Immunlogy Flashcards
(102 cards)
1
Q
IBD treatments
A
Azathioprine, ciclosporin, mercaptopurine, and methotrexate
2
Q
Folic and MTX
A
Used to reduce MTX toxicity , given weekly on different day to MTX
3
Q
Antiproliferative drugs
A
Azathioprine or mycophenolate
4
Q
Calcineurin inhibitors
A
Ciclosporin or tacrolimus
5
Q
Other immunosupressantas
A
Sirolimus or corticosteroids
6
Q
Corticosteroid immunosuppresent side effect
A
Suppress clinical signs of infection and allow diseases such as septicaemia or tuberculosis
7
Q
What to give after severe chicken pox exposure
A
Varicella–zoster immunoglobulin (VZIG)
8
Q
What to give after measles exposure
A
Immunoglobulin
9
Q
What is azathioprine metabolised to
A
Mercaptopurine
10
Q
When should azathioprine dose be reduced
A
Allopurinol
11
Q
What antiproliferative drug has a more selective mode of action
A
Azathioprine
12
Q
What corticosteroid has an antitumour effect
A
Prednisolone
13
Q
Ciclosporin side effects
A
Nephrotixic
14
Q
Ciclosporin indication
A
Organ and tissue transplantation, for prevention of graft rejection following bone marrow, kidney, liver, pancreas, heart, lung, and heart-lung transplantation, and for prophylaxis and treatment of graft-versus-host disease
15
Q
What calcineurin inhibitor is more neurotoxic
A
Tacrolimus
16
Q
Sirolimus inhibitor
A
Renal transplant
17
Q
Tacrolimus side effects
A
Neurotoxic, cardiomyopathy, affects glucose metabolism, liver toxicity jaundice
18
Q
What is MS
A
Chronic, immune-mediated, demyelinating inflammatory condition of the central nervous system, which affects the brain, optic nerves and spinal cord, and leads to progressive severe disability
19
Q
Relapsing-remitting MS
A
Periods of exacerbation of symptoms and remission/stability
20
Q
What is secondary progressive MS
A
Progressive disability unrelated to relapses occurs 6-10 years after onset, steadily worsens
21
Q
Active MS disease definition
A
2 clinically significant releases in last 2 years
22
Q
Treating active MS disease
A
Interferon beta, teriflunomide, dimethyl fumarate
23
Q
Drug MS treatment
A
Interferon beta, glatiramer acetate, fingolimod and natalizumab, vit D
24
Q
Very active disease treatment
A
Natalizumab alemtuzumab
25
Secondary progressive MS treatment
Interferon beta
26
Chronic MS symptoms
Neurological dysfunction, fatigue, spasticity, visual problems, and emotional lability
27
Treating MS symptoms
Stop smoking, methylprednisolone
28
Treating MS fatigue/ impaired mobility
Amantadine, exercise
29
MS spasticity treatment
Baclofen, gabapentin, dantrolene, tizanidine, cannabis
30
MS emotional lability treatment
Amitryptyline
31
MS oscilopsia is/treatment
Feeling like always moving, gabapentin, memantine
32
Prostate cancer risk factors
>70 afro caribbean, obesity, family
33
Prostate cancer symptoms
Urinary outflow obstruction, or, pelvic or back pain due to bone metastases
34
How is severity/treatment decided
Baseline prostate specific antigen (PSA) levels, tumour grade (Gleason score), the stage of the tumour, the patient's life expectancy (based on age and comorbid conditions), treatment morbidity, and patient preference.
35
Prostate cancer treatment
Watchful waiting, active surveillance, prostatectomy, radiotherapy (such as external beam), brachytherapy, hormone therapy, and chemotherapy
36
Prostate hormone therapy
Anti-androgen or LHRH or gonadorelin antagonist or bilateral ochidectomy
37
What should be given in conjunction to radical radiotherapy
Androgen deprivation therapy
38
Treating metastatic prostate cancer
Chemo with docetaxel
39
What to give to those hoping to maintain sexual function
Bicalutamide
40
Preventing skeletal events in metastatic prostate cancer
Zoledronic acid
41
What to give metastatic prostate cancer progresses after chemo
Abiraterone with/or prednisolone and enzalutamide
42
When to stop chemo for metastatic prostate cancer
10 cycles
43
Alternative to LHRH treatment
Bilateral orchidectomy
44
LHRH Treatment
Histrelin, triptorelin, goserelin, leuprolide
45
Breast cancer risk factors
Age, early onset of menstruation, late menopause, older age at first completed pregnancy, and a family history, HRT oral contraception
46
LHRH stands for
Luteinizing hormone-releasing hormone (LHRH) agonists
47
What protects against breast cancer
Physical activity, breast feeding
48
Breast cancer types
```
Non invasive =ductal carcinoma
Invasive = spread beyond ducts
Early stage = stage I/II
Locally advanced = stage III
And advanced = stage IV
```
49
Aim of breast cancer treatment
Reduce mortality, increase progression free and disease free survival and improve QoL
50
Different forms of breast cancer treatment
Surgery , radiotherapy ,adjuvant drug therapy, neoadjuvant drug therapy
51
When is tamoxifen recommended
Premenopausal women without history of increased thromboembolic disease or endometrial cancer
52
When is anastrazole used
Postmenopausal women without severe osteoporosis
53
What breast cancer drug may lead to early meopause
Tamoxifen
54
Drugs to stop in breast cancer
HRT
55
Relieving menopausal symptoms
SSRI for hot flushes in those not taking tamoxifen, or clonidine, venlafaxine and gabapentin
56
When is tamoxifen recommended
Tamoxifen is recommended for premenopausal women who do not have a history of, or increased risk of thromboembolic disease or endometrial cancer
57
How long should chemoprevention be given
5 years
58
When should chemoprevention be offered
Given to all those at high risk
59
Biological treatment in advanced breast cancer
Trastuzumab and paclitaxel
60
First line treatment in advanced breast cancer
Chemo
61
Adjuvant breast bisphosphonate therapy
Zoledronic and sodium clodronate, improve disease-free survival and overall survival in postmenopausal women with node-positive invasive breast cancer
62
Adjuvant biological breast treatment
Trastuzumab if HER2 positive invasive
63
Adjuvant endocrine breast therapy
Tamoxifen as reducing oestrogen may reduce progression in premenopausal or aromatase inhibitor (zole-anastrazole) in post-menopausal
64
Predictive factors
(ER), progesterone receptor (PR), and human epidermal growth receptor 2 (HER2) status of the primary tumour
65
Alternative to radiotherapy
Adjuvant endocrine therapy for minimum of 5 years
66
Treatment of early / locally advanced breast cancer
Surgery to breast/axillary lymph nodes with/without radiotherapy (if recurrence likely use) possibly followed by adjuvant drug therapy
67
Cytotoxic side effects
Extravasation, oral mucositis, tumour lysis syndrome, hyperuricemia, bone marrow suppression, alopecia, thromboembolism,
68
What cancer drugs don’t cause bone marrow suppression
Vincristine, bleomycin
69
How should vincristine be used
IV
70
When is broad Abx needed for neutropenia
Neutrophil count less than 1.06×10^9/litre
71
When to prevent hyperuricaemia
When chemo associated with acute renal failure
72
Who is at risk of tumour lysis syndrome
Non-Hodgkin’s lymphoma (especially if high grade and bulky disease), Burkitt’s lymphoma, acute lymphoblastic leukaemia and acute myeloid leukaemia
73
What commonly causes mucositis
Fluorouracil, methotrexate, and the anthracyclines
74
Mucositis prevention
Oral hygiene (sucking ice when getting flurouracil infusion)
75
Treating sore mouth/mucositis
Saline mouthwash, anti-inflammatory/antiseptic mouthwash
76
Cancer drugs causing permanent male sterility
Alkylating drug/procarbazine
77
Mildly emetogenic
Fluorouracil, etoposide, methotrexate (<100mg/m2), the vinca alkaloids, and abdominal radiotherapy
78
Moderately emetogenic
Taxanes, doxorubicin hydrochloride, intermediate and low doses of cyclophosphamide, mitoxantrone, and high doses of methotrexate (0.1– 1.2 g/m2).
79
Highly emetogenic
Cisplatin, dacarbazine, and high doses of cyclophosphamide
80
Treating low risk emesis
Dexamethasone, lorazepam
81
Treating high risk emesis
5ht3 receptor antagonist + dexamethasone, aprepitant
82
5ht3 receptor antagonis
ondansetron, granisetron, dolasetron, and palonosetron
83
Treating delayed CINV
Metoclopramide, dexamethasone, rolapitant
84
Anthracycline side effects
Extravasation cardiotoxic
85
Anthracycline drugs
Doxorubicin, daunorubicin, epirubicin and idarubicin
86
Folic acid uses
Counteract folate antagonist action of methotrexate, used in methotrexate overdose
87
Methotrexate side effects
Liver toxicity (jaundice), GI toxicity (inflamed mouth) nausea, vomiting, blood disorder dyspnoea, cough, mucositis
88
Folinic acid and tripethoprim
Does not counteract antibacterial activity
89
Why is folinic used with fluorouracil
Better response rate in metastatic colorectal cancer
90
Causes of cystitis
oxazaphosphorines, cyclophosphamide and ifosfamide
91
Treating cystitis/urothelial toxicity
Mesna
92
What cancer drugs shouldn’t be used with radiotherapy
Anthracycline as increases toxicity
93
Doxorubicin indications
Acute leukaemia’s, Hodgkin’s and non-Hodgkin’s lymphomas, paediatric malignancies, and some solid tumours including breast cancer.
94
Vinca alkaloid indications
Leukaemia’s, lymphomas, and some solid tumours
95
Vinca examples and derivatives
Vinca alkaloids, vinblastine sulfate, vincristine sulfate, and vindesine sulfate. Vinorelbine is a semi-synthetic vinca alkaloid. Involved in treatment of breast cancer.
96
Vinca examples and derivative
Vinca alkaloids, vinblastine sulfate, vincristine sulfate, and vindesine sulfate. Vinorelbine is a semi-synthetic vinca alkaloid. Involved in treatment of breast cancer.
97
Alkylating mechanism
Damage DNA so interfere with cell replication
98
Cyclophosphamide indication
Wide range of malignancies, including some leukaemias, lymphomas, and solid tumours, rheumatoid arthritis
99
Cyclophosphamide side effects
Agranulocytosis, alopecia, bone marrow CYSTITIS, decreased leucocytes fever haemorrhage, neutropenia, sperm abnormalities, thrombocytopenia
100
Carmustine use
Multiple myeloma, non-Hodgkin’s lymphomas, Hodgkin's disease, and brain tumour
101
Estramustine use
Used in prostate cancer
102
Taxane example
Paclitaxel, Docetaxel
