. Another carbonic anhydrase question - not my day. Didnt read this question fully though. CA deficiency in erythrocytes only; whats elevated in venous blood?
K+ wrong; i thought systemically, acidosis = H/K exchange
Ca
Cl
HCO3
Mg
Na
9. Lady with UMN issues. What helps?
Inhibit nicotinic-R in Renshaw - wrong
Activate GABA-R in muscle spindle afferents
Activate glutamate-R in gamma motoneurons
Activate serotonin-R in alpha motoneurons
Inhibit glycine-R in Golgi tendon afferents
Inhibition of (a)2-R in excitatory interneurons
10. Guy on steroids hurts his arm. Antecubital swelling and ecchymoses from antecubital fossa to mid forearm on anterior side, tender there also. Able to flex elbow actively, but unable to flex elbow or supinate against resistance. Injured muscle-tendon unit innervated by what?
Radial - wrong; i was thinking brachioradialis
Anterior interosseous
Median
Musculocutaneous
Ulnar
11. Still unclear on what would improve the lady taking a thiazide with improved BP but low K+
Atenolol - wrong
Furosemide
Losartan
Nifedipine
Prazosin
12. Septic arthritis in 18 year old kid; gram + stain picture shows what I think look like intracellular bugs
Ceftiraxone
Doxycycline - wrong
Genatmicin
Metronidazole
Vancomycin
13. Apparently autistic kid? 3 years old, 20 word vocab. Doesn't speak in sentences, points alot, no physical abnormalities. Kid is looking at reflex hammer instead of acknowledging mom's presence.
Inform her that the child will need special education - wrong
Further evaluation to determine cause of language delay
MRI
Reassure that this is normal
Advise to enroll in preschool early
14. Guy smokes 2 packs a day lives in basement apartment. Dizzie, headache, nausea for 4 hours. No physical abnormalities; what explains it?
Acidosis with heme dissociation shift right
Activation of nicotinic-R in locus caeruleus
Cerebral arteriolar constriction due to increased CO2 in blood
Competative inhibition of oxyhemeoglobin formation
Inactiation of cytochrome oxygenase by cyanide - wrong; seemed like a lot of cigs
Probably competitive inhibition - CO poisoning. I skimmed over the part that said it was WINTER - and basement apartments i guess only have space heaters right? Sure.
15. What else would you give to someone w/ acute hep C already receiving (a)IFN?
IL-2 - wrong
Infliximab
Levamisole
Ribavirin
Thlidomide
16. Guy with prostate cancer; Low back pain. Most appropriate drug MoA:
Activation of GnRH receptors - probably correct if given CONTINUOUSLY
Activation of LH receptors
Blockade of estrogen receptors
Blockade of FSH receptors -wrong, convinced myself T --> DHT was FSH stimualted
Inhibition of 11-B hydroxylase
Thoughts, or some scolding to get me motivated welcome