Deck 1 Flashcards
PTLD occurrence
highest in?
lowest in?
Highest = intestinal/ multi-organ transplant
Lowest = HSCT/ renal transplant
Mnx of PTLD?
1st line = Lower the immunosuppressant dose
2nd line = Rituximab
Gene responsible for EARLY onset Alzheimers?
Gene responsible for late onset Alzheimers?
Gene reduces risk of Alzheimers most?
early = APP gene - amyloid precursor protein
late = APOE
protective =APOE e2
What drugs inhibit glucuronidation?
Valproate
The rest all induce glucoronidation!
How is F8 released from vWF?
Thrombin activity
When do you start Desmopressin?
NA > 145
+
Urine output > 300 mls/hr for 3 hours
Metastatic Head and neck cancer - 1st line treatment? and 2nd line treatment?
1st line - 5-fluorouracil + Cisplatin
2nd line - nivolumab!
NUDT15 mutation causes increased side effects of what drug?
Azathiopurine
TH17 producing IL17 can be involve in what bone process?
Bone formation and erosion
2nd line therapy for ankylosing spondylitis for both Axial and peripheral Ankylosing spondylitis?
TNFa inhibitor and IL7 blocker
( Adalimumab, Secukinumab) -must continue for 2 years!
What IL promotes entheseal (enthesitis) inflammation?
What IL promotes osteoproliferation?
Enthesitis = IL-23
Osteoproliferation = IL-22
Reactive arthritis associated with what causes more severe chronic disease?
HLA-B27
When treat aortic aneurysm? electively
When license is removed in AAA?
AAA > 5 cm in female, > 5.5 cm in male
when AAA > 5.5cm
Low hepatic extraction ratio drugs?
NCAIDS
N- NSAIDS
CA- Carbamazepine
DI - Diazepam
S - S-warfarin ( commonest type of warfarin)
What protein binds to acid drug?
What protein binds to alkaline drug?
Albumin = Acid
Alkaline/basic = Alpha-1-Glycoprotein
Classes for prescribing drugs in pregnancy and means?
A = Good B1 = Limited woman taking drugs - but no animal studies or data showing it's bad
B2 = animals studies inadequate/lacking
B3 = animals studies shows damage, but unknown in human
C = Causing reversible damage in fetus
D = Damage irreversible
X = Death/lethal
Acamprosate mechanism of action?
Indication
NMDA/GABA modulator
Indication - alcohol dependence = maintain abstinence
non-addictive
Baclofen mechanism of action?
GABA-B Agonist
Disulfiram mechanism of action?
inhibit aldehyde dehydrogenase - more side effects of alcohol
Methadone mechanism of action?
mu opioid receptor agonist
K channel blocker - causes prolonged QTc
Amitriptyline toxicity - what to give?
Sodium bicarbonate
Commonest reason drug remove from market?
Drug induced liver injury - DILI
Morphine act on what receptor?
G-coupled protein receptor ( mu receptor)
diazepam mechanism of action?
GABA agonist - Voltage gated CI channel
Base excess high in the positives means?
amount of acid needed to restore PH to normal value
Metabolic alkalosis
attacking compensating primary respiratory acidosis ( HCO will go up)
Cushing’s
HCI loss via vomiting
Sweet syndrome diagnosis
Major and minor criteria?
Major
- Abrupt onset of tender nodules/plaques
- Dense neutrophilic infiltrate
Minor ( 2 of 4)
- Fever
- After GI/fever/malignancy/DRUG INDUCED - abx
- Elevated CRP/ESR
- Steroids responsive!
when consider Ponticelli treatment in Membranous nephropathy?
(Prednisolone + chlorambucil)
-severe proteinuria > 8g + significant renal dysfunction
Otherwise CYP
Tamoxifen in DCIS?
Reduce recurrence of CONTRALATERAL DCIS
Intention to treat analysis always affect treatment in what ways?
Underestimate it
H.pylori confirmation of eradication test
Abx must stop how many weeks prior to test?
PPI must stop how many weeks prior to test?
ABX - 4 weeks
PPI - 2 weeks
