Midterm 3 Flashcards
Promethazine
H1 blocker
anticholinergic
Antinausea for motion sickness
treats meniere’s
Dexxamethasone
long acting steroid
inject into ear to reduce fluid
treats meniere’s
Antibiotics for Otitis Media
Amoxicillin
Amoxicillin + clavulanate
Cefaclor
Second level drugs: trimethoprim (sulfa)
Macrolides
Incorrect statement concerning open angle glaucoma
Associated with rapid closure of drainage canals for the aqueous humor
Accounts for 90% of the glaucoma cases
African Americans are especially vulnerable
Diabetes and high blood pressure are risk factors
Not associated with rapid closure of drainage canals
Subtle, slow closure
Which is not a risk factor for cataracts
Diabetes
Arthritis
Aging
Construction worker
Arthritis
Treatment for cataracts is surgical removal
Correct statements concerning Ag-related Macular degeneration
Occurs in 90% of patients older than 80
Almost never occurs in patients less than 50
Antioxidant treatment is very effective in preventing this condition
Progress of disease is fast if hemorrhage and fluid buildup are associated
Associated with loss of peripheral vision
Bevacizumab is used to treat the wet form of this disorder
Most common cause of severe loss of sight in patients older than 60
Almost never occurs in patients less than 50
Progress of disease is fast is hemorrhage and fluid buildup are associated
Bevacizumab is used to treat the wet form of this disorder
Most common cause of severe loss of sight in patients older than 60
- Occurs in 10% of patients older than 80
- Antioxidant treatment is minimally effective in preventing AMD
- Associated with loss of central vision
Other: Smoking is a risk factor, associated with polymorphisms, No treatment for dry AMD
How predictive of breast cancer is mammography
25%
50
85
99
85%
Palpation gets how much breast cancer (that mammography doesn’t)
10%
Incorrect statement concerning breast carcinoma
50% chance to be the diagnosis of a lump found in breast of 23 year-old female
More likely to occur in women with a history of breast cysts
No apparent racial link
BRCA 1 and 2 are the most common genes associated with this condition
not 50% chance to be the diagnosis in 23 year old
Rare before 25 years (or before menopause)
Incidence of breast carcinoma by age 70
30% incidence by age 70
Which of the following are the survival rates for breast cancers classified as stage O and stage IV respectively
40% and 86%
99 and 5
55 and 10
92 and 13
92% and 13%
Obesity has been determined to be a link in which of the following
cervical cancer and breast cysts
endometrial polyps and endometrial adenocarcinoma
endometrial polyps and endometritis
ovarian cysts and ovarian carcinoma
endometrial polyps and endometrial adenocarcinoma
Endometrial Polyps occur when
late menopause
hypertension
Obesity
Cervical cancers risks
HPV - multiple sex partners immunosuppression early age of first sexual contact oral contraception for more than 5 years nicotine use
Breast cyst age
20-40
fibrolytic changes
doesn’t really occur after menopause
can calcify/look like cancer
Endometrial adenocarcinoma risks
obesity
Diabetes
Hypertension
Endometritis risks
IUDs
infection
Ovarian cysts/masses (neoplastic)/cancer
contraceptives can decrease risk
treatment is total hysterectomy and surrounding tissue, chemotherapy
most are sporadic
Non-steroidal synthetic estrogen
steroidal
non steroidal - diethylstillbesterol
Steroidal - ethinyl estradiol
Which is not an effect of diethylstillbesterol
Increases CNS excitability
Maintains skin elasticity
Increases pigmentation around the eyes
Increases bone adsorption
does not increase bone adsorption
decreases bone adsorption
also: sexual maturity
increased endometrial and uterine growth
Increase blood coagulability
Which of the following characteristics differ between progestins and ethinylestradiol
Used in oral contraception
Contraindicated in patients with severe heart disease
When used in combination the reduction in ovulation approaches 100%
Effects are blocked by tamoxifen
Effects are blocked by tamoxifen - blocks estrogen only
Effects of progestins
Increase aldosterone, increase Na and water retention, increase BP and blood volume
Increase fat deposition
decrease CNS excitability
Increase body temp
Clinical uses of progestins
Replacement therapy
Oral contraception
Long-term ovarian suppression - endometriosis and such
contraindications of progestins
Breast cancer
Severe hypertension or heart disease
Clinical uses of estrogen
Primary hypogonadism
Postmenopausal - smallest dose
Adverse effects of estrogen
postmenopausal bleeding nausea hypertension hyperpigmentation increases some cancers (breast and endometrial)
Contraindications for estrogen
Liver disease
Breast/endometrial cancers
thrombolytic disorders
Used to treat breast cancers
Tamoxifen
blocks actions of estrogen
Morning after pill
MIfepristone
blocks progesterone and glucocorticoid receptor
Suppresses ovarian function
Danazol
masculinizing effect
treats endometriosis
treats fibrous changes in breast
Ovulation - inducing druge
Clomiphene
Minipill
progesterone only
fewer side effects, less effective
Autoimmune disorder often associated with ulcers and carditis
Rheumatoid arthritis
pyogenic infections often caused by staph aureus
osteomyelitis
can result in kyphosis and scoliosis
osteoporosis
due to tissue wear and tear and present in most people older than 65
osteoarthritis
type 1 collagen and dentin deficiency
osteogenesis imperfecta
prevented by consuming citrus fruit
scurvy
Non-steroidal synthetic estrogen
steroidal
non steroidal - diethylstillbesterol
Steroidal - ethinyl estradiol
Which is not an effect of diethylstillbesterol
Increases CNS excitability
Maintains skin elasticity
Increases pigmentation around the eyes
Increases bone adsorption
does not increase bone adsorption
decreases bone adsorption
also: sexual maturity
increased endometrial and uterine growth
Increase blood coagulability
Which of the following characteristics differ between progestins and ethinylestradiol
Used in oral contraception
Contraindicated in patients with severe heart disease
When used in combination the reduction in ovulation approaches 100%
Effects are blocked by tamoxifen
Effects are blocked by tamoxifen - blocks estrogen only
Effects of progestins
Increase aldosterone, increase Na and water retention, increase BP and blood volume
Increase fat deposition
decrease CNS excitability
Increase body temp
Clinical uses of progestins
Replacement therapy
Oral contraception
Long-term ovarian suppression - endometriosis and such
contraindications of progestins
Breast cancer
Severe hypertension or heart disease
Clinical uses of estrogen
Primary hypogonadism
Postmenopausal - smallest dose
Adverse effects of estrogen
postmenopausal bleeding nausea hypertension hyperpigmentation increases some cancers (breast and endometrial)
Contraindications for estrogen
Liver disease
Breast/endometrial cancers
thrombolytic disorders
Used to treat breast cancers
Tamoxifen
blocks actions of estrogen
Morning after pill
MIfepristone
blocks progesterone and glucocorticoid receptor
Suppresses ovarian function
Danazol
masculinizing effect
treats endometriosis
treats fibrous changes in breast
Ovulation - inducing druge
Clomiphene
Minipill
progesterone only
fewer side effects, less effective
Autoimmune disorder often associated with ulcers and carditis
Rheumatoid arthritis
pyogenic infections often caused by staph aureus
osteomyelitis
can result in kyphosis and scoliosis
osteoporosis
due to tissue wear and tear and present in most people older than 65
osteoarthritis
type 1 collagen and dentin deficiency
osteogenesis imperfecta
prevented by consuming citrus fruit
scurvy
Carisoprodol
muscle relaxant
can develop dependence, sedative
abnormal keratization located deep in dermia
dyskeratosis
elevated dome or flat topped less than 5mm
papule
flat and circumscribed discolored area less than 5mm
macule
Effective against VSV
Famcyclovir
longer lasting than acyclovir
thymidine kinase dependent
Correct statements concerning acne vulgaris and its treatment
Its inflammatory state typically consists of opened comedones known as blackheads
It is usually associated with increased testosterone activity in both males and females
Abscesses form from ruptured sebaceous glands
Associated with trapped fungus in the sebaceous glands
Salicylic acid is used for treatment due to its ability to dry and destroy the sebaceous gland
Benzoyl peroxide is effective in treatment of acne due to its keratolytic effects
Isotretinoin is a very effective systemic treatment for long-term improvement of acne
The most serious side effect of isotretinoin treatment is dry skin
corrected wrong answers:
Inflammatory state i is closed comodones and white heads
Associated with trapped bacteria, not fungus
Salicylic acid only opens gland by removing keratin, does not destroy gland (Retinol destroys)
Most serious side effect of isotretinoin is birth defects
elevated dome more than 5 mm
nodule
traumatic breakage of skin (from scratching)
excoriation
Which best describes uticaria
hypersensitivity-related hives in response to antigens such as pollens and drugs
mediated by IgE
Cellular memory of a reaction to an antigen such that future repeated exposures causes increased dermatitis reaction
Allergic contact dermatitis
Wide range of reactions to infections and drugs including blisters and necrosis with varying severities of expression
Erythema multiforma
Delayed hypersensitive reaction that can be pruritic, edematous and oozing
Eczematous dermatitis
Select the incorrect statement concerning psoriasis
Caused by use of NSAIDS
Treated by immunosuppressant drugs
Associated with well-marked pink to salmon colored plaques
Can be accompanied by increased hear attacks
not caused by NSAIDS
caused by auto-rejection, or environmentally induced
epidermal acnthosis- hyperplasia
treated with NSAIDS and immunosuppressant drugs
the leading cause of cancer-induced death in USA
lung cancer
Which of the following is the most common expression of skin cancer
basal cell carcinoma
squamous cell carcinoma
non-metastatic melanoma
metastatic melanoma
basal cell carcinoma - least aggressive, slow growing, no metastasis
squamous cell - 2nd most common, usually no metastasis, red scaly plaques, locally aggressive
Metastatic - most rare, most aggressive, metastasizes
Which of the following is least likely to be associated with high doses of COX 1 and 2 non-selective, treating inflammatory disorders
diabetes hypertension altered liver functions asthma renal insufficiency
diabetes
others: tinnitus, nausea, bleeding
Which of the following muscle relaxants is classified as a desensitizing nicotinic ganglionic blocker
succinylcholine dantrolene baclofen D-tubocurarine carisoprodol
Succinylcholine - depolarizes by desensitizing, fast acting, causes twitch
not inhibited by acetylcholinesterase inhibitor
Alters Ca trafficking
Dantrolene
muscle relaxant
Baclofen
Non-depolarizing, GABA B agent
muscle relaxant
D-tubocurarine
Inhibited by acetylcholinesterase inhibitor
competitive for ACh, blocks nicotinic receptor
muscle relaxant
Carisoprodol
muscle relaxant
can develop dependence, sedative
Non-thymidine kinase dependent antiviral
Foscarnet
Correct statement concerning liver disorders
- Obstruction caused by gallstones can result in cholecystitis
- Viral infections are the #1 cause of hepatotoxicity
- Fibrosis is more likely to result in cirrhosis than steatosis
- Most hepatotoxic events occur around the central hepatic vein
- There is a cure for hepatitis C, but no immunization
- Hep A and E viruses cause both an acute and chronic hepatitis
- Fatty liver disease and resulting cirrhosis is caused entirely by alcoholism
- Wilson’s disease is a hepatitis caused by a calcium metabolic defect
Wrong answers corrected
Drugs are #1 cause of hepatotoxicity - not virus
Hep A and E cause only acute, not chronic (BCD are both)
Fatty liver disease and resulting cirrhosis caused by alcoholism, diabetes and obesity
Wilson’s disease is a copper metabolic defect, not calcium
Most effective for herpes 1 and 2
less on VZV
Acyclovir
thymidine kinase dependent
Effective against VSV
Famcyclovir
longer lasting than acyclovir
thymidine kinase dependent
Correct statements concerning acne vulgaris and its treatment
Its inflammatory state typically consists of opened comedones known as blackheads
It is usually associated with increased testosterone activity in both males and females
Abscesses form from ruptured sebaceous glands
Associated with trapped fungus in the sebaceous glands
Salicylic acid is used for treatment due to its ability to dry and destroy the sebaceous gland
Benzoyl peroxide is effective in treatment of acne due to its keratolytic effects
Isotretinoin is a very effective systemic treatment for long-term improvement of acne
The most serious side effect of isotretinoin treatment is dry skin
corrected wrong answers:
Inflammatory state i is closed comodones and white heads
Associated with trapped bacteria, not fungus
Salicylic acid only opens gland by removing keratin, does not destroy gland (Retinol destroys)
Most serious side effect of isotretinoin is birth defects
Cellular mechanisms that result in tumors
Inhibit apoptosis
Stimulates growth factor oncogenes
Stimulates production of telomerases to prevent cellular senescence
Suppresses the P53 gene
Increases angioneogenesis by enhancing release of vascular endothelial growth factor
Ames test
determines the carcinogenic properties of a chemical by measuring the bacterial DNA responses to substance
typically found in younger patients and associated with Reed Sternberg cells
Hodgkin’s lymphoma
a very aggressive non-Hodgkin’s lymphoma of B lymphocytes with a poor prognosis
Burkitt’s lymphoma
associated with elevated HCG
Choriocarcinoma
mesenchymal cancer typically found in AIDS patients
Kaposi’s sarcoma
Malignant tumors of columnar cells and able to form glands
adenoid carcinoma
the leading cause of cancer-induced death in USA
lung cancer
Correct statements concerning cancer treatments
- Imatinib is a tyrosine hydroxylase inhibitor used to treat multiple types of cancer such as myelogenous leukemia
- Cyclophosphamide is a nitrosourea that is used to treat brain tumors because of its ability to pass through the blood brain barrier
- Methyltrexate is a folic acid analog that interferes with the formation of key DNA in cancer cells such as those associated with breast cancer
- Vincristine is a natrual product that interferes with tubulin polymerization
- Doxorubicin is a form of 5-fluorouracil that inibits thymidine synthases
- The secondary cancer most likely to occur as a complication of cancer treatment with alkylating agents is myelogenous leukemia
- Stage I breast cancers only have an approximate 10% cure rate
wrong statements corrected
Cyclophosphamide is not a nitrosourea
Procarbazine is nitrosourea that passes BBB and treats brain tumors (and Hodgkin’s lymphoma)
Doxorubicin is an anti-biotic that treats cancer, forms free radicals
Bleomycin too
Stage I breast cancers have 92% survival/cure rate
State IV has 10%
Cyclophosphamide
Alkylating agent
treats: Leukemia, Hodgkin’s, Breast cancer, Multiple myeloma
Transfers alkyl group to cell parts like DNA, breaks DNA
Which is most common cancer in children
Acute lymphoblast leukemia (ALL)
most common G.I. malignancy
Colorectal cancer
Multiple myeloma
Plasma cell malignancy
Most commonly in bone marrow
Most common acute leukemia of adult
Acute myelogenous leukemia
Identify the incorrect statements concerning gastrointestinal disorders
- Infectious esophagitis can be associated with infection by the cytomegalovirus (herpes and candida included)
- Barrett esophagus can be associated with reflux esophagitis
- Chronic gastritis is most often caused by herpes simplex virus
- Hirschprung disease is a congenital defect associated with auto-immune gastritis
- Celiac sprue can be associated with enamel defects and delayed eruption of teeth
- Crohn’s disease is associated with an expression of intestinal inflammation that is more consistently expressed throughout the intestines than ulcerative colitis
- Invasive colonic adenocarcinoma is responsible for 15% of all cancer deaths in the USA
- Reflux esophagitis is most likely to occur in young adults
Wrong answers corrected:
Chronic gastritis is caused by H. pylori, not herpes
hirschsprung disease is a congenital defect of G.I. innervation, not auto-immune
Crohn’s disease is associated with intestinal inflammation that is more patchy, not consistent
Reflux esophagitis is more common in older adults
More one Chronic gastritis, celiac, chrohns, irritable bowel
j
Correct statement concerning liver disorders
- Obstruction caused by gallstones can result in cholecystitis
- Viral infections are the #1 cause of hepatotoxicity
- Fibrosis is more likely to result in cirrhosis than steatosis
- Most hepatotoxic events occur around the central hepatic vein
- There is a cure for hepatitis C, but no immunization
- Hep A and E viruses cause both an acute and chronic hepatitis
- Fatty liver disease and resulting cirrhosis is caused entirely by alcoholism
- Wilson’s disease is a hepatitis caused by a calcium metabolic defect
Wrong answers corrected
Drugs are #1 cause of hepatotoxicity - not virus
Hep A and E cause only acute, not chronic (BCD are both)
Fatty liver disease and resulting cirrhosis caused by alcoholism, diabetes and obesity
Wilson’s disease is a copper metabolic defect, not calcium
Correct statements concerning drugs used to treat G.I. and liver disorders
- Aluminum salts are not very effective in the treatment of GERD
- Cimetidine and ranitidine are OTC H1 blockers used to treat acid reflux
- Omeprazole is a proton pump inhibitor often combined with H2 blockers to treat peptic ulcer disease
- Prevpac is primarily used to treat severe diarrhea
- Bisacodyl is a fast acting smooth muscle stiumlant used to treat constipation
- Loperamine is principally used to treat stomach cramps
- Irritable bowel syndome is a common disorder in young adults primarily treated by relieving symptoms
- Crohn’s disease is treated with antiviral medications such as acyclovir
- If exposed to HBV, a dentist should immediately begin treatment with the HBV vaccine series
- Linaclotide is FDA-approved to treat the diarrhea associated with irritable bowel syndrome
Wrong answers corrected
Cimetidine and ranitidine are H2 blockers, do treat acid reflux
Prevpac is used to treat peptic ulcer disease caused by H. pylori
Loperamine is used to treat diarrheas, not cramps
Crohn’s disease is treated with anti-inflammatories and antibiotics
Linaclotide is FDA-approved to treat Constipation associated with irritable bowel syndrome
Treatment for Crohn’s
Mess on the Metro with Cortney
Mesalamine, metronidazole, corticosteroids
Cimetidine
H2 blocker
treats GERD
drowsiness
Rantidine
H2 blocker
treats GERD
drowsiness
Docusate
causes diarrhea, water retention, stool softener
Atropine
anti-cholinergic
treats diarrhea
and nerve gas
Loperamide
treats diarrhea
mild opioid
Bismuth subsalicylate
Peptobismal
treats diarrhea
