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MBBS > 206 SSNS - Disease & Pharmacology > Flashcards

206 SSNS - Disease & Pharmacology Flashcards

1
Q

3 probably sites of action of antiemetic drugs

A

In medulla oblongata:

  • The chemoreceptor trigger zone (CTZ)
  • Vomiting centre
  • Vestibular nuclei
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2
Q

Ménière’s disease

A

Inner ear disorder that causes vertigo, fluctuating sensorineural hearing loss, tinnitus

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3
Q

Treatment of Ménière’s disease & example

A

Low-salt diet
Diuretic - Hydroclorothiazide + Triamterene
Anticholinergic
Antiemetics - Metoclopramide
Antihistamines (w calcium channel blocking activity) - Cinnarizine
Benzodiazepines

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4
Q

Histamine H1 receptor antagonist

vestibular disorders

A

Cyclizine - motion sickness, vestibular disorders

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5
Q

Histamine analogue

vestibular disorders

A

Betahistine

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6
Q

Muscarinic receptor antagonist

vestibular disorders

A

Hyoscine - motion sickness

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7
Q

Dopamine D2 receptor antagonist

vestibular disorders

A

Prochlorperazine - vomiting caused by migraine, vestibular disorders

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8
Q

5-Hydroxytryptamine (5-HT3) receptor antagonists
- “setrons”
(vestibular disorders)

A

Ondansetron - cytotoxic drugs or radiation

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9
Q

Cannabinoids

vestibular disorders

A

Nabilone - cytotoxic drugs

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10
Q

Neurokinin-1 (NK1) receptor antagonists

vestibular disorders

A

Fosaprepitant - cytotoxic drugs

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11
Q

Which drugs are used for hyperemesis gravidarum (妊娠劇吐)?

A

Cyclizine

Promethazine

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12
Q

What’s an peculiar effect of metoclopramide?

A

Oculogyric crisis

- a prolonged involuntary upward deviation of the eye

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13
Q

Impetigo

A

Infection of the epidermis

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14
Q

3 types of impetigo

A

Classic
Bullous
Ecthyma

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15
Q

Classic impetigo

A

Vesicles surrounded by erythema

Fluid filled lesions break down to form “honey coloured” crusts

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16
Q

Bullous impetigo

A

A raised area of skin
Degrades desmosomes - loss of adhesion of superficial epidermis

*Staphylococcus aureus

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17
Q

Ecthyma impetigo

A

Ulcerating form
Involves dermal layer

*Streptococcus pyogenes

膿皰瘡

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18
Q

Staphylococcus scaled skin syndrome

A

Caused by *staphylococcus aureus - secretes toxins that degrades desmosomes

Bullous impetigo

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19
Q

Erysipelas

A

Infection of the dermis - requires a break in skin integrity

Involves upper dermis & superficial lymphatics
Raised lesions
Clear line of demarcation

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20
Q

Cellulitis

A

Infection of the dermis - requires a break in skin integrity

Involves lower dermis & subcutaneous fat
Not raised lesions
Irregular/diffuse inflammation

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21
Q

Signs of cellulitis & erysipelas

A

Erythema (redness)
Swelling
Pain
W or w/o fever

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22
Q

What pathogen may cause cellulitis/erysipelas?

A

β-hemolytic streptococcui

  • S.pyogenes
  • S aggalactiae
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23
Q

α-hemolysis

A

Partial hemolysis

  • caused by enzymes that denature hemoglobin inside RBC causing greenish discoloration around colony
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24
Q

β-hemolysis

A

Complete hemolysis

  • caused by enzymes that lyse RBC causing complete clearing around the colony - white colonies
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25
Q

γ-hemolysis

A

No hemolysis

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26
Q

Folliculitis

A

Superficial infection of hair follicles

  • Accumulations of bacteria & purulent material (pus) in hair follicles
  • Staphylococus aureus
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27
Q

3 types of skin abscesses

A

Trauma
Single hair follicle
Multiple hair follicles

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28
Q

Pathogens that cause skin abscess

A

Staphylococcus aureus
Group A streptococcus
Mycobacterium tuberculosis
Fungi: Coccidiodes, Canida, Cryptococcus

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29
Q

Necrotizing fasciitis

A

Involves skin of mucosa breach

  • defined portal of entry
  • from outside to inside

壞死性筋膜炎

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30
Q

Myonecrosis

A

No skin/mucosal breach

  • no defined portal of entry
  • from inside to outside

肌壞死

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31
Q

Viral warts

A

Benign proliferation of skin & mucosa

*HPV

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32
Q

Molluscum contagiosum

A

*poxvirus (aka moolluscum contagiosum virus)

Benign lesions anywhere on body

傳染性軟疣

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33
Q

Orf disease

A

Zoonotic viral skin infection

*parapox virus

Solitary lesions

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34
Q

Herpes simplex

A

Cause localized blistering

After primary infection, virus resides in dorsal root nerves

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35
Q

HSV-1

A

Mainly oral or facial infections

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36
Q

HSV-2

A

Mainly genital or rectal infections

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37
Q

Eczema herpeticum

A

*HSV

Complication of atopic eczema

  • widespread eruption of crusted papules/blisters - not localized

疱疹性濕疹

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38
Q

Herpes zoster

A

*varicella-zoster virus

Primary infection - chickenpox
Recurrent infection - shingles

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39
Q

Dermatophytoses

A

Fungal infections of superficial keratinized structures (skin, hair, nails)

皮膚癬菌

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40
Q

Candidiasis

A

*Candida spp.

White plaques on mucosal areas
Erythema w satellite lesions in skin fold

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41
Q

Drugs used topically for skin conditions or to treat disorders in other organs.
(Skin medication)

A 
Glucocorticoids
Antimicrobial agents
Hormone antagonists
Vitamin D derivatives
Vitamin A retinoids
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42
Q

Topical Gluococorticoids

Skin medication

A

First thing prescribed when there’s skin problem - steroid

only use mild steroids on face

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43
Q

Black box warning of topical calcineurin inhibitors

A

Possible link to cancers, in particular lymphoma and skin cancer

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44
Q

Topical Vitamin D Analogues

Skin medication

A

Calcipotriene

Calcitrol

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45
Q

Folic acid antagonists

Psoriasis

A

Methotrexate
Pemetrexed
Ralitrexed

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46
Q

Immunosuppressive/Biological Therapy of psoriasis

A

Adalimumab

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47
Q

TNF-α inhibitors

A

Infliximab

AE: latent TB

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48
Q

Serious adverse effect of TNF-α inhibitors

A

Latent TB and other serious infections may recur

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49
Q

Conjunctivitis

A

Infection of the conjunctiva

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50
Q

Keratoconjunctivitis

A

Keratitis (Infection of cornea) + Conjunctivitis (Infection of conjunctiva)

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51
Q

Chorioretinitis

A

Infection of choroid/retina

52
Q

Neonatal conjunctivitis

A

Conjunctivitis in newborn - 4 weeks of age

53
Q

Adult conjunctivitis

A

Conjunctivitis in > 4 weeks of age

54
Q

Why is there a distinction between newborn and adult conjunctivitis?

A

Organisms are different

55
Q

Features of bacterial conjunctivitis (2)

A 
Red eye (hyperemia)
Discharge
56
Q

How does symptoms of gonococcal conjunctivitis differ from chlamydial conjunctivitis?

A

Gonococcal conjunctivitis - pus discharge

Chlamydial conjunctivitis - watery discharge

57
Q

Trachoma

A

*certain strains of C. trachomatis

May cause “Chronic follicular conjunctivitis”

58
Q

Viral conjunctivitis (presentation)

A

“pink eye”

Watery discharge

59
Q

Keratitis

A

Infection of cornea

60
Q

Bacterial keratitis

A

*Pseudomonas aeruginosa

Pain, redness, photophobia, discharge
Hypopyon

61
Q

Hypopyon

A

Collection of pus at bottom of anterior chamber

62
Q

Viral keratitis

A

*HSV-1

Dendritic ulcers
Very painful

63
Q

Adenoviral keratitis

A

Bilateral, usually follows a URT infection conjunctivitis

64
Q

Fungal keratitis

A

*Candida albicans

Corneal lesions

65
Q

Protozoa causes of keratitis

A

*Acanthamoeba

Often extremely painful

66
Q

Uveitis

A

Infection of uveal tract - middle layer of tissue in the eye wall

67
Q

What does anterior uveitis affect?

A

Ciliary muscle
Posterior chamber
Iris

68
Q

What does posterior uveitis affect?

A

Choroid

Retina

69
Q

Is uveitis commonly infectious or non-infectious?

A

Non-infectious

70
Q

What most commonly causes chorioretinitis?

A

*Toxoplasma gondii

弓形蟲

71
Q

Toxoplasma retinitis

A

Protozoan infection

Acute greyish white chorioretinal focal lesion
Chorioretinal scars

弓形體視網膜炎

72
Q

Cytomegalovirus retinitis

A

Immunocompromised individuals

White retinal lesions
Haemorrhagic

73
Q

HSV/VZV retinitis

A

Cause acute retinal necrosis

急性視網膜壞死

74
Q

Endophthalmitis

A

Infection of aqueous/vitreous humor

Devastating infection inside of the eye
Very painful, with decreasing vision
Very red eye
Sight threatening

眼內炎

75
Q

Hordeolum (stye)

A

Localised infection of sebaceous gland

*Staphylococcus aureus

麥粒腫/針眼

76
Q

Blepharitis

A

Diffuse inflammation of eyelid margin

*Staphylococcus aureus

77
Q

Dacryocystitis

A

Infection of lacrimal sac

*Staphylococcus aureus

78
Q

Orbital cellulitis (presentation)

A

Painful

Proptosis (protrusion of eyeball)

79
Q

Preseptal cellulitis (Periorbital cellulitis)

A

Infection of eyelid and surrounding skin anterior to the orbital septum

80
Q

Cold sore

A

*HSV

Reactivation from nerves causes active infection

81
Q

How is HSV confirmed in the lab?

A

Swab of lesion in virus transport medium - detection of viral DNA by PCR

82
Q

Herpangina

A

Vesicles/ulcers on soft palate
Painful papulo-vesiculo-ulcerative oral lesions

*Coxsackie virus

83
Q

Painful papulo-vesiculo-ulcerative oral lesions

A

Herpangina 皰疹性咽峽炎

mouth blisters, is a painful mouth infection caused by coxsackieviruses

84
Q

Acute pharyngitis

A

Inflammation of the part of throat behind soft palate (oropharynx)

85
Q

Tonsillitis

A

Inflammation of the tonsils

86
Q

Self-care management of sore throat (4)

A 
Analgesia (paracetemol/ibuprofen)
Medicated lozenges (local anesthetic/antiseptic/analgesics)
Avoid: hot drinks
Increase fluid intake
87
Q

The most common bacterial cause of sore throat

A

*Streptococcus pyogenes

Cause acute follicular tonsillitis

88
Q

Complications of Streptococcus pyogenes

A

Rheumatic fever 風濕熱

Glomerulonephritis

89
Q

Diphtheria

A

*Corynebacterium diptheriae

Severe sore throat w grey white membrane across pharynx
Produce potent exotoxin - cardiotoxic & neurotoxic

白喉

90
Q

Infectious mononucleosis

“Glandular fever”

A

*Epstein–Barr virus (EBV)

Protracted but self-limiting

91
Q

2 phases of primary infection with Epstein–Barr virus (EBV)

A
  1. Primary infection in early childhood rarely results in infectious mononucleosis
  2. Primary infection in >10 y.o. often causes infectious mononucleosis
92
Q

Candida

A

*Candida albicans

White patches on red, raw mucous membranes in throat/mouth

93
Q

Acute otitis media

A

Middle ear infection
URI involving middle ear by extension of infection up the Eustachian tube

*Haemophilus influenzae

94
Q

Why are infants are children more prone to acute otitis media?

A

Their Eustachian tubes are narrower more horizontal, pathogens can be trapped

95
Q

Infections of middle ear are often ______ with ______ secondary infection

A

viral; bacterial

96
Q

Otitis externa

“Swimmer’s ear”

A

Inflammation of the outer ear canal

  • Bacterial: Staphylococcus aureus
  • Fungal: Aspergillus niger
97
Q

Malignant otitis

A

Not ear cancer

Extension of otitis externa into bone surrounding ear canal (mastoid & temporal)

98
Q

Routes of ocular administration

A

Topical

Ocular injections

99
Q

What is the ideal for corneal penetration?

A

Lipid:water:lipid sandwich

100
Q

Epithelium or cornea:
Lipid soluble drugs ______; Hydrophilic drugs ______

(penetrate/limited)

A

penetrate; limited

Epithelium is lipophilic/hydrophobic

101
Q

Stroma of cornea:
Water soluble drugs ______; Hydrophobic drugs ______

(penetrate/limited)

A

penetrate; limited

Stroma is lipophobic/hydrophilic

102
Q

What drug has both lipophilic & hydrophilic properties and penetrates cornea easily?

A

Chloramphenicol

103
Q

Eye discharge in bacterial infection vs viral infection

A

Bacterial: purulent
Viral: watery

104
Q

Indication of chloramphenicol eye drops

A

For bacterial conjunctivitis

105
Q

Hypromellose eye drops

A

Artificial tears - for viral conjunctivitis

106
Q

Treatment of bacterial keratitis (small & large ulcers)

A

Small: Moxifloxacin
Large: Tobramycin

107
Q

Treatment of Herpes Simplex keratitis

A

Valacyclovir or Acyclovir

108
Q

Acute sinusitis

A

Inflammation in the nasal cavity and paranasal sinuses

109
Q

Platinum-based treatment with high-dose cisplatin for?

A

Chemoradiotherapy for Squamous-cell carcinoma of head & neck

110
Q

Indication of carboplatin-fluorouracil (5-fluorouracil)

A

For carcinoma of stomach, colon, rectum, breast, head & neck & pancreas

  • Inhibit thymidylate synthase → inhibition of DNA synthesis
111
Q

MOA of Cetuximab - EGFR mAb

A

Specifically binds to EGFR and competitively inhibits binding of EGFR

Inhibits cell growth, inducing apoptosis

112
Q

Checkpoint inhibitor therapy w pembrolizumab & nivolumab

Drugs/chemotherapy to treat head & neck tumors

A

Targets immune checkpoints

Bind to PD-1

113
Q

Platinum analogs

Drugs/chemotherapy to treat head & neck tumors

A

Cisplatin
Carboplatin
Oxaliplatin

  • act like alkylating agents and kill tumor cells
114
Q

What is the best-selling anti-cancer drug?

A

Paclitaxel

115
Q

MOA of paclitaxel & docetaxel

A

Acts as a mitotic spindle poison → inhibition of mitosis & cell division

116
Q

MOA of Etoposide

A

Inhibit topoisomerase → inhibition of DNA synthesis

117
Q

MOA of chloramphenicol eye drops

A

Binds reversibly to 50S bacterial ribosome → inhibits microbial protein synthesis

118
Q

Trichromats

A

1 of the 3 cone types is anomalous

Protanomalous, deuteranomalous, tritanomalous

119
Q

Dichromats

A

1 of the 3 cone types is missing

Protanope, deuteranope, tritanope

120
Q

Monochromats

A

No color vision

121
Q

L-cones

A

Sense long-wavelength (red)

122
Q

M-cones

A

Sense medium-wavelength (green)

123
Q

S-cones

A

Sense short-wavelength (blue)

124
Q

Drugs/chemotherapy to treat head & neck tumors

A

Platinum-based treatment with high-dose cisplatin
Carboplatin-fluorouracil
Cetuximab - EGFR mAb
Checkpoint inhibitor therapy w pembrolizumab & nivolumab

125
Q

Drugs to treat vestibular disorders

A

Histamine H1 receptor antagonists - Cyclizine
Histamine analogue - betahistine
Muscarinic receptor antagonists - hyoscine
Dopamine D2 receptors antagonists - prochlorprerazine
5-HT3-receptor antagonists - ordansetron
Cannabinoid - nabilone
NK1 receptor antagonist - fosaprepitant

MBBS (28 decks)

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