2 weeks after a whipple operation, your patient continues to have early satiety with oral intake. You decide to start metoglopramide (Reglan) and erythromycin. What receptor does erythromycin bind to increase gastrointestinal motility?
Motilin (found primarily in the stomach, duodenum, and colon)
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ABSITE
2 weeks after a whipple operation, your patient continues to have early satiety with oral intake. You decide to start metoglopramide (Reglan) and erythromycin. What receptor does erythromycin bind to increase gastrointestinal motility? correct answerMotilin (found primarily in the stomach, duodenum, and colon)
Proteins are synthesized from:
a. mRNA
b. tRNA
c. dsDNA
d. ssDNA correct answermRNA
1 week after an APR, our patient develops urosepsis requiring volume resuscitation, antibiotics, and moderate amounts of levophed and vasopressin. E. coli grows out from the blood cultures. What portion of the lipopolysaccharide complex accounts for its toxicity correct answerLipid A (with gram negative sepsis; stimulator of TNFα)
Steroid hormones:
a. Bind a receptor on the plasma membrane and activate a plasma membrane enzyme
b. Bind a cytoplasmic receptor, enter the nucleus, and affect transcription of proteins
c. Bind a receptor in the nucleus and affect transcription of proteins
d. Do not enter the cell correct answer(b)
Bind a receptor in the cell cytoplasm, enter the nucleus as a steroid-receptor complex, and affect transcription of proteins 4 days after an Ivor-Lewis esophagectomy, you decide to start enteral tube feeding through a J-tube. The long chain fatty acids contained in the tube feeds:
a. Enter the circulation via the portal system
b. Enter the circulation via lymphatics
c. Are only synthesized in the body
d. Are not found in chylomicrons correct answer(b)
Long-chain FAs enter the body through terminal lacteals (absorption through the lymphatic system) either as free LCFAs or as chylomicrons
Medium- and short-chain FAs along with proteins/CHO enter through the portal circulation
Cells divide during what phase of the cell cycle?
a. G1
b. S
c. G2
d. M correct answer(d)
Cells divide during the M phase (most radiosensitive)
Cell cycle length is determined by what phase of the cell cycle?
a. G1
b. S
c. G2
d. M correct answer(a) G1 ↔ G0 phase determines cell cycle length (most variable cell period)
Most RNA/protein synthesis
Of the following, which is the most critical component in the neovascularization of tumor metastases?
a. HER receptor
b. VEGF receptor
c. Neu receptor
d. FGF receptor correct answer(d)
Vascular endothelial growth factor (VEGF) receptor
For its anticoagulation effects, heparin binds:
a. Protein C
b. Protein S
c. Anti-thrombin III
d. Factor VII correct answer(c)
ATIII (heparin-ATIII complex binds thrombin, factor IX, factor X, and factor XI)
7 days after a kidney transplant, your patient develops severe acute rejection with vasculitis on biopsy. You decide to start the monoclonal antibody OKT3. Monoclonal antibodies:
a. Bind 1 epitope at one site
b. Bind 1 epitope at multiple sites
c. Bind multiple epitopes on a single antigen
d. Bind multiple epitopes on multiple antigens correct answer(a) They bind one epitope at the exact same binding site
You start coumadin on a patient with a pulmonary embolus. Three days later, he starts sloughing off skin
across his arms and legs. All of the following are true of this patients most likely condition except:
a. This likely would have been prevented by starting heparin before coumadin
b. Patients with protein C deficiency are more susceptible to this problem
c. The skin sloughing is caused by skin necrosis
d. This is likely due to hemophilia A correct answer(d)
Coumadin-induced skin necrosis occurs in patients started on coumadin without being given heparin first. It results from a relatively hypercoagulable state that can occur in some individuals because of the shorter half-life of protein C & S compared to factors II, VII, IX, and X. Protein C & S ↓ after coumadin before the other factors ↓, resulting in a relatively hypercoagulable state.
While performing a LAR for colon cancer in a patient on chronic dialysis, you notice a significant amount of bloody oozing from your dissection plane. All of the following are true of uremic induced platelet dysfunction except:
a. Down regulates GpIb
b. Down regulates GpIIb/IIIa
c. Stimulates von Willebrand's factor release
d. Treatment of choice is dialysis correct answer(c)
Uremia downregulates GpIb, GpIIb/IIIa, and vWF
Dialysis is the initial treatment of choice for uremic coagulopathy. Other therapeutic options include DDAVP and conjugated estrogens (which stimulate the release of factor VIII and vWF).
The most common blood transfusion reaction is:
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