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
2
Q
Ménière’s disease
A
Inner ear disorder that causes vertigo, fluctuating sensorineural hearing loss, tinnitus
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
4
Q
Histamine H1 receptor antagonist
vestibular disorders
A
Cyclizine - motion sickness, vestibular disorders
5
Q
Histamine analogue
vestibular disorders
A
Betahistine
6
Q
Muscarinic receptor antagonist
vestibular disorders
A
Hyoscine - motion sickness
7
Q
Dopamine D2 receptor antagonist
vestibular disorders
A
Prochlorperazine - vomiting caused by migraine, vestibular disorders
8
Q
5-Hydroxytryptamine (5-HT3) receptor antagonists
- “setrons”
(vestibular disorders)
A
Ondansetron - cytotoxic drugs or radiation
9
Q
Cannabinoids
vestibular disorders
A
Nabilone - cytotoxic drugs
10
Q
Neurokinin-1 (NK1) receptor antagonists
vestibular disorders
A
Fosaprepitant - cytotoxic drugs
11
Q
Which drugs are used for hyperemesis gravidarum (妊娠劇吐)?
A
Cyclizine
Promethazine
12
Q
What’s an peculiar effect of metoclopramide?
A
Oculogyric crisis
- a prolonged involuntary upward deviation of the eye
13
Q
Impetigo
A
Infection of the epidermis
14
Q
3 types of impetigo
A
Classic
Bullous
Ecthyma
15
Q
Classic impetigo
A
Vesicles surrounded by erythema
Fluid filled lesions break down to form “honey coloured” crusts
16
Q
Bullous impetigo
A
A raised area of skin
Degrades desmosomes - loss of adhesion of superficial epidermis
*Staphylococcus aureus
17
Q
Ecthyma impetigo
A
Ulcerating form
Involves dermal layer
*Streptococcus pyogenes
膿皰瘡
18
Q
Staphylococcus scaled skin syndrome
A
Caused by *staphylococcus aureus - secretes toxins that degrades desmosomes
Bullous impetigo
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
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
21
Q
Signs of cellulitis & erysipelas
A
Erythema (redness)
Swelling
Pain
W or w/o fever
22
Q
What pathogen may cause cellulitis/erysipelas?
A
β-hemolytic streptococcui
- S.pyogenes
- S aggalactiae
23
Q
α-hemolysis
A
Partial hemolysis
- caused by enzymes that denature hemoglobin inside RBC causing greenish discoloration around colony
24
Q
β-hemolysis
A
Complete hemolysis
- caused by enzymes that lyse RBC causing complete clearing around the colony - white colonies
25
γ-hemolysis
No hemolysis
26
Folliculitis
Superficial infection of hair follicles
- Accumulations of bacteria & purulent material (pus) in hair follicles
* Staphylococus aureus
27
3 types of skin abscesses
Trauma
Single hair follicle
Multiple hair follicles
28
Pathogens that cause skin abscess
Staphylococcus aureus
Group A streptococcus
Mycobacterium tuberculosis
Fungi: Coccidiodes, Canida, Cryptococcus
29
Necrotizing fasciitis
Involves skin of mucosa breach
- defined portal of entry
- from outside to inside
壞死性筋膜炎
30
Myonecrosis
No skin/mucosal breach
- no defined portal of entry
- from inside to outside
肌壞死
31
Viral warts
Benign proliferation of skin & mucosa
*HPV
32
Molluscum contagiosum
*poxvirus (aka moolluscum contagiosum virus)
Benign lesions anywhere on body
傳染性軟疣
33
Orf disease
Zoonotic viral skin infection
*parapox virus
Solitary lesions
34
Herpes simplex
Cause localized blistering
| After primary infection, virus resides in dorsal root nerves
35
HSV-1
Mainly oral or facial infections
36
HSV-2
Mainly genital or rectal infections
37
Eczema herpeticum
*HSV
Complication of atopic eczema
- widespread eruption of crusted papules/blisters - not localized
疱疹性濕疹
38
Herpes zoster
*varicella-zoster virus
Primary infection - chickenpox
Recurrent infection - shingles
39
Dermatophytoses
Fungal infections of superficial keratinized structures (skin, hair, nails)
皮膚癬菌
40
Candidiasis
*Candida spp.
White plaques on mucosal areas
Erythema w satellite lesions in skin fold
41
Drugs used topically for skin conditions or to treat disorders in other organs.
(Skin medication)
```
Glucocorticoids
Antimicrobial agents
Hormone antagonists
Vitamin D derivatives
Vitamin A retinoids
```
42
Topical Gluococorticoids
| Skin medication
First thing prescribed when there's skin problem - steroid
only use mild steroids on face
43
Black box warning of topical calcineurin inhibitors
Possible link to cancers, in particular lymphoma and skin cancer
44
Topical Vitamin D Analogues
| Skin medication
Calcipotriene
| Calcitrol
45
Folic acid antagonists
| Psoriasis
Methotrexate
Pemetrexed
Ralitrexed
46
Immunosuppressive/Biological Therapy of psoriasis
Adalimumab
47
TNF-α inhibitors
Infliximab
AE: latent TB
48
Serious adverse effect of TNF-α inhibitors
Latent TB and other serious infections may recur
49
Conjunctivitis
Infection of the conjunctiva
50
Keratoconjunctivitis
Keratitis (Infection of cornea) + Conjunctivitis (Infection of conjunctiva)
51
Chorioretinitis
Infection of choroid/retina
52
Neonatal conjunctivitis
Conjunctivitis in newborn - 4 weeks of age
53
Adult conjunctivitis
Conjunctivitis in > 4 weeks of age
54
Why is there a distinction between newborn and adult conjunctivitis?
Organisms are different
55
Features of bacterial conjunctivitis (2)
```
Red eye (hyperemia)
Discharge
```
56
How does symptoms of gonococcal conjunctivitis differ from chlamydial conjunctivitis?
Gonococcal conjunctivitis - pus discharge
Chlamydial conjunctivitis - watery discharge
57
Trachoma
*certain strains of C. trachomatis
May cause "Chronic follicular conjunctivitis"
58
Viral conjunctivitis (presentation)
"pink eye"
| Watery discharge
59
Keratitis
Infection of cornea
60
Bacterial keratitis
*Pseudomonas aeruginosa
Pain, redness, photophobia, discharge
Hypopyon
61
Hypopyon
Collection of pus at bottom of anterior chamber
62
Viral keratitis
*HSV-1
Dendritic ulcers
Very painful
63
Adenoviral keratitis
Bilateral, usually follows a URT infection conjunctivitis
64
Fungal keratitis
*Candida albicans
Corneal lesions
65
Protozoa causes of keratitis
*Acanthamoeba
Often extremely painful
66
Uveitis
Infection of uveal tract - middle layer of tissue in the eye wall
67
What does anterior uveitis affect?
Ciliary muscle
Posterior chamber
Iris
68
What does posterior uveitis affect?
Choroid
| Retina
69
Is uveitis commonly infectious or non-infectious?
Non-infectious
70
What most commonly causes chorioretinitis?
*Toxoplasma gondii
弓形蟲
71
Toxoplasma retinitis
Protozoan infection
Acute greyish white chorioretinal focal lesion
Chorioretinal scars
弓形體視網膜炎
72
Cytomegalovirus retinitis
Immunocompromised individuals
White retinal lesions
Haemorrhagic
73
HSV/VZV retinitis
Cause acute retinal necrosis
急性視網膜壞死
74
Endophthalmitis
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
Hordeolum (stye)
Localised infection of sebaceous gland
*Staphylococcus aureus
麥粒腫/針眼
76
Blepharitis
Diffuse inflammation of eyelid margin
*Staphylococcus aureus
77
Dacryocystitis
Infection of lacrimal sac
*Staphylococcus aureus
78
Orbital cellulitis (presentation)
Painful
| Proptosis (protrusion of eyeball)
79
Preseptal cellulitis (Periorbital cellulitis)
Infection of eyelid and surrounding skin anterior to the orbital septum
80
Cold sore
*HSV
Reactivation from nerves causes active infection
81
How is HSV confirmed in the lab?
Swab of lesion in virus transport medium - detection of viral DNA by PCR
82
Herpangina
Vesicles/ulcers on soft palate
Painful papulo-vesiculo-ulcerative oral lesions
*Coxsackie virus
83
Painful papulo-vesiculo-ulcerative oral lesions
Herpangina 皰疹性咽峽炎
| mouth blisters, is a painful mouth infection caused by coxsackieviruses
84
Acute pharyngitis
Inflammation of the part of throat behind soft palate (oropharynx)
85
Tonsillitis
Inflammation of the tonsils
86
Self-care management of sore throat (4)
```
Analgesia (paracetemol/ibuprofen)
Medicated lozenges (local anesthetic/antiseptic/analgesics)
Avoid: hot drinks
Increase fluid intake
```
87
The most common bacterial cause of sore throat
*Streptococcus pyogenes
Cause acute follicular tonsillitis
88
Complications of Streptococcus pyogenes
Rheumatic fever 風濕熱
| Glomerulonephritis
89
Diphtheria
*Corynebacterium diptheriae
Severe sore throat w grey white membrane across pharynx
Produce potent exotoxin - cardiotoxic & neurotoxic
白喉
90
Infectious mononucleosis
| "Glandular fever"
*Epstein–Barr virus (EBV)
Protracted but self-limiting
91
2 phases of primary infection with Epstein–Barr virus (EBV)
1. Primary infection in early childhood rarely results in infectious mononucleosis
2. Primary infection in >10 y.o. often causes infectious mononucleosis
92
Candida
*Candida albicans
White patches on red, raw mucous membranes in throat/mouth
93
Acute otitis media
Middle ear infection
URI involving middle ear by extension of infection up the Eustachian tube
*Haemophilus influenzae
94
Why are infants are children more prone to acute otitis media?
Their Eustachian tubes are narrower more horizontal, pathogens can be trapped
95
Infections of middle ear are often ______ with ______ secondary infection
viral; bacterial
96
Otitis externa
| "Swimmer's ear"
Inflammation of the outer ear canal
* Bacterial: Staphylococcus aureus
* Fungal: Aspergillus niger
97
Malignant otitis
Not ear cancer
| Extension of otitis externa into bone surrounding ear canal (mastoid & temporal)
98
Routes of ocular administration
Topical
| Ocular injections
99
What is the ideal for corneal penetration?
Lipid:water:lipid sandwich
100
Epithelium or cornea:
Lipid soluble drugs ______; Hydrophilic drugs ______
(penetrate/limited)
penetrate; limited
Epithelium is lipophilic/hydrophobic
101
Stroma of cornea:
Water soluble drugs ______; Hydrophobic drugs ______
(penetrate/limited)
penetrate; limited
Stroma is lipophobic/hydrophilic
102
What drug has both lipophilic & hydrophilic properties and penetrates cornea easily?
Chloramphenicol
103
Eye discharge in bacterial infection vs viral infection
Bacterial: purulent
Viral: watery
104
Indication of chloramphenicol eye drops
For bacterial conjunctivitis
105
Hypromellose eye drops
Artificial tears - for viral conjunctivitis
106
Treatment of bacterial keratitis (small & large ulcers)
Small: Moxifloxacin
Large: Tobramycin
107
Treatment of Herpes Simplex keratitis
Valacyclovir or Acyclovir
108
Acute sinusitis
Inflammation in the nasal cavity and paranasal sinuses
109
Platinum-based treatment with high-dose cisplatin for?
Chemoradiotherapy for Squamous-cell carcinoma of head & neck
110
Indication of carboplatin-fluorouracil (5-fluorouracil)
For carcinoma of stomach, colon, rectum, breast, head & neck & pancreas
- Inhibit thymidylate synthase → inhibition of DNA synthesis
111
MOA of Cetuximab - EGFR mAb
Specifically binds to EGFR and competitively inhibits binding of EGFR
Inhibits cell growth, inducing apoptosis
112
Checkpoint inhibitor therapy w pembrolizumab & nivolumab
| Drugs/chemotherapy to treat head & neck tumors
Targets immune checkpoints
| Bind to PD-1
113
Platinum analogs
| Drugs/chemotherapy to treat head & neck tumors
Cisplatin
Carboplatin
Oxaliplatin
- act like alkylating agents and kill tumor cells
114
What is the best-selling anti-cancer drug?
Paclitaxel
115
MOA of paclitaxel & docetaxel
Acts as a mitotic spindle poison → inhibition of mitosis & cell division
116
MOA of Etoposide
Inhibit topoisomerase → inhibition of DNA synthesis
117
MOA of chloramphenicol eye drops
Binds reversibly to 50S bacterial ribosome → inhibits microbial protein synthesis
118
Trichromats
1 of the 3 cone types is anomalous
Protanomalous, deuteranomalous, tritanomalous
119
Dichromats
1 of the 3 cone types is missing
Protanope, deuteranope, tritanope
120
Monochromats
No color vision
121
L-cones
Sense long-wavelength (red)
122
M-cones
Sense medium-wavelength (green)
123
S-cones
Sense short-wavelength (blue)
124
Drugs/chemotherapy to treat head & neck tumors
Platinum-based treatment with high-dose cisplatin
Carboplatin-fluorouracil
Cetuximab - EGFR mAb
Checkpoint inhibitor therapy w pembrolizumab & nivolumab
125
Drugs to treat vestibular disorders
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
