ABEM Pharmacology & Medical Management Flashcards

Which medication class can cause a length-dependent peripheral neuropathy as a side effect?

Answer: Platinum-based chemotherapy agents

Cisplatin and other platinum-based chemotherapeutics cause a sensory-predominant length-dependent neuropathy by accumulating in dorsal root ganglia neurons.

Pyridostigmine is used in myasthenia gravis because it:

Answer: Inhibits acetylcholinesterase, increasing synaptic ACh

Pyridostigmine inhibits acetylcholinesterase, preventing breakdown of acetylcholine and prolonging its availability at the neuromuscular junction.

A patient with Lambert-Eaton Myasthenic Syndrome (LEMS) would most likely benefit from which pharmacological agent?

Answer: 3,4-Diaminopyridine (amifampridine)

3,4-Diaminopyridine blocks presynaptic potassium channels, prolonging the action potential and increasing calcium influx to enhance ACh vesicle release.

Which vitamin deficiency is classically associated with a peripheral neuropathy affecting both sensory and motor fibers?

Answer: Vitamin B12 (cobalamin)

Vitamin B12 deficiency causes subacute combined degeneration affecting the dorsal columns and peripheral nerves, producing a sensorimotor neuropathy.

Corticosteroids are used in inflammatory myopathies such as polymyositis primarily because they:

Answer: Suppress the aberrant immune-mediated attack on muscle

Corticosteroids suppress the autoimmune inflammatory cascade that causes muscle fiber destruction in inflammatory myopathies.

Which drug used in the treatment of ALS has been shown to modestly slow disease progression?

Answer: Riluzole

Riluzole, a glutamate release inhibitor, is FDA-approved for ALS and modestly extends survival by reducing excitotoxic motor neuron injury.