Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

402 EXAM > INFECTION > Flashcards

INFECTION Flashcards

1
Q

How can pathogens enter the body?

A

Eyes, mouth, nose, airways, uro-genital tract, skin, rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Immune system definition?

A

the collection of organs, tissues, cells, and cell products, whose role is to differentiate self from nonself.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Four key processes of the immune system?

A

Prevention
Recognition
Elimination
Memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the first line of defence of the immune system?

A

Physical and chemical barriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the second line of defence of the immune system?

A

Innate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the third line of defence of the immune system?

A

Adaptive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is the skin adapted to prevent pathogens entering?

A

Tough outer layer of cells that produce keratin
Has oleic acid that can kill some bacteria
Secretes lysozyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is lysozyme?

A

An enzyme present in skin, tears and saliva that can break down the outer wall of some bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is oleic acid?

A

non-essential omega-9 fatty acid produced by the body which supports the skin barrier as it can kill some bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are mucosal membranes adapted to prevent pathogens entering?

A

Secretes mucus which traps foreign particles and pathogens
Some contain cilia to sweep mucus and particles out of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the overall distinguishing feature of the innate immune system?

A

Inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The vast majority of infections are cleared by?

A

Innate immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Remember the defining characteristic of the immune system is to discriminate self from non-self
How is achieved in two ways for innate immunity?

A

Cells contain receptors that recognise common constituents of pathogens
The bodies own cells contain inhibitory mechanisms that prevent attacks on self

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do pattern recognition receptors found on host cells recognise and bind to?

A

Pathogen Associated Molecular Patterns (PAMPs)
Damage/Danger Associated Molecular Patterns (DAMPs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What cell receptors recognise PAMPs/DAMPs?

A

Pattern Recognition receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

An example of a Pattern Recognition receptor?

A

Toll like receptors (TLRs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does TLR4 detect?

A

Lipopolysaccharide from gram-negative bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What toll like receptor detects lipopolysaccharide from gram-negative bacteria?

A

TLR4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does TLR3 detect?

A

Double-stranded DNA which is common in viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What toll like receptor detects double-stranded DNA which is common in viruses?

A

TLR3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does TLR2 detect?

A

Lipoteichoic acid from gram-positive bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What toll like receptor detects lipoteichoic acid from gram-positive bacteria?

A

TLR2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the cells involved in the innate immune system?

A

Mast cells
Dendritic cells
Macrophages
Basophils
Natural killer cells
Complement proteins
Eosinophils
Neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What do phagocytes do?

A

Engulf and destroy other cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are granulocytes?

A

Types of white blood cell which are professional phagocytes and have granular cytoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Three types of granulocytes?

A

Basophils
Neutrophils
Eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the most common type of granulocyte?

A

Neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Neutrophil appearance?

A

Multi-lobed nucleus
Granules in cytoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Main functions of neutrophils?

A

Phagocytosis
Release of antimicrobial substances
Neutrophil Extracellular Traps
Chemotaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How to neutrophils phagocytose?

A

Recognise pathogen via PAMP/DAMP, extend cells membrane around pathogen, engulf pathogen into vesicle, vesicle fuses with a lysosome to break it down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What antimicrobial substances can neutrophils secrete?

A

Myeloperoxidase
Collagenase
Lysozyme
Reactive oxygen species
Nitric oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are neutrophil extracellular traps?

A

Neutrophils can release their DNA and proteins to form sticky webs that trap pathogens making it easier for other immune cells to destroy them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What attracts neutrophils to the site of infection?

A

Chemotactic signals from activated macrophages, peptide fragments of cleaved complement proteins and some PAMPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Roles of macrophages?

A

Phagocytosis
Immune response activation, they present antigens to T-cells
Wound healing
Cytokine production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which are larger, neutrophils or macrophages?

A

Macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What type of nucleus does an eosinophil have?

A

Bi-lobed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What type of nucleus does a neutrophil have?

A

multi-lobed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Main functions of eosinophils?

A

Parasite defence
Allergic reactions
Asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is pus?

A

Dead neutrophils/pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How do natural killer cells work?

A

Check if cells have appropriate immune recognition cells on surface. If not they are likely cancerous or infected so they are persuaded to commit apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Four symptoms of inflammtion?

A

Pain
Redness
Heat
Swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is dolor?

A

Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is rubor?

A

Redness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is calor?

A

Heat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is turgor?

A

Swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What causes the symptoms of inflammation?

A

Blood vessels dilate, leading to local swelling
and the accumulation of components of the
immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Where are mast cells found?

A

In mucosal tissues, not in circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Antibody composition?

A

Tetrameric, with four polypeptide chains
2 identical heavy chains (H) and two identical light chains (L), held together by covalent disulphide bonds at the hinge and between H and L chains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Types of antibodies?

A

IgG
IgM
IgD
IgA
IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Where is IgG found?

A

Free in blood plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Where is IgM found?

A

Surface of B cell
In blood plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Where is IgD found?

A

Surface of B cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Where is IgA found?

A

Saliva
Tears
Milk
Other body secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Where is IgE found?

A

Secreted by plasma cells in skin and tissues surrounding GI and respiratory tracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Where do T cells develop?

A

Thymus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Where do B cells develop?

A

Bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What do MHCs do?

A

help the immune system distinguish between self and non-self and determine whether to attack or leave a cell alone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Where are MHC class I found?

A

All nucleated cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Where are MHC class II found?

A

Some immune cells such as macrophages, dendritic cells and B cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Types of T-cell?

A

T-helper (CD4+)
T-regulatory (CD4+)
T-cytotoxic (CD8+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is inflammation?

A

A biological response to harmful stimuli, characterized by symptoms such as pain, redness, heat, and swelling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What leads to local swelling during inflammation?

A

Dilation of blood vessels and accumulation of immune system components.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What do activated macrophages secrete during inflammation?

A

Cytokines, including chemokines that attract neutrophils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are some examples of cytokines involved in inflammation?

A
  • TNF-α
  • Prostaglandins
  • Leukotrienes
  • Platelet activating factor
  • C5a
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is chronic inflammation?

A

A persistent inflammatory response caused by factors such as pathogens, tumors, autoimmunity, and tissue damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What are some causes of chronic inflammation?

A
  • Pathogen
  • Tumours
  • Autoimmunity
  • Atherosclerosis
  • Heart disease
  • Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is Inflammatory Bowel Disease (IBD)?

A

A condition including Ulcerative colitis and Crohn’s disease, characterized by an immune reaction to gut microbiota.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is Crohn’s Disease?

A

An inflammatory condition where macrophages recruit TH1 cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is Coeliac Disease?

A

An autoimmune disease mediated by CD4+ T cells leading to B cell activation and IgA release.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is Rheumatoid Arthritis?

A

An autoimmune disease causing chronic inflammation of the joints, affecting multiple body systems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What do antibodies produced in Rheumatoid Arthritis react to?

A

The Fc region of IgG.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What happens to IgM-IgG complexes in Rheumatoid Arthritis?

A

They are deposited in joints and activate the complement cascade, causing type III hypersensitivity reaction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What are the three types of lymphoid organs?

A
  • Primary Lymphoid Organs
  • Secondary Lymphoid Organs
  • Tertiary Lymphoid Organs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

True or False: Ulcerative colitis and Crohn’s disease are classified as autoimmune diseases.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is autoimmunity?

A

The breaking of self tolerance leading to response to self antigens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What happens during the process of self tolerance?

A

Self reactive cells are inactivated or undergo death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are the types of tolerance mechanisms involved in autoimmunity?

A
  • Central tolerance
  • Peripheral tolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What can trigger the development of autoimmunity?

A

Infection can break self-tolerance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What characterizes Type II autoimmune diseases?

A

Cytotoxic, antibody-dependent disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What occurs when antibodies bind to cell surface receptors in Type II autoimmune diseases?

A

They either prevent endogenous ligand binding or mimic ligand effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is Graves disease associated with?

A

Hyperthyroidism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What does Myasthenia Gravis lead to?

A

Progressive muscle paralysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What defines Type III autoimmune diseases?

A

Immune complex disease where antibodies bind to soluble antigens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is a common autoimmune disease affecting 1-2% of the population?

A

Rheumatoid Arthritis (RA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is a significant characteristic of RA?

A

Joint destruction and chronic disability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is the role of B cells in Rheumatoid Arthritis?

A

They produce autoantibodies known as Rheumatoid Factor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What is the prevalence of Rheumatoid Factor in RA patients?

A

Found in ~80% of RA patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What cytokines are secreted by B cells in RA?

A
  • TNFα
  • TNF-like molecules
  • IL-6
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What type of hypersensitivity is Type IV autoimmune disease?

A

Delayed type hypersensitivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What cells are primarily involved in Type IV hypersensitivity?

A

T-lymphocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is Coeliac disease classified as?

A

A type IV hypersensitivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What causes the pathology in Coeliac disease?

A

An immune response to the food allergen gluten.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What is the consequence of the immune response in Coeliac disease?

A

Loss of intestinal villi and severe inflammation of the intestine wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What is a major challenge in treating autoimmune diseases?

A

Suppression of the immune system increases susceptibility to infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is the role of antigen-presenting cells in Type IV autoimmune diseases?

A

Macrophages stimulate the proliferation of CD4+ T cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is a consequence of activated CD8+ T cells in Type IV autoimmune diseases?

A

They destroy target cells on contact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What is the significance of immune complexes in Type III autoimmune diseases?

A

They initiate local inflammatory reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What genetic element is associated with Coeliac disease?

A

The MHC receptor that binds peptides with glutamic acid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the socio-economic impact of Rheumatoid Arthritis?

A

It presents a serious socio-economic burden.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is the typical age range for the onset of Rheumatoid Arthritis?

A

Individuals between the ages of 25-35.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

True or False: Type IV autoimmune diseases are antibody mediated.

A

False.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What is hypersensitivity?

A

An inappropriate immune response to harmless antigens or self-antigens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What are the different forms of hypersensitivity?

A

Type I, Type II, Type III, and Type IV hypersensitivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What is the major immune reactant involved in Type I hypersensitivity?

A

IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What does sensitisation in Type I hypersensitivity involve?

A

Production of an IgE response to an innocuous antigen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What type of cells are activated upon subsequent exposure to an allergen in Type I hypersensitivity?

A

Mast cells and basophils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What is atopy?

A

A predisposition to develop allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What role does IgE play in the immune system?

A

Clearing worm infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What hypothesis is proposed regarding the increase in atopic allergic disease?

A

Hygiene hypothesis, modified as counter-regulation hypothesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What cytokine is involved in class switching to IgE production?

A

IL-4.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What is atopic dermatitis?

A

A form of eczema characterized by itchy, red, dry, and cracked skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What is the prevalence of atopic dermatitis in young children?

A

10% to 20% in the first decade of life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What are the severe symptoms of atopic dermatitis?

A

Cracked, sore, and bleeding skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What can result from injecting an antigen directly into the bloodstream?

A

Anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What is anaphylaxis?

A

A severe allergic reaction that can lead to catastrophic loss of blood pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What are Type II hypersensitivity reactions often caused by?

A

Some drugs, e.g., penicillin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What happens in Type II hypersensitivity involving penicillin?

A

The drug binds to RBCs, inducing an antibody response and causing anemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What are Type III hypersensitivity reactions?

A

Reactions that arise from stimulation with soluble antigens causing immune complex disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What is an example of a Type III hypersensitivity reaction?

A

Serum sickness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

What mediates Type IV hypersensitivity reactions?

A

Antigen specific effector T cells of TH1 or CD8+ subtypes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What is an example of a Type IV hypersensitivity reaction?

A

Coeliac disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Fill in the blank: The major role of ___ is in clearance of worm infections.

A

IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

True or False: Environmental factors play a role in the development of allergies.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What condition can mild activation of mast cells lead to?

A

Urticaria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What can severe activation of mast cells lead to?

A

Anaphylactic shock.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

What is a common food allergy example?

A

Peanut allergy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What is the role of Treg cells in allergy?

A

Suppressing TH2 cytokine production.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

What are the consequences of decreased microbial stimulation?

A

Reduced production of Treg cells, leading to increased atopy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

What is the immune reactant in Type I reaction?

A

IgE

Type I reactions are mediated by Immunoglobulin E (IgE) antibodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

What is the allergic determinant in Type I reaction?

A

Soluble

Type I reactions typically involve soluble allergens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

What does the immune reactant binding to allergen trigger in Type I reaction?

A

Mast cell degranulation

This leads to the release of histamines and other mediators.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Some example conditions of Type I reaction?

A
  • Allergic rhinitis
  • Asthma
  • Anaphylaxis

These conditions are common manifestations of Type I hypersensitivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

What is the immune reactant in Type II reaction?

A

IgG or IgM

Type II reactions are mediated by Immunoglobulin G (IgG) or Immunoglobulin M (IgM) antibodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

What is the allergic determinant in Type II reaction?

A

Cellular

Type II reactions typically involve cellular antigens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

What does the immune reactant binding to allergen trigger in Type II reaction?

A

Complement activation and cell lysis

This can lead to the destruction of target cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Some example conditions of Type II reaction?

A
  • Hemolytic anemia
  • Goodpasture syndrome
  • Graves’ disease

These conditions exemplify Type II hypersensitivity reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What is the immune reactant in Type III reaction?

A

IgG

Type III reactions are primarily mediated by Immunoglobulin G (IgG) antibodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

What is the allergic determinant in Type III reaction?

A

Soluble

Type III reactions involve soluble immune complexes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

What does the immune reactant binding to allergen trigger in Type III reaction?

A

Inflammation and tissue damage

This occurs due to the deposition of immune complexes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Some example conditions of Type III reaction?

A
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Serum sickness

These are examples of conditions associated with Type III hypersensitivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

What is the immune reactant in Type IV reaction?

A

T cells

Type IV reactions are mediated by T lymphocytes (T cells).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

What is the allergic determinant in Type IV reaction?

A

Cellular

Type IV reactions involve cellular antigens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

What does the immune reactant binding to allergen trigger in Type IV reaction?

A

Delayed-type hypersensitivity response

This leads to inflammation and tissue damage over time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Some example conditions of Type IV reaction?

A
  • Contact dermatitis
  • Tuberculin skin test
  • Graft-versus-host disease

These conditions represent Type IV hypersensitivity reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

What is the lymphatic system?

A

A network of vessels and nodes that conveys lymph, returning plasma-derived interstitial fluids to the bloodstream and integrating the immune system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

What are the primary functions of the lymphatic system?

A
  • Defend the body against pathogens
  • Develop body immunity
  • Remove excess fluids
  • Absorb and transport fats
  • Produce immune cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Where do immune cells develop?

A

In the primary lymphoid organs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

What are the primary lymphoid organs?

A
  • Bone marrow
  • Thymus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

What is the role of haematopoietic stem cells?

A

They reside in the bone marrow and are responsible for blood formation (haematopoiesis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

What is the function of the thymus?

A

T-lymphocytes complete maturation in the thymus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

What is a bone marrow transplant?

A

A method to treat certain types of cancer, including leukemia and lymphoma, often referred to as stem cell transplants.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

What are secondary lymphoid organs?

A

Organs where the immune response is initiated, including lymph nodes, spleen, and mucosa-associated lymphoid tissue (MALT).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

What is the function of the spleen?

A

Organizes the immune response against blood-borne pathogens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

What are the distinct regions of lymph nodes?

A
  • Cortex
  • Follicle
  • Para-cortex
  • Medulla
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

What is Mucosa-Associated Lymphoid Tissue (MALT)?

A

Tissue that organizes responses to antigens entering mucosal tissues, including tonsils and Peyer’s patches.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

What are the four classic signs of inflammation?

A
  • Dolor: pain
  • Rubor: redness
  • Calor: heat
  • Turgor: swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

What role do macrophages play in the immune response?

A

They recognize, engulf, and destroy foreign invaders and inform other immune cells about the invaders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

What are cytokines?

A

Signaling molecules secreted by immune system cells that mediate inflammation and immunity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

What is the difference between innate and adaptive immunity?

A

Innate immunity is activated by chemical characterization of the antigen, while adaptive immunity is antigen-specific.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What is rheumatoid arthritis?

A

An autoimmune disease characterized by chronic inflammation of the joints and can affect other systems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

What triggers chronic inflammation?

A
  • Pathogen
  • Tumours
  • Autoimmunity
  • Atherosclerosis
  • Heart disease
  • Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

What is the acute phase response?

A

An intrinsic body defense during acute illnesses involving changes in the production of blood proteins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Fill in the blank: The major histocompatibility complex is abbreviated as _______.

A

MHC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

True or False: T-lymphocytes complete maturation in the bone marrow.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

What are the components involved in the immune response?

A
  • TNF-α
  • Chemokines
  • Prostaglandins
  • Leukotrienes
  • Platelet activating factor
  • C5a
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

What are the 7 types of eczema?

A
  1. Atopic Eczema
  2. Seborrhoeic Eczema
  3. Nappy Rash
  4. Contact Dermatitis
  5. Dyshidrotic Eczema
  6. Stasis Dermatitis
  7. Neurodermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

What is Atopic Eczema?

A

An immune system induced condition that is more common in children and often develops before their first birthday

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

What are common symptoms of Atopic Eczema?

A

Mild: dry, scaly, red, itchy
Severe: weeping, crusting, bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

What are common trigger factors for Atopic Eczema?

A
  • Soap and detergents
  • Skin infection
  • House-dust mites
  • Animal dander
  • Pollens
  • Overheating
  • Rough clothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

What are Emollients?

A

Moisturising treatments applied topically to soothe, smooth, protect, and hydrate the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

What is Complete Emollient Therapy?

A

A way of keeping skin moisturised by using a combination of products liberally and frequently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

What is the recommended application frequency for emollients?

A

At least 3-4 times a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

What is the concern with Aqueous cream as an emollient?

A

Can cause skin reactions such as stinging, burning, itching, and redness in some patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

What should be done if a patient reports irritation from Aqueous cream?

A

Discontinue treatment and try an alternative emollient that does not contain SLS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

What are the four potencies of topical corticosteroids?

A
  • Mild
  • Moderate
  • Potent
  • Very potent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

What is the recommended application method for topical corticosteroids?

A

Applied thinly to affected areas only, no more than twice a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

What is the purpose of using corticosteroids in eczema treatment?

A

To reduce inflammation and irritation during flare-ups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

What is Seborrhoeic Eczema commonly known as?

A

Cradle cap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

What are the characteristics of Seborrhoeic Eczema?

A

Greasy, yellow or brown scaly patches that appear on the scalps of young babies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

What should be avoided to prevent cradle cap complications?

A

Do not pick at the scales as it may prompt an infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

What is the primary cause of Nappy Rash?

A

Prolonged exposure to urine and/or faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

What are the signs of a bacterial infection in nappy rash?

A

Marked redness with exudate, and vesicular and pustular lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

What is the treatment for fungal infection related to nappy rash?

A

Antifungal cream, such as Clotrimazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

When should a doctor be consulted for nappy rash?

A

If it spreads to other areas or worsens despite treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

What is the application direction for emollients?

A

Apply in a downward motion, following the direction of the hairs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

What is the purpose of using emollients in eczema management?

A

To hydrate the skin, reduce itching/scratching, and prevent secondary infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

What is Finger Tip Dosage Unit (FTDU)?

A

Length of cream/ointment from the tip of an adult index finger to the crease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

What should be done before applying corticosteroids?

A

Apply emollient up to 20 minutes before to hydrate the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

What is an example of an antifungal cream?

A

Clotrimazole

Clotrimazole is commonly used to treat fungal infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

When should barrier preparations be applied in relation to candidal infections?

A

After the candidal infection has settled.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

What are the types of conditions associated with Nappy Rash?

A

Bacterial and Fungal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

When should a doctor be consulted regarding Nappy Rash?

A

If it is spreading to other areas, getting worse or not responding to treatment, bacterial infection is present or suspected, fungal infection coexists with oral thrush, or systemic symptoms like fever occur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

What factors influence prescribing?

A

Factors include:
* Readily available
* Selectively toxic against a range of organisms
* Site of infection
* Mode of administration
* Chemically stable
* Metabolism and excretion
* Duration of treatment
* Toxicity
* Cost
* Local rates of resistance

These factors help determine the most effective antibiotic for a patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

What are the characteristics of an ideal antibiotic?

A

Characteristics include:
* Appropriate spectrum of activity
* No toxicity to the host
* Low propensity for resistance development
* No hypersensitivities induced
* Rapid and extensive tissue distribution
* Relatively long half-life
* Free of drug interactions
* Convenient administration
* Relatively inexpensive
* Chemically stable

An ideal antibiotic should effectively treat infections without harming the patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

Name two Gram-positive rods that produce antibiotics.

A

Examples include:
* Bacillus subtilis: Bacitracin
* Bacillus polymyxa: Polymyxin

These microbes are known for their antibiotic production.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

What is the definition of an antibiotic?

A

An antibiotic is a substance produced by a microorganism that inhibits the growth of another microbe in low concentrations.

Antibiotics can be derived from natural sources, semi-synthetic, or synthetic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

What type of drugs are relatively easy to develop?

A

Antibacterials are relatively easy to develop due to the differences between prokaryotic and eukaryotic cells.

This allows for low toxicity in antibacterial drugs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

Which type of drugs are the most difficult to develop?

A

Antivirals are the most difficult to develop because viruses use host cell enzymes and machinery for reproduction.

This complicates targeting the virus without affecting the host.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

What is the key to antimicrobial chemotherapy?

A

The key is selective toxicity.

This means that the drug should target the pathogen without harming the host.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

What is Minimum Inhibitory Concentration (MIC)?

A

MIC is the minimum concentration of antibiotic required to inhibit the growth of the test organism.

It is a crucial measurement in determining antibiotic effectiveness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

What is the difference between bacteriostatic and bactericidal?

A

Bacteriostatic inhibits growth, while bactericidal kills the organism.

Understanding this difference is important for selecting appropriate treatments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

What are common targets of antimicrobial agents?

A

Targets include:
* Inhibit cell wall production
* Inhibit protein synthesis
* Inhibit nucleic acid synthesis
* Block biosynthetic pathways
* Disrupt bacterial membranes

These targets help disrupt essential functions of pathogens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

What is antibiotic resistance?

A

Antibiotic resistance is the inability to kill or inhibit the organism with clinically achievable drug concentrations.

Resistance can be innate or acquired through mutation or foreign DNA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
204
Q

What factors accelerate the development of antibiotic resistance?

A

Factors include:
* Inadequate antibiotic levels
* Short duration of treatment
* Overwhelming numbers of organisms
* Overuse/misuse of antibiotics

These factors can lead to increased resistance in microbial populations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
205
Q

What are the four biosafety levels in labs dealing with pathogens?

A

Biosafety levels include:
* BSL-1: No disease in healthy humans
* BSL-2: Moderately hazardous agents
* BSL-3: Microbes in safety cabinets
* BSL-4: Severe or fatal disease agents

These levels dictate the safety protocols in laboratory settings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
206
Q

What is the function of an autoclave?

A

An autoclave is used for moist heat sterilization.

It is an effective method for sterilizing equipment and materials.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
207
Q

What is lyophilization used for?

A

Lyophilization is used for the long-term preservation of microbial cultures.

It prevents the formation of damaging ice crystals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

How does refrigeration control microbial growth?

A

Refrigeration decreases microbial metabolism, growth, and reproduction.

It slows down chemical reactions and limits available liquid water.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
209
Q

What is the ultimate means of sterilization?

A

Incineration is the ultimate means of sterilization.

It effectively destroys all forms of microbial life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
210
Q

Fill in the blank: The ideal antimicrobial agents should be _______.

A

[inexpensive, fast-acting, stable during storage, harmless to humans]

These characteristics enhance the effectiveness and safety of antimicrobial agents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
211
Q

What are the differences between a prokaryote and a eukaryote?

A

Prokaryotes lack a nucleus and membrane-bound organelles, while eukaryotes have a nucleus and membrane-bound organelles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
212
Q

What are the main groups of microbiological organisms that are eukaryotes?

A
  • Fungi
  • Protozoa
  • Algae
  • Helminths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
213
Q

What is the difference between a Gram positive bacteria and Gram negative bacteria?

A

Gram positive bacteria have a thick peptidoglycan layer and retain the crystal violet stain, while Gram negative bacteria have a thin peptidoglycan layer and do not retain the stain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
214
Q

What organism/s can cause tonsilitis?

A
  • Streptococcus pyogenes
  • Epstein-Barr virus
  • Adenovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
215
Q

What organism/s can cause meningitis?

A
  • Neisseria meningitidis
  • Streptococcus pneumoniae
  • Haemophilus influenzae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
216
Q

What are the main structural components of a virus?

A
  • Nucleic acid (DNA or RNA)
  • Protein coat (capsid)
  • Lipid envelope (in some viruses)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
217
Q

What are the main modes of action of antibiotics?

A
  • Inhibiting cell wall synthesis
  • Inhibiting protein synthesis
  • Inhibiting nucleic acid synthesis
  • Disrupting metabolic pathways
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
218
Q

What are the main modes of action of anti fungal agents?

A
  • Inhibiting cell wall synthesis
  • Disrupting cell membrane function
  • Inhibiting nucleic acid synthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
219
Q

What is the life cycle of Thread worm?

A

The life cycle includes eggs being ingested, larvae hatching in the intestine, and adult worms residing in the colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
220
Q

What are the definitions of ‘commensalism’ and ‘parasitism’?

A
  • Commensalism: a relationship where one organism benefits and the other is neither helped nor harmed.
  • Parasitism: a relationship where one organism benefits at the expense of the other.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
221
Q

Describe the prokaryotic cell

A

A prokaryotic cell is a simple, unicellular organism that lacks a nucleus and membrane-bound organelles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
222
Q

Describe the flagella

A

Flagella are long, whip-like structures that aid in the movement of prokaryotic cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
223
Q

Describe pilus

A

Pilus is a hair-like structure on the surface of prokaryotic cells that helps in adhesion and conjugation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
224
Q

What is different between the prokaryotic cell and the eukaryotic cell

A

Prokaryotic cells lack a nucleus and membrane-bound organelles, whereas eukaryotic cells have both.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
225
Q

Why do we have more antibiotics than antivirals and antifungals?

A

We have more antibiotics because bacteria are easier to target with specific mechanisms compared to viruses and fungi.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
226
Q

What are the main targets for antibiotics?

A

The main targets for antibiotics include:
* Cell wall synthesis
* Protein synthesis
* Nucleic acid synthesis
* Metabolic pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
227
Q

Describe the mode of action of the antibiotics, penicillin

A

Penicillin inhibits cell wall synthesis in bacteria, leading to cell lysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
228
Q

Describe the mode of action of the antibiotics, tetracycline

A

Tetracycline inhibits protein synthesis by blocking the attachment of tRNA to the ribosome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
229
Q

Describe the mode of action of the antibiotics, rifampin

A

Rifampin inhibits RNA synthesis by binding to bacterial RNA polymerase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
230
Q

What are the main causes of antibiotic resistance? What do we need to do to control antibiotic resistance?

A

Main causes of antibiotic resistance include:
* Overuse of antibiotics
* Misuse in agriculture
* Incomplete courses of treatment

To control resistance, we need to:
* Promote appropriate antibiotic use
* Enhance infection prevention
* Invest in new antibiotic research

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
231
Q

How can bacteria be grown and identified in the laboratory?

A

Bacteria can be grown on selective media, incubated at specific temperatures, and identified using biochemical tests.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
232
Q

What other mechanisms can be used to kill bacteria in the environment?

A

Other mechanisms include:
* Disinfectants
* Heat sterilization
* UV radiation
* Chemical agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
233
Q

Describe the infection – conjunctivitis caused by bacterial infection

A

Conjunctivitis is an inflammation of the conjunctiva that can be caused by bacteria, leading to redness, swelling, and discharge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
234
Q

Describe the infection – whooping cough

A

Whooping cough is a highly contagious bacterial infection characterized by severe coughing fits and is caused by Bordetella pertussis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
235
Q

Describe the infection – impetigo

A

Impetigo is a superficial bacterial skin infection that causes red sores, commonly seen in children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
236
Q

When treating bacterial infections, what are the main considerations?

A

Main considerations include:
* Correct antibiotic choice
* Patient allergies
* Susceptibility testing
* Potential side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
237
Q

What is a ribosome?

A

A molecular machine responsible for protein synthesis

Ribosomes are found in all living cells and translate messenger RNA into polypeptides.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
238
Q

Where is the nucleoid found?

A

In prokaryotic cells, it contains the genetic material

The nucleoid is not membrane-bound and is typically located in the cytoplasm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
239
Q

What is the function of the glycocalyx?

A

Provides protection and helps in adherence to surfaces

It is a sticky layer composed of polysaccharides and proteins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
240
Q

What structure is responsible for locomotion in some microorganisms?

A

Flagellum

Flagella are long whip-like appendages that enable movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
241
Q

What are the characteristics of protozoa?

A

Single-celled eukaryotes, similar to animals in nutrient needs and structure

They can reproduce asexually or sexually and are capable of locomotion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
242
Q

What type of reproduction do most protozoa use?

A

Asexual reproduction

Some protozoa also reproduce sexually.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
243
Q

What are viruses composed of?

A

Small amounts of DNA or RNA and a protein coat

They are acellular and require a host to replicate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
244
Q

What distinguishes prokaryotes from eukaryotes?

A

Prokaryotes lack a nucleus and membrane-bound organelles

They are typically smaller and have a simpler structure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
245
Q

What organisms are included in the eukaryotes classification?

A

Algae, protozoa, fungi, animals, and plants

Eukaryotes have a nucleus and are generally larger and more complex than prokaryotes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
246
Q

What are the two main types of cells in microbiology?

A

Bacteria and Archaea

Both are unicellular and lack nuclei.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
247
Q

What is the primary component of bacterial cell walls?

A

Peptidoglycan

This structure provides strength and rigidity to the cell wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
248
Q

What are molds and yeasts classified as?

A

Molds are multicellular; yeasts are unicellular

Molds reproduce by spores, while yeasts reproduce by budding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
249
Q

Fill in the blank: Prokaryotic cells are typically _______ in size compared to eukaryotic cells.

A

smaller

Prokaryotic cells are generally about 1.0 µm in diameter.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
250
Q

True or False: Viruses can be seen with light microscopy.

A

False

Viruses require electron microscopy for visualization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
251
Q

What is the diameter of a typical bacterium like Staphylococcus?

A

1 µm

This size is characteristic for many species of bacteria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
252
Q

What are the reproductive structures of algae categorized by?

A

Pigmentation, storage products, and composition of the cell wall

These factors help in the classification of different algal species.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
253
Q

What type of organism are parasitic worms classified as?

A

Multi-celled organisms

They can range in size from microscopic forms to large tapeworms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
254
Q

What is the primary role of the Golgi body?

A

Modification and transport of proteins

It plays a crucial role in the post-translational modification of proteins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
255
Q

What are the three types of symbiotic relationships involving bacteria?

A
  • Mutualism
  • Commensalism
  • Parasitism

Mutualism benefits both organisms, commensalism benefits one without harming the other, and parasitism benefits one while harming the other.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
256
Q

What is an opportunistic pathogen?

A

A normal microbiota that can cause disease under unusual circumstances.

This can occur due to immune suppression or changes in normal microbiota.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
257
Q

List the routes of entry for pathogenic bacteria.

A
  • Skin
  • Mucous membranes
  • Placenta
  • Parenteral route

Parenteral route includes punctures or breaks in the skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
258
Q

Name two examples of Gram-positive bacteria.

A
  • Staphylococcus spp.
  • Streptococcus spp.

These are commonly associated with opportunistic infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
259
Q

What is the significance of Lipid A in Gram-negative bacteria?

A

Triggers fever, vasodilation, inflammation, shock, and blood clots.

Lipid A is a component of the outer membrane of Gram-negative bacterial cell walls.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
260
Q

Which bacteria are known to cause meningitis?

A
  • Neisseria meningitidis
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Listeria monocytogenes
  • Streptococcus agalactiae

These species account for 90% of bacterial meningitis cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
261
Q

What are the common pathogens for conjunctivitis?

A
  • Staphylococcus spp.
  • Streptococcus spp.
  • Haemophilus influenzae
  • Neisseria gonorrhoeae
  • Moraxella spp.

Conjunctivitis is mostly viral but can be bacterial if pus is produced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
262
Q

Fill in the blank: The bacteria that cause _______ can invade when the skin is compromised.

A

Impetigo

Impetigo is often caused by Staphylococcus aureus or Streptococcus pyogenes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
263
Q

True or False: Otitis media is most common in adults.

A

False

Otitis media is common in children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
264
Q

What is the causative agent of whooping cough?

A

Bordetella pertussis

This pathogen produces numerous virulence factors that contribute to the disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
265
Q

What is the primary treatment for bacterial meningitis?

A

Intravenous antimicrobial drugs

Vaccines are available for some causative agents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
266
Q

What are the signs and symptoms of tonsillitis?

A

Sore throat and difficulty swallowing

May progress to scarlet or rheumatic fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
267
Q

Name two Gram-negative bacteria that are opportunistic pathogens.

A
  • Escherichia coli
  • Serratia marcescens

These belong to the Enterobacteriaceae family.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
268
Q

What are the phases of pertussis progression?

A
  • Incubation
  • Catarrhal
  • Paroxysmal
  • Convalescent

Each phase has distinct symptoms and implications for treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
269
Q

What is the main method for diagnosing impetigo?

A

Presence of vesicles

Treatment includes penicillin and careful cleaning of infected areas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
270
Q

What is the role of vaccines in the prevention of bacterial infections?

A

Vaccines are available for key pathogens like S. pneumoniae, H. influenzae type b, and N. meningitidis.

Vaccination helps reduce the incidence of these infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
271
Q

True or False: Most cases of conjunctivitis clear naturally within 3-5 days.

A

True

Topical antibiotics may be needed if symptoms persist or if specific pathogens are suspected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
272
Q

What is the typical treatment for otitis media?

A

Amoxicillin

90% of cases clear without treatment after 7-9 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
273
Q

What is the main structural component of the prokaryotic cell wall?

A

Mainly composed of peptidoglycan with β-lactam bonds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
274
Q

Which bacteria lack a cell wall?

A

Mycoplasma pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
275
Q

What is the difference in cell wall structure between bacteria and archaea?

A

Archaea have no peptidoglycan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
276
Q

What is a tetrapeptide?

A

A chain of four amino acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
277
Q

What are the two main components of the prokaryotic cell membrane?

A

Lipid bilayer and absence of sterols

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
278
Q

What is the function of the glycocalyx in prokaryotes?

A

Protection against digestion and desiccation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
279
Q

What is the glycocalyx primarily composed of?

A

Generally polysaccharide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
280
Q

What is the role of endospores in bacteria?

A

Formed when bacteria are under stress and are highly resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
281
Q

Which type of bacteria form endospores?

A

Bacillus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
282
Q

What are the main components of prokaryotic cell structure?

A
  • Ribosome
  • Cytoplasm
  • Nucleoid
  • Glycocalyx
  • Cell wall
  • Cytoplasmic membrane
  • Inclusions
  • Flagellum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
283
Q

What is the structure of prokaryotic DNA?

A

Single chromosome, circular DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
284
Q

What are plasmids?

A

Circular, normally short, often multiple copies of DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
285
Q

What is the difference between fimbriae and pili?

A
  • Fimbria - adhere to host surfaces
  • Pilus - structure for sexual reproduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
286
Q

What is the function of flagella in prokaryotes?

A

Allows movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
287
Q

What is binary fission?

A

A method of bacterial reproduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
288
Q

What factors affect microbial growth?

A
  • Temperature
  • Pressure
  • Nutrients
  • Oxygen
  • pH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
289
Q

What are thermophiles?

A

Organisms that thrive at high temperatures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
290
Q

What are halophiles?

A

Organisms that thrive in high salt concentrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
291
Q

What are the two categories of prokaryotes based on cell structure?

A
  • Archaea
  • Bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
292
Q

What is Bergey’s Manual used for?

A

Classification of prokaryotes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
293
Q

How many phyla of prokaryotes are there?

A

At least 28 phyla (2 archaea, 26+ bacteria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
294
Q

What characterizes Gram-negative non-proteobacteria?

A

Stain pink with Gram stain but often lack a cell wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
295
Q

What are some examples of Gram-positive bacteria?

A
  • Bacillus
  • Listeria
  • Lactobacillus
  • Streptococcus
  • Staphylococcus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
296
Q

What are methanogens?

A

Organisms that convert CO2, H2, and organic acids to methane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
297
Q

What are extremeophiles?

A

Organisms that require extreme conditions to survive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
298
Q

What type of bacteria includes nitrogen fixers?

A

Proteobacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
299
Q

What is the role of gas vesicles in prokaryotes?

A

Help in buoyancy and flotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
300
Q

What is the jelly-like substance found in prokaryotic cells called?

A

Cytoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
301
Q

Fill in the blank: The prokaryotic cell’s genetic material is found in the _______.

A

Nucleoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
302
Q

What are the characteristics of viruses?

A

Minuscule, acellular infectious agents having either DNA or RNA, cannot carry out metabolic pathways, neither grow nor respond to the environment, cannot reproduce independently, and recruit the cell’s metabolic pathways to increase their numbers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
303
Q

What is a virion?

A

The complete virus particle, including its genetic material and protective protein coat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
304
Q

What types of genetic material can viruses have?

A
  • DNA
  • RNA

Viruses may have single-stranded or double-stranded forms of these nucleic acids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
305
Q

What are the different shapes of viral capsids?

A
  • Helical
  • Polyhedral
  • Complex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
306
Q

What is the function of a viral capsid?

A

Provides protection for viral nucleic acid and acts as a means of attachment to host cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
307
Q

What is the viral envelope composed of?

A

A phospholipid bilayer and proteins, often including virally coded glycoproteins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
308
Q

How are viruses classified?

A
  • Morphology
  • Serology
  • Genetic material
  • Baltimore classification system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
309
Q

What is the Baltimore Classification System based on?

A

The form of genetic material and the method of replication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
310
Q

List the classes of viruses in the Baltimore Classification System.

A
  • Class 1: dsDNA
  • Class 2: ssDNA
  • Class 3: dsRNA
  • Class 4: ssRNA (Positive Sense)
  • Class 5: ssRNA (Negative Sense)
  • Class 6: ssRNA (Positive Sense with Reverse Transcription)
  • Class 7: Partially dsDNA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
311
Q

What are the steps in viral replication?

A
  • Attachment
  • Entry
  • Uncoating
  • Replication
  • Assembly and release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
312
Q

What is the difference between lytic replication and lysogeny?

A

Lytic replication usually results in the death and lysis of the host cell, while lysogeny allows infected cells to grow and reproduce normally for generations before they lyse.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
313
Q

What is a prophage?

A

An inactive phage that integrates into the chromosome of a host bacterium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
314
Q

How do viruses relate to cancer?

A

Viruses cause 20–25% of human cancers by carrying copies of oncogenes, promoting existing oncogenes, or interfering with tumor suppression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
315
Q

True or False: Viruses are considered living entities.

A

False; some consider them complex pathogenic chemicals, while others view them as the least complex living entities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
316
Q

Fill in the blank: Viruses can cause many infections in ______, ______, ______, and ______.

A

[humans, animals, plants, bacteria]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
317
Q

What does the term ‘capsomere’ refer to?

A

The protein subunits that make up a viral capsid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
318
Q

What are the signs and symptoms of Viral Conjunctivitis?

A

Itchy eyes, tearing, redness, discharge, light sensitivity

Most cases are caused by adenovirus but can be caused by many others, with Herpes Simplex virus being the most problematic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
319
Q

What is the main pathogen responsible for Viral Conjunctivitis?

A

Adenovirus

Herpes Simplex virus is also a significant cause.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
320
Q

Is Viral Conjunctivitis a self-limiting disease?

A

Yes, it is highly contagious and self-limiting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
321
Q

What treatment is available for Viral Conjunctivitis caused by HSV?

A

Topical antivirals such as idoxuridine, vidarabine, and trifluridine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
322
Q

How is Viral Conjunctivitis diagnosed?

A

Symptoms are generally used, but further investigation may be required in severe cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
323
Q

What preventive measures can be taken for Viral Conjunctivitis?

A

Avoid touching the eye, use separate towels and linen, stay at home.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
324
Q

What are the signs and symptoms of Viral Otitis Media?

A

Severe pain in the ears.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
325
Q

What is the primary pathogen associated with Viral Otitis Media?

A

Adenoviruses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
326
Q

How does Viral Otitis Media spread?

A

Viruses in the pharynx spread to the sinuses via the throat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
327
Q

Is there an effective treatment for Viral Otitis Media?

A

No known treatment is effective.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
328
Q

What are the signs and symptoms of Viral Meningitis?

A

Similar to those of bacterial meningitis, usually milder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
329
Q

What pathogens are primarily responsible for Viral Meningitis?

A

90% of cases are caused by viruses in the genus Enterovirus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
330
Q

How is Viral Meningitis diagnosed?

A

By characteristic signs and symptoms in the absence of bacteria in the CSF.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
331
Q

Are there specific treatments for Viral Meningitis?

A

No specific treatment exists.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
332
Q

What are the signs and symptoms of Cold Sores (Herpes)?

A

Slow spreading skin lesions, recurrence of lesions is common.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
333
Q

Which pathogens cause Cold Sores?

A

Human herpes viruses 1 and 2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
334
Q

What is the primary pathogenesis of Cold Sores?

A

Painful lesions caused by inflammation and cell death, causing fusion of cells to form syncytia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
335
Q

What is the site of viral latency for Cold Sores?

A

Trigeminal (V) nerve ganglion, brachial ganglia, sacral ganglia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
336
Q

How are Cold Sores spread?

A

Spread between mucous membranes of mouth and genitals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
337
Q

What is the diagnosis for Cold Sores based on?

A

Presence of characteristic lesions and immunoassay revealing viral antigens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
338
Q

What are the symptoms of Hand, Foot and Mouth Disease?

A

Cold-like symptoms, loss of appetite, mild fever, non-itchy red rash with bumps or fluid-filled sacs, painful mouth ulcers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
339
Q

What pathogens are associated with Hand, Foot and Mouth Disease?

A

Coxsackie virus A16, A6, A10, and Enterovirus 71.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
340
Q

How does Hand, Foot and Mouth Disease spread?

A

By oral-oral or fecal-oral route.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
341
Q

Is there a vaccine for Hand, Foot and Mouth Disease?

A

No vaccine exists; prevention is through good hand hygiene.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
342
Q

What are the signs and symptoms of Respiratory Syncytial Virus (RSV)?

A

Fever, runny nose, coughing in babies or immunocompromised individuals, mild cold-like symptoms in older children and adults.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
343
Q

What is the primary pathogen responsible for Respiratory Syncytial Virus (RSV)?

A

Respiratory syncytial virus (RSV).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
344
Q

What is the pathogenesis of RSV?

A

Virus causes syncytia to form in the lungs, immune response further damages the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
345
Q

How is RSV transmitted?

A

Via close contact with infected persons.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
346
Q

How is RSV diagnosed?

A

Diagnosis made by immunoassay.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
347
Q

What is the key mechanism of action for antiviral drugs?

A

Selective toxicity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
348
Q

What are some mechanisms of action for antiviral drugs?

A
  • Inhibition of pathogen’s attachment to host
  • Inhibition of DNA or RNA synthesis
  • Inhibition of protein synthesis
  • Prevention of virus attachment.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
349
Q

What is the role of protease inhibitors in antiviral treatment?

A

Interfere with an enzyme HIV needs in its replication cycle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
350
Q

What do nucleotide or nucleoside analogs do?

A

Interfere with the function of nucleic acids and prevent further replication, transcription, or translation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
351
Q

What is the significance of reverse transcriptase inhibitors?

A

Act against an enzyme HIV uses in its replication cycle and do not harm people.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
352
Q

What are fungi classified as?

A

Eukaryotes

Eukaryotes have a nuclear membrane, 80S ribosomes, and organelles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
353
Q

What is the vegetative body of a fungus called?

A

Thallus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
354
Q

How do fungi move?

A

Non-motile under any conditions; grow towards food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
355
Q

What is the composition of the cell wall in fungi?

A

Chitin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
356
Q

What are the major forms of fungi?

A
  • Multicellular
  • Unicellular (e.g., yeasts)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
357
Q

What conditions do airborne fungal spores require to germinate?

A

Favorable conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
358
Q

What temperatures are optimal for fungal growth?

A

25 – 37 °C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
359
Q

What type of organisms are fungi?

A

Heterotrophic organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
360
Q

What are the main nutritional modes of fungi?

A
  • Saprotrophic (decaying matter)
  • Parasitic (living matter)
  • Mutualistic relationships
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
361
Q

What are lichens formed from?

A

Fungi and cyanobacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
362
Q

What are the two main types of reproduction in fungi?

A
  • Asexual (mitosis, binary fission)
  • Sexual (meiosis, schizogony)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
363
Q

What is a sporangium?

A

A structure that releases spores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
364
Q

How many species of fungi are there approximately?

A

1.5 million species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
365
Q

How many fungi species have been characterized?

A

80,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
366
Q

What division of fungi includes Zygomycota?

A

Division Zygomycota

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
367
Q

What are dermatophytes?

A

Fungi that cause superficial infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
368
Q

What is the common name for Tinea pedis?

A

Athlete’s foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
369
Q

What type of infection is caused by C. albicans?

A

Mucosal membrane infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
370
Q

What is Sporotrichosis caused by?

A

Sporothrix schenckii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
371
Q

What type of infections can systemic fungal diseases lead to?

A

Invasive/systemic infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
372
Q

What is mycotoxicosis?

A

Toxins produced by fungi under certain conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
373
Q

What is required for the diagnosis of fungal infections?

A

Tissue sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
374
Q

What is the key mechanism of action for antifungals?

A

Selective toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
375
Q

What do echinocandins inhibit?

A

Synthesis of glucan in cell walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
376
Q

What do azoles disrupt in fungal cells?

A

Ergosterol synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
377
Q

What is the effect of Amphotericin B?

A

Attaches to ergosterol in fungal membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
378
Q

True or False: Mycotoxicosis is only harmful to humans.

A

False

All animal species are affected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
379
Q

Fill in the blank: Fungi are _______ organisms.

A

Heterotrophic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
380
Q

What type of fungi can be facultative anaerobes?

A

Yeasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
381
Q

What is a dikaryon?

A

A cell with two genetically distinct nuclei (n + n)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
382
Q

What is the classification for the division Ascomycota?

A

Division Ascomycota

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
383
Q

List two examples of subcutaneous fungal infections.

A
  • Sporotrichosis
  • Mycetoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
384
Q

What are the steps involved in the activation of cytotoxic T cells?

A

Antigen presentation, Helper T cell differentiation, Clonal expansion, Self-stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
385
Q

What is the first antibody produced?

A

IgM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
386
Q

Which antibody is the most common and longest-lasting?

A

IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
387
Q

What is the primary association of IgA?

A

Associated with body secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
388
Q

What role does IgE play?

A

Involved in response to parasitic infections and allergies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
389
Q

What is known about the function of IgD?

A

Exact function is not known

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
390
Q

How do antibodies function?

A

Activation of complement and inflammation, Neutralization, Opsonization, Killing by oxidation, Agglutination, Antibody-dependent cellular cytotoxicity (ADCC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
391
Q

What are antibodies?

A

Immunoglobulins similar to BCRs, Secreted by activated B cells called plasma cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
392
Q

What is the structure of an antibody?

A

Heavy chain, Light chain, Epitope, Antigen-binding sites, Variable region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
393
Q

What is the function of the B cell receptor (BCR)?

A

Each B cell generates a single BCR that recognizes only one epitope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
394
Q

Where do B lymphocytes mature?

A

In the red bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
395
Q

What is the major function of B lymphocytes?

A

The secretion of antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
396
Q

What type of antigens do B cell receptors (BCRs) recognize?

A

Exogenous antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
397
Q

How are T lymphocytes produced?

A

Produced in the red bone marrow and mature in the thymus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
398
Q

What are the types of T lymphocytes based on surface glycoproteins?

A

Cytotoxic T lymphocyte, Helper T lymphocyte, Regulatory T lymphocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
399
Q

What is the primary role of cytotoxic T lymphocytes?

A

Directly kills other cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
400
Q

What is the function of helper T lymphocytes?

A

Helps regulate the activities of B cells and cytotoxic T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
401
Q

What do regulatory T lymphocytes do?

A

Repress adaptive immune responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
402
Q

What is the significance of memory T cells?

A

Persist for months or years and are immediately functional upon subsequent contacts with epitope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
403
Q

What are the two types of humoral immune responses?

A

T-independent humoral immunity, T-dependent humoral immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
404
Q

What is the historical significance of vaccination?

A

Originally meant protection against Smallpox; led to significant reduction in mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
405
Q

Who introduced the practice of variolation to Britain?

A

Lady Mary Wortley Montague

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
406
Q

What did Edward Jenner discover?

A

First vaccination using cowpox to protect against Smallpox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
407
Q

What is the main property of antigens?

A

Molecules the body recognizes as foreign and worthy of attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
408
Q

What are epitopes?

A

Three-dimensional regions recognized by the immune system as part of antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
409
Q

What are the five attributes of adaptive immunity?

A

Specificity, Inducibility, Clonality, Unresponsiveness to self, Memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
410
Q

What is the primary response in adaptive immunity?

A

The initial immune response to a specific pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
411
Q

What is the secondary response in adaptive immunity?

A

The enhanced immune response upon re-exposure to the same pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
412
Q

Fill in the blank: The most common intracellular pathogens are _______.

A

viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
413
Q

True or False: Vaccination for Smallpox was discontinued in the UK in 1971.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
414
Q

What did Louis Pasteur advance in the field of vaccines?

A

Anthrax and Rabies vaccines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
415
Q

What is the most cost-effective and easiest way to prevent disease?

A

Vaccines

Vaccines are widely recognized for their role in public health and disease prevention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
416
Q

Who discovered the first vaccine?

A

Edward Jenner

Jenner is known for developing the smallpox vaccine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
417
Q

What is active immunisation?

A

The process of stimulating the immune system to produce a response against a specific pathogen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
418
Q

What is passive immunotherapy?

A

The administration of pre-formed antibodies to provide immediate immunity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
419
Q

What are the key characteristics of the ideal vaccine?

A
  • Triggers an immune response that creates memory
  • Requires only one administration
  • No risk of infection
  • No side effects
  • Effective against 100% of infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
420
Q

What factors influence vaccine design?

A
  • Type of infection
  • Pathogenicity of the pathogen
  • Determination of the antigen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
421
Q

What are the types of vaccines?

A
  • Attenuated (modified live) vaccines
  • Inactivated vaccines
  • Subunit vaccines
  • Toxoid vaccines
  • Recombinant vaccines
  • DNA/RNA vaccines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
422
Q

What does attenuation refer to in vaccine development?

A

Active organisms that have lost their virulence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
423
Q

What is a disadvantage of attenuated vaccines?

A

Not suitable for immunocompromised patients or pregnant women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
424
Q

What are inactivated vaccines?

A

Vaccines containing whole agents killed by heat or formaldehyde.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
425
Q

What is the main issue with the oral Polio Vaccine developed by Albert Sabin?

A

The vaccine can revert to wild type within the host, leading to disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
426
Q

What is a subunit vaccine?

A

Vaccines that use antigenic fragments of the pathogen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
427
Q

What is the purpose of conjugate vaccines?

A

To attach polysaccharides to an inactivated toxin to enhance immune response.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
428
Q

What is a key characteristic of the Pneumococcal Conjugate vaccine?

A

It covers 13 serotypes and triggers mucosal immunity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
429
Q

What are toxoid vaccines?

A

Vaccines created by inactivating toxins from bacteria using formaldehyde.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
430
Q

What is the first recombinant vaccine?

A

Hepatitis B Vaccine

Developed by Pablo Valenzuela in 1986.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
431
Q

What is the mechanism of DNA vaccines?

A

Plasmids containing genes encoding an antigen are injected into host cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
432
Q

What is a characteristic of RNA vaccines?

A

They use messenger RNA to encode the antigen of choice.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
433
Q

What is the effectiveness of the Pfizer/BioNTech SARS-CoV-2 vaccine?

A

95% effective.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
434
Q

What storage temperature is required for the Pfizer/BioNTech vaccine?

A

-80 °C.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
435
Q

What is the main advantage of recombinant vaccines?

A

They can be quickly designed and produced after identifying a novel virus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
436
Q

What is the effectiveness range of the Oxford AstraZeneca vaccine?

A

60-90% depending on dosage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
437
Q

What is the most cost-effective and easiest way to prevent disease?

A

Vaccines

Vaccines are considered a primary method for disease prevention due to their effectiveness and accessibility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
438
Q

Who discovered the first vaccine?

A

Edward Jenner

Jenner developed the smallpox vaccine, which was the first successful vaccine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
439
Q

What is passive immunotherapy?

A

Administration of antiserum containing preformed antibodies

This provides immediate protection against recent infections or ongoing diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
440
Q

What are some limitations of antisera?

A

Antisera have several limitations, including:
* Containing antibodies against many antigens
* Can trigger allergic reactions (serum sickness)
* Potential contamination with viral pathogens
* Antibodies degrade relatively quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
441
Q

What is one advantage of passive immunotherapy?

A

One advantage is its role in breast-feeding

Breast milk provides antibodies that help protect infants.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
442
Q

What is the cause of meningitis in newborn babies?

A

Group B Streptococcus

This bacterium can cause serious infections in infants.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
443
Q

What are the two types of onset for Group B Streptococcus infection?

A

Early onset and late onset

Early onset occurs within 0-7 days, while late onset occurs between 7-90 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
444
Q

What is the standard method of vaccine administration?

A

Intramuscular

This method is commonly used for most vaccines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
445
Q

What are some alternative methods of vaccine administration?

A

Alternative methods include:
* Cutaneous (skin patch)
* Subcutaneous
* Mucosal membrane
* Oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
446
Q

What is an adjuvant?

A

Substance required to enhance immune response

Commonly used with toxoids or subunit vaccines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
447
Q

What is the role of aluminium hydroxide in vaccines?

A

It is commonly used as an adjuvant to enhance immune response

It stimulates cytokine production and enhances phagocytosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
448
Q

What temperature range must vaccines be stored at?

A

2-8 °C

Proper storage is crucial to maintain vaccine efficacy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
449
Q

What is the Cold Chain in vaccine storage?

A

The system ensuring vaccines are kept at the required temperature throughout storage and transport

This includes using designated refrigerators and cool boxes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
450
Q

What is a potential issue with attenuated vaccines?

A

They may cause disease or spread to immunocompromised individuals

Caution is required when administering these vaccines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
451
Q

What is the recommended vaccine schedule for infants at 2 months?

A

6 in 1 – DTaP/IPV/Hib/HepB, MenB, Rotavirus vaccine

This schedule includes vaccines for various diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
452
Q

What vaccine is given at 12-13 months?

A

Hib/Men C, MMR, Pneumococcal vaccine, Meningitis B

This age is critical for several vaccinations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
453
Q

What special vaccines are recommended for travelers?

A

Hepatitis A, Typhoid, Cholera, Yellow fever

These vaccines are necessary for specific travel destinations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
454
Q

What is a common myth propagated by the anti-vaccine campaign?

A

Vaccines cause Autism

This claim has been widely debunked and is based on flawed research.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
455
Q

What are some concerns of the anti-vaccine campaign?

A

Concerns include:
* Mercury and formaldehyde in vaccines
* Potential for illness post-vaccination
* Belief that unvaccinated children do not affect vaccinated ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
456
Q

Fill in the blank: Vaccines must never be used past their _______.

A

use by date

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
457
Q

What is the vaccine schedule for elderly individuals starting at 65 years?

A

Flu vaccine, Pneumococcal Vaccine (PPV)

Vaccination is important to prevent diseases in older adults.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
458
Q

What is the vaccine given to pregnant women from 16 weeks?

A

Whooping cough vaccine

This helps protect both the mother and the baby.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
459
Q

What causes otitis media?

A

Otitis media is caused by inflammation and infection of the middle ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
460
Q

What are the common symptoms experienced by older and younger children with otitis media?

A

Common symptoms include ear pain, irritability, difficulty sleeping, and fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
461
Q

Which factors can increase the risk of developing otitis media?

A

Factors include exposure to secondhand smoke, allergies, and frequent upper respiratory infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
462
Q

What is the recommended treatment for otitis media?

A

Treatment may include pain management and antibiotics if bacterial infection is suspected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
463
Q

What antibiotic would you recommend for an 18 month old child with bilateral otitis media?

A

Amoxicillin is commonly recommended.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
464
Q

What advice could you offer to reduce the risk of developing otitis media?

A

Advice includes breastfeeding infants, avoiding smoke exposure, and ensuring vaccinations are up to date.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
465
Q

What complications can occur with otitis media?

A

Complications may include hearing loss, speech delays, and the spread of infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
466
Q

Which areas of skin are affected by non-bullous impetigo and what are the symptoms?

A

The face and limbs are commonly affected; symptoms include red sores that can burst and ooze.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
467
Q

Which areas of skin are affected by bullous impetigo and what are the symptoms?

A

Bullous impetigo typically affects the trunk and extremities; symptoms include larger blisters filled with clear fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
468
Q

What treatment and lifestyle advice could you offer to the parents of a young child diagnosed with impetigo?

A

Treatment includes topical antibiotics; advise keeping the sores clean and covered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
469
Q

Which antibiotics are recommended for impetigo and what is the recommended duration of treatment?

A

Oral antibiotics include cephalexin; topical options include mupirocin for 7 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
470
Q

What causes tonsillitis?

A

Tonsillitis is caused by viral or bacterial infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
471
Q

What are the main symptoms associated with tonsillitis?

A

Main symptoms include sore throat, difficulty swallowing, and swollen tonsils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
472
Q

What symptoms would indicate tonsillitis due to a bacterial infection?

A

Symptoms include severe sore throat, fever, and white patches on the tonsils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
473
Q

What advice can you offer to patients to reduce their risk of contracting tonsillitis?

A

Advice includes practicing good hygiene and avoiding close contact with infected individuals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
474
Q

What advice to manage symptoms can you offer to someone who has tonsillitis?

A

Advice includes staying hydrated, using throat lozenges, and taking pain relievers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
475
Q

What causes ringworm and which part of the body can be affected?

A

Ringworm is caused by fungal infections and can affect the skin, scalp, and nails.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
476
Q

What are the common symptoms of ringworm?

A

Symptoms include red, itchy, and scaly patches of skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
477
Q

Which patient groups are more at risk of developing ringworm?

A

At-risk groups include children, athletes, and those with weakened immune systems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
478
Q

What advice could you offer to prevent ringworm spreading?

A

Advice includes maintaining good hygiene, avoiding sharing personal items, and keeping skin dry.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
479
Q

Which medications are used to treat tinea capitis?

A

Oral antifungals such as griseofulvin are used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
480
Q

Which medications are used to treat tinea corporis?

A

Topical antifungals such as clotrimazole or terbinafine are used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
481
Q

Which medications are used to treat tinea pedis?

A

Topical antifungals like miconazole or oral antifungals may be prescribed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
482
Q

Which medications are used to treat tinea cruris?

A

Topical antifungals such as ketoconazole are typically used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
483
Q

Which medications are used to treat onychomycosis?

A

Oral antifungals such as terbinafine or itraconazole are used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
484
Q

What are the types of impetigo?

A

Non-bullous impetigo and Bullous impetigo

Non-bullous impetigo is more common and characterized by honey-colored crusts, while bullous impetigo presents with painless, fluid-filled blisters.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
485
Q

What characterizes non-bullous impetigo?

A

Crusts, usually honey-coloured, form and the skin heals without scarring unless scratched deeply

The infection can spread to other body areas, making treatment important.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
486
Q

What are the key features of bullous impetigo?

A

Painless, fluid-filled blisters without redness on surrounding skin

It is less common than non-bullous impetigo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
487
Q

What are the infective agents associated with impetigo?

A

Strep. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis

These bacteria are normally broad-spectrum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
488
Q

Do we need to use antibiotics in all cases of impetigo?

A

No, absolute benefits are small and clinical significance is questionable

Benefits must be weighed against potential harms like allergic reactions or antibiotic-associated diarrhea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
489
Q

What is the recommended antibiotic for treating impetigo?

A

Amoxicillin (broad spectrum)

It is effective against the three common pathogens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
490
Q

What is the dose of Amoxicillin for children aged 1–11 months?

A

125 mg 3 times a day

Doses vary for different age groups.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
491
Q

What are the risk factors for developing impetigo?

A
  • Crowded conditions
  • Skin-to-skin contact
  • Warm weather
  • Contact sports
  • Broken skin
  • Immuno-suppressed patients

These factors increase the chances of spreading and developing the infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
492
Q

Who is most commonly affected by impetigo?

A

Children

Adults with itchy skin conditions like eczema are also at risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
493
Q

What complications can arise from untreated impetigo?

A

Ecthyma

Ecthyma is a more serious infection that develops deeper into the skin, leading to painful blisters and potential scarring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
494
Q

What is the incidence of impetigo in children under 4 years?

A

2.8%

The incidence lowers to 1.6% for children over 4 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
495
Q

What are common symptoms of acute otitis media?

A
  • Ear ache
  • Pulling and rubbing on the ear
  • Cough and runny nose
  • Red/yellow or cloudy eardrum

Occasionally, the eardrum may be bulging.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
496
Q

What are the common side effects of antibiotics like Amoxicillin?

A
  • Skin rash
  • Diarrhea
  • Nausea

These side effects occur in approximately 1 in 100 patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
497
Q

What is the pharmacokinetics of Amoxicillin?

A

VD is 0.2-0.4L/kg, peak plasma concentrations at 2 hrs, T½ = 1 hr

It crosses the placenta and has very little presence in breast milk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
498
Q

What does ‘OTITIS’ refer to?

A

Inflammation of the ear

It is often associated with infections like acute otitis media.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
499
Q

What is the significance of the Eustachian tube in children?

A

It is shorter in children than adults, allowing easy entry of bacteria and viruses

This facilitates direct extension of infections from the nasopharynx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
500
Q

What is the recommended duration for treating impetigo with antibiotics?

A

3 to 10 days depending on the severity

Treatment duration can vary based on clinical judgment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
501
Q

What factors can increase the risk of recurrent acute otitis media?

A
  • Passive smoking
  • Breastfeeding less than 4 months
  • Recent upper respiratory infections
  • Drinking while lying down

These factors can contribute to higher recurrence rates.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
502
Q

What is the typical duration for viral conjunctivitis to clear up without treatment?

A

7 to 14 days

Some cases may take 2 to 3 weeks or more.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
503
Q

What are the common infective agents that cause viral conjunctivitis?

A
  • Adenoviruses
  • Rubella virus
  • Rubeola (measles) virus
  • Herpes viruses (simplex and Epstein Barr)

Adenoviruses are one of the most common causes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
504
Q

True or False: Viral conjunctivitis is highly contagious.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
505
Q

What is the medical term for inflammation as used in conjunctivitis?

A

‘itis’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
506
Q

What are the characteristics of acute bacterial conjunctivitis?

A

Most common form in outpatient settings

Common agents include Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
507
Q

What distinguishes bacterial conjunctivitis from viral conjunctivitis?

A

Bacterial conjunctivitis typically has a purulent exudate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
508
Q

What is hyperacute bacterial conjunctivitis?

A

A severe type that develops rapidly, can lead to corneal perforation, and is often caused by Neisseria gonorrhoeae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
509
Q

What is the first-line treatment for bacterial conjunctivitis?

A

Chloramphenicol

It is a broad-spectrum bacteriostatic antibiotic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
510
Q

What is the mechanism of action of chloramphenicol?

A

Binds to bacterial ribosomes and inhibits bacterial protein synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
511
Q

Fill in the blank: The conjunctiva is the thin covering that covers the _______ part of the eyes and the underside of the eyelids.

A

white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
512
Q

What are the symptoms of allergic conjunctivitis?

A

Often accompanied by eyelid swelling and itching.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
513
Q

What can cause chlamydial conjunctivitis in neonates?

A

Infection from mothers with Chlamydia trachomatis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
514
Q

What are the symptoms of chlamydial conjunctivitis in sexually active individuals?

A

Typically unilateral with hyperemia and purulent discharge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
515
Q

What serious reaction can occur from β-lactam antibiotics?

A

Hypersensitivity reactions, including anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
516
Q

What is flucloxacillin used for?

A

Inhibits peptidoglycan synthesis and is effective against Staphylococcus aureus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
517
Q

What is the recommended duration for topical fusidic acid treatment?

A

Not longer than 10 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
518
Q

True or False: Fusidic acid kills bacteria.

A

False

It is bacteriostatic and inhibits replication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
519
Q

What should be avoided to prevent resistance when using fusidic acid?

A

Using it for longer than 10 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
520
Q

What are common causes of conjunctivitis?

A
  • Viruses
  • Bacteria
  • Allergens
  • Contact lens use
  • Chemicals
  • Fungi
  • Certain diseases (e.g., chlamydia, gonorrhea)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
521
Q

What is the first line of treatment for bacterial conjunctivitis in immunocompromised patients?

A

Topical and/or oral antibiotics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
522
Q

What is the definition of sore throat?

A

Symptom of pain at the back of the throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
523
Q

What is acute pharyngitis?

A

Inflammation of the orthopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
524
Q

What percentage of patients experience sore throat symptoms in a year?

A

6% (120 people per 2000 patients/GP/year)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
525
Q

Is sore throat more common in children or adults?

A

More common in children/young adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
526
Q

What are the primary causes of sore throat?

A

Viral or bacterial infection

Less commonly, non-infectious causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
527
Q

What viruses are commonly associated with sore throat?

A
  • Rhinovirus
  • Coronavirus
  • Parainfluenza
  • Influenza (4%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
528
Q

What bacterium is commonly responsible for bacterial sore throat?

A

Streptococcus pyogenes (GABHS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
529
Q

What is the triad of symptoms for glandular fever?

A
  • Sore throat
  • Fever
  • Lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
530
Q

What should not be prescribed for glandular fever?

A

Amoxicillin or Ampicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
531
Q

What are some non-infectious causes of sore throat?

A
  • Irritation
  • Hayfever (rare)
  • Adverse drug reactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
532
Q

What are potential complications of sore throat?

A
  • Otitis media
  • Sinusitis
  • Quinsy (Peri-tonsillar abscess)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
533
Q

What is quinsy?

A

A collection of pus beside the tonsil in the peritonsillar space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
534
Q

What is the prognosis for sore throat?

A

Self-limiting, 3 - 7 days in most people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
535
Q

What are the Centor criteria for predicting bacterial infection in sore throat?

A
  • Presence of tonsillar exudate
  • Presence of tender anterior cervical lymphadenopathy
  • History of fever
  • Absence of cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
536
Q

What does a Centor score of 3 or 4 suggest?

A

40-60% chance of GABHS and may benefit from antibiotics treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
537
Q

What should be done if a patient shows signs of breathing difficulty or dehydration?

A

Refer to A&E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
538
Q

What is the recommended management for sore throat?

A
  • Avoid contact with others
  • Paracetamol or ibuprofen
  • Adequate fluid intake
  • Medicated lozenges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
539
Q

What is the first-line antibiotic for bacterial sore throat?

A

Phenoxymethylpenicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
540
Q

What is the risk associated with broad-spectrum antibiotics in sore throat treatment?

A

Increased risk of Clostridium difficile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
541
Q

What is the effectiveness of antibiotics according to Cochrane review?

A

Reduction of 1 day’s illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
542
Q

What is the NICE guidance on antibiotic prescribing for sore throat?

A

Antibiotics are unnecessary for most patients with sore throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
543
Q

What is ringworm also known as?

A

Tinea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
544
Q

What are dermatophytes?

A

Fungi that live off keratin found in skin, nails, and hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
545
Q

What groups are at higher risk of developing ringworm?

A
  • Very young or very old
  • African-Caribbean (for scalp ringworm)
  • Type 1 diabetes
  • Weakened immune system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
546
Q

What is the recommended treatment for mild fungal infections?

A
  • Topical clotrimazole
  • Miconazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
547
Q

What is the treatment for tinea capitis?

A

Topical application of ketoconazole and systemic itraconazole or terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
548
Q

What is the mechanism of action of clotrimazole?

A
  • Fungistatic (inhibition of sterol synthesis)
  • Fungicidal at higher concentrations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
549
Q

What should be done if treatment for ringworm fails?

A

Consider oral antifungals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
550
Q

What is a common symptom of ringworm?

A

Pink, flat, ring-shaped lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
551
Q

What causes otitis media?

A

Otitis media is caused by inflammation and infection of the middle ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
552
Q

What are the common symptoms experienced by older and younger children with otitis media?

A

Common symptoms include ear pain, irritability, difficulty sleeping, and fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
553
Q

Which factors can increase the risk of developing otitis media?

A

Factors include exposure to secondhand smoke, allergies, and frequent upper respiratory infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
554
Q

What is the recommended treatment for otitis media?

A

Treatment may include pain management and antibiotics if bacterial infection is suspected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
555
Q

What antibiotic would you recommend for an 18 month old child with bilateral otitis media?

A

Amoxicillin is commonly recommended.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
556
Q

What advice could you offer to reduce the risk of developing otitis media?

A

Advice includes breastfeeding infants, avoiding smoke exposure, and ensuring vaccinations are up to date.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
557
Q

What complications can occur with otitis media?

A

Complications may include hearing loss, speech delays, and the spread of infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
558
Q

Which areas of skin are affected by non-bullous impetigo and what are the symptoms?

A

The face and limbs are commonly affected; symptoms include red sores that can burst and ooze.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
559
Q

Which areas of skin are affected by bullous impetigo and what are the symptoms?

A

Bullous impetigo typically affects the trunk and extremities; symptoms include larger blisters filled with clear fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
560
Q

What treatment and lifestyle advice could you offer to the parents of a young child diagnosed with impetigo?

A

Treatment includes topical antibiotics; advise keeping the sores clean and covered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
561
Q

Which antibiotics are recommended for impetigo and what is the recommended duration of treatment?

A

Oral antibiotics include cephalexin; topical options include mupirocin for 7 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
562
Q

What causes tonsillitis?

A

Tonsillitis is caused by viral or bacterial infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
563
Q

What are the main symptoms associated with tonsillitis?

A

Main symptoms include sore throat, difficulty swallowing, and swollen tonsils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
564
Q

What symptoms would indicate tonsillitis due to a bacterial infection?

A

Symptoms include severe sore throat, fever, and white patches on the tonsils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
565
Q

What advice can you offer to patients to reduce their risk of contracting tonsillitis?

A

Advice includes practicing good hygiene and avoiding close contact with infected individuals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
566
Q

What advice to manage symptoms can you offer to someone who has tonsillitis?

A

Advice includes staying hydrated, using throat lozenges, and taking pain relievers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
567
Q

What causes ringworm and which part of the body can be affected?

A

Ringworm is caused by fungal infections and can affect the skin, scalp, and nails.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
568
Q

What are the common symptoms of ringworm?

A

Symptoms include red, itchy, and scaly patches of skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
569
Q

Which patient groups are more at risk of developing ringworm?

A

At-risk groups include children, athletes, and those with weakened immune systems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
570
Q

What advice could you offer to prevent ringworm spreading?

A

Advice includes maintaining good hygiene, avoiding sharing personal items, and keeping skin dry.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
571
Q

Which medications are used to treat tinea capitis?

A

Oral antifungals such as griseofulvin are used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
572
Q

Which medications are used to treat tinea corporis?

A

Topical antifungals such as clotrimazole or terbinafine are used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
573
Q

Which medications are used to treat tinea pedis?

A

Topical antifungals like miconazole or oral antifungals may be prescribed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
574
Q

Which medications are used to treat tinea cruris?

A

Topical antifungals such as ketoconazole are typically used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
575
Q

Which medications are used to treat onychomycosis?

A

Oral antifungals such as terbinafine or itraconazole are used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
576
Q

What is Parasitology?

A

A branch of Science that deals with the Parasites and the infections they cause.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
577
Q

Define ‘Parasite’.

A

An organism that is dependent on another organism in all stages of its life cycle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
578
Q

What is a ‘Host’?

A

An organism which holds the parasite.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
579
Q

What does ‘Symbiosis’ mean?

A

A relation in which both the parasite and host are totally dependent on each other.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
580
Q

Define ‘Commensalisms’.

A

A relation in which the parasite only is dependent and does not harm the host.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
581
Q

What is ‘Parasitism’?

A

A relation where parasite benefits from the host and can’t live independently, while the host suffers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
582
Q

List the 4 types of parasites based on interaction with the host.

A
  • Ecto-parasite
  • Endo-parasite
  • Erratic or Aberrant Parasite
  • Free-living parasite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
583
Q

What is an Ecto-parasite?

A

An organism that lives on the surface of another organism (host).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
584
Q

Define Endo-parasite.

A

An organism which lives in another organism inside the host body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
585
Q

What is an Erratic or Aberrant Parasite?

A

An organism which wanders from its usual site of infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
586
Q

What is a Free-living parasite?

A

An organism which is capable of living in the environment and leading a non-parasitic existence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
587
Q

What is a Definitive host?

A

A host that holds the adult stage where sexual reproduction of a parasite takes place.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
588
Q

Define Intermediate host.

A

A host that harbours some developmental stages of the parasite before transferring it to another host.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
589
Q

What is a Parenthetic host?

A

A host that harbours the parasite not at a developmental stage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
590
Q

What is Permanent parasitism?

A

Whole period of life parasitism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
591
Q

Define Facultative parasitism.

A

Opportunistic parasite when opportunity arises.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
592
Q

What is Occasional parasitism?

A

Relation with unusual host.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
593
Q

List the direct effects of the parasite on the host.

A
  • Blockage of blood vessels
  • Producing toxins
  • Deficiency of nutrients or fluids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
594
Q

What are the indirect effects of the parasite on the host?

A
  • Immunological reaction of the host
  • Propagation of certain tissues due to parasite invasion
  • Tissue damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
595
Q

What classification rules do parasites follow?

A

Classification follows the same rules of zoological nomenclature: Phylum, Subphylum, Class, Order, Family, Genus, Species.

596
Q

Name the three phyla focused on for parasitic organisms.

A
  • Protozoa
  • Helminthes
  • Arthropods
597
Q

What are the characteristics of Protozoa?

A
  • Eukaryotic
  • Unicellular
  • Lack a cell wall
598
Q

What are the two main life stages of pathogenic Protozoa?

A
  • Trophozoites
  • Dormant cysts
599
Q

What is Trophozoite?

A

The active, feeding, multiplying stage of protozoa usually associated with pathogenesis.

600
Q

What is encystation?

A

The conversion of a trophozoite to cyst form.

601
Q

What is excystation?

A

The process of transforming back into a trophozoite.

602
Q

How are Protozoa classified by motility?

A

Classified by their method of locomotion: Flagella, Cilia, Pseudopodia.

603
Q

What are Helminths?

A

Multicellular, bilaterally symmetrical animals that have three germ layers.

604
Q

List the three main groups of Helminths.

A
  • Cestodes
  • Trematodes
  • Nematodes
605
Q

What characterizes Cestodes?

A

Tape worms that are dorsoventrally flattened with flat segmented, ribbon shape.

606
Q

Define Nematodes.

A

Round worms with size ranging from 2mm to 1m, with males being smaller than females.

607
Q

What are Pinworms?

A

Nematodes that are long, thin, unsegmented, cylindrical helminths.

608
Q

List the signs and symptoms of Pinworms.

A
  • Peri-anal itching
  • Irritability
  • Decreased appetite
609
Q

What causes Pinworm infestation?

A

Caused by Enterobius vermicularis.

610
Q

What is the treatment for Pinworm infestation?

A

Self-limited or treated with pyrantel pamoate or mebendazole.

611
Q

What are Trematodes?

A

Flukes, flat, leaf-shaped worms with two suckers for food and attachment.

612
Q

What is the significance of Arthropods in parasitology?

A

They affect human health by being direct agents or intermediate hosts for parasites.

613
Q

What are the three most common classes of Arthropods of medical significance?

A
  • Crustacia
  • Arachnida
  • Insecta
614
Q

What is the role of anti-helminthic treatments?

A

Inhibit various biological processes in helminths.

615
Q

List some examples of anti-helminthic treatments.

A
  • Benzimidazole
  • Iodoquinol
  • Ivermectin
  • Praziquantel
616
Q

What are common insecticides used for treating head lice?

A
  • Permethrin
  • Phenothrin
  • Malathion
  • Dimeticone
617
Q

What does pathogenicity mean?

A

Ability to cause disease

Pathogenicity involves characteristics like invasiveness, infectivity, and toxigenicity.

618
Q

What are the three characteristics of pathogenicity?

A
  • Invasiveness
  • Infectivity
  • Pathogenic potential
  • Toxigenicity
619
Q

What are the determinants of pathogenicity?

A
  • Host to host (sneezing, etc.)
  • Contamination of inanimate objects
  • Food sources
  • Environmental contamination
620
Q

What are adhesins?

A

Specialized molecules or structures on the pathogen’s cell surface to bind complementary receptor sites on the host cell surface

Examples include filamentous hemagglutinin, fimbrae, glycocalyx, lectin, pili, S-layer, teichoic and lipoteichoic acids.

621
Q

How do pathogens exit the body?

A

Through various mechanisms like sneezing, coughing, or other bodily fluids.

622
Q

What are exotoxins?

A

Among the most lethal substances known, associated with specific diseases and highly immunogenic.

623
Q

What are endotoxins?

A

LPS bound to the host, toxic in high doses, and weakly immunogenic.

624
Q

What is toxigenicity?

A

The ability of a pathogen to produce toxins that can damage the host.

625
Q

What are leukocidins?

A

Substances produced by some pathogens that cause degranulation of lysosomes.

626
Q

What is the most common STI in the UK?

627
Q

What type of pathogen is Chlamydia?

A

Intracellular pathogen

628
Q

What are the two forms of Chlamydia?

A
  • Elementary bodies (EB)
  • Reticulate bodies (RB)
629
Q

What is the role of elementary bodies (EB) in Chlamydia?

A

Infective form that attaches to host cells and is resistant to environmental extremes.

630
Q

What symptoms can Chlamydia cause in women?

A
  • Unusual vaginal discharge
  • Pain when urinating
  • Low abdominal pain
  • Bleeding between periods
  • Pain during or bleeding after sex
631
Q

What symptoms can Chlamydia cause in men?

A
  • White/cloudy watery discharge
  • Pain or burning sensation when urinating
  • Testicular pain or swelling
632
Q

What is the treatment for Chlamydia?

A
  • Azithromycin (single dose)
  • Doxycycline (7 days)
  • Erythromycin (14 days)
633
Q

What is Neisseria gonorrhoeae?

A

Gram negative diplococci and the microbe responsible for gonorrhoea.

634
Q

What are the common symptoms of gonorrhoea in men?

A
  • Acute inflammation
  • Painful urination
  • Purulent discharge
635
Q

What is the treatment for gonorrhoea?

A
  • Ceftriaxone (single intra-muscular injection)
  • Azithromycin (single oral dose)
636
Q

What virus causes genital herpes?

A

Human herpes virus (HHV)

637
Q

What are the structural features of the herpes virus?

A
  • Double stranded DNA
  • Icosahedral capsid
  • Enveloped
638
Q

What are the symptoms of genital herpes?

A

Painful lesions on the genitalia.

639
Q

What is the treatment for genital herpes?

A
  • Acyclovir
  • Valaciclovir
  • Vododeoxyuridine
640
Q

What causes genital warts?

A

Human Papillomavirus (HPV)

641
Q

What is the structure of HIV?

A
  • Retrovirus
  • Enveloped
  • Positive sense single-stranded RNA
  • Reverse transcriptase
642
Q

What are the symptoms of an initial HIV infection?

A
  • Fever
  • Fatigue
  • Weight loss
  • Diarrhoea
  • Body aches
643
Q

What is the treatment for HIV?

A

Anti-retroviral therapy (ART) involving a cocktail of 3-4 different antiviral drugs.

644
Q

What is AIDS?

A

Acquired immunodeficiency syndrome, characterized by a decline in CD4 cells and increased susceptibility to infections.

645
Q

What are the four stages of syphilis?

A

Primary, secondary, latent, and tertiary.

646
Q

What are the common symptoms of non-gonococcal urethritis?

A
  • Painful/burning sensation when urinating
  • Irritation and soreness at the tip of the penis
  • White/cloudy discharge
647
Q

What is a common complication of untreated chlamydia in women?

A

Pelvic Inflammatory Disease

648
Q

What is the role of reverse transcriptase in HIV?

A

Transcribes RNA into DNA, allowing the virus to integrate into the host’s genome.

649
Q

Fill in the blank: Exotoxins are highly _______.

A

immunogenic

650
Q

What is the definitive test for HIV?

A

PCR of RNA

651
Q

What is the primary treatment for HIV?

A

Anti-retroviral therapy (ART)

652
Q

What is included in the cocktail for ART?

A

3-4 different antiviral drugs

653
Q

What type of drugs are nucleotide analogs?

A

Antiviral drugs used in ART

654
Q

Name a class of drugs that inhibit the integration of viral DNA.

A

Integrase inhibitors

655
Q

What do protease inhibitors do?

A

Inhibit the protease enzyme in HIV

656
Q

What is the role of reverse transcriptase inhibitors?

A

Stop the replication of HIV

657
Q

True or False: Anti-retroviral therapy is inexpensive.

658
Q

What challenge exists in developing an HIV vaccine?

A

HIV is highly mutable

659
Q

What immune response is needed from a vaccine?

A

IgA and T-lymphocytes

660
Q

What can be detrimental about IgG production in HIV?

A

IgG-virus complex binds to B cells and virus remains infective

661
Q

How does HIV spread through syncytia?

A

By forming multinucleated giant cells

662
Q

Which cells does HIV infect that are typically activated by vaccines?

A

Macrophages, dendritic cells, and Helper T cells

663
Q

What is the primary mode of HIV transmission?

A

Sexual contact

664
Q

What advice would you give to prevent HIV infection?

A

Use condoms and engage in safe sex practices

665
Q

What is the scientific name for pubic lice?

A

Pthirus pubis

666
Q

What are symptoms caused by pubic lice?

A

Itching and rash in the infected area

667
Q

How are pubic lice spread?

A

Through sexual contact and close personal contact

668
Q

What is the treatment for pubic lice?

A

Topical insecticides

669
Q

What is the life cycle stage where Sarcoptes scabiei lays eggs?

A

Adult females deposit 2-3 eggs per day

670
Q

How long does it take for scabies eggs to hatch?

671
Q

What causes the itching and rash in scabies?

A

Immune response to mites, saliva, eggs, and feces

672
Q

What is the diagnosis method for scabies?

A

Microscopic observation of skin scrapings

673
Q

What is the treatment for scabies?

A

Topical permethrin or oral ivermectin

674
Q

What type of organism is Trichomonas vaginalis?

675
Q

How is Trichomonas vaginalis transmitted?

A

Exclusively via sex

676
Q

What are symptoms of Trichomonas vaginalis in women?

A

Purulent, odorous discharge; vaginal and cervical lesions

677
Q

What is a common symptom of Trichomonas vaginalis in men?

A

Inflammation of the urethra and bladder

678
Q

What is the treatment for Trichomonas vaginalis?

A

Nitroimidazole drugs

679
Q

What type of infections are included in the pathogenesis of microbes?

A

STIs such as Chlamydia, Gonorrhoea, Syphilis, and others

680
Q

What is a common non-specific symptom of STIs?

A

Non-specific urethritis

681
Q

What are the main disease states discussed in the management of STIs?

A

Chlamydia, Gonorrhoea, Syphilis, Trichomoniasis, Genital Herpes, HIV/AIDS, Pubic Lice

682
Q

What are the categories of agents used in the management of STIs?

A
  • Penicillins
  • Cephalosporins
  • Macrolides
  • Nitroimidazoles
  • Antiviral agents
  • Antiretrovirals
  • Insecticides
683
Q

What is the definition of antimicrobial agents?

A

Any compound that kills or inhibits microorganisms

684
Q

How are antibiotics defined?

A

A substance produced by one microorganism, which inhibits the growth of other microorganisms

685
Q

What is selective toxicity?

A

The principle that antimicrobials inhibit or kill microorganisms with minimal or no adverse effects on host cells/tissues

686
Q

What are the main modes of action of antibiotics?

A
  • Inhibition of bacterial cell wall synthesis
  • Inhibition of bacterial protein synthesis
  • Inhibition of folate synthesis
  • Inhibition of transcription of bacterial RNA
  • Inhibition of bacterial DNA gyrase and topoisomerase IV
687
Q

What are the two main groups of antibiotics affecting the bacterial cell wall?

A
  • Beta-lactam antibiotics
  • Glycopeptides
688
Q

Why is the bacterial cell wall an ideal target for antibacterial agents?

A

Mammalian cells do not have cell walls

689
Q

What is peptidoglycan and its significance in bacterial cell walls?

A

A macromolecule composed of sugar chains cross-linked with peptide bridges, accounting for the shape, strength, and integrity of bacterial cells

690
Q

What are the common side effects of penicillins?

A

Diarrhoea, hypersensitivity reactions

691
Q

What defines the bactericidal action of penicillins?

A

Inhibition of bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs)

692
Q

What are the characteristics of penicillins regarding spectrum of activity?

A

Active against many Gram-positive organisms and some Gram-negative cocci

693
Q

Fill in the blank: The __________ is composed of a fused thiazolidine ring and a beta-lactam ring.

A

penicillin nucleus

694
Q

True or False: Penicillins can be administered orally regardless of food intake.

695
Q

What is the effect of beta-lactamases on penicillins?

A

They can inactivate penicillins, leading to treatment failure

696
Q

What is the significance of acid stability in penicillins?

A

Na and K salts of penicillins are very soluble but hydrolyzed in solution, affecting oral administration

697
Q

Which antibiotic group is commonly used for treating STIs?

A

Antibacterial agents

698
Q

What is the role of aminoglycosides in bacterial treatment?

A

Inhibition of bacterial protein synthesis

699
Q

What are the clinical considerations when using penicillins?

A
  • Take before food (except Amoxycillin)
  • Monitor for hypersensitivity reactions
  • Consider renal function for dosing
700
Q

What is the recommended way to administer penicillins?

A

Orally on an empty stomach, except for Amoxycillin

Amoxycillin can be taken with food.

701
Q

What is the site of action of beta-lactamases?

A

The beta-lactam ring of penicillins

Beta-lactamases are enzymes that provide resistance to certain antibiotics.

702
Q

What are the consequences of beta-lactamase production by bacteria?

A

Destruction of many penicillins, leading to antibiotic resistance

Certain bacteria, like some Staphylococcus strains, produce beta-lactamases.

703
Q

What are beta-lactamase inhibitors used with penicillins?

A

Clavulanate and Tazobactam

These inhibitors help restore the effectiveness of penicillins against beta-lactamase-producing bacteria.

704
Q

What percentage of patients experience allergy to penicillins?

A

About 10%

Anaphylaxis occurs in approximately 0.01% of patients.

705
Q

What is the risk of cross-hypersensitivity with penicillins?

A

5-10% with other penicillins, cephalosporins, and carbapenems

This can complicate treatment options for allergic patients.

706
Q

How does food affect the absorption of penicillins?

A

Absorption is impaired by food, except for Amoxycillin

This means that penicillins should generally be taken on an empty stomach.

707
Q

What is the preferred parenteral route for administering penicillins?

A

Intravenous (IV)

Intramuscular (IM) injection can be painful, with exceptions for Procaine and Benzathine penicillins.

708
Q

What are common side effects of penicillins?

A

Diarrhea, nausea, rash, superinfection

Rare side effects include anaphylactic shock and Stevens-Johnson syndrome.

709
Q

What are the four main groups of penicillins?

A

Natural Penicillins, Aminopenicillins, Antistaphylococcal penicillins, Antipseudomonal penicillins

Each group differs in spectrum, stability, route of administration, side effects, and cost.

710
Q

What are examples of narrow spectrum penicillins?

A

Benzylpenicillin (Penicillin G), Phenoxymethylpenicillin (Penicillin V)

These are mainly effective against Gram-positive organisms and some Gram-negative cocci.

711
Q

What is Benzylpenicillin primarily used for?

A

Bacterial endocarditis, meningitis, aspiration pneumonia, syphilis

It is inactive orally and must be given parenterally.

712
Q

What defines the first generation of cephalosporins?

A

Cefazolin, Cefalotin, Cefalexin

They are characterized by their effectiveness against Gram-positive bacteria.

713
Q

What is the mode of action of cephalosporins?

A

Bactericidal, binding to penicillin-binding proteins (PBPs) in bacterial membranes

They are generally more stable to beta-lactamases than penicillins.

714
Q

What are the adverse effects associated with cephalosporins?

A

Generally well-tolerated, but can cause rash and nephrotoxicity

Cross-hypersensitivity with penicillins is also a concern.

715
Q

What are examples of broad-spectrum cephalosporins?

A

Cefotaxime, Ceftriaxone, Cefepime

These have increased activity against Gram-negative organisms.

716
Q

What are the main classes of antibacterials affecting protein synthesis?

A

Aminoglycosides, Macrolides, Lincosamides, Tetracyclines, Chloramphenicol, Oxazolidinones

These can be either bactericidal or bacteriostatic.

717
Q

What is the structure of bacterial ribosomes?

A

Composed of a 30S and a 50S subunit forming a 70S ribosome

Human ribosomes are larger, composed of 40S and 60S subunits.

718
Q

What is the mode of action of macrolides?

A

Bacteriostatic, inhibit protein synthesis by binding to the 50S ribosomal subunit

Examples include Erythromycin, Azithromycin, and Clarithromycin.

719
Q

What are macrolides used for clinically?

A

Broad spectrum against Gram-positive and some Gram-negative bacteria

They are alternatives for patients allergic to penicillins.

720
Q

What is the clinical usage of macrolides?

A

Broad spectrum against Gram + and some Gram - bacteria. Also active against H.pylori, M.pneumoniae, Treponema pallidum, Bordetella pertussis, Chlamydia, Legionella, and Campylobacter. Not active against enterococci.

Used as alternatives in patients allergic to penicillins or cephalosporins.

721
Q

What is Erythromycin used for?

A

Treatment and prophylaxis of Mycobacterium avium complex (MAC) and pertussis.

Erythromycin is the drug of choice for several infections, including Legionnaire’s disease.

722
Q

List common adverse effects of macrolides.

A
  • Nausea
  • Vomiting
  • Rashes
  • Diarrhoea
  • Abdominal pain and cramps
  • Candidal infections

Rare effects include anaphylaxis, acute respiratory distress, and Stevens-Johnson syndrome.

723
Q

What is the order of macrolides regarding drug interactions?

A

Erythromycin > Clarithromycin > Roxithromycin > Azithromycin

Macrolides inhibit CYP3A4, leading to clinically significant drug interactions.

724
Q

What are the clinical uses of Azithromycin?

A
  • Community-acquired pneumonia
  • Trachoma
  • Chlamydial genital infections
  • Gonorrhoea
  • Prophylaxis and treatment of MAC infections

Azithromycin is the main macrolide used in STIs.

725
Q

What is the mode of action of tetracyclines?

A

Bacteriostatic, reversibly bind to 30S subunit of ribosome.

Active against Rickettsia spp, Mycoplasma, Chlamydia, some Gram + and Gram - bacteria.

726
Q

List clinical uses of tetracyclines.

A
  • Sinusitis
  • Infection exacerbations of COPD
  • Pneumonia
  • Acne
  • Q fever
  • Syphilis
  • Malaria prophylaxis

Demeclocycline is used to treat SIADH but not as an antibiotic.

727
Q

What is a significant practice point for tetracyclines?

A

Chelation with Calcium, Magnesium, Aluminium, Iron can affect absorption.

Tetracycline is poorly absorbed from GIT and should be given in high doses.

728
Q

What are the adverse effects of Nitroimidazoles?

A
  • Nausea
  • Diarrhoea
  • Metallic taste
  • Thrombophlebitis (IV use)

Rare effects include pancreatitis, hepatitis, peripheral neuropathy, and CNS toxicity.

729
Q

What is the mode of action of Metronidazole?

A

Antibacterial and antiprotozoal, active against obligate anaerobic bacteria and protozoa by undergoing intracellular chemical reduction to active metabolites.

These metabolites are cytotoxic and interact with DNA, causing cell death.

730
Q

What is the treatment regimen for Chlamydia trachomatis?

A

Doxycycline 100mg BD for 7 days OR Azithromycin 1g oral stat.

Especially if pregnant or if adherence could be problematic.

731
Q

What is the first-line treatment for Syphilis?

A

Penicillin.

Rates of Syphilis are increasing globally, especially in low to middle-income countries.

732
Q

Describe the stages of viral infection in animal cells.

A
  • Adsorption
  • Penetration
  • Uncoating
  • Synthesis
  • Assembly
  • Release

The sequence of events that follows can be divided into these 6 main stages.

733
Q

What are guanine analogues and their clinical indications?

A
  • Aciclovir: Herpes simplex and shingles
  • Famciclovir: Herpes simplex and shingles
  • Valaciclovir: Herpes simplex, shingles, and CMV
  • Ganciclovir: CMV
  • Valganciclovir: CMV

Converted by viral and cellular enzymes to nucleotides which inhibit viral DNA polymerase.

734
Q

What are examples of antiviral drugs classified as neuraminidase inhibitors?

A
  • Oseltamivir
  • Zanamivir

They are used for treating Influenza A and B.

735
Q

True or False: Azithromycin is used for treating only Gram + infections.

A

False.

Azithromycin is also effective against Gram - bacteria and various STIs.

736
Q

What are the main clinical uses of Aciclovir?

A

Treatment and suppression of episodes of genital herpes simplex, shingles, and H.simplex encephalitis

Aciclovir is an antiviral medication that is effective in treating infections caused by certain types of viruses.

737
Q

What conditions are Ganciclovir and Valganciclovir used to treat?

A

CMV retinitis, CMV infection in bone marrow and organ transplant patients, prevention of CMV disease following solid organ transplant

Ganciclovir is particularly used in immunocompromised patients.

738
Q

What is Cytomegalovirus (CMV) responsible for in immunocompromised patients?

A

Severe disseminated infections, pneumonia, encephalitis, hepatitis, or retinitis

CMV can affect any organ but is most often associated with these conditions.

739
Q

What is a significant problem associated with Aciclovir?

A

Multiple daily dosing and the requirement for adequate hydration to prevent renal complications

Aciclovir crystals can form in renal tubules if hydration is not maintained.

740
Q

When is the best time to start treatment for shingles to achieve optimal response?

A

Within 48 hours of onset of symptoms

Starting treatment beyond 72 hours offers little benefit unless the patient is immunocompromised.

741
Q

What is the difference between Valaciclovir and Aciclovir?

A

Valaciclovir is a pro-drug that is converted to aciclovir in the liver, providing better oral bioavailability

This means that Valaciclovir requires fewer doses compared to Aciclovir.

742
Q

What are the common oral agents preferred for treating shingles and H.simplex?

A

Famciclovir and Valaciclovir

These agents are preferred due to better oral bioavailability and less frequent dosing.

743
Q

What is the dosage of Aciclovir for the first episode of genital herpes?

A

400 mg Q8H for 10 days

Alternative treatments include Famciclovir or Valaciclovir at specified dosages.

744
Q

What is the purpose of antiretroviral therapy in HIV/AIDS treatment?

A

Restoration and preservation of immune function, improving quality of life, and reducing HIV-related disease progression

Antiretroviral therapy cannot cure HIV but aims to manage the infection effectively.

745
Q

Name at least three classes of antiretroviral agents.

A
  • Nucleoside reverse transcriptase inhibitors (NRTI)
  • Non-nucleoside reverse transcriptase inhibitors (NNRTI)
  • Protease inhibitors (PI)

Each class works through different mechanisms to suppress HIV replication.

746
Q

What is HAART in the context of HIV treatment?

A

Highly Active Antiretroviral Therapy

HAART typically involves using three or more antiretrovirals from different classes to effectively suppress HIV replication.

747
Q

What are common adverse effects associated with antiretroviral therapy?

A
  • Lipodystrophy
  • Hyperglycaemia
  • Dyslipidaemia
  • Hepatotoxicity
  • Bone density changes
  • Rash

The incidence of adverse drug reactions can vary significantly between different antiretroviral groups.

748
Q

Which cells are primarily targeted by the HIV virus?

A

T4 lymphocytes, but also glial cells, monocytes, and macrophages

The binding of HIV to CD4 antigens leads to immunosuppression.

749
Q

What is seroconversion illness, and when does it occur?

A

Occurs 2-4 weeks after HIV infection, presenting with fever, headache, pharyngitis, nausea, CNS symptoms, mucocutaneous ulcers, rashes

It is experienced by 5-70% of patients.

750
Q

What is the rationale for starting antiretroviral therapy in HIV-infected individuals?

A

Reduction in HIV-associated morbidity and mortality, prevention of HIV transmission

Treatment has shown to reduce transmission risk significantly, especially in serodiscordant couples.

751
Q

When should antiretroviral therapy be initiated?

A

In all pregnant women with HIV, patients with HIV and chronic Hepatitis B requiring treatment, asymptomatic patients with CD4 count <500 cells/microlitre

There are specific recommendations for different CD4 count thresholds.

752
Q

What is the most common regimen for HIV treatment?

A

Two NRTI/NtRTIs plus either one NNRTI or one PI

An example of a regimen includes Emtricitabine and Tenofovir with Efavirenz.

753
Q

What are the most common components of an HIV antiretroviral regimen?

A

Two NRTI/NtRTIs (Emtricitabine and Tenofovir) plus either one NNRTI (Efavirenz) or one PI (Atanzavir) or one Integrase inhibitor (Dolutegravir or Elvitegravir + cobicistat or Raltegravir)

Emtricitabine and Tenofovir are available in combination as Truvada®, while Efavirenz + Emtricitabine + Tenofovir is available as Atripla®.

754
Q

What is required when commencing therapy with antiretrovirals?

A

Comprehensive counselling regarding the nature of disease, treatment implications, and importance of compliance (>90% compliance required for best results)

Assessment of cardiovascular risk, diabetes, general health, CD4 counts, viral load, opportunistic infections, hepatitis, and other STIs is also necessary.

755
Q

How often should therapy with antiretrovirals be monitored initially?

A

Initially 2-4 weeks after starting therapy and then every 3-4 months if stable, with a review extended to 6 months if stable for >2 years

Monitoring should include clinical status, compliance, HIV viral load, and CD4 cell count.

756
Q

What is the target for HIV viral load after starting antiretroviral therapy?

A

Viral load should fall at least 10-fold within 4-6 weeks and to <50 copies/ml after 3-6 months in all patients

CD4 count usually increases by 100-200 cells/microliter after 12 months.

757
Q

What should be monitored every 3 months during antiretroviral therapy?

A

Blood counts, electrolytes, LFTs, and RFTs

Cardiovascular risk factors such as smoking, diet, exercise, BP, weight, BSL, and serum lipids should also be assessed.

758
Q

What is the first-line treatment for Candidiasis in HIV patients?

A

Nystatin or Miconazole for minor infections; systemic antifungals like Fluconazole or Itraconazole for severe cases

Fluconazole is given at 50-100mg daily for 10-14 days.

759
Q

What is the first-line treatment for Pneumocystis jiroveci pneumonia (PCP)?

A

Co-trimoxazole either orally or IV for 21 days

Monitoring of full blood counts and renal and liver function is required twice-weekly.

760
Q

What is recommended for maintenance therapy after successful PCP treatment?

A

Trimethoprim + Sulfamethoxazole or Dapsone or Atovaquone or Pentamidine

Options are listed in order of preference.

761
Q

When should primary prophylaxis for PCP be started in HIV patients?

A

If CD4 count is <200 cells/microliter or CD4 cell % <14% or if the patient suffers from oropharyngeal candidiasis

This is to prevent the onset of PCP.

762
Q

What is the treatment for Mycobacterium avium complex (MAC) in HIV patients?

A

Ethambutol plus either Clarithromycin or Azithromycin, with or without Rifabutin

Primary prophylaxis should start when CD4 count is <50 cells/microliter.

763
Q

What are the main antiviral drugs used for CMV infections in HIV patients?

A

Ganciclovir, Valganciclovir, Foscarnet, Cidofovir

Valganciclovir is often preferred for outpatient treatment due to its oral administration.

764
Q

What is the main disadvantage of Ganciclovir?

A

Bone marrow suppression and cytotoxic precautions required in preparation

It is related in structure and mechanism of action to aciclovir but is effective against CMV.

765
Q

What are other potential opportunistic infections in HIV patients?

A
  • Cryptococcus neoformans
  • Cryptosporidium parvum
  • Hepatitis B and C viruses
  • Herpes simplex virus (HSV)
  • Isospora belli
  • Mycobacterium tuberculosis
  • Toxoplasma gondii
  • Treponema pallidum
  • Varicella-zoster virus (VZV)

HIV/AIDS patients are also at greater risk of certain malignancies such as Kaposi’s sarcoma and malignant melanoma.

766
Q

What is the risk percentage of acquiring HIV from percutaneous exposure?

A

Approximately 0.3%

Mucocutaneous exposure has a risk of <0.1%.

767
Q

What should be done immediately after potential HIV exposure?

A

Wash the site of exposure with soap and water without scrubbing

Allow free bleeding but do not squeeze or suck the wound.

768
Q

What does PEP stand for?

A

Post Exposure Prophylaxis

PEP is a medical treatment to prevent HIV infection after potential exposure.

769
Q

List some body fluids associated with risk of HIV infection.

A
  • Breast milk
  • CSF
  • Amniotic fluid
  • Any visibly blood stained fluid

CSF stands for cerebrospinal fluid.

770
Q

What should you do immediately after exposure to a potential HIV source?

A
  • Wash the site with soap and water without scrubbing
  • Allow free bleeding but do not squeeze or suck the wound
  • Irrigate affected mucous membranes with water
771
Q

When is follow-up testing required for the exposed person after a potential HIV exposure?

A

If the source is HIV antibody/antigen negative and unlikely to be in the window period, no follow-up is required.

772
Q

What is the risk of HIV transmission determined by?

A
  • Nature of the exposure
  • Likelihood that the source is HIV positive
  • Other factors associated with the source and exposed person
773
Q

When should PEP be started after exposure?

A

As soon as possible after exposure and within 72 hours.

774
Q

What is recommended for low-risk exposures in PEP regimens?

A
  • Emtricitabine + Tenofovir (Truvada®) 200+300mg oral daily for 4 weeks
  • Lamivudine + Zidovudine (Combivir®) 150+300mg oral BD for 4 weeks
775
Q

What additional agents are recommended for high-risk exposures in PEP regimens?

A
  • Lopinavir + Ritonavir (Kaletra®) 400+100mg oral BD for 4 weeks
  • Raltegravir 400mg oral BD for 4 weeks
776
Q

What does PrEP stand for?

A

Pre-Exposure Prophylaxis

PrEP is the use of antiretrovirals by HIV-negative individuals to reduce the risk of HIV exposure.

777
Q

What is an important consideration when using PrEP?

A

PrEP offers no protection for other STIs.

778
Q

Which group of individuals is shown to benefit significantly from PrEP?

A

Men who have sex with men.

779
Q

What is the treatment for pubic lice?

A
  • Use Maldison or permethrin applications
  • Consider shaving pubic and body hair
  • Wash underwear and bedding
780
Q

What is a recommended method for treating eyelashes infested with pubic lice?

A

Apply a layer of white soft paraffin twice daily for 8 days.

781
Q

What is complement?

A

Complement is at the centre of the development of inflammatory reactions. It is a heat labile component of the serum comprising 16 plasma proteins that constitute 10% of total serum proteins.

782
Q

What are the functions of complement?

A
  • Triggering and amplification of inflammatory reactions
  • Attraction of phagocytes by chemotaxis
  • Clearance of immune complexes
  • Cellular activation
  • Direct microbial killing
  • Important role in the development of antibody responses
783
Q

What is the significance of complement components in individuals?

A

Individuals lacking specific complement components, such as C3, are subject to overwhelming bacterial infections.

784
Q

What are the three primary pathways of complement activation?

A
  • Lectin Pathway
  • Classical Pathway
  • Alternative Pathway
785
Q

What is the terminal pathway in complement activation?

A

The terminal pathway is the final stage that all three complement activation pathways lead to.

786
Q

What is the role of C3 in complement activation?

A

C3 is the most abundant and important of the complement proteins, involved in all three activation pathways.

787
Q

How are complement proteins named?

A

Complement proteins are named in the order of discovery, not the order of function (C1, C4, C3, C5, C6, C7, C8, C9).

788
Q

What is opsonization in the context of complement proteins?

A

Opsonization is primarily mediated by C3b and C4b, which bind covalently to pathogen surfaces, allowing phagocytes to recognize and engulf them.

789
Q

What are anaphylatoxins and their role in inflammation?

A

Anaphylatoxins, primarily C3a and C5a, are important inflammatory activators that induce vascular permeability and recruit phagocytes.

790
Q

How does the Membrane Attack Complex (MAC) lead to cell lysis?

A

C5b binds to the target surface, recruits C6 and C7, and forms a complex that inserts into the lipid bilayer, leading to cell lysis.

791
Q

How do C4b and C3b contribute to immune complex clearance?

A

C4b and C3b covalently bind to immune complexes, which are recognized by CR1 complement receptors on red blood cells for transport to the liver and spleen.

792
Q

What is a pseudoallergic response?

A

A pseudoallergic response occurs without prior sensitization and can manifest as acute allergic reactions, especially with liposome or polymeric nanoparticle infusion.

793
Q

What is the connection between complement activation and allergic reactions to liposomes?

A

Liposome-induced pseudoallergic responses are strongly correlated with complement activation, leading to rapid production of anaphylatoxins.

794
Q

What was reported regarding Doxil® and complement activation?

A

In a study, 13 out of 29 cancer patients experienced acute allergic reactions, with complement activation detected in 72% of patients.

795
Q

What is the effect of PEGylation on complement activation?

A

PEGylation appears to induce cardiopulmonary distress due to complement activation related pseudoallergic responses.

796
Q

What were the findings regarding PEG and complement activation in experiments?

A
  • Increase in C4 and SC5b levels suggests Lectin pathway
  • No activation with C4 depleted serum indicates dependence on C4b2a
  • No factor B split products (Bb) rules out Alternative Pathway
  • Activation in C1q depleted serum confirms Classical Pathway not involved
797
Q

What adverse reactions have been observed with PEG in veterinary products?

A

Adverse reactions include ataxia, restlessness, trembling, respiratory abnormalities, and even death in livestock.

798
Q

How does PEG potentially affect human diseases?

A

PEG has been perceived as immunologically safe but may lead to unexplained adverse reactions similar to those observed in veterinary settings.

799
Q

What is the concentration effect of PEGs on complement activation?

A

PEGs with molecular weights below 10nm activate exclusively through the C4 pathway, while those above 10nm activate through both the lectin and alternative pathways.

800
Q

Fill in the blank: The _____ pathway is the most recently described activation pathway that bypasses antibody for efficient activation on pathogens.

801
Q

True or False: The Classical pathway of complement activation is antibody-independent.

802
Q

What is the role of soluble complement receptor type 1 (sCR1)?

A

sCR1 inhibits complement activation and suppresses liposome-induced cardiopulmonary changes.

803
Q

What is the mechanism by which PEG targets spinal cord contusions?

A

PEG anatomically seals membranes of damaged axons through fusion, restoring neuronal excitability.

804
Q

Who is more likely to experience UTIs?

A

More common in women (50% at some stage) but more serious in men (complicated UTIs).

805
Q

What are the types of UTIs?

A
  • Upper urinary tract infections - pyelonephritis
  • Lower UTIs - cystitis, urethritis, prostatitis
806
Q

What is cystitis?

A

A common infection of the bladder.

807
Q

What is urethritis usually associated with?

A

Usually sexually transmitted.

808
Q

What are common symptoms of UTIs?

A
  • Increased urinary frequency
  • Dysuria
  • Haematuria
  • Fever
  • Confusion
  • Flank pain (pyelonephritis)
809
Q

What does leukocyte esterase indicate?

A

An enzyme released by WBCs indicating infection.

810
Q

What do bacteria like E. coli convert nitrates to?

811
Q

What constitutes uncomplicated cystitis?

A

Healthy adult, non-pregnant woman with no fever, loin or flank pain.

812
Q

What are the antibiotic treatment guidelines for UTIs in women?

A

3 days of antibiotic treatment.

813
Q

What is the first-line antibiotic for uncomplicated cystitis?

A

Nitrofurantoin 100mg m/r bd.

814
Q

What should be avoided when prescribing nitrofurantoin?

A

If eGFR is less than 45mL per min.

815
Q

What are the second-line antibiotics for UTIs?

A

Trimethoprim 200mg bd.

816
Q

What does ESBL stand for?

A

Extended-spectrum beta-lactamases.

817
Q

Which bacteria commonly produce ESBLs?

A
  • Escherichia coli (E. coli)
  • Klebsiella species
818
Q

What serious condition can E. coli with ESBLs cause?

A

Urinary tract infections that can progress to blood poisoning.

819
Q

What has been the trend regarding ESBL-producing enterobacteriaceae from 2001 to 2012?

A

Increase in resistance.

820
Q

What is the first-line treatment for resistant UTIs?

A

Pivmecillinam 400mg STAT then 200mg tds after sensitivity testing.

821
Q

What is the recommended treatment for pregnant women with complicated UTIs?

A
  • 1st line: Nitrofurantoin 100mg m/r bd for 7 days
  • 2nd line: Amoxicillin 500mg tds
  • 3rd line: Cefalexin 500mg bd
822
Q

What defines recurrent UTIs (RUTI)?

A

More than 3 infections a year.

823
Q

What should be done if haematuria is present in recurrent UTIs?

A

Rule out red flag factors.

824
Q

What is the recommended prophylactic antibiotic for recurrent UTIs?

A

Trimethoprim 100mg nocte or nitrofurantoin 50-100mg nocte for 6 months.

825
Q

What is prostatitis?

A

An infection that can occur at any age, unlike BPH and prostate cancer.

826
Q

What is the typical treatment duration for prostatitis?

A

4-week course, usually with quinolone.

827
Q

What is a common complication of acute pyelonephritis?

A
  • Septic shock
  • Chronic pyelonephritis
  • Chronic renal insufficiency
828
Q

What are the common symptoms of acute pyelonephritis?

A
  • Urinary urgency
  • Urinary frequency
  • Burning sensation
  • Haematuria
  • Nocturia
  • Dysuria
  • Cloudy urine
  • Fever
  • Chills
  • Nausea
  • Flank pain
  • Poor appetite
  • Low back pain
  • Fatigue
829
Q

What is the first-line treatment for acute pyelonephritis?

A

Ciprofloxacin 500mg bd for 7 days.

830
Q

What should be done if a UTI is resistant to trimethoprim and nitrofurantoin?

A

Pivmecillinam 400mg tds for 7 days.

831
Q

What is the largest organ of the body?

A

Skin

Skin accounts for 15% of the total adult body weight.

832
Q

What are the primary functions of the skin?

A

Protection against external influences, prevention of dehydration (thermoregulation)

Skin acts as a barrier to physical, chemical, and biological agents.

833
Q

What are the three layers of the skin?

A

Epidermis, dermis, subcutaneous tissue

834
Q

What type of cells primarily compose the epidermis?

A

Keratinocytes

835
Q

What is the function of keratinocytes?

A

Synthesize keratin, a threadlike protein

836
Q

What are the four layers of the epidermis?

A

Basal cell layer (stratum germinativum), squamous cell layer (stratum spinosum), granular cell layer (stratum granulosum), cornified or horny cell layer (stratum corneum)

837
Q

What is keratinization?

A

The differentiation process of keratinocytes as they move from the basal layer to the skin surface

838
Q

What occurs in the basal layer of the epidermis?

A

Active cell division and proliferation of basal cells

839
Q

What is the role of melanocytes in the epidermis?

A

Pigment-synthesizing cells that produce melanin

840
Q

True or False: Keratinocytes make up about 80% of the cells in the epidermis.

841
Q

What are Langerhans cells involved in?

A

T-cell responses and phagocytosis

842
Q

What is the function of Merkel cells?

A

Mechanoreceptors that increase tactile resolution and sensitivity

843
Q

Fill in the blank: The epidermis is a _______ epithelium layer.

A

stratified, squamous

844
Q

What is the cornified layer rich in?

A

Protein and low in lipid content

845
Q

What regulates cell proliferation and differentiation in the epidermis?

A

Cellular signaling molecules (hormones, growth factors, cytokines)

846
Q

What can result from the disruption of epidermal thickness equilibrium?

A

Conditions such as psoriasis and skin tumors

847
Q

What is the role of desmosomes in the squamous cell layer?

A

Provide resistance to physical stresses

848
Q

What is the significance of keratohyaline granules in the granular layer?

A

Involved in the synthesis and modification of keratins

849
Q

What happens to keratinocytes during terminal differentiation?

A

They convert into protective corneocytes through apoptosis

850
Q

What is the primary role of the dermis?

A

Maintenance of post-natal structure and function

851
Q

How does UV light exposure affect melanocytes?

A

Stimulates an increase in melanin production and transfer to keratinocytes

852
Q

What type of junctions do Merkel cells form with basal keratinocytes?

A

Desmosomal junctions

853
Q

What is the characteristic of the cells in the cornified layer?

A

They are large, flat, and considered dead cells

854
Q

What percentage of the total epidermal cell population do the cells that develop and circulate in the epidermis represent?

A

2%–8%

These cells maintain constant numbers and distributions in specific areas of the body.

855
Q

What attaches the dermal-epidermal junction to the basal lamina?

A

Hemi-desmosomes

These structures distribute shearing forces through the epithelium.

856
Q

What is the function of the dermal-epidermal junction?

A

Provides support, developmental signals, directs cytoskeleton organization, and functions as a semi-permeable barrier

It allows the exchange of fluid between the epidermis and dermis.

857
Q

What are epidermal appendages derived from?

A

Ectoderm

This includes eccrine and apocrine glands, ducts, and pilo-sebaceous units.

858
Q

What is the primary function of eccrine sweat glands?

A

Thermal regulation

Eccrine sweat glands are particularly plentiful on the soles of the feet.

859
Q

What are the three parts of the eccrine sweat unit?

A
  • Intra-epidermal spiral duct
  • Straight dermal portion
  • Coiled secretory duct
860
Q

Where are apocrine sweat glands primarily located?

A

Axillae and perineum

They are involved in scent release and do not open to the skin surface directly.

861
Q

What biological functions does hair serve?

A
  • Protection from environmental elements
  • Distribution of sweat-gland secretions
  • Psychosocial role in society
862
Q

What determines the number and distribution of hair follicles?

A

Inheritance

The phenotype of hair is expressed early during embryonic development.

863
Q

In hair differentiation, what structures are produced at the base of the hair follicle?

A
  • Hair cone
  • Cuticle
  • Inner root sheaths
864
Q

What is the role of matrix cells in the hair bulb?

A

Produce inner and outer root sheaths and the hair shaft

These cells are involved in hair growth.

865
Q

What determines hair color?

A

Distribution of melanosomes in the hair shaft

Aging leads to loss of melanocytes and greying of hair.

866
Q

What are the three stages of the hair growth cycle?

A
  • Anagen
  • Catagen
  • Telogen
867
Q

What is the growth rate of fingernails compared to toenails?

A

Fingernails grow at 0.1 mm per day, 2-3 times faster than toenails

The slow growth rate of toenails can indicate past toxic exposure.

868
Q

What is the primary component of the dermis?

A

Collagen

Collagen provides flexibility, elasticity, and strength to the skin.

869
Q

What are the two components of the dermal vasculature?

A
  • Sub-papillary superficial plexus
  • Deeper plexus
870
Q

What role do mast cells play in the body?

A

Active role in allergy, atherosclerosis, parasitic diseases, malignancy, pulmonary fibrosis, arthritis, and asthma

They are concentrated in the papillary dermis.

871
Q

What is the function of the smooth muscle in the skin?

A

Causes hair follicles to contract and pull into a vertical position

This results in ‘gooseflesh’ skin.

872
Q

What type of sensations do unmyelinated nerve fibers transmit?

A

Pain, temperature, and itch sensations

These fibers end around hair follicles and in the papillary dermis.

873
Q

What are some conditions associated with mast cells?

A

Allergy, atherosclerosis, parasitic diseases, malignancy, pulmonary fibrosis, arthritis, asthma.

874
Q

Where do fat cells develop during fetal development?

A

In the subcutaneous tissue.

875
Q

What separates lobules of fat cells in subcutaneous fat?

A

Fibrous septa made up of collagen and large blood vessels.

876
Q

What is the function of lipocytes?

A

Energy storage and hormone conversion.

877
Q

What hormone do lipocytes produce that regulates body weight?

878
Q

What are some common skin disorders?

A
  • Acne
  • Alopecia areata
  • Basal cell carcinoma
  • Bowen’s disease
  • Contact dermatitis
  • Eczema (atopic eczema)
  • Melanoma
  • Psoriasis
  • Scabies
  • Vitiligo.
879
Q

What are the three major types of skin cancer?

A
  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Melanoma.
880
Q

What is a common treatment for skin pigmentation problems?

A

Hydroquinone (2-4%).

881
Q

What is the most effective drug for treating hyperpigmentation?

A

Triluma (4% hydroquinone, tretinoin, and a corticosteroid).

882
Q

What is the mainstay of skin whitening ingredients?

A

Hydroquinone.

883
Q

Fill in the blank: Hydroquinone is the most effective _______ available in skin lightening products.

A

tyrosinase inhibitor.

884
Q

What is the first-line treatment for head lice in pregnant or breastfeeding women?

A

Wet combing or dimeticone 4% lotion

Dimeticone is preferred for young children aged 6 months to 2 years and individuals with asthma or eczema.

885
Q

Why are shampoos generally not recommended for head lice treatment?

A

Shampoos are diluted too much and have insufficient contact time to kill eggs.

886
Q

What is the first-line treatment for oral thrush?

A

Miconazole oral gel

Unlicensed for use in children younger than 4 months, or 5-6 months for pre-term infants.

887
Q

What should be done if a candida infection fails to respond after 1 to 2 weeks of treatment?

A

The child should be sent for investigation to eliminate the possibility of underlying disease.

888
Q

Which viruses commonly cause Hand, Foot and Mouth Disease?

A

Coxsackieviruses

The most common is coxsackie virus A16.

889
Q

What hygiene measures should be advised to reduce the risk of transmission of Hand, Foot and Mouth Disease?

A

General hygiene measures.

890
Q

What is a common concern regarding threadworms?

A

It can be highly distressing.

891
Q

Is exclusion from school or nursery required for threadworms?

A

It depends on the specific case.

892
Q

What is scabies?

A

Common infestation of the skin caused by tiny mites that burrow into the skin.

893
Q

How is scabies commonly spread?

A

Between family members.

894
Q

What are common symptoms of scabies in babies?

A

Tiny and very itchy spots all over the body, including soles of the feet, armpits, and genital area.

895
Q

What treatment is recommended for scabies?

A

Creams that kill the scabies mite need to be given to the whole family at the same time.

896
Q

What is chickenpox?

A

A common illness that mainly affects children and causes an itchy, spotty rash.

897
Q

When do symptoms of chickenpox typically start?

A

One to three weeks after becoming infected.

898
Q

Is chickenpox contagious, and when?

A

Yes, until all the blisters have scabbed over.

899
Q

What is ringworm?

A

A common fungal skin infection that causes a ring-like red rash almost anywhere on the body.

900
Q

How is ringworm usually treated?

A

Using non-prescription creams.

901
Q

What are early symptoms of meningitis?

A
  • Pain in the muscles, joints, or limbs
  • Unusually cold hands and feet or shivering
  • Pale or blotchy skin and blue lips
  • Severe headache
  • Fever
  • Vomiting
  • Feeling generally unwell
902
Q

What is considered a fever in adults and children?

A

A body temperature of 38ºC (100.4ºF) or above.

903
Q

What are later symptoms of meningitis?

A
  • Drowsiness
  • Confusion
  • Seizures or fits
  • Unable to tolerate bright lights (photophobia)
  • Stiff neck
  • Rapid breathing rate
  • Blotchy red rash that does not fade with pressure
904
Q

What are paediatric warning symptoms?

A
  • Loss of appetite
  • > 24hrs without wet nappy
  • Loss of weight
  • Persistent raised temperature
  • Breathing problems
  • Significant earache
  • Discharge from one nostril only
  • Temperature and sore throat
  • Persistent night cough
  • Blood loss from any orifice
  • Neck stiffness
  • Photophobia
  • Rash which does not blanch on pressure
905
Q

What is urticaria?

A

A raised, itchy rash that appears on the skin, also known as hives, weals, or welts.

906
Q

What causes urticaria?

A

High levels of histamine and other chemical messengers released in the skin due to triggers.

907
Q

What are common triggers for urticaria?

A
  • Allergic reactions (e.g., food allergy, insect bites)
  • Cold or heat exposure
  • Infections (e.g., cold)
  • Certain medications (e.g., NSAIDs, antibiotics)
908
Q

What is anaphylaxis?

A

A severe allergic reaction that can be life-threatening.

909
Q

What are some symptoms of anaphylaxis?

A
  • Swollen eyes, lips, tongue, hands, and feet
  • Feeling lightheaded or faint
  • Narrowing of the airways
  • Abdominal pain, nausea, and vomiting
  • Collapsing and becoming unconscious
910
Q

What is baby acne?

A

Pimples that develop on a baby’s cheeks, nose, and forehead within a month of birth.

911
Q

How can you improve the appearance of baby acne?

A

Washing the baby’s face with water and a mild moisturiser.

912
Q

What is Fifth disease?

A

A viral infection that causes a rash, often referred to as slapped cheek syndrome.

913
Q

What is hand, foot, and mouth disease?

A

A common viral illness causing a blistery rash on hands and feet, and ulcers in the mouth.

914
Q

What is impetigo?

A

A highly contagious bacterial infection of the surface layers of the skin causing sores and blisters.

915
Q

How is impetigo treated?

A

With antibiotics (oral or topical).

916
Q

What is slapped cheek syndrome?

A

A viral infection causing a bright red rash on both cheeks and a fever, common in children.

917
Q

What advice can be offered for chickenpox?

A
  • Daily baths
  • Cut fingernails to prevent secondary infection
  • Paracetamol/ibuprofen for fever
  • Calamine or virasoothe for itchiness
  • Stay off school until last spot crusts over
918
Q

What should be done if a rash does not blanch on pressure?

A

This could indicate a serious condition and should be evaluated by a GP.

919
Q

Fill in the blank: Urticaria occurs when a trigger causes high levels of _______ to be released in the skin.

920
Q

What are the objectives of the immunology therapeutics course related to childhood eczema?

A

Describe skin structure & function, understand types of eczema affecting children and their management, understand general management of emollients and corticosteroids in childhood dermatological conditions.

921
Q

How many types of eczema are there?

A

7 types of eczema.

922
Q

What are the three common types of eczema in early years?

A
  • Atopic Eczema
  • Seborrhoeic Eczema
  • Nappy rash (Contact dermatitis)
923
Q

What is Atopic Eczema?

A

Immune system induced eczema.

924
Q

What is Seborrhoeic Eczema also known as?

A

Cradle cap or dandruff.

925
Q

What causes nappy rash?

A

Contact dermatitis.

926
Q

What are the functions of the skin?

A
  • Provides barrier
  • Reduces water and electrolyte loss
  • Prevents entry of micro-organisms
  • Temperature regulation
  • Sensation (touch, pain, temperature, itch)
927
Q

What is the typical age of onset for Atopic Eczema in children?

A

Often develops before their first birthday.

928
Q

What percentage of children in the UK are affected by Atopic Eczema?

A

1 in 5 children.

929
Q

What are the symptoms of mild Atopic Eczema?

A

Dry, scaly, red, itchy.

930
Q

What are some common trigger factors for Atopic Eczema?

A
  • Soap and detergents
  • Skin infection
  • House-dust mites
  • Animal dander
  • Pollens
  • Overheating
  • Rough clothing
931
Q

What are emollients?

A

Moisturising treatments applied topically to soothe, smooth, protect, and hydrate the skin.

932
Q

What is Complete Emollient Therapy (CET)?

A

A regimen to keep skin moisturized by using a combination of products liberally and frequently.

933
Q

What should be done if a patient reports skin irritation after using aqueous cream?

A

Discontinue treatment and try an alternative emollient that does not contain SLS.

934
Q

How often should emollients be applied?

A

At least 3-4 times a day.

935
Q

What should you avoid doing when applying emollients?

A

Do not rub; apply in a downward motion.

936
Q

What are topical corticosteroids used for?

A

To reduce inflammation and irritation in flare-ups of eczema.

937
Q

What are the available forms of topical corticosteroids?

A
  • Creams
  • Lotions
  • Gels
  • Mousses/Foams
  • Ointments
  • Tapes
938
Q

What is the potency classification of corticosteroids?

A
  • Mild
  • Moderate
  • Potent
  • Very Potent
939
Q

What is the recommended application frequency for corticosteroids?

A

Once or twice a day for 1-2 weeks.

940
Q

What is a Finger Tip Dosage Unit (FTDU)?

A

Length of cream/ointment from a tube squeezed from the tip of an adult index finger to the crease.

941
Q

What is Seborrhoeic Eczema commonly known as?

A

Cradle cap.

942
Q

What are the characteristics of cradle cap?

A

Greasy, yellow or brown scaly patches on the scalp.

943
Q

What should be done if cradle cap does not improve?

A

Use greasy emollients or soap substitutes.

944
Q

What causes nappy rash?

A

Prolonged exposure to urine and/or faeces.

945
Q

What is the treatment for bacterial infection of nappy rash?

A

Advise about skin care, apply barrier preparation, and refer to a doctor.

946
Q

When should a doctor be consulted for nappy rash?

A

If it spreads, worsens, or if there are systemic symptoms.

947
Q

What is an example of an antifungal cream?

A

Clotrimazole

Clotrimazole is commonly used to treat fungal infections.

948
Q

When should barrier preparation be applied for nappy rash?

A

After the candidal infection has settled

This ensures that the barrier can effectively protect the skin.

949
Q

What are the two types of infections commonly associated with nappy rash?

A

Bacterial and Fungal

Both types can cause complications in nappy rash.

950
Q

What are the signs that indicate a need to see a doctor for nappy rash?

A

Spreading to other areas, getting worse or not responding to treatment, bacterial infection present or suspected, fungal infection co-existing with oral thrush, systemic symptoms (fever)

These signs indicate potential complications that require medical evaluation.

951
Q

What should you be able to describe regarding childhood dermatological conditions?

A

Basic skin structure & function

Understanding skin anatomy is essential for assessing and treating dermatological issues.

952
Q

What types of eczema should one understand that affects children?

A

Types of eczema

Knowledge of different eczema types is crucial for effective management.

953
Q

What are the general management strategies for childhood dermatological conditions?

A

Emollients and corticosteroids

These are commonly used to manage various skin conditions in children.

954
Q

What is the antibody responsible for rapid onset immune response during a food allergy?

A

IgE

IgE is crucial in mediating allergic reactions.

955
Q

Food allergy can be classified into which two types?

A

Immunoglobulin E (IgE)-mediated allergy and Non-Immunoglobulin E (Non-IgE)-mediated allergy

These classifications help in understanding the mechanisms behind food allergies.

956
Q

What type of reactions are IgE-mediated reactions characterized by?

A

Acute and rapid onset

These reactions can lead to severe symptoms shortly after exposure.

957
Q

How are Non-IgE-mediated reactions characterized?

A

Non-acute and delayed onset

Symptoms may take hours or even days to appear.

958
Q

What is the testing method for IgE-mediated food allergy?

A

Skin prick test or blood test

These tests measure specific IgE antibodies.

959
Q

What does testing for non-IgE-mediated food allergy involve?

A

Elimination diet

The suspected allergen is avoided for 2-6 weeks before being reintroduced slowly.

960
Q

True or False: Applied kinesiology and hair analysis can confirm a suspected allergy.

A

False

These methods are not recognized as valid diagnostic tools.

961
Q

What are the risk factors for developing a food allergy?

A
  • Family history of allergy-related conditions
  • Other allergies
  • Age

These factors can increase the likelihood of developing food allergies.

962
Q

What distinguishes a food allergy from a food intolerance?

A

A true food allergy causes an immune system reaction, while food intolerance symptoms are generally less serious and often limited to digestive problems.

Allergies can be life-threatening, whereas intolerances usually are not.

963
Q

What are common symptoms of cow’s milk allergy?

A
  • Skin reactions (red itchy rash, swelling)
  • Digestive problems (stomach ache, vomiting, colic)
  • Hay fever-like symptoms
  • Eczema that doesn’t improve

Symptoms can vary widely among individuals.

964
Q

What is the first line treatment for anaphylaxis?

A
  • Securing the airway
  • Restoration of BP
  • Administration of adrenaline injection
  • High flow oxygen and rehydration
  • IV corticosteroid + IV/IM antihistamine

Prompt treatment is crucial for survival.

965
Q

What is the mechanism of action of Solu-Cortef?

A

It has an anti-inflammatory and immunosuppressive effect with a delayed onset of action to prevent further deterioration.

It is used in severe allergic reactions.

966
Q

What is an EpiPen used for and what is its dosage for non-pediatric patients?

A

It is used for immediate self-administration in allergic emergencies, with a dose of 0.3mg intramuscularly.

Pediatric dosage is 0.01mg/kg.

967
Q

What actions does adrenaline perform in anaphylaxis?

A
  • Strong vasoconstrictor action
  • Bronchial smooth muscle relaxation
  • Alleviates pruritis, urticaria, and angioedema

Adrenaline counteracts the life-threatening effects of anaphylaxis.

968
Q

What is lactose intolerance?

A

A condition where individuals have difficulty digesting lactose, leading to gastrointestinal discomfort.

It can be triggered by the consumption of dairy products.

969
Q

Fill in the blank: Non-IgE-mediated food allergy involves a _______ diet.

A

elimination

This diet helps identify food intolerances or allergies.

970
Q

Fill in the blank: Food intolerance symptoms may take several hours, even several _______ to appear.

A

days

This delayed reaction is a hallmark of food intolerance.

971
Q

What is an important counselling point regarding the use of Prednisolone?

A

Prednisolone should be stopped after the course is completed (e.g. three days)

Prednisolone is a corticosteroid used to reduce inflammation and suppress the immune system.

972
Q

What should patients be cautious about when taking sedating antihistamines?

A

Be careful if driving or operating machinery

Sedating antihistamines can cause drowsiness, impacting the ability to perform tasks that require alertness.

973
Q

What is crucial to ensure when prescribing an adrenaline auto-injector?

A

Specify the brand to be dispensed to ensure patients receive the device they have been trained to use

Different brands may have specific injection techniques that the patient needs to be familiar with.

974
Q

What should patients do regarding their self-injectable adrenaline?

A

Always keep the self-injectable adrenaline with them and inform friends about its location and use

This ensures that help can be provided quickly in case of an anaphylactic reaction.

975
Q

What identification should patients wear to assist emergency personnel?

A

Wear a necklace or bracelet identifying their severe allergy

This helps medical responders quickly understand the patient’s allergy status in emergencies.

976
Q

What should patients regularly check regarding their EpiPen?

A

Regularly check the expiry date of the EpiPen

Expired EpiPens may not work effectively in an emergency.

977
Q

What should a patient do after using an EpiPen?

A

Always seek medical help immediately after using the EpiPen

This is important even if symptoms appear to be improving.

978
Q

What is a contraindication for the yellow fever vaccine?

A

History of hypersensitivity to eggs, chicken proteins, or any other component of the vaccine

This is important for preventing allergic reactions in susceptible individuals.

979
Q

What physiological understanding is crucial regarding food allergies?

A

Know what happens physiologically during a food allergy reaction

Understanding the body’s response is essential for managing and treating food allergies.

980
Q

What is important to know about assessing and diagnosing food allergies?

A

Know how food allergies are assessed and diagnosed

Accurate diagnosis is critical for effective management and avoidance of allergens.

981
Q

What are some risk factors for developing food allergies?

A

Genetic predisposition, environmental factors, early exposure to allergens

Understanding these factors can help in prevention strategies.

982
Q

What are the signs and symptoms of a food allergy reaction?

A

Hives, swelling, difficulty breathing, gastrointestinal symptoms

Recognizing these symptoms can lead to prompt treatment and management.

983
Q

What are the key differences between food allergy and food intolerance?

A

Food allergy involves an immune response, while food intolerance does not

This distinction is important for diagnosis and treatment.

984
Q

What are the three types of symbiotic relationships involving bacteria?

A
  • Mutualism
  • Commensalism
  • Parasitism

Mutualism benefits both organisms, commensalism benefits one without harming the other, and parasitism benefits one while harming the other.

985
Q

What type of bacteria can become opportunistic pathogens?

A

Normal Microbiota

Normal microbiota usually do not cause disease but can become pathogenic under certain conditions.

986
Q

What are the routes of entry for pathogenic bacteria?

A
  • Skin
  • Mucous membranes
  • Placenta
  • Parenteral route

Parenteral route includes punctures or breaks in the skin.

987
Q

List examples of Gram positive bacteria.

A
  • Staphylococcus spp.
  • Streptococcus spp.
  • Bacillus spp.
  • Clostridium spp.
  • Mycoplasma spp.
  • Corynebacterium spp.
  • Mycobacterium spp.
  • Propionebacterium spp.
  • Nocardia spp.
  • Actinomyces spp.

These bacteria have a thick peptidoglycan layer and stain positively in Gram staining.

988
Q

What are the characteristics of Staphylococcus spp.?

A
  • Gram positive cocci
  • Cluster in grapelike arrangements
  • Facultatively anaerobic
  • Non-motile
  • Low G+C

Staphylococcus aureus and Staphylococcus epidermidis are notable examples.

989
Q

What diseases can Staphylococcus aureus cause?

A
  • Food poisoning
  • Impetigo
  • Scalded skin syndrome
  • Conjunctivitis
  • Folliculitis
  • Toxic shock syndrome
  • Bacteremia

Staphylococcus aureus can produce multiple toxins leading to these conditions.

990
Q

What are the characteristics of Streptococcus spp.?

A
  • Gram positive cocci
  • Arranged in pairs or chains
  • Facultatively anaerobic
  • Non-motile
  • Low G+C

Examples include Streptococcus pyogenes and Streptococcus pneumoniae.

991
Q

What diseases can Streptococcus pneumoniae cause?

A
  • Meningitis
  • Pneumonia
  • Otitis media
  • Scarlet fever
  • Pharyngitis
  • Tonsillitis

Streptococcus pneumoniae is a major cause of respiratory infections.

992
Q

What triggers fever and inflammation in Gram negative bacteria?

A

Lipid A in the outer membrane

Lipid A is an endotoxin that can cause severe systemic reactions.

993
Q

What are the true pathogens among Neisseria spp.?

A
  • Neisseria gonorrhoeae
  • Neisseria meningitidis

These bacteria are known for causing serious infections like gonorrhea and meningitis.

994
Q

What are the major pathogens causing bacterial meningitis?

A
  • Neisseria meningitidis
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Listeria monocytogenes
  • Streptococcus agalactiae

These pathogens are responsible for the majority of bacterial meningitis cases.

995
Q

What is the primary treatment for impetigo?

A

Penicillin and careful cleaning of infected areas

Proper hygiene is also crucial for prevention.

996
Q

What are the signs and symptoms of otitis media?

A

Severe pain in the ears

Otitis media is common in children and can result from bacteria spreading from the pharynx.

997
Q

What is the causative agent of whooping cough?

A

Bordetella pertussis

This bacterium produces several virulence factors that contribute to its pathogenicity.

998
Q

Fill in the blank: Pertussis progresses through four phases: ______, catarrhal, paroxysmal, and convalescent.

A

Incubation

999
Q

True or False: Most cases of conjunctivitis are caused by bacterial infections.

A

False

Many cases are viral, but bacterial infections can occur and are often indicated by pus production.

1000
Q

What is the main prevention method for whooping cough?

A

DTaP vaccine

Vaccination is crucial for preventing this highly contagious disease.

1001
Q

What is the main component of prokaryotic cell walls?

A

Peptidoglycan with β-lactam bonds

1002
Q

Which bacteria lack cell walls?

A

Mycoplasma pneumoniae

1003
Q

How do the cell walls of archaea differ from those of bacteria?

A

Archaea do not contain peptidoglycan

1004
Q

What is a tetrapeptide?

A

A chain of four amino acids

1005
Q

What is the structure of the cell membrane in prokaryotes?

A

Lipid bilayer, similar to eukaryotes but without sterols

1006
Q

What additional molecules are found in the outer membrane of Gram-negative bacteria?

A

Porins and lipopolysaccharides

1007
Q

What is the function of the glycocalyx?

A

Protection against digestion and desiccation

1008
Q

What is the glycocalyx generally composed of?

A

Polysaccharides

1009
Q

What is a common characteristic of pathogens regarding the glycocalyx?

A

It allows biofilm formation

1010
Q

What are storage granules in prokaryotic cells?

A

Glycogen and polysaccharides

1011
Q

What are endospores?

A

Highly resistant structures formed by bacteria under stress

1012
Q

Which bacteria are known for forming endospores?

1013
Q

What is the structure of the nucleoid in prokaryotes?

A

Single chromosome, circular DNA without a membrane

1014
Q

What are plasmids?

A

Circular DNA, normally short, often multiple copies

1015
Q

What are pili or fimbriae used for?

A

Adhering to host surfaces and sexual reproduction

1016
Q

What is the main function of flagella in prokaryotes?

1017
Q

What is the typical duration of binary fission in bacteria?

A

30 to 120 minutes

1018
Q

What factors affect microbial growth?

A

Temperature, pressure, nutrients, oxygen, pH

1019
Q

What are thermophiles and psychrophiles?

A

Types of bacteria classified by temperature preference

1020
Q

What are autotrophs and heterotrophs?

A

Autotrophs produce their own food; heterotrophs consume others

1021
Q

What are obligate and facultative anaerobes?

A

Obligate anaerobes cannot survive in oxygen; facultative can

1022
Q

What are the main classifications of prokaryotes?

A

Archaea, Gram positive, Gram negative

1023
Q

What is unique about Gram-negative Proteobacteria?

A

They include nitrogen fixers and sulfur reducers

1024
Q

What distinguishes Gram-positive bacteria?

A

They have a thick peptidoglycan layer

1025
Q

What are methanogens?

A

Archaea that convert CO2, H2, and organic acids to methane

1026
Q

What are extremeophiles?

A

Organisms that require extreme conditions to survive

1027
Q

What is Bergey’s Manuals of Determinative and Systematic Bacteriology?

A

A classification system for prokaryotes

1028
Q

What is the significance of Gram-negative non-proteobacteria?

A

They stain pink and are often without a cell wall

1029
Q

What types of bacteria can be photosynthetic?

A

Oxygenic and anoxygenic bacteria

1030
Q

What are examples of photosynthetic bacteria?

A

Chlamydias, Spirochetes, Cyanobacteria

1031
Q

What are viruses?

A

Minuscule, acellular infectious agents having either DNA or RNA

Causes many infections in humans, animals, plants, and bacteria

1032
Q

What is the metabolic capability of viruses?

A

Cannot carry out any metabolic pathway

Neither grow nor respond to the environment

1033
Q

How do viruses reproduce?

A

Cannot reproduce independently; recruit the cell’s metabolic pathways to increase their numbers

1034
Q

What is a virion?

A

The complete virus particle, containing genetic material and a protein coat

1035
Q

What types of genetic material can viruses have?

A

May be DNA or RNA, but never both

Types include dsDNA, ssDNA, dsRNA, ssRNA

1036
Q

What are the basic shapes of viruses?

A

Three basic shapes:
* Helical
* Polyhedral
* Complex

1037
Q

What is a viral envelope?

A

Acquired from host cell during viral replication or release; composed of phospholipid bilayer and proteins

1038
Q

What role do glycoproteins play in viruses?

A

Envelope’s proteins and glycoproteins often play a role in host recognition

1039
Q

What is the Baltimore Classification system?

A

A method to classify viruses based on their type of genetic material and replication strategy

1040
Q

What are the four possible types of nucleic acid genomes in viruses?

A
  • Double stranded DNA
  • Double stranded RNA
  • Single stranded DNA
  • Single stranded RNA
1041
Q

What are the two essential processes during viral replication?

A
  • Produce copies of the viral genome
  • Produce mRNA which is translated into viral proteins
1042
Q

What is the lytic replication cycle?

A

Replication cycle usually results in death and lysis of the host cell

1043
Q

What is lysogeny in viral replication?

A

Modified replication cycle where infected host cells grow and reproduce normally before they lyse

1044
Q

What is the significance of temperate phages?

A

They can integrate their genetic material into the host genome as prophages

1045
Q

What percentage of human cancers are caused by viruses?

1046
Q

Name some specific viruses known to cause human cancers.

A
  • Burkitt’s lymphoma
  • Hodgkin’s disease
  • Kaposi’s sarcoma
  • Cervical cancer
1047
Q

Are viruses considered alive?

A

Some consider them complex pathogenic chemicals; others consider them the least complex living entities

1048
Q

Fill in the blank: Viruses can take control of their _______.

1049
Q

What are the three pathways for animal virus entry?

A

Multiple pathways possible, specific details not provided

1050
Q

What is the role of capsids in viruses?

A

Provide protection for viral nucleic acid and means of attachment to host’s cells

1051
Q

What is the function of capsomeres?

A

Composed of proteinaceous subunits that make up the capsid

1052
Q

What are the signs and symptoms of Viral Conjunctivitis?

A

Itchy eyes, tearing, redness, discharge, light sensitivity

Most cases are caused by adenovirus but can also be due to other viruses.

1053
Q

Which pathogen is most problematic in Viral Conjunctivitis?

A

Herpes Simplex virus

This virus can lead to more severe symptoms and complications.

1054
Q

How is Viral Conjunctivitis treated?

A

No treatment unless caused by HSV; topical antivirals like Idoxuridine, vidarabine, or trifluridine can be used

Treatment is not necessary for non-HSV cases.

1055
Q

What is the epidemiology of Viral Conjunctivitis?

A

Self-limiting disease, highly contagious

It can spread easily in crowded environments.

1056
Q

What are the signs and symptoms of Viral Otitis Media?

A

Severe pain in the ears

This condition is common in children.

1057
Q

What pathogen is primarily responsible for Viral Otitis Media?

A

Adenoviruses

These viruses can lead to inflammation and pain.

1058
Q

What is the diagnosis and treatment for Viral Otitis Media?

A

Symptoms often diagnostic; no effective treatment exists

There is no known way to prevent otitis media.

1059
Q

What are the signs and symptoms of Viral Meningitis?

A

Similar to bacterial meningitis but usually milder

Symptoms may include fever, headache, and stiff neck.

1060
Q

What pathogens are responsible for 90% of Viral Meningitis cases?

A

Viruses in the genus Enterovirus

These viruses are commonly found in the environment.

1061
Q

How is Viral Meningitis diagnosed?

A

By characteristic signs and symptoms in absence of bacteria in the CSF

This is crucial for differentiating it from bacterial meningitis.

1062
Q

What is the pathogenesis of cold sores (Herpes)?

A

Painful lesions caused by inflammation and cell death, cause fusion of cells to form syncytia

The lesions are typically slow spreading.

1063
Q

What is the site of viral latency for the herpes virus?

A

Trigeminal (V) nerve ganglion, brachial ganglia, sacral ganglia

These sites allow the virus to remain dormant in the host.

1064
Q

How is cold sores (Herpes) transmitted?

A

Spread between mucous membranes of mouth and genitals

This can occur through direct contact.

1065
Q

What are the signs and symptoms of Hand, Foot, and Mouth Disease?

A

Cold-like symptoms, loss of appetite, mild fever, non-itchy red rash, painful mouth ulcers

Symptoms can vary in severity.

1066
Q

What pathogens cause Hand, Foot, and Mouth Disease?

A

Coxsackie virus A16, A6, A10, Enterovirus 71

Enterovirus 71 can cause more complications.

1067
Q

How is Hand, Foot, and Mouth Disease diagnosed?

A

By symptoms

There is no specific treatment or vaccine available.

1068
Q

What is the most common childhood respiratory disease?

A

Respiratory Syncytial Virus (RSV)

It affects infants and immunocompromised individuals severely.

1069
Q

What are the signs and symptoms of Respiratory Syncytial Virus?

A

Fever, runny nose, coughing in babies; mild cold-like symptoms in older children and adults

Symptoms can escalate quickly in vulnerable populations.

1070
Q

How is RSV diagnosed?

A

Made by immunoassay

This helps confirm the presence of the virus.

1071
Q

What is the mechanism of action for antiviral agents targeting viral metabolism?

A

Prevent viral uncoating or interfere with replication enzymes

Examples include amantadine and protease inhibitors.

1072
Q

What do nucleotide or nucleoside analogs do?

A

Interfere with function of nucleic acids, distorting their shapes

These are often used against viruses and rapidly dividing cancer cells.

1073
Q

What is the prevention method for viral attachment?

A

Attachment antagonists block viral attachment or receptor proteins

This is a new area of antimicrobial drug development.

1074
Q

What are the key characteristics of eukaryotes?

A

Nuclear membrane, 80S ribosome, organelles

Eukaryotes include organisms like fungi, plants, and animals.

1075
Q

What is the vegetative body of a fungus called?

A

Thallus

The thallus is the non-fruiting part of the fungus.

1076
Q

Are fungi motile or non-motile?

A

Non-motile under any conditions

Fungi grow towards food but do not move themselves.

1077
Q

What is the composition of the cell wall in fungi?

A

Chitin

Chitin is a polymer that provides structural support.

1078
Q

What types of organisms are fungi classified as?

A

Heterotrophic organisms

Fungi absorb organic matter for nutrition.

1079
Q

What are the major forms of fungi?

A

Multicellular and unicellular

Yeasts are an example of unicellular fungi.

1080
Q

What temperature range do airborne fungal spores germinate?

A

25 – 37 °C

This range is optimal for fungal growth.

1081
Q

What are the two main types of reproduction in fungi?

A

Asexual and Sexual

Asexual reproduction involves mitosis, while sexual reproduction involves meiosis.

1082
Q

What is a common method of asexual reproduction in fungi?

A

Budding

Other methods include fragmentation and spore production.

1083
Q

What is the term for fungal infections affecting the skin, nails, and hair?

A

Superficial/Cutaneous infections

Common examples include ringworm and athlete’s foot.

1084
Q

Name one species of fungi that is known to cause disease.

A

Candida Spp.

Candida can cause infections in humans and animals.

1085
Q

What is the classification division for bread molds?

A

Zygomycota

Zygomycota includes fungi such as Rhizopus.

1086
Q

What type of infections do dermatophytes typically cause?

A

Superficial infections

They often affect keratinized layers of the skin.

1087
Q

What is Tinea capitis?

A

Ringworm of the scalp

It is a type of dermatophyte infection.

1088
Q

What environmental conditions favor subcutaneous fungal infections?

A

Tropical or subtropical environments

Walking barefoot increases the risk for localized infections.

1089
Q

What is mycotoxicosis?

A

Toxins produced by fungi under certain conditions

Affects all animal species and can cause various symptoms.

1090
Q

What is the role of Echinocandins in antifungal therapy?

A

Inhibit the synthesis of glucan in cell walls

They are considered a penicillin of antifungals.

1091
Q

What do azoles do in the context of antifungal action?

A

Disrupt ergosterol synthesis

This leads to cell membrane disruption in fungi.

1092
Q

True or False: Fungi are obligate aerobes.

A

True

Most fungi require oxygen for growth, although yeasts can be facultative anaerobes.

1093
Q

What is the primary method for diagnosing fungal infections?

A

Tissue sample required

This can be challenging due to the nature of fungal growth.

1094
Q

What is the significance of the term ‘dikaryon’ in fungal reproduction?

A

It refers to a cell with two distinct nuclei (n + n)

Dikaryons are formed during sexual reproduction.

1095
Q

Fill in the blank: The genus _______________ is known for causing cryptococcal meningitis.

A

Cryptococcus

Cryptococcus neoformans is a significant pathogen.

1096
Q

What are biologic drugs?

A

Large molecules made using living cells, usually by genetically modifying cells.

1097
Q

How do biologic drugs compare in size to small-molecule drugs?

A

Biologic drugs are often 200 to 1,000 times the size of small-molecule drugs.

1098
Q

What is a biosimilar?

A

A less costly imitation of biologics that is not an exact copy.

1099
Q

What percentage of global prescription drug sales is expected to be biological products by 2020?

A

More than 50%.

1100
Q

How many biologics reached blockbuster status in 2020?

A

62 biologics.

1101
Q

What was the global biologics market value in 2020?

A

$299 billion.

1102
Q

List some types of products that are considered biologics.

A
  • Vaccines
  • Blood and blood components
  • Somatic cells
  • Gene therapy
  • Tissues
  • Recombinant therapeutic proteins
1103
Q

What is the FDA’s definition of biological products?

A

Products applicable to the prevention, treatment, or cure of disease or condition of human beings, including blood-derived products, vaccines, and most protein products.

1104
Q

Give examples of therapeutic proteins classified as biologics.

A
  • Monoclonal antibodies
  • Cytokines
  • Enzymes
  • Immunomodulators
1105
Q

What are monoclonal antibodies (MAbs)?

A

Antibodies that have been artificially produced against a specific antigen.

1106
Q

What are the three principal modes of action for monoclonal antibodies?

A
  • Block the action of specific molecules
  • Target specific cells
  • Function as signaling molecules
1107
Q

What challenges are associated with the production of biologics?

A
  • Complexity
  • Price
  • Administration
  • Immunogenicity
  • Formulation and stability
1108
Q

What is the primary difference between biologics and conventional drugs?

A

Biologics are biotechnology products with high molecular weight and complex structures.

1109
Q

Fill in the blank: Biologics are highly sensitive to _______.

A

environment.

1110
Q

What does the term ‘immunogenicity’ refer to in the context of biologics?

A

The ability of a substance to provoke an immune response.

1111
Q

What are antibody-drug conjugates?

A

Therapeutic agents that combine monoclonal antibodies with cytotoxic drugs for targeted delivery.

1112
Q

What is the purpose of antibody engineering?

A

To create less immunogenic versions of monoclonal antibodies for therapeutic use.

1113
Q

Why are biosimilars not considered bioidentical?

A

Due to their complex makeup, biosimilars cannot be exact copies of the biologic reference product.

1114
Q

What is required for a biosimilar to gain approval?

A

Demonstration of high similarity to an FDA-approved biological product with no clinically meaningful differences.

1115
Q

True or False: Biosimilars are chemically identical to their reference biologics.

1116
Q

What are some examples of biologics used for therapeutic purposes?

A
  • Human growth hormone
  • Erythropoietin (EPO)
  • Insulin
  • Etanercept
  • Pegfilgrastim
1117
Q

What is the significance of post-translational modifications in biologics?

A

They can significantly impact the quality, safety, or effectiveness of the product.

1118
Q

What is hybridoma technology used for?

A

To produce a cell line capable of producing a specific type of antibody indefinitely.

1119
Q

What is the role of Chinese hamster ovary (CHO) cells in antibody production?

A

They are the predominant host used to produce therapeutic proteins.

1120
Q

Fill in the blank: The first monoclonal antibodies were _______ molecules.

1121
Q

What may cause different types and levels of modifications in the manufacturing of biosimilars?

A

Type of cell and environments used to manufacture

The modifications can affect the quality, safety, or effectiveness of the product.

1122
Q

Can biosimilars be identical to a biologic reference product?

A

No, biosimilars cannot and are not required to be exactly like the biologic reference product

This is in contrast to generics, which can be identical to a small molecule reference product.

1123
Q

What do regulatory authorities require to demonstrate similarity in biosimilars?

A

Manufacturers generally need to generate lab, non-clinical, and clinical data

This data must show that the product provides the same therapeutic benefit and risks to patients as the reference product.

1124
Q

What are biobetters?

A

Drugs in the same class as existing, approved biologics but are not identical to the original

Biobetters are engineered with improvements.

1125
Q

How are biobetters different from biosimilars?

A

Biobetters are considered completely new and benefit from patent and market protection

Unlike biosimilars, which are less costly imitations.

1126
Q

Give an example of a first-generation mAb for lymphomas, leukemia, and autoimmune diseases.

A

Rituxan (Rituximab)

This is a first-generation monoclonal antibody.

1127
Q

What is a biosimilar of Rituxan?

A

Reditux

It is a biosimilar of Rituxan (Rituximab).

1128
Q

What is an example of a biobetter?

A

Gazyva (Obinutuzumab)

Gazyva is considered a biobetter compared to existing biologics.

1129
Q

What are biologic drugs characterized as?

A

Big, complex, and sensitive molecules with a complicated production process

They offer unparalleled target specificity and therapeutic potential.

1130
Q

What are the challenges associated with biologic drugs?

A

Delivery, stability, and cost issues

These challenges impact their use and accessibility.

1131
Q

How do biosimilars differ from generics?

A

Biosimilars are not exact copies of biologics

Unlike generics, which can be identical to small molecule reference products.

1132
Q

Fill in the blank: Biosimilars are _______ imitations of biologics.

A

Less costly

This characteristic makes biosimilars an attractive option in the market.

1133
Q

True or False: Biobetters are identical to the original biologics.

A

False

Biobetters are engineered with improvements and are not identical.

1134
Q

What does GIT stand for?

A

Gastrointestinal Tract

1135
Q

What are common symptoms of GI conditions?

A
  • Abdominal pain & discomfort
  • Nausea
  • Vomiting
  • Diarrhoea
  • Constipation
  • Blood in stools
  • Weight changes
  • Bloating
1136
Q

What does the acronym SOCRATES represent in assessing abdominal pain?

A
  • Site
  • Onset
  • Character
  • Radiation
  • Associated symptoms
  • Timing
  • Exacerbating and relieving factors
  • Severity
1137
Q

What characterizes abdominal pain that is sudden in onset?

A

Usually a symptom of a more serious condition

1138
Q

What are some identifiable causes of abdominal pain?

A
  • Food
  • Trauma
1139
Q

What type of pain is described as ‘colicky’?

A

Pain that comes and goes, associated with conditions like appendicitis, biliary and renal colic, and intestinal obstruction

1140
Q

What symptoms are suggestive of more serious pathology in abdominal pain?

A
  • Nausea
  • Vomiting
  • Weight loss
  • Melaena (black stools)
  • Altered bowel habits
  • Haematemesis
1141
Q

What is IBS?

A

Irritable Bowel Syndrome, a functional bowel disorder affecting 10-20% of the adult population in the western world

1142
Q

What are common symptoms of IBS?

A
  • Abdominal pain and discomfort in the LLQ
  • Symptoms relieved on defecation
  • Altered bowel habits (diarrhoea/constipation)
  • Bloating
1143
Q

What are red flag symptoms that may indicate a serious condition related to IBS?

A
  • Blood in stools
  • Fever
  • Nausea/vomiting
  • Severe abdominal pain
  • Changes in bowel habits in patients over 45
1144
Q

What dietary approach is recommended for managing IBS?

A

Identify and avoid food triggers, such as FODMAPs

1145
Q

What is the definition of diarrhoea?

A

The passage of three or more loose or liquid stools per day

1146
Q

What are the three types of diarrhoea?

A
  • Acute diarrhoea (lasting less than 14 days)
  • Persistent diarrhoea (lasting more than 14 days)
  • Chronic diarrhoea (lasting more than 4 weeks)
1147
Q

What are common causes of diarrhoea?

A
  • Viruses (e.g., norovirus)
  • Bacteria (e.g., food poisoning)
  • Parasitic causes
  • Drugs (e.g., laxatives, metformin)
  • IBS
  • IBD
  • Coeliac disease
1148
Q

What is coeliac disease?

A

A chronic immune-mediated systemic disorder triggered by dietary gluten in genetically predisposed individuals

1149
Q

What are some symptoms of coeliac disease?

A
  • Bloating
  • Diarrhoea
  • Nausea
  • Flatulence
  • Constipation
  • Tiredness
  • Headaches
  • Sudden weight loss
  • Hair loss
  • Anaemia
  • Osteoporosis
  • Rash (Dermatitis herpetiformis)
  • Neurological disorders
1150
Q

What is the main management strategy for coeliac disease?

A

Adherence to a gluten-free diet

1151
Q

Fill in the blank: The presence of blood in stools is suggestive of _______.

1152
Q

True or False: IBS affects twice as many men as women.

1153
Q

What is the recommended first-line treatment for refractory abdominal pain in IBS?

A

Low dose tricyclic antidepressants

1154
Q

What is the role of loperamide in diarrhoea management?

A

It helps reduce the frequency of diarrhoea

1155
Q

What are common exacerbating factors for biliary colic?

A

Fatty foods

1156
Q

What type of disease is coeliac disease?

A

Chronic inflammatory intestinal disease and autoimmune disease

1157
Q

What triggers coeliac disease?

A

Induced by gluten, referred to as true gluten intolerance

1158
Q

What is the prevalence of coeliac disease?

A

Affects 1 in 100 people

1159
Q

What are common symptoms of coeliac disease?

A
  • Bloating
  • Diarrhoea
  • Nausea
  • Flatulence
  • Constipation
  • Tiredness
  • Headaches
  • Sudden weight loss
  • Hair loss
  • Anaemia
  • Osteoporosis
  • Rash (Dermatitis herpetiformis)
  • Neurological disorders
1160
Q

What serious complications can arise from untreated coeliac disease?

A
  • Kidney and liver disease
  • Malignancies (lymphomas)
  • Higher mortality (factor of 1.9-3.8)
1161
Q

What proteins are involved in gluten?

A
  • Gliadin (most studied)
  • Glutenin
  • Hordeins (in barley)
  • Secalins (in rye)
1162
Q

What is the maximum gluten tolerance for coeliac sufferers?

A

20 parts per million

1163
Q

What is the immune response mechanism in coeliac disease?

A

T-cell mediated (CD4+), involving MHC Class II molecules and cytokines like Interferon-γ and IL-15

1164
Q

What are the genetic markers associated with coeliac disease?

A
  • HLA-DQ2 (90% of cases)
  • HLA-DQ8 (10% of cases)
1165
Q

What is the role of transglutaminase in coeliac disease?

A

Deamidates gluten, allowing it to bind to MHC II molecules with high affinity

1166
Q

What are the primary methods for diagnosing coeliac disease?

A
  • Serum analysis for anti-gliadin/Transglutaminase antibodies
  • ELISA
  • Biopsy of the intestine
  • HLA Typing
1167
Q

What is the primary treatment for coeliac disease?

A

Gluten-free diet

1168
Q

What is the gluten content limit for foods to be considered gluten-free?

A

Less than 20 ppm gluten

1169
Q

What are some potential treatments for coeliac disease?

A
  • Genetically modified gluten
  • Zonulin inhibitors
  • Therapeutic vaccine
  • Probiotics
  • Tissue transglutaminase inhibitors
1170
Q

What is a concern regarding the use of probiotics in coeliac disease?

A

Conflicting evidence on efficacy and potential for probiotic bacteremia

1171
Q

What additional nutritional considerations must be made for coeliac sufferers?

A
  • Calcium
  • Iron
  • Folate
  • Magnesium
  • Fat-soluble vitamins
1172
Q

What is the relationship between coeliac disease and enterobacteriaceae?

A

Coeliac disease patients carry higher numbers of enterobacteriaceae, which can cause disease

1173
Q

Fill in the blank: Coeliac disease is linked with increased rates of _______.

A

osteoporosis, infertility, autoimmune disorders, malignant disease

1174
Q

What is the GI tract?

A

A long tube open at both ends for the transit of food during processing.

1175
Q

Main portions of the GI tract include:

A
  • Esophagus
  • Stomach
  • Small intestine
  • Large intestine
  • Rectum
1176
Q

What are accessory structures in the digestive system?

A

Structures that contribute to food processing but are not part of the GI tract.

1177
Q

List some accessory structures.

A
  • Teeth
  • Tongue
  • Salivary glands
  • Liver
  • Gallbladder
  • Pancreas
1178
Q

How many layers does the GI tract contain?

A

Four layers.

1179
Q

What is the function of the muscularis propria?

A

Facilitates peristalsis, producing rhythmic waves to move food through the gut.

1180
Q

What are the two plexuses of the enteric nervous system?

A
  • Submucosal plexus
  • Myenteric plexus
1181
Q

What is the role of the autonomic nervous system in digestion?

A

Regulates digestive processes via parasympathetic and sympathetic divisions.

1182
Q

What is mechanical digestion?

A

The physical breakdown of food, such as chewing.

1183
Q

What is chemical digestion?

A

The enzymatic breakdown of food into smaller molecules.

1184
Q

Fill in the blank: Salivary amylase converts polysaccharides to _______.

A

disaccharides.

1185
Q

What are the phases of deglutition (swallowing)?

A
  • Oral Phase
  • Pharyngeal Phase
  • Oesophageal Phase
1186
Q

What occurs during the oral phase of swallowing?

A

Food is prepared into a pellet (food bolus) for easy passage.

1187
Q

What cranial nerves are involved in the oral phase of swallowing?

A
  • Trigeminal
  • Facial
  • Hypoglossal
1188
Q

What is the role of the epiglottis during swallowing?

A

Closes the larynx to prevent food from entering the trachea.

1189
Q

What is the function of the esophagus?

A

Transports food to the stomach via rhythmic contractions.

1190
Q

What are the two important sphincters of the esophagus?

A
  • Upper esophageal sphincter
  • Lower esophageal sphincter
1191
Q

What is the shape of the stomach?

A

J-shaped enlargement of the GI tract.

1192
Q

What hormone is released by G cells in the stomach?

1193
Q

What does gastrin stimulate?

A

The release of gastric acid (HCl) in the stomach.

1194
Q

Where does most digestion and absorption occur?

A

In the small intestine.

1195
Q

What is the function of circular folds in the small intestine?

A

Increase surface area for digestion and absorption.

1196
Q

What does intestinal juice do?

A

Provides a vehicle for absorption of substances from chyme.

1197
Q

What does the pancreas produce?

A
  • Enzymes that digest carbohydrates, proteins, fats, and nucleic acids
  • Sodium bicarbonate to buffer stomach acid
1198
Q

What is the function of bile?

A

Emulsifies fats for digestion.

1199
Q

What does the gallbladder do?

A

Stores bile until needed.

1200
Q

How does the sodium gradient affect absorption in the small intestine?

A

It drives the sodium/amino acid symporter to move sodium and amino acids in the same direction.

1201
Q

What are the main functions of the colon?

A

Absorption of water and electrolytes, and formation of feces.

1202
Q

What are the functions of the colon?

A

The colon is responsible for the absorption of water, electrolytes, and some vitamins, and it also plays a role in feces formation.

The colon’s functions are crucial for maintaining fluid balance in the body.

1203
Q

What substances make up feces?

A

Feces consist of:
* Water
* Inorganic salts
* Sloughed-off epithelial cells
* Bacteria
* Products of bacterial decomposition
* Undigested portions of food

The composition of feces reflects the processes of digestion and absorption occurring in the colon.

1204
Q

What is the role of bacteria in the colon?

A

Bacteria in the colon are involved in:
* Breaking down substances
* Synthesizing some vitamins

The bacterial action is essential for the final stages of digestion.

1205
Q

What triggers the defecation reflex?

A

The defecation reflex is triggered when the rectal wall distends, sending sensory nerve impulses to the sacral spinal cord.

This reflex involves coordinated motor impulses that lead to the contraction of rectal muscles and the opening of the anal sphincter.

1206
Q

What happens during the cephalic phase of digestion?

A

The cephalic phase stimulates gastric secretion and motility.

This phase is initiated by the sight, smell, or thought of food.

1207
Q

What mechanisms are involved in the gastric phase of digestion?

A

The gastric phase involves neural and hormonal mechanisms that regulate gastric juice pH and gastric motility.

This phase is crucial for the digestion of food in the stomach.

1208
Q

What is the intestinal phase of digestion?

A

The intestinal phase of digestion involves neural and hormonal mechanisms that regulate digestive processes in the intestines.

This phase ensures the proper digestion and absorption of nutrients in the small intestine.

1209
Q

Fill in the blank: The colon absorbs _______ and electrolytes.

A

[water]

The absorption of water is essential for maintaining hydration and electrolyte balance in the body.

1210
Q

True or False: Feces are composed only of undigested food.

A

False

Feces also contain water, bacteria, and other components resulting from digestion.

1211
Q

What occurs when the external anal sphincter is voluntarily relaxed?

A

Defecation occurs, and the feces are expelled.

This process is part of the defecation reflex facilitated by the contraction of rectal muscles.

1212
Q

What role do stretch receptors play in defecation?

A

Stretch receptors send sensory nerve impulses to the sacral spinal cord when the rectal wall distends.

These impulses initiate the motor responses necessary for defecation.

1213
Q

What is Inflammatory Bowel Disease (IBD)?

A

Immune-mediated chronic intestinal condition

IBD includes two major types: Ulcerative Colitis and Crohn’s Disease.

1214
Q

What are the two major types of Inflammatory Bowel Disease?

A
  • Ulcerative Colitis
  • Crohn’s Disease
1215
Q

What is the primary purpose of sigmoidoscopy?

A

Routine in patients with lower abdominal symptoms or in cases of diarrhoea

Normal mucosa appears shiny with superficial vessels and no contact bleeding.

1216
Q

What is gastroscopy used to identify?

A
  • Reflex oesophagitis
  • Gastritis
  • Ulcers
  • Cancer
1217
Q

What is the main feature of Crohn’s Disease?

A

Transmural inflammation

It can occur anywhere along the gastrointestinal tract.

1218
Q

What are common complications associated with Crohn’s Disease?

A
  • Fatty liver
  • Renal stones
  • Adhesions
  • Gallstones
  • Perianal and internal fistulae
  • Strictures
  • Eyes
  • Joints
  • Spine
1219
Q

What characterizes Ulcerative Colitis in terms of stool appearance?

A

Blood, mucus, pus, urgency, nocturnal defecation, tenesmus, pre-defecation pain relieved by passing stool

1220
Q

What is the usual site affected by Ulcerative Colitis?

A

Rectum, spreads to colon

1221
Q

True or False: Fistulas are common in Ulcerative Colitis.

1222
Q

What are the goals of treatment for Inflammatory Bowel Disease?

A
  • Treat and reduce intestinal inflammation
  • Promote mucosal healing
  • Reduce risk of colorectal cancer
  • Control and relieve symptoms
  • Treat complications
  • Minimise toxicity
  • Maintain remission
  • Address psychosocial issues
  • Replenish nutritional deficits
  • Improve QoL
1223
Q

What are the anti-inflammatory drugs used in IBD management?

A
  • Corticosteroids
  • Aminosalicylates
  • Thiopurines
  • Biologics
1224
Q

What is the mode of action of Aminosalicylates?

A

Inhibits leukotriene and prostanoid formation, scavenges free radicals, decreases neutrophil chemotaxis

1225
Q

What is the importance of monitoring TPMT activity in patients using Thiopurines?

A

To assess the risk of pancreatitis

1226
Q

What is the effect of smoking on Crohn’s Disease?

A

Worsens the condition

1227
Q

What is the Montreal Classification used for?

A

Classification of Crohn’s Disease

1228
Q

What is the Crohn’s Disease Activity Index (CDAI)?

A

A scoring system used to assess the severity of Crohn’s Disease

1229
Q

Fill in the blank: The usual site affected by Crohn’s Disease is the _______.

A

terminal ileum and ascending colon

1230
Q

What are the raised ESR and anaemia indicators associated with?

A

Both Crohn’s Disease and Ulcerative Colitis

1231
Q

What are the common extraintestinal symptoms seen in both CD and UC?

A
  • Eye effects
  • Mucocutaneous lesions
  • Skin effects
  • Weight loss
  • Anaemia
1232
Q

What is the role of rectal preparations in IBD management?

A

Targeted treatment depending on disease extent

Includes suppositories, foam, and enemas.

1233
Q

What is a significant risk factor for developing Ulcerative Colitis?

A

Appendectomy appears protective

1234
Q

What is ethylcellulose?

A

A polymer used in pharmaceuticals and food applications

Ethylcellulose is often used as a thickening agent and film-forming agent.

1235
Q

What is the purpose of colonoscopic surveillance after 10 years?

A

To monitor for potential complications or cancers in patients with IBD

Regular surveillance helps in early detection of colorectal cancer in IBD patients.

1236
Q

What is osteopenia?

A

A condition of lower than normal bone density

Osteopenia increases the risk of fractures.

1237
Q

What does the Montreal Classification categorize?

A

Crohn’s Disease

It classifies the disease based on location, behavior, and age of onset.

1238
Q

What is the Crohn’s Disease Activity Index (CDAI)?

A

A scoring system to assess the severity of Crohn’s Disease

The CDAI helps in evaluating treatment effectiveness.

1239
Q

What does the Harvey–Bradshaw Index measure?

A

The clinical activity of Crohn’s Disease

It is a simplified version of CDAI focusing on fewer parameters.

1240
Q

What does the Truelove & Witts severity Index assess?

A

The severity of Ulcerative Colitis

It categorizes the disease based on symptoms and clinical findings.

1241
Q

What is the Paediatric UC Activity Index used for?

A

To assess disease activity in children with Ulcerative Colitis

This index considers age-specific symptoms and health status.

1242
Q

What are common surgical indications for IBD?

A

Poor response to long-term medical treatment, emergency situations, cancer, abscesses, fistulas, strictures

Surgery may be necessary when conservative treatments fail.

1243
Q

What is a proctocolectomy with ileostomy?

A

Surgical removal of the rectum and colon with creation of an ileostomy

This procedure is performed for both Crohn’s Disease and Ulcerative Colitis.

1244
Q

What is the consequence of ileostomy on drug treatments?

A

May affect drug absorption due to altered intestinal anatomy

Drugs absorbed in the upper small intestine may not be adequately absorbed post-surgery.

1245
Q

What is diverticulae?

A

Herniation of colonic mucosa through areas of weakness in the colon

Diverticulae can be found incidentally during imaging studies.

1246
Q

What is diverticulosis?

A

Presence of diverticula without inflammation

It may lead to changes in bowel habits and abdominal pain.

1247
Q

What is diverticulitis?

A

Acute inflammation of diverticula

Diverticulitis can present with severe abdominal pain and fever.

1248
Q

Fill in the blank: The _______ is a scoring system to evaluate the severity of Crohn’s Disease.

A

Crohn’s Disease Activity Index (CDAI)

1249
Q

True or False: A colostomy is likely to cause significant problems with drug absorption.

A

False

A colostomy is less likely to significantly impact drug absorption compared to an ileostomy.

1250
Q

What is Travel Health?

A

Travel Health is a relatively new medical specialty that addresses the health, safety, and welfare needs of travelers.

1251
Q

Why is Travel Health important?

A

Travel Health is important because travelers are at greater risk of disease or death compared to non-travelers, especially when visiting developing countries.

1252
Q

What are the main areas of involvement in Travel Health?

A
  • Pre-travel health assessments and advice
  • Prescription and recommendation of medicines
  • Provision of specialist travel first aid kits
  • Vaccinations and preventative measures
  • Management of health problems in returning travelers
1253
Q

What is the estimated incidence of health problems among travelers to developing countries?

A

For every 100,000 travelers visiting a developing country for 1 month, approximately 50,000 will develop some health problem.

1254
Q

True or False: The majority of travel-related deaths are caused by infectious diseases.

A

False. Only 1-4% of travel-related deaths are caused by infectious diseases.

1255
Q

What are common causes of mortality in travelers?

A
  • Ischaemic heart disease (35%)
  • Trauma (25%)
  • Malaria
1256
Q

What is the most common travel-related illness?

A

Traveller’s Diarrhoea, with 25-90% of travelers experiencing symptoms in the first 2 weeks of travel.

1257
Q

Fill in the blank: The CDC Yellow Book provides _______.

A

Health Information for International Travel.

1258
Q

What is the role of NaTHNaC?

A

NaTHNaC aims to protect British travelers and is commissioned by Public Health England.

1259
Q

What percentage of travelers to developing countries develop health problems while overseas?

A

75% of travelers to developing countries develop health problems while overseas.

1260
Q

What is the most common vaccine-preventable travel-related condition?

A

Influenza.

1261
Q

What factors contribute to the higher rate of motor vehicle accidents (MVAs) among tourists?

A
  • Driving on the opposite side of the road
  • Taking greater risks while overseas
  • Involvement of alcohol and/or drugs
1262
Q

What is the significance of the term ‘Emporiatrics’?

A

Emporiatrics is another term for Travel Health, reflecting its multidisciplinary nature.

1263
Q

What are the health risks associated with casual sex among travelers?

A
  • Up to 20% of travelers practice casual sex
  • 50% do not use condoms
  • Up to 25% of European cases of syphilis and gonorrhea are acquired overseas
1264
Q

What are the common tropical diseases of concern for travelers?

A
  • Malaria
  • Dengue
  • Yellow Fever
1265
Q

What is the role of pharmacists in Travel Health?

A

Pharmacists play a key role in the provision of specialist travel first aid kits and advising on medications.

1266
Q

What is the estimated rate of HIV acquisition for UK citizens while overseas?

A

300 times greater than when in the UK.

1267
Q

What are some resources for Travel Health information?

A
  • NaTHNaC
  • CDC Yellow Book
  • British National Formulary
1268
Q

What are the common causes of morbidity in travelers?

A
  • Traveller’s Diarrhoea
  • Respiratory tract infections
  • Influenza
1269
Q

What is the significance of the ‘Great Colonial Age’ in Travel Medicine?

A

It marked the beginning of systematic studies of tropical diseases encountered by Europeans.

1270
Q

What is the primary aim of Travel Health services?

A

To prevent illnesses and injuries occurring to travelers going abroad and manage problems arising in travelers returning from abroad.

1271
Q

What percentage of travelers may require alteration of travel plans due to Traveller’s Diarrhoea?

A

25% may require some alteration of travel plans.

1272
Q

What percentage of European cases of syphilis and gonorrhea are acquired overseas?

A

Up to 25%

Conservative estimates suggest significant transmission of STIs through international travel.

1273
Q

What is the rate of HIV acquisition for UK citizens while overseas?

A

300x greater

This highlights the increased risk for UK travelers in certain regions.

1274
Q

What percentage of German tourists to Thailand do not use condoms?

A

30-40%

This reflects attitudes towards sexual health among travelers.

1275
Q

What factor increases the risk of STIs among travelers?

A

Alcohol/drugs

Substance use can impair judgment and lead to unsafe sexual practices.

1276
Q

What is a major public health and social concern related to travel?

A

Sex tourism

This issue involves complex social dynamics and health risks.

1277
Q

What can be the prevalence of HIV and STIs among sex workers in some countries?

A

50% or greater

This statistic underscores the vulnerability of sex workers to STIs.

1278
Q

What has been observed regarding multidrug-resistant STIs?

A

Increased incidence

This trend poses challenges for treatment and public health.

1279
Q

Are all sex tourists male?

A

No

While male sex tourism is more common, female tourists also engage in such practices.

1280
Q

How do travelers impact global health trends?

A

They can significantly affect the spread of infectious diseases

Examples include the spread of SARS and COVID-19.

1281
Q

What is the average annual growth rate of international tourist arrivals to developing countries from 2005-2013?

A

4.8%

This contrasts with developed countries, which had a lower growth rate.

1282
Q

What is the estimated number of international tourist arrivals worldwide per year by 2020?

A

1.6 billion

This figure illustrates the scale of global travel.

1283
Q

What percentage of the Australian population travels overseas each year?

A

> 10%

This indicates a significant portion of Australians engage in international travel.

1284
Q

What trend is observed regarding tourist destinations?

A

Travelers are increasingly visiting higher risk destinations

This shift requires greater awareness of health risks.

1285
Q

How do travelers’ perceptions of risk change over time?

A

They are decreasing

What was once considered risky is now seen as more mundane.

1286
Q

What is the majority type of traveler according to UNWTO statistics?

A

Leisure travelers (52%)

This highlights the dominant purpose of travel among individuals.

1287
Q

What trend is noted in the business travel sector?

A

Growth in business travel

This reflects economic changes and globalization.

1288
Q

Why are VFRs (visiting friends and relatives) considered an important group in travel health?

A

They spend more time in close proximity with local populations

This increases their exposure to local health risks.

1289
Q

What percentage of international travelers obtain travel health advice before their journey?

A

36-52%

This indicates a gap in health preparedness among travelers.

1290
Q

What is a key component of a quality Travel Health Service?

A

Prevent and/or minimize health risks associated with travel

This includes individualized risk assessments.

1291
Q

What is included in a pre-travel health risk assessment?

A

Assessment of the traveller’s baseline health and destination risks

This helps tailor health advice to individual needs.

1292
Q

What is the recommended time frame for pre-travel consultations?

A

4-8 weeks before travel

This allows adequate time for vaccinations and health preparations.

1293
Q

What is a key point to consider in the pre-travel health risk assessment?

A

Itinerary-related data

Includes countries and regions being visited, planned activities, and potential disease exposure.

1294
Q

What traveller-related data should be assessed?

A

Age and gender, vaccination history, full medical, allergy and medication history, pregnancy/breastfeeding status, planned medical care or surgery, attitudes/traits of traveller, budget

Important for determining higher risk travellers.

1295
Q

What are the three groups of travel vaccinations?

A
  • Required vaccines
  • Routine vaccines
  • Recommended vaccines
1296
Q

What is an example of a required vaccine for travel?

A

Yellow fever

Required for travellers returning from endemic areas.

1297
Q

What is a common issue with routine vaccines?

A

Increasingly, children are not vaccinated and/or adults have not had recent boosters.

1298
Q

What are examples of recommended vaccines?

A
  • Cholera
  • Typhoid
  • Japanese encephalitis
  • Rabies
1299
Q

What is important to do before travel regarding vaccinations?

A

Plan an appropriate vaccination program requiring adequate time.

1300
Q

What are some educational interventions for travellers?

A

Tailored, prioritized, and individualized to meet the needs of the traveler

Includes obligatory counselling on health risks.

1301
Q

What are some environmental risks to consider for travellers?

A
  • Altitude
  • Marine and diving-associated diseases
  • Heat or cold
  • Motion sickness
1302
Q

What is the definition of traveller’s diarrhoea?

A

3 loose or watery stools in a 24 hour period with/without one or more of: abdominal pain, nausea, vomiting, fever, cramps, blood or mucus in stools, faecal urgency.

1303
Q

What percentage of travellers experience symptoms of traveller’s diarrhoea in the first 2 weeks?

1304
Q

What is a common cause of traveller’s diarrhoea?

A

Bacterial infections

50-75% of cases are due to bacteria.

1305
Q

What are common risk factors for traveller’s diarrhoea?

A
  • Adventurous behaviour
  • Particular destinations
  • Length of stay
  • Consumption of unclean water or food
1306
Q

What is a key principle of food hygiene for travellers?

A

Be careful of what and where they eat, and gradually introduce local foods.

1307
Q

What types of food should be avoided to prevent traveller’s diarrhoea?

A
  • Moist foods served at room temperature
  • Raw fruits and vegetables that cannot be peeled
  • Food from street vendors unless freshly prepared
1308
Q

What precautions should be taken regarding tap water while travelling?

A

Avoid tap water, ice cubes, ice blocks, and milk products if suspected to be unsafe.

1309
Q

What are some strategies for maintaining personal hygiene while travelling?

A

Regular handwashing, even in extreme conditions, and using alcoholic hand rub.

1310
Q

What is the average duration of illness for enterotoxigenic E. coli (ETEC) infection?

1311
Q

True or False: 50% of stool samples from travellers’ diarrhoea cases are negative for pathological organisms.

1312
Q

Fill in the blank: The most common travel-related health condition is __________.

A

traveller’s diarrhoea

1313
Q

What is an example of a food that is considered low-risk?

A

Dry foods like bread without spreads

Considered safer than moist foods.

1314
Q

What is the incubation period for Giardia intestinalis?

A

12-15 days

1315
Q

What is the average duration for illness caused by Noroviruses?

A

24-48 hours

1316
Q

What is a common misconception about high-class restaurants and food safety?

A

Better presentation may involve greater handling, increasing contamination risk.

1317
Q

What precautions should be taken regarding tap water in many countries?

A

Tap water should be avoided if suspected to be hazardous, as well as ice cubes, ice blocks, and milk products.

This applies to both developing and some developed countries.

1318
Q

Is swimming pool water safe to drink?

A

No, swimming pool water is not sterile and should not be drunk.

It is chlorinated but still poses health risks.

1319
Q

What should travelers avoid regarding water sources?

A

Travelers should avoid swimming in and drinking water from areas where schistosomiasis is a known risk.

1320
Q

What is a safe practice when consuming bottled water?

A

Only drink bottled water from bottles with intact seals and that do not appear tampered with.

Street vendors may refill bottles with tap water.

1321
Q

What beverages are generally considered safe for travelers?

A

Soft drinks, carbonated water, wine, and bottled beers are generally considered safe if opened at the table.

1322
Q

What should travelers be cautious about regarding fruit juices?

A

Fruit juices and cordials may have been prepared with contaminated water.

1323
Q

What is the most common method of water disinfection used by travelers?

A

Boiling water for 3-5 minutes is the most common method.

1324
Q

Why should water be boiled longer at high altitudes?

A

Water boils at a lower temperature at altitude, necessitating a longer boiling time.

1325
Q

What should travelers avoid using for water treatment during pregnancy?

A

Avoid iodine in pregnancy, thyroid disease, or if allergic to iodine.

1326
Q

What are the potential benefits of cholera vaccines?

A

Newer cholera vaccines provide some protection against certain strains of ETEC, but only about 50% of ETEC strains express the enterotoxin.

1327
Q

What is the effectiveness of Pepto-Bismol in reducing the risk of travelers’ diarrhea?

A

Pepto-Bismol results in a 60% reduction of travelers’ diarrhea risk.

1328
Q

What should be the goals of treatment for travelers’ diarrhea?

A

The goals are to avoid dehydration, reduce severity and duration of symptoms, and prevent interruption of planned activities.

1329
Q

Which agent is the choice for symptomatic treatment of diarrhea?

A

Loperamide is the antimotility agent of choice.

1330
Q

What is the recommended treatment for severe diarrhea if blood is present?

A

Seek medical attention if blood is present in stools or symptoms are severe.

1331
Q

What is the average incubation period for Plasmodium falciparum?

A

The average incubation period for Plasmodium falciparum is 7-14 days.

1332
Q

What is the significance of P. falciparum in malaria?

A

P. falciparum can cause a severe, rapidly progressive, and frequently fatal form of malaria.

1333
Q

What are the key risk groups for malaria?

A

Migrants residing in non-endemic areas returning to visit relatives in endemic areas are a key risk group.

1334
Q

What increases the risk of malaria during pregnancy?

A

Malaria is very dangerous in pregnancy and may cause spontaneous abortion and stillbirth.

1335
Q

What are the early symptoms of malaria often described as?

A

Early symptoms of malaria are often described as ‘flu-like’.

1336
Q

What is the recommended first-line treatment for P. falciparum?

A

Artemether and lumefantrine is the first-line treatment.

1337
Q

What should be considered for travelers with severe diarrhea symptoms?

A

Consider carrying Ciprofloxacin and Metronidazole for severe symptoms during long trips to remote locations.

1338
Q

What is the incubation period for P. vivax?

A

The average incubation period for P. vivax is 12-17 days.

1339
Q

What is the relationship between chloroquine and P. vivax?

A

P. vivax remains sensitive to chloroquine, although resistance is developing.

1340
Q

What should be done if there is no clear diagnosis of diarrhea in returning travelers?

A

Treat empirically for Giardia if there is no clear diagnosis.

1341
Q

What is the frequency of fevers in benign forms of malaria for P.vivax?

A

Every 48 hours.

1342
Q

What is the frequency of fevers in benign forms of malaria for P.malariae?

A

Every 72 hours.

1343
Q

How do fevers in falciparum malaria differ from benign forms?

A

Fevers are irregular, with coma and death occurring within as little as 24 hours after initial symptoms.

1344
Q

List some common symptoms of malaria.

A
  • Fever
  • Myalgia
  • Arthralgia
  • Diarrhoea
  • Headache
  • Nausea
  • Vomiting
  • Malaise
1345
Q

What serious complication can develop if benign forms of malaria are untreated?

1346
Q

What is a major risk for non-immune travellers with falciparum malaria?

A

High risk of complications.

1347
Q

What happens to red blood cells in falciparum malaria?

A

The surface is altered, causing them to adhere to blood vessel walls, potentially leading to cerebral malaria.

1348
Q

What are some complications associated with falciparum malaria?

A
  • Thrombocytopenia
  • Renal insufficiency
  • Hypoglycaemia
  • Splenomegaly
1349
Q

What factors influence the choice of chemoprophylaxis regimen for malaria?

A
  • Destination country and area
  • Time of year
  • Rural or urban
  • Activities at destination
  • Accommodation and style of travel
  • Presence of contraindications (age, pregnancy, medical history)
  • Presence of P.falciparum resistance
1350
Q

What is the first line treatment for uncomplicated P.falciparum malaria?

A

Artemether with lumefantrine.

1351
Q

What is the first line treatment for severe P.falciparum malaria?

A

Artesunate.

1352
Q

What is the purpose of primaquine in malaria treatment?

A

Eradication of liver stages of malaria to prevent relapse.

1353
Q

True or False: Quinine is the first line treatment for P.falciparum malaria.

1354
Q

What is the usual regimen for chloroquine?

A

300mg base per week.

1355
Q

What are the major side effects of chloroquine?

A
  • Fatal cardiac arrhythmia in overdose
  • Nausea
  • Vomiting
  • Chronic retinopathy
  • Itching
  • Tinnitus
1356
Q

What is a caution when using doxycycline for malaria?

A

Do not use in pregnancy or children under 8 years.

1357
Q

What is the recommended starting time frame for chemoprophylaxis before entering an endemic area?

A

1 week before.

1358
Q

Fill in the blank: Mefloquine should ideally be started ______ before leaving.

A

2-3 weeks.

1359
Q

What is standby treatment (SBT) for malaria?

A

Treatment prescribed for travellers to take on expeditions to start treatment if malaria is suspected.

1360
Q

What should a patient be trained to recognize when prescribed SBT?

A

Symptoms of malaria.

1361
Q

What is a recommended method to avoid mosquito bites?

A

Apply insect repellents to the skin.

1362
Q

What is the effectiveness range of chemoprophylaxis for malaria?

A

75-95% effective.

1363
Q

What are some severe complications of malaria during pregnancy?

A
  • Acidosis
  • Hypoglycaemia
  • Pulmonary oedema
1364
Q

True or False: Chemoprophylaxis is 100% effective.

1365
Q

What should be avoided to prevent mosquito bites?

A

Nighttime exposure for Anopheles and daytime exposure for Aedes mosquitoes.

1366
Q

What is the dosing schedule for co-artemether (Riamet) in standby treatment?

A

4 tablets at time 0, 8, 24, 36, 48, and 60 hours.

1367
Q

What should be avoided to prevent mosquito bites?

A

Perfumes and aftershave lotion

These can attract mosquitoes.

1368
Q

What is the risk of malaria during pregnancy?

A

Malaria is more likely to be severe in pregnancy, with increased risks of acidosis, hypoglycaemia, and pulmonary oedema

It can also lead to low birth weight and foetal death.

1369
Q

What medications should be avoided during pregnancy for malaria treatment?

A

Doxycycline after the first 18 weeks and mefloquine throughout pregnancy

Chloroquine and proguanil can be used.

1370
Q

What are the main categories of travel vaccines?

A

Required, Routine, and Recommended

Vaccines may vary depending on legal requirements and travel destinations.

1371
Q

What is the most common vaccine-preventable disease in travelers after influenza?

A

Hepatitis A

It is transmitted via the faecal/oral route.

1372
Q

What are some common symptoms of rabies?

A

Apprehension, headache, fever, sensory changes, excitability, hallucinations, hydrophobia, delirium, convulsions

Rabies is invariably fatal without treatment.

1373
Q

What is ‘Economy Class Syndrome’?

A

Deep vein thrombosis (DVT) occurring in long-haul flights due to lack of mobility and cramped conditions

It can lead to pulmonary embolism (PE).

1374
Q

What factors contribute to the risk of DVT in air travelers?

A
  • Lower partial pressure of oxygen at altitude
  • Consumption of alcohol or caffeine leading to dehydration

These can affect circulation.

1375
Q

Fill in the blank: Vaccinations may be divided into three categories: Required, ________, and Recommended.

1376
Q

What should be considered when establishing an immunization plan for travelers?

A
  • Traveller’s immune status
  • Medical history
  • History of allergy
  • Destinations visited
  • Length of stay
  • Type of travel
  • Traveller’s age
  • Time from consultation to departure
  • Intended activities at destination
1377
Q

True or False: Hepatitis B has a higher case fatality rate than Hepatitis A.

A

True

Hepatitis B has a case fatality rate of 2% compared to Hepatitis A’s 0.1%.

1378
Q

What is the risk of rabies for travelers?

A

High in rural areas of Africa, Asia, Europe, North and South America, particularly in Asia where 90% of rabies deaths occur

Risk increases with length of stay in rabies-endemic countries.

1379
Q

What are the initial symptoms of rabies?

A

Apprehension, headache, fever, sensory changes

Advanced symptoms include excitability and hydrophobia.

1380
Q

What should be considered when evaluating the need for rabies vaccination?

A

Cost of pre-exposure vaccination versus risk of exposure

Availability of rabies immunoglobulin and vaccine for post-exposure treatment.

1381
Q

What is the incidence of Hepatitis A in travelers?

A

3000-6000 per month

Case fatality rate is 0.1%.

1382
Q

Fill in the blank: The lack of mobility for long periods during flights is a major cause of _________.

1383
Q

Which vaccine is legally required for entry into some countries?

A

Yellow fever vaccine

Required in specific countries in South America and Africa.

1384
Q

What is DVT commonly referred to as in the context of travel?

A

Economy Class Syndrome

This term reflects the increased risk of deep vein thrombosis during long flights.

1385
Q

List possible risk factors for deep vein thrombosis (DVT) in travelers.

A
  • Previous history of DVT or PE
  • Flights greater than 12 hours
  • Older age groups (greater than 50 years)
  • Overweight or obese people
  • Being very tall in height
  • Smoking
  • Reduced mobility
  • Dehydration
  • Trauma
  • Recent surgery
  • Pregnancy or recent childbirth
  • Medications (combined oral contraceptives, hormone replacement therapy, hypnotics)
  • Chronic diseases (heart disease, malignancy, ulcerative colitis, varicose veins)
  • Hypercoagulability
1386
Q

What is one recommendation for all passengers to prevent travel-related DVT?

A

Avoid excessive alcohol and caffeine

Staying hydrated can help reduce the risk of DVT.

1387
Q

Fill in the blank: Jet lag is a term used to describe symptoms associated with the psychological and physiological _______ of crossing several time zones.

A

desynchronisation

1388
Q

What are common symptoms of jet lag?

A
  • Difficulty sleeping
  • Fatigue
  • Confusion
  • Irritability
  • Digestive disorders
  • Joint stiffness
  • Headache
1389
Q

True or False: Jet lag is worse when traveling westward than eastward.

1390
Q

What factors can aggravate jet lag?

A
  • Direction of travel
  • Age
  • Number of time zones crossed
  • Napping
  • Previous bad travel experiences
  • Sleep deprivation prior to journey
  • Dehydration and excessive alcohol consumption
  • Stress
  • Poor diet and overeating
1391
Q

What is melatonin used for in the context of travel?

A

To reduce the effects of jet lag

Its use remains controversial, with inconsistent trial results.

1392
Q

What should travelers do before departure to relieve jet lag?

A
  • Be well rested prior to the journey
  • Choose flights with transits to arrive at normal sleeping times
  • Avoid planning critical tasks immediately on arrival
1393
Q

What measures should travelers take during the flight to relieve jet lag?

A
  • Avoid sleep deprivation
  • Set watches to destination time
  • Plan sleep during the journey
  • Drink plenty of fluid
  • Avoid alcohol and caffeine
1394
Q

What are some specific health concerns associated with cruise ship travel?

A
  • Spread of diseases in crowded environments
  • Vectorborne diseases from port visits
  • Need for ship’s medical facilities
  • Various illnesses on-board (respiratory illness, seasickness, GI illness)
1395
Q

What is the most common cause of gastrointestinal illness outbreaks on cruise ships?

A

Norovirus

It accounts for over 90% of GI outbreaks with a confirmed cause.

1396
Q

What should travelers consider when taking medicines abroad?

A
  • Keep away from children
  • Carry written instructions and a letter of authorization
  • Package medicines appropriately to prevent misunderstandings at customs
1397
Q

Fill in the blank: Loose tablets are likely to become pulverised if carried in a _______.

1398
Q

What legal issues may travelers face regarding medicines?

A
  • Varying legal status of medicines between countries
  • Potential problems with controlled drugs
1399
Q

What recommendations should be given regarding the packaging of medicines?

A
  • Use solid dosage forms packaged in blister packs
  • Keep medicines cool
  • Pack in at least two caches in case baggage is lost
1400
Q

What should travellers carry in terms of medication?

A

An adequate supply of their regular medication plus some overage in case of delays.

This includes medicines that may be used infrequently at home but required during travel.

1401
Q

What are some examples of medicines that may cause problems crossing borders?

A

Examples include:
* Stimulant sinus medications (e.g., pseudoephedrine)
* Vicks inhalers
* Some natural products and vitamins.

These restrictions can vary by country.

1402
Q

What should travellers do if they carry large quantities of medication?

A

Have a letter of authorisation.

This letter can help clarify the purpose of the medication to border officials.

1403
Q

What are common reasons for travellers to purchase medicines overseas?

A

Reasons may include:
* Saving space in luggage
* Saving money
* Lost or forgotten medications
* Treating unexpected travel-related conditions
* Usurping pricing arrangements in their own country.

These reasons may lead to potential risks.

1404
Q

What are some important considerations for travellers attempting to purchase medicines overseas?

A

Considerations include:
* Communication issues
* Identification of medications
* Availability of medicines
* Quality of medicines.

These factors significantly impact the safety and efficacy of medications obtained abroad.

1405
Q

What issue should travellers be aware of when purchasing medicines abroad?

A

The problem of counterfeit pharmaceuticals.

Counterfeit medicines can affect therapeutic response and may contain harmful excipients.

1406
Q

What are key factors to consider when selecting a medical kit for travel?

A

Factors include:
* Itinerary
* Size of the group
* Size of the kit
* Chronic diseases and regular medicines
* Packaging
* Stability of medications.

These factors ensure the kit meets the traveller’s specific needs.

1407
Q

What is a recommended legal practice for travellers carrying medications?

A

Keep medications appropriately packaged and labelled.

Additionally, carry a doctor’s letter or copies of prescriptions.

1408
Q

List some items that should be included in a travel medical kit.

A

Items include:
* Analgesics (e.g., Ibuprofen, Acetaminophen)
* Antihistamines/Decongestants (e.g., Benadryl)
* Wound care supplies (e.g., adhesive bandages)
* Gastrointestinal medications (e.g., Antacid)
* Miscellaneous items (e.g., water purification tablets).

A well-stocked medical kit can address a variety of health issues during travel.

1409
Q

What is Rheumatoid Arthritis (RA)?

A

A chronic systemic inflammatory (autoimmune) condition characterized by persistent symmetric polyarthritis (synovitis) affecting hands and feet

RA may also affect extraarticular tissues/organs such as skin, lungs, heart, and eyes.

1410
Q

What are the common signs and symptoms of RA?

A
  • Persistent symmetric polyarthritis (synovitis) of hands and feet
  • Progressive articular deterioration
  • Difficulty performing activities of daily living (ADLs)
  • Constitutional symptoms
  • Common sites of involvement: upper and lower extremities

Common joints include metacarpophalangeal joints, wrists, knees, and hips.

1411
Q

What is the global prevalence of RA?

A

3 cases per 10,000 population with 1% prevalence

RA peaks in prevalence between ages 35-50 years.

1412
Q

Who is more affected by RA?

A

Women are three times more affected than men; the difference diminishes with older ages

First-degree relatives of RA patients have a 2-3 fold increase in risk.

1413
Q

What genetic factor is associated with an increased risk of RA?

A

HLA-DR4 allele increases severity and development of RA

This indicates a genetic predisposition to the disease.

1414
Q

What are some lifestyle risk factors for RA?

A
  • Increased smoking duration
  • Red meat intake
  • Vitamin D deficiency
  • Excessive coffee consumption
  • High salt intake

Hormonal factors, particularly prolactin levels, also play a role.

1415
Q

What are the phases of RA pathophysiology?

A
  • Phase I - Interaction of genetic and environmental risk factors
  • Phase II - Production of RA autoantibodies (e.g., RF, anti-CCP)
  • Phase III - Begin arthralgia or joint stiffness
  • Phase IV - Development of arthritis
  • Phase V - Established RA
1416
Q

What is the role of cytokines in RA pathogenesis?

A

B-cells and T-cells inappropriately enter the joint, releasing cytokines that cause the synovium to release proteolytic enzymes, destroying bone and cartilage

Key cytokines include TNF-α, IL-1, IL-6, IL-8, TGF-ß, FGF, and PDGF.

1417
Q

What are the key components of RA diagnosis?

A
  • History
  • Symptoms
  • Blood tests
  • X-ray

The process involves differentiating RA from other conditions with similar signs or symptoms.

1418
Q

What are the diagnostic criteria for RA according to ACR/EULAR 2010?

A
  • Joint involvement
  • Serology
  • Acute-phase reactants
  • Duration of symptoms
1419
Q

What lab tests are typically raised in active RA?

A
  • ESR
  • CRP
  • IgM-RF (present in 80% of RA patients)
  • Anti-CCP (useful for early detection)

ANA can help differentiate types of disease.

1420
Q

What is the Disease Activity Score (DAS-28)?

A

A measure that counts the number of swollen and tender joints, and includes ESR or CRP and a global health score

DAS-28 > 5.1 indicates active disease, while < 2.6 indicates remission.

1421
Q

What are the aims of RA management?

A
  • Reduce symptoms
  • Slow/limit joint damage
  • Preserve/improve function
  • Achieve/maintain disease remission

There is currently no cure for RA.

1422
Q

What non-pharmacological measures are recommended for RA management?

A
  • Physiotherapy
  • Exercise
  • Diet
  • Psychological education
  • Stress reduction
  • Surgical interventions
1423
Q

What pharmacological treatments are used for RA?

A
  • NSAIDs
  • Glucocorticoids
  • DMARDs
  • Biologicals

NSAIDs can worsen cardiovascular risks associated with RA.

1424
Q

What is the recommended initial treatment for RA flares?

A

Short-term treatment with glucocorticoids to rapidly decrease inflammation

Long-term use should be discussed with patients due to potential complications.

1425
Q

True or False: The earlier treatment for RA starts, the better the chance of longer remission.

1426
Q

What are the long-term complications of glucocorticoid therapy?

A

Fully discussed and all other treatment options have been offered

Long-term use of glucocorticoids can lead to various complications including osteoporosis, diabetes, and cardiovascular issues.

1427
Q

What is the initial dosage of oral prednisolone?

A

60mg/day gradually reduced to 7.5mg over 7 weeks

This tapering schedule is important to minimize withdrawal symptoms and side effects.

1428
Q

What is the dosage of Methylprednisolone acetate (Depo-Medrone®) and its administration route?

A

120mg intramuscularly on a PRN basis

PRN means ‘as needed’, indicating that the medication is not given on a regular schedule.

1429
Q

Which Disease Modifying Anti-Rheumatic Drugs (DMARDs) are no longer initiated?

A

Gold, Ciclosporin, and Penicillamine

These older DMARDs have largely been replaced by more effective treatments with better safety profiles.

1430
Q

What is considered the gold standard DMARD for rheumatoid arthritis (RA)?

A

Methotrexate

Methotrexate is widely recognized for its efficacy in managing RA but has associated risks.

1431
Q

What are the side effects of Methotrexate?

A
  • Liver impairment
  • Neutropenia
  • Anaemia
  • Pneumonitis
  • Nausea

Monitoring of blood counts and liver function is essential during treatment.

1432
Q

What is Sulfasalazine and how does it work?

A

Pro-drug activated in the colon with anti-RA effects due to the inhibition of transcription factors

It is important to monitor patients for side effects such as cough, diarrhea, and fever.

1433
Q

What side effects are associated with Leflunomide?

A

Diarrhea

Leflunomide is an effective DMARD that requires monitoring for gastrointestinal side effects.

1434
Q

What is the mechanism of action of Hydroxychloroquine?

A

Interferes with antigen presentation and activation of the immune response

Hydroxychloroquine is also used for malaria and lupus, with ocular toxicity as a serious side effect.

1435
Q

What is the recommended first-line treatment for RA according to NICE CG100?

A

cDMARD monotherapy ideally within three months of diagnosis

This includes Methotrexate, Leflunomide, or Sulfasalazine.

1436
Q

What are biological medications classified by?

A

Their mechanism of action

This includes classifications such as Anti-TNF-alpha inhibitors, CD20 inhibitors, and Janus Kinase inhibitors.

1437
Q

What was the first TNF alpha inhibitor?

A

Infliximab

Infliximab has paved the way for subsequent biologic therapies.

1438
Q

Which biological medications are recommended for treating severe rheumatoid arthritis?

A
  • Adalimumab
  • Etanercept
  • Infliximab
  • Certolizumab pegol
  • Golimumab
  • Tocilizumab
  • Abatacept

These are recommended only if the disease is severe and has not responded to intensive therapy with DMARDs.

1439
Q

Under what conditions can Adalimumab, Etanercept, Certolizumab pegol, or Tocilizumab be used as monotherapy?

A

When methotrexate is contraindicated or intolerant, and the criteria for severity are met

Monotherapy is considered when the patient cannot tolerate DMARDs.

1440
Q

What is the dosing frequency for Rituximab when treating RA?

A

No more frequently than every 6 months

Rituximab is given in combination with Methotrexate for better efficacy.

1441
Q

What defines an adequate response to Rituximab therapy?

A

An improvement in DAS28 of 1.2 points or more

The DAS28 score is a measure of disease activity in rheumatoid arthritis.

1442
Q

What is the typical journey of a patient with RA after presenting to their GP?

A
  • Initiation with analgesia/NSAIDs
  • Referred to a rheumatology specialist
  • If RA is confirmed, treatment with DMARDs starts
  • If DAS-28 remains above 5.2 after six months, biologic treatment may start

This pathway ensures timely and effective management of RA.

1443
Q

What is the pathophysiology of COVID-19 and influenza?

A

Involves viral entry, replication, and immune response leading to symptoms and potential complications

Pathophysiology refers to the functional changes associated with or resulting from disease or injury.

1444
Q

What is the NICE guidance for managing COVID-19 and influenza in primary care?

A

Focus on clinical assessment, testing, antiviral therapy referral, and patient education

NICE stands for the National Institute for Health and Care Excellence.

1445
Q

List the risk factors for severe illness from COVID-19.

A
  • Increasing age
  • Male sex
  • Co-morbidities (e.g., hypertension, diabetes)
  • Health and social care workers
  • Black and Asian ethnic groups
  • Lower socioeconomic groups
1446
Q

What types of tests are used for diagnosing COVID-19?

A
  • Clinical assessment
  • Lateral flow testing
  • PCR testing
  • Blood tests (Serology and generic tests)
  • COVID Oximetry at Home Monitoring
1447
Q

What are the symptoms of severe COVID-19 illness?

A
  • Progressively worsening breathlessness
  • Haemoptysis
  • Cyanosis
  • Collapse or syncope
  • New confusion
  • Drowsiness
  • Reduced urine output
  • Hypoxia
1448
Q

True or False: Hospital referral is required for all COVID-19 patients.

A

False

Referral is based on the severity of symptoms.

1449
Q

What advice should be given to patients with COVID-19 not needing hospital referral?

A
  • Stay at home
  • Self-manage symptoms
  • Get vaccinated
  • Ensure adequate ventilation and hygiene
  • Access mental health support
1450
Q

What are the criteria for referring patients for antiviral therapy?

A

Patients with risk factors for severe illness such as:
* Down syndrome
* Solid cancers
* Respiratory conditions (COPD & Asthma)
* Immune deficiencies

1451
Q

What is the purpose of the PANORAMIC trial?

A

To evaluate antiviral treatments for COVID-19 in community settings, particularly among high-risk, vaccinated populations

1452
Q

What is the mechanism of action of Nirmatrelvir?

A

Inhibits the SARS-CoV-2 main protease (Mpro), stopping viral replication

Nirmatrelvir is used in combination with ritonavir.

1453
Q

What are common side effects of Paxlovid?

A
  • Altered taste
  • Diarrhoea
  • Headache
  • Muscle aches
1454
Q

What is the mechanism of action of Sotrovimab?

A

Binds to the spike protein of SARS-CoV-2, blocking the virus from entering human cells

1455
Q

What are the administration requirements for Remdesivir?

A

200mg IV on day 1, followed by 100mg IV on days 2 and 3 for non-hospitalised patients

For hospitalised patients, it is given for 5-10 days.

1456
Q

Fill in the blank: The RECOVERY trial showed that dexamethasone reduced death by a ______ in ventilated patients.

1457
Q

What is the role of antibiotics in managing COVID-19?

A

Do not prescribe antibiotics to prevent secondary bacterial pneumonia; start for suspected or confirmed secondary infections

Antibiotics are ineffective against viral infections.

1458
Q

What are common complications of COVID-19?

A
  • Acute respiratory distress syndrome
  • Venous thromboembolism
  • Acute myocardial injury
  • Acute kidney injury
  • Sepsis
1459
Q

What are the common causes of Acute Kidney Injury (AKI) in COVID-19?

A
  • Volume depletion
  • Haemodynamic changes
  • Viral infection causing tubular injury
  • Thrombotic vascular processes
  • Glomerular pathology
1460
Q

What should be monitored in patients treated for AKI?

A

Haematuria, proteinuria, and abnormal serum electrolyte levels

1461
Q

What is the mechanism of action of Molnupiravir?

A

Targets SARS-CoV-2 RNA-dependent RNA polymerase and introduces errors into the viral RNA during replication

1462
Q

List common side effects of Molnupiravir.

A
  • Diarrhoea
  • Nausea
  • Dizziness
  • Headache
1463
Q

What is the recommended use of corticosteroids in COVID-19 treatment?

A

Dexamethasone is first-line; suppresses immune response and reduces inflammation

Important for managing cytokine storms.

1464
Q

What condition can increase the risk of AKI?

A

Remdesivir

Risk factors for AKI include treatments for pre-existing conditions such as ACE inhibitors and NSAIDs.

1465
Q

What symptoms should be managed in patients to prevent fluid loss?

A

Fever and increased respiratory rate

1466
Q

What causes acute myocardial injury?

A

Direct damage, systemic inflammation, endothelial dysfunction, hypoxia

Direct damage occurs via ACE2 receptor interaction; systemic inflammation leads to myocarditis; endothelial dysfunction triggers a hypercoagulable state.

1467
Q

What are the diagnostic tools for acute myocardial injury?

A

ECG, Troponin, NT-proBNP

1468
Q

What are the three parts of Virchow’s triad affected by COVID-19?

A

Endothelial dysfunction, hypercoagulable state, immobility

1469
Q

What should be used to assess risks of VTE?

A

A validated risk assessment tool

1470
Q

What is the choice between prophylactic or treatment dose of anticoagulants based on?

A

Oxygen supply needs and bleeding risk

1471
Q

What are common differential diagnoses for influenza?

A

Common cold, respiratory syncytial virus, parainfluenza virus, strep pharyngitis, meningitis, bacterial pneumonia, glandular fever, whooping cough, malaria

1472
Q

What are common respiratory complications of influenza?

A

Acute bronchitis, asthma exacerbations, otitis media, pneumonia

1473
Q

What are some non-respiratory complications of influenza?

A

Myocarditis, pericarditis, febrile convulsions, myalgia, neurological complications

Includes conditions like Reyes syndrome and toxic shock syndrome.

1474
Q

What should be considered when a patient brings a prescription for Oseltamivir after 48 hours?

A

Potential issues with treatment efficacy due to timing

1475
Q

What is a self-care recommendation for managing influenza?

A

Maintain hydration and plenty of rest

1476
Q

What is a key criterion for antiviral treatment in high-risk patients?

A

Influenza must be circulating as per national surveillance

1477
Q

What are ‘at risk’ groups for influenza?

A

Over 65 years, children under 6 months, pregnant women, and individuals with chronic conditions

1478
Q

What is the mechanism of action of neuraminidase inhibitors?

A

Inhibit the enzyme neuraminidase, preventing viral replication and spread

1479
Q

What should be prescribed for a lower risk of oseltamivir resistance?

A

Oral oseltamivir

1480
Q

How is Oseltamivir administered?

A

Oral, BD dosing based on age and weight

1481
Q

What are common side effects of Oseltamivir?

A

Nausea and vomiting

1482
Q

What is the administration route for Zanamivir?

A

Inhaled via Diskhaler, OD

1483
Q

What are common side effects of Zanamivir?

A

Throat irritation and cough

1484
Q

What role do pharmacists play in managing viral infections?

A

Manage antiviral treatments and patient education

1485
Q

What is one purpose of vaccination campaigns?

A

Prevent viral infections

1486
Q

What is a key difference between COVID-19 and influenza vaccines?

A

Composition and mechanism of action

1487
Q

What strategy can improve vaccination uptake in vulnerable groups?

A

Targeted outreach and education

402 EXAM (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions