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Duke Med 2014, we're almost done! **This quiz is intended as a study aid for the Duke Med Class of 2014** If you're not a Duke Med Student, look for another quiz to play!
60-65% of gastric and duodenal ulcers are caused by this infective agent
If you had arthritis, you might be one of the 5% of patients with gastroduodenal ulcers that get them from use of these substances
Among other causes of PUD is a tumor, the effects of which are referred to as this syndrome
What shape does the infective agent causing PUD have?
There are many tests for detecting colonization with the infective agent. Which is the best balance of cost effectiveness and accuracy?
If you wanted to use a breath test (usually prohibitively expensive) for the PUD-causing organism, an isotope of what compound would be inhaled by the patient?
If using antibiotics to eliminate an infectious cause of PUD, rapidly-evolving resistance means you should use at least this many drugs
Marshall figured out that bismuth is toxic to PUD-causing bacteria. Can it substitute for one of the antibiotics you use?
What other class of acid-reducing drugs helps heal ulcers (so should be part of therapy) and is toxic to these organisms in vitro?
One drug used for first line therapy is a cell wall inhibitor. Name it.
One drug used for first line therapy is a protein synthesis inhibitor. Name it.
One drug used for patients with a penicillin allergy is a source of intracellular free radicals. Name it.
For 'backup' therapy, what drug that you haven't already named will you use?
How long should you medicate to eradicate PUD caused by bacteria?
You studied the mechanism for producing gastric acid, so I don't have to ask you about it, right? (Say yes)
Just to double check, name the primary regulator of acid secretion
Name a competitive antagonist of the receptor for that molecule that reduces acid secretion by about 60%
If you really want to knock out acid production, you can use a drug that irreversibly blocks the H+/K+ ATPase. Name one.
Caveat: the drug you just named has a delivery problem - it's inactivated by acid. Where, then, does its absorption occur?
If you want to promote ulcer healing without changing pH, what is one drug you can use to creat a physical barrier?
Maalox is a great anatacid name - it comes from what two elements, the hydroxides of which neutralize acid?
As mentioned above, pain relievers can cause ulcers. Name a prostaglandin agonist intended to prevent this.
N/V, D, & C
There are three main input signals to the central vomiting center. Name the one that you would shut down with scopolamine.
Name the type of receptor antagonized by scopolamine
Scopolamine is available by prescription. The OTC alternatives also have a side effect of drowsiness because they antagonize what other receptor?
Name an OTC drug for motion sickness
The vagus nerve and the chemoreceptor trigger zone are activated to trigger vomiting by three receptors. Name one.
Name a drug that prevents dopamine from activating one of these receptors
One of the drugs listed above also helps move material along the digestive tract as an agonist of what kind of receptor?
Name a drug that stops the first wave of post-chemo vomiting by acting as a serotonin receptor antagonist
Name a drug that prevents Substance P from activating the vagus nerve and the CTZ
The final part of the post-chemo anti-emetic trio is a glucocorticoid. Which one is used?
Name a patient-related risk factor for post-operative N/V. With two or more, you'll give anti-emetic therapy.
The first line of defense against diarrhea is to increase bulk. In fact, these hygroscopic preparations can also help reduce constipation. Name one.
Name a mu agonist, a peripheral narcotic (OTC because it can't get you high) that reduces GI motility to stop diarrhea
If diarrhea is caused by excess bile salts or certain bacteria, name a drug used to treat it
Pepto-bismol contains a compound that kill H. pylori, increases bicarbonate and mucus production, and inhibits intestinal secretion. Name a preparation of this compound.
For constipation, non-absorbable sugars can draw water into the lumen. Name one.
A stool softener essentially adds grease to the stool. Name one.
Name a stimulant that increases peristalsis to treat constipation
Non-absorbable salts can be used as bowel prep agents. Name the one that can also be used at a low dose to treat constipation.
Name another non-absorbable salt used just for bowel prep
Name the wonder drug for chronic constipation that activates ClC-2 channels and increases chloride secretion into the intestinal lumen
For mild inflammatory bowel disease, name a drug that inhibits prostaglandin and leukotriene synthesis and modulates B-cell responses
For acute flare-ups of IBD (and gout, RA, and osteoarthritis), you'd use a glucocorticoid (you know which ones). Name a purine synthesis inhibitor you can use for chronic therapy of serious IBD.
Now name an anti-TNF alpha humanized chimeric monoclonal antibody that can be used to treat serious IBD
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