D027 Advanced Pathopharmacological Foundations - Set 2 - Part 1

Correct Answer: Cobblestone tissue appearance

Crohn's disease characteristically shows cobblestone appearance on biopsy due to transmural inflammation creating alternating areas of ulceration and healing.
Option a is incorrect because continuous mucosal inflammation characterizes ulcerative colitis, not the patchy pattern of Crohn's disease.
Option c is incorrect because Crohn's causes transmural inflammation affecting all layers, not just superficial mucosal ulceration.
Option d is incorrect because crypt abscesses are more characteristic of ulcerative colitis than Crohn's disease pathology.

Correct Answer: Leukotriene receptor antagonists

Leukotriene receptor antagonists like montelukast provide asthma control without the growth suppression concerns of medium-dose inhaled corticosteroids.
Option a is incorrect because oral corticosteroids have even greater systemic effects on growth than inhaled corticosteroids.
Option c is incorrect because long-acting beta agonists require combination with corticosteroids and don't address the concern.
Option d is incorrect because anticholinergics are primarily for COPD and don't replace controller therapy in asthma.

Correct Answer: Atropine sulfate

Atropine must be available during Tensilon testing to treat potential cholinergic crisis if excessive acetylcholine causes severe symptoms.
Option a is incorrect because epinephrine treats anaphylaxis, not the cholinergic crisis that may occur during Tensilon testing.
Option c is incorrect because naloxone reverses opioid effects, not the cholinergic excess from edrophonium administration.
Option d is incorrect because glucagon treats hypoglycemia or beta-blocker overdose, not cholinergic crisis during testing.

Correct Answer: Glutamate activity

Memantine regulates glutamate activity as an NMDA receptor antagonist, improving information processing and retrieval in Alzheimer's patients.
Option a is incorrect because dopamine pathway regulation is used in Parkinson's disease, not Alzheimer's cognitive symptoms.
Option c is incorrect because serotonin modulation treats depression and anxiety, not the cognitive decline in Alzheimer's.
Option d is incorrect because GABA transmission affects anxiety and seizures, not the memory problems in Alzheimer's.

Correct Answer: Fosfomycin

Fosfomycin offers safe one-time dosing for UTI treatment during pregnancy without the fetal risks of other antibiotics.
Option a is incorrect because nitrofurantoin carries risks near term and isn't given as single-dose therapy.
Option c is incorrect because fluoroquinolones like ciprofloxacin are contraindicated in pregnancy due to fetal cartilage concerns.
Option d is incorrect because trimethoprim affects folate metabolism and poses risks during pregnancy, especially first trimester.

Correct Answer: IV hydration

IV hydration takes priority in vaso-occlusive crisis to improve blood flow and reduce sickling before addressing pain symptoms.
Option a is incorrect because oxygen helps but hydration more directly addresses the blood viscosity causing vaso-occlusion.
Option b is incorrect because transfusion is reserved for severe anemia or specific complications, not routine vaso-occlusive crisis.
Option d is incorrect because antibiotics treat infection-triggered crises but don't address the primary vaso-occlusive mechanism.

Correct Answer: Roflumilast

Roflumilast, a PDE4 inhibitor, specifically benefits COPD patients with chronic bronchitis phenotype experiencing frequent exacerbations despite bronchodilator therapy.
Option a is incorrect because theophylline has narrow therapeutic window and isn't specifically indicated for chronic bronchitis phenotype.
Option c is incorrect because oral steroids treat acute exacerbations, not serve as maintenance therapy for stable COPD.
Option d is incorrect because antibiotics treat infections and exacerbations, not provide ongoing COPD maintenance therapy.

Correct Answer: IgA tissue transglutaminase

IgA tissue transglutaminase antibodies with HLA-DQ2 or HLA-DQ8 genetic markers specifically diagnose celiac disease autoimmune response.
Option a is incorrect because anti-nuclear antibodies indicate systemic lupus or other autoimmune conditions, not celiac disease.
Option c is incorrect because rheumatoid factor tests for rheumatoid arthritis, not the intestinal autoimmunity of celiac.
Option d is incorrect because anti-smooth muscle antibodies suggest autoimmune hepatitis, not celiac disease's intestinal involvement.

Correct Answer: Cinnamon extract

Cinnamon lowers blood glucose and combined with metformin can cause hypoglycemia and metabolic complications including lactic acidosis.
Option a is incorrect because ginkgo biloba affects bleeding and seizure threshold, not glucose metabolism with metformin.
Option c is incorrect because lavender affects CNS relaxation and doesn't interact with metformin's metabolic effects.
Option d is incorrect because green tea's caffeine and antioxidants don't significantly interact with metformin metabolism.

Correct Answer: Beta blockers

Beta blockers control tachycardia and cardiovascular symptoms in thyroid storm while antithyroid drugs address the underlying hyperthyroidism.
Option a is incorrect because ACE inhibitors manage hypertension but don't control the sympathetic overdrive in thyroid storm.
Option c is incorrect because calcium channel blockers don't adequately control the adrenergic symptoms of thyroid crisis.
Option d is incorrect because digoxin treats heart failure and arrhythmias but doesn't address thyroid storm's hyperdynamic state.

Correct Answer: Discontinuation syndrome

Discontinuation syndrome causes flu-like symptoms, dizziness, and mood changes when SSRIs are stopped abruptly, requiring gradual tapering.
Option a is incorrect because serotonin syndrome results from excess serotonin with drug combinations, not SSRI withdrawal.
Option c is incorrect because neuroleptic malignant syndrome occurs with antipsychotics, not SSRI discontinuation effects.
Option d is incorrect because anticholinergic syndrome involves different medications and doesn't result from SSRI withdrawal.

Correct Answer: Single X vulnerability

Males have only one X chromosome, so a single mutated gene causes color blindness without a normal backup.
Option a is incorrect because it describes why females are protected, not why males are more frequently affected.
Option c is incorrect because color blindness genes are on the X chromosome, not the Y chromosome.
Option d is incorrect because hormonal differences don't determine color blindness inheritance, X-linked genetics do.

Correct Answer: Calcimimetics

Calcimimetics trick the parathyroid gland by mimicking increased calcium circulation, reducing parathyroid hormone production without surgical intervention.
Option a is incorrect because bisphosphonates prevent bone loss but don't directly affect parathyroid hormone production.
Option c is incorrect because vitamin D would worsen hypercalcemia by increasing calcium absorption, not reducing it.
Option d is incorrect because calcitonin lowers calcium acutely but doesn't address the parathyroid hormone overproduction.

Correct Answer: Antibiotics

Antibiotics treat the bacterial pneumonia causing parapneumonic effusion, addressing the infection source rather than just fluid symptoms.
Option a is incorrect because diuretics treat heart failure effusions but don't address the infectious cause of parapneumonic effusion.
Option c is incorrect because anticoagulants treat pulmonary embolism effusions, not infection-related parapneumonic fluid accumulation.
Option d is incorrect because bronchodilators treat airway obstruction, not the pleural space infection causing effusion.

Correct Answer: Weight gain, dyslipidemia

Second-generation antipsychotics characteristically cause weight gain, dyslipidemia, and hyperglycemia, collectively creating metabolic syndrome in patients.
Option a is incorrect because movement disorders are more common with first-generation than second-generation antipsychotic medications.
Option c is incorrect because cardiac arrhythmias aren't the primary concern with second-generation antipsychotics' metabolic effects.
Option d is incorrect because kidney dysfunction isn't a characteristic side effect pattern of second-generation antipsychotics.

Correct Answer: Hyperresonant percussion

Hyperresonant percussion indicates air accumulation in pneumothorax, distinguishing it from fluid or consolidation causing decreased breath sounds.
Option a is incorrect because dull percussion suggests fluid accumulation like effusion or hemothorax, not pneumothorax.
Option c is incorrect because normal percussion wouldn't occur with pneumothorax's air accumulation in the pleural space.
Option d is incorrect because flat percussion indicates solid tissue or massive effusion, not air-filled pneumothorax.

Correct Answer: Switch from ACE

Stage four CKD often requires switching from ACE inhibitors to alternative antihypertensives due to hyperkalemia and worsening kidney function.
Option a is incorrect because increasing ACE inhibitors worsens hyperkalemia risk in advanced chronic kidney disease stages.
Option b is incorrect because adding potassium supplements is dangerous with CKD's existing hyperkalemia risk.
Option d is incorrect because thiazides become less effective as kidney function declines in stage four CKD.

Correct Answer: Forty-eight hours

Antiviral medications work best when started within forty-eight hours of influenza symptom onset for maximum effectiveness.
Option a is incorrect because twelve hours is unnecessarily restrictive and may prevent appropriate treatment access.
Option b is incorrect because twenty-four hours is earlier than necessary, though still within the effective window.
Option d is incorrect because seventy-two hours exceeds the optimal window for antiviral effectiveness in influenza.

Correct Answer: Six months

Generalized anxiety disorder diagnosis requires excessive worrying for at least six months with difficulty controlling the worry.
Option a is incorrect because two weeks is too short to differentiate from situational anxiety or adjustment reactions.
Option b is incorrect because one month doesn't meet the duration criteria for generalized anxiety disorder diagnosis.
Option c is incorrect because three months falls short of the six-month requirement for GAD diagnostic criteria.

Correct Answer: Iron overload

Regular transfusions in beta thalassemia cause iron accumulation, making additional iron supplements dangerous and potentially fatal.
Option a is incorrect because allergic reactions aren't the primary concern with iron in transfused thalassemia patients.
Option c is incorrect because kidney damage isn't the main risk of iron supplementation in beta thalassemia.
Option d is incorrect because while liver can be affected, total body iron overload is the primary concern.