Property:AnswerAExp
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Bosentan is a competitive antagonist of endothelin-1 receptors that is used to treat pulmonary hypertension. +
Fomepizole is a potent inhibitor of alcohol dehydrogenase; similar to ethanol, it acts to block the formation of the toxic metabolites. It is primarily used as an antidote to ethylene glycol poisoining. +
The intercostal space contains the intercostal Vein, Artery, and Nerve (VAN) in that order from superior to inferior. +
Glycosylation refers to the addition of a carbohydrate to a protein. The glycosylation of proteins does not target them for degradation. Glycosylation is often necessary for the proper function or folding of the modified protein. One example of a heavily glycosylated protein family is the heparin sulfate proteoglycans. +
GLUT1 is expressed in erythrocytes and the brain. It does not translocate to the cell membrane with exercise. +
The masseter is one of the muscles of mastication, but it is responsible for closing the jaw. +
The internal abdominal oblique lies deep to the external abdominal oblique and superficial to the transversus abdominis. It is responsible for rotation and side-bending of the trunk. In males, the cremaster muscle is attached to the internal abdominal oblique. +
Sumatriptan is a serotonin analogue that acts as a 5-HT<sub>1B/1D</sub> agonist to relieve migraine headaches. +
Hydrochlorathiazide is not particularly helpful in this patient, considering that large doses of thiazide diuretics increase uric acid retention. +
Keratoacanthomas are benign skin growths characterized by a dimpled, keratin filled center. They grow rapidly before spontaneously regressing. +
While ''E. coli'' is the leading cause of urinary tract infections among sexually active women, ''E.coli'' is a gram-negative rod. +
Methimazole is an anti-thyroid drug that inhibits thyroperoxidase, an enzyme essential for the synthesis of T4. Because De Quervain’s thyroiditis eventually causes hypothyroidism, an anti-thyroid drug is not recommended. +
While Coxsackie B virus infection is the most common cause of pleurisy and pericarditis, the chest x-ray in this patient clearly demonstrates a large left-sided pneumothorax. +
''' Correct ''' : This patient has type I heparin-induced thrombocytopenia that is typically characterized by a slight fall in platelet count (< 50%) within the first two days after heparin initiation and often returns to normal with continued heparin administration. The mechanism of the thrombocytopenia is nonimmune and appears to be due to a direct effect of heparin on platelet activation. +
''' Incorrect ''' : LMW heparin should not be substituted for unfractionated heparin after HIT develops. +
''' Incorrect ''' : The 14C-serotonin release assay remains the gold standard among the diagnostic tests for HIT, where platelets from normal donors are radiolabeled with 14C-serotonin are added to patient’s serum along with either high or low heparin concentrations. A positive test is the release of 14C-serotonin when therapeutic (0.1 U/mL) concentrations of heparin are used, rather than high (100 U/mL) concentrations. This assay is not generally available and due to its high cost it is not done routinely. +