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MBBS > 203 UG - Disease & Pharmacology > Flashcards

203 UG - Disease & Pharmacology Flashcards

1
Q

Diuretics

A

Thiazide/thiazide-like diuretics - Hydrochlorothiazide

Loop diuretics - Frusemide

Potassium sparing diuretics - Spironolactone

Amiloride

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2
Q

Thiazide/thiazide-like diuretics

A

Hydrochlorothiazide

First line in HT

  • Block the Na+ and Cl- cotransporter (NCC) in the distal convoluted tubule

AE: Hypokalaemia and metabolic alkalosis

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3
Q

Loop diuretics

A

Frusemide

  • Inhibit NaCl reabsorption by the Na+/K+/2Cl–
    Cotransporter (NKCC2) in the thick ascending limb (TAL) of loop of Henle
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4
Q

Potassium-sparing diuretics

A

Spironolactone

  • Aldosterone/mineralocorticoid receptor antagonists in the late distal and cortical collecting tubules
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5
Q

MOA of Amiloride

Diuretics

A

Inhibition of Na+ influx through the epithelial Na+ channels (ENaC) channels in the luminal membrane

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6
Q

Treatments for Lower Urinary Tract Symptoms

A

Alpha1-blockers - Prazosin
5α-reductase inhibitor - Finasteride
Anticholinergic agents - Oxybutynin
Beta-3 adrenergic agonist - Mirabegron

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7
Q

Treatments for Prostate cancer

A

Androgen deprivation therapy

  • Luteinizing hormone-releasing hormone (LHRH) analogs - Goserelin
  • LHRH agonist monotherapy; LHRH agonist with 1st-generation anti-androgen - Flutamide
  • LHRH antagonist - Degarelix
  • Second-generation anti-androgens - Abirateroneacetate
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8
Q

Treatments for Testicular Cancer

A

Cisplatin

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9
Q

Treatments for Bladder/urothelial Cancer

A

Intravesical chemotherapy or BCG, immunotherapy

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10
Q

Treatments for Renal Cancer

A

Sunitinib – multikinase inhibitor

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11
Q

Platinum Analogs and its AE

A

Cisplatin - Nausea, vomiting, nephrotoxicity

Carboplatin - Myelosuppression

Oxaliplatin - Laryngopharyngeal dysesthesias

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12
Q

What is checkpoint inhibitor therapy?

A

For cancer

Targets immune checkpoints which are key regulators of the immune system.

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13
Q

Drugs used in checkpoint inhibitor therapy

A

Pembrolizumab - Humanized immunoglobulin G4 mAb to programmed death-1 (PD-1) receptor.

Nivolumab - PD-1 mAb

Atezolizumab - PD-L1 mAb

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14
Q

Cystitis

A

Lower UTI
infection confined to the bladder

膀胱炎

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15
Q

Pyelonephritis

A

Upper UTI
infection involving the ureters +/ kidneys

腎盂腎炎

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16
Q

Infection vs colonisation

UTI

A

Infection – the presence of bacteria and immune cells, i.e. evidence of active infection.

Colonization – the presence of bacteria, evidence that bacteria have established a symbiotic relationship with the host.

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17
Q

Complicated UTI

A

UTI complicated by

  • systemic symptoms
  • urinary structural abnormality/stones
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18
Q

Bacteriuria

A

Bacteria present in urine
- doesn’t always mean infection

細菌尿

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19
Q

Why do women have a higher risk of having UTI than men?

A
  • short wide urethra
  • proximity of urethra to anus
  • increased risk with sexual activity, pregnancy
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20
Q

Routes of infection of UTI

A 
Ascending infection (common)
Bloodstream (uncommon)
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21
Q

If a person has no infection, where do we normally find pathogens in the urinary tract?

A

Lower end of urethra

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22
Q

Most common cause of uncomplicated UTI

A

E. coli

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23
Q

Important virulence factor for uropathogenic bacteria

A

Gram-negative coliform

Express flagella for motility & pilli for attachment

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24
Q

______ is a key mediator of gram-negative bacteria virulence

A

Lipopolysaccharide

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25
Q

Virulence factor of Proteus sp. infection-causing urolithiasis

A

Urease production

  • breaks down urea to form ammonia, which increases urinary pH - precipitation of salts.
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26
Q

Urolithiasis

A

The presence of calculi (precipitated salts) anywhere along the course of the urinary tracts

尿石症

27
Q

Presence of which 3 UTI symptoms suggest an involvement of upper urinary tract infection

A

Fever
Loin pain
Rigors

28
Q

UTI symptoms

A

Dysuria (pain passing urine)
Frequency of urination
Nocturia
Haematuria

Fever
Loin pain
Rigors

29
Q

When should we give catheterized patients antibiotics?

A

Only if there’s supporting evidence of UTI

30
Q

Asymptomatic bacteriuria in pregnancy is usually?

A

Treated with antibiotics

If left untreated:

  • 20-30% progress to pyelonephritis
  • may lead to intra-uterine growth retardation (IUGR) of premature labor
31
Q

Ideal antibiotic for uncomplicated lower UTI should be:

A

Excreted in urine in high concentration
Oral
Inexpensive
Few side effects

32
Q

How long should gentamicin be prescribed?

complicated UTI or pyelonephritis

A

Maximum 3 days

  • bc narrow TI - may cause toxicity
33
Q

Vertically transmitted pathogens

“TORCHES pathogens”

A 
Toxoplasmosis
Other (Hep B, VZV, HIV, parvovirus B19, enterovirus, LCV)
Rubella
Cytomegalovirus
HErpes simplex virus
Syphilis.
34
Q

Congenital/ in utero/ transplacental infections

A

Passage of microbiological pathogens from mother to foetus during development.
- Via transversing the placenta.

35
Q

Perinatal infections

A

Infection of the neonate via maternal blood/ infected birth canal during birth.

36
Q

Postnatal infections

A

Infection of the neonate via the normal routes (airborne, droplet, bodily fluids, fecal-oral)

37
Q

What characterizes cytomegalovirus?

A

Blueberry muffin rash

38
Q

Gonorrhoea presentation

A

Mucopurulent urethral discharge
- white, creamy, thick

*Neisseria gonorrhoeae

39
Q

Chlamydia presentation

A 
Urethral discharge (milky)
- watery, milky

*Chlamydia trachomatis

40
Q

Reiter’s syndrome

A

Can’t see
Can’t pee (urethritis)
Can’t climb a tree

  • relates conjunctivitis, urethritis & arthritis
41
Q

What characterizes primary syphilis?

A

Chancre lesion

42
Q

Is bacterial vaginosis an STI?

A

No

- but will increase chances of getting STI (chlamydia, trichomoniasis, HIV)

43
Q

Normal vagina pH

A

4 - 4.5

44
Q

What is the most common viral STI?

A

Human papilloma virus

45
Q

HPV presentation

A

Anogenital warts

46
Q

What is the feature of bacterial vaginosis which Trichomnas vaginalis infection?

A

Presence of endosymbionts

47
Q

Candida albicans

A

30% of females colonised w small numbers

48
Q

Candida albicans infection presentation

A

Intensely itchy white vaginal discharge

白色念珠菌

49
Q

Normal vaginal flora contains high levels of?

A

Lactobacillus spp.

50
Q

Definition of infertility

A

Failure to achieve a clinical pregnancy after 12 months of more of regular unprotected sexual intercourse (in absence of a known reason) in a couple who have never had a child

51
Q

Follicular phase

A

When follicle matures

52
Q

Luteal phase

A

When corpus luteum degenerates

黃體期

53
Q

Anovulatory infertility

A

When ovaries do not release an oocyte during a menstrual cycle

54
Q

How does hypogonadotropic hypogonadism cause anovulatory infertility?

A

Lack of GnRH → decreased FSH & LH → follicles do not develop → no ovulation

55
Q

How does hypergonadotropic hypogonadism cause anovulatory infertility?

A

Over-active hypothalamic-pituitary axis → too much GnRH, FSH or LH → follicles do not develop properly → no ovulation

56
Q

How does hyperprolactinemia cause anovulatory infertility?

A

Increased release of prolactin → negative feedback - inhibits GnRH, FSH, LH → decrease FSH & LH → no ovulation

57
Q

Polycystic ovarian syndrome

A

Multiple cysts covering the surface of ovaries → hyperandrogenism → decreases ovulation

58
Q

Premature ovarian failure

A

Depletion of follicles

59
Q

Luteal phase defects

A

Abnormality in corpus luteum → insufficient progesterone production

60
Q

Endometriosis

A

Presence of endometrial glands outside uterine cavity

61
Q

Most cases of recurrent genital herpes are caused by?

A

HSV-2

62
Q

SERM for breast cancer

A

Tamoxifen

63
Q

Tamoxifen act as an ______ on oestrogen receptors in mammary tissue;
Tamoxifen act as an ______ on oestrogen receptors in bone.

A

antagonist; agonist

MBBS (28 decks)

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