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GI > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Symptoms of dyspepsia?

A

Upper abdominal pain (above the navel)

Belching

Nausea

Abdominal bloating

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2
Q

Ratio of duodenal to gastric ulcers?

A

Duodenal:gastric 4:1

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3
Q

Which type of peptic ulcer is worse?

A

A gastric ulcer as it may become malignant, a duodenal ulcer is normally benign

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4
Q

What are the risk factors for developing a peptic ulcer?

A

H.pylori infection - acid increase

Smoking, predisposition, stress - acid increase and less mucosal defence

NSAIDS - less mucosal defence

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5
Q

Symptoms of duodenal ulcers?

A

Weight gain

Relieved by milk/eating/rest/antacids

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6
Q

Symptoms of gastric ulcers?

A

Vomit/Melena

Upper abdominal pain
Weight loss/appetite loss/anaemia

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7
Q

Complications associated with gastric ulcers?

A

Haemorrhages
Peritonitis
Obstruction
Pain

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8
Q

Main reason for GORD occurrence?

A

Lower Oesophageal Sphincter not closing properly, and acid reflux into the oesophagus

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9
Q

Symptoms of GORD?

A 
Belching
Chronic sore throat
Laryngitis
Gum inflammation
Bad breath
Sour taste
Pain on swallowing
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10
Q

Risk factors for GORD?

A 
Caffein
Chocolate
Smoking
Overweight
Alcohol
Tomato-based foods
Spicy foods
Mint flavouring
Citrus fruits
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11
Q

Two examples of classes of drugs that inhibit acid secretion?

A

PPIs

Histamine receptor antagonists

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12
Q

An example of a class of drug that neutralises excess acid?

A

Antacids

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13
Q

Three examples of classes of drugs that protect the GI mucosa?

A

Prostaglandin analogue
Gel formers
Dopamine receptor antagonists

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14
Q

An example of a PPI?

A

Omeprazole

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15
Q

S/E of PPIs?

A

Interactions with warfarin may enhance the metabolism due to acting on the p450 enzyme

only omeprazole and pantoprazole

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16
Q

How long does one dose of PPI last, why?

A

24hrs as it is irreversible and the proton pumps have to be resynthesized

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17
Q

Two examples of histamine receptor antagonists?

A

Cimetidine and Ranitidine

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18
Q

Interactions of Histamine receptor antagonists?

A

May inhibit p450 enzyme of Warfarin/Theophylline

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19
Q

Examples of antacids?

A

Aluminium hydroxide
Magnesium trisilicate
Calcium
Sodium Bicarbonate

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20
Q

What S/Es of antacids are there?

A 
Aluminium = constipation
Magnesium = Diarrhoea

Risk of malabsorption when taken with other drugs

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21
Q

Example of a prostaglandin analogue?

A

Misoprostol

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22
Q

Examples of gel formers?

A

Bismuth subsalicylate

Sucralfate

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23
Q

S/E of Bismuth?

A

Greying of tooth enamel

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24
Q

Examples of dopamine receptor antagonists?

A

Domperidone

Metoclopromide

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25
Q

THow does treatment of GORD differ if the patient is H.Pylori positive to negative?

A

If positive give antibiotics then PPI, H2 antagonists, OTC antacids

If negative then don’t give the antibiotics

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26
Q

What is the H.Pylori treatment?

A

Triple therapy:

Amoxicillin and clarithromycin/metronidazole and Omeprazole

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27
Q

What type of antibiotics are Amoxicillin/Clarithromycin/Metronidazole?

A

Amoxicillin - Cell wall synthesis inhibitor

Clarithromycin - Protein synthesis inhibitor

Metronidazole - Nucleic acid synthesis inhibitor

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28
Q

Why does diarrhoea develop in coeliac disease?

A

Less surface area fro water resorption

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29
Q

Common infective organisms that cause diarrhoea?

A

Bacteria:

  • E. Coli
  • Salmonella
  • Cholera
  • C. Difficile

Viruses:

  • Norwalk virus
  • Rota virus

Parasites:

_ Cryptosporidium parvum

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30
Q

Three main types of drugs that cause diarrhoea, and why?

A

Cholinergics - Increased Ach

Cytotoxic agents - Loss of gut epithelia

Broad spectrum anitbiotics - Change in gut flora

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31
Q

Consequences of diarrhoea?

A

Dehydration

Metabolic acidosis

Potassium depletion

Hypovolaemia

CV collapse

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32
Q

Different dehydration signs at 95% hydration and 90% hydration?

A

95%:

  • Thirst
  • Skin turgor
  • Tachycardia
  • Sunken eyes

90% (life threatening)

  • Anuria
  • Hypotension
  • Feeble and rapid radial pulse
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33
Q

4 Main treatments for acute diarrhoea?

A

ORT (oral rehydration therapy)

Antimotility drugs: Relieve symptoms

Antispasmodics: reduce cramping + pain

Antibacterials

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34
Q

What should the tonicity of ORT be?

A

Isotonic or slightly hypotonic when rehydrated

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35
Q

What does glucose do to sodium transport?

A

Aids sodium transport

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36
Q

How do antimotility drugs work?

A

Reduce awareness of urge, increase muscle activity but diminish propulsive activity

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37
Q

Examples of antimotility drugs?

A

Opiates: Loperamide, cophenotrope

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38
Q

Side effects of antimotility drugs?

A

Nausea and vomiting, cramps

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39
Q

Examples of antispasmodics?

A

Muscarinic antagonists: Atropine, Dicycloverine

Peppermint oil: not an antimuscarinic but has direct smooth muscle relaxation

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40
Q

How are antibacterials used in diarrhoea?

A

Prophylaxis: Co-trimoxazole

In infection: Ciprofloxacin, norfloxacin (quinolones)

In psuedomembranous or C. difficile: Metronidazole

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41
Q

What drugs can be used in chronic diarrhoea?

A

Adsorbants: kaolin (binds toxins)

Bulk forming agents: Methylcellulose

Antimotility drugs (secondary to ORT)

Opiates: loperamide hydrochloride, codeine phosphate

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42
Q

Exact definition of constipation?

A

Fewer than three bowel movements per week (A chamge to the normal routine)

Stools hard, dry and small

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43
Q

Reasons for constipation? (get some)

A

Dehydration

Travel

Dehydration

Chronic and idiopathic

Milk

Medications

Reduced physical activity

IBS

Disease

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44
Q

Diseases associated with constipation?

A

Neurological:

  • MS
  • Stroke
  • Parkinsons

Metabolic:

  • Diabetes
  • Uraemia
  • Hyperkalaemia

Systemic disorders:

  • Amyloidosis
  • Lupus
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45
Q

Medications that can cause constipation?

A

Antidepressants

Antiepileptics

Diuretics

Narcotics

Antacids (aluminium)

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46
Q

How do bulk forming laxatives work to reduce constipation?

A

Increase faecal mass

Stimulates peristalsis (as a reaction to mechanical stretch)

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47
Q

Drugs used in constipation?

A

Bulk forming laxatives

Stimulants

Foecal softeners

Osmotics

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48
Q

Examples of stimulants?

A

Bisacodyl

Dantron

Senna

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49
Q

How do dantron and senna work?

A

Stimulate smooth muscle activity

Stimulate myenteric plexus
Increase intestinal motility

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50
Q

S/E of stimulants?

A

Cramp

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51
Q

Examples of foecal softeners

A

Detergent properties: Docusate

Liquid paraffin (lubricate)

Arachis oil (lubricate)

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52
Q

S/E of liquid paraffin?

A

Anal seepage
Granulomatous reaction
Lipoid pneumonia

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53
Q

How do osmotic laxatives work?

A

Withdraw fluid from the bowel or retain fluid they are administered with

Accelerate the transfer through Gut tube, large volume in colon

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54
Q

Examples of osmotic laxatives?

A

Lactulose

Macrogols

Magnesium salts

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55
Q

Key examples of viruses that are based on RNA?

A

Influenza A,B and C

RSV

HIV

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56
Q

Key examples of viruses that are based on DNA?

A

HSV

CMV

Varicella

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57
Q

5 targets for antiviral drugs?

A

Fusion (to the cell)

Uncoating

Nucleic acid replication

Protease

Release

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58
Q

An antiviral drug that works at the fusion target? How’s it work? S/E?

A

Enfurvitide binds to gp41 on HIV surface, and so inhibits CD4/HIV interaction.

Infections, depression

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59
Q

An antiviral drug that works at the uncoating target? How’s it work? S/E?

A

Amantadine: inhibits viral ion channel and stops uncoating, anti-influenza drug

Dopaminergic effects, nervousness, anxiety, insomnia

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60
Q

Antiviral drugs (HIV) that work at the nucleic acid replication target? How’s it work? S/E?

A

HIV

Zidovudine: Inhibits reverse transcriptase, nucleoside, incorparated into viral RNA

Nevirapine: non-nucleoside, inhibits RT by binding at a different site

Anaemia, Bone marrow suppression, liver toxicity

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61
Q

Antiviral drug (Herpes) that works at the nucleic acid replication target? How’s it work? S/E?

A

Acyclovir: Inhibits DNA polymerase, incorporated into DNA, guanine analogue

Nausea and vomiting, headache

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62
Q

Antiviral drug that work at the protease target? How’s it work? What virus? S/E?

A

HIV

Indinavir - HIV protease inhibitor

Kidney stones, hyperlipidaemia

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63
Q

Antiviral drug that work at the release target? How’s it work? What virus? S/E?

A

Influenza

Oseltamivir - inhibits influenza neuraminidase activity

S/E: nausea/vomiting, diarrhoea, headache

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64
Q

Types of viral resistance?

A

HIV RT nucleoside inhibitors - mutation of drug binding site

HIV RT non-nucleoside inhibitors - single point gene gene mutations

HIV protease inhibitors - mutation in HIV target protein

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65
Q

Whats mycoses?

A

Fungal infection

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66
Q

What makes fungal infections much more likely?

A

Immunosuppression

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67
Q

Main categories of anti-fungal drugs?

A

Polyenes

Imidazoles/Triazoles

Others

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68
Q

Three main targets for anti-fungals?

A

Cell wall synthesis inhibitors

Nucleic acid synthesis inhibitors

Mitotic spindle

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69
Q

How do polyenes work?

A

Generates pores in cell walls - causing loss of K+ ions

Replaces ergosterol in cell wall synthesis and incomplete chains are formed

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70
Q

Polyenes S/E’s?

A

Nephrotoxicity

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71
Q

Two examples of polyenes?

A

Amphotericin

Nystatin

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72
Q

How do Imidazoles and triazoles work?

A

Both inhibit the formation of ergosterol, by inhibiting the enzyme lanosterol demethylase

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73
Q

Three examples of imidazoles?

A

Clotrimazole

Miconazole

Ketoconazole

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74
Q

S/Es of Ketoconazole?

A

Hepatotoxicity

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75
Q

Three examples of Triazoles?

A

Fluconazole

Itraconazole

Voriconazole

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76
Q

Contraindications of intraconazole?

A

Contraindicated with calcium-channel blockers, caution use in heart failure

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77
Q

How does terbinafine work?

A

Inhibits squalene epoxidase, again leading to inhibition of ergosterol formation, and membrane disruption

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78
Q

How does flucytosine work?

A

Inhibits the conversion of uracil to DNA

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79
Q

Down sides of Flucytosine?

A

Resistance rapidly develops, only used in combination

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80
Q

IBD treatment in dietary changes?

A

High fibre, healthy diet

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81
Q

Treatment for IBS?

A

Propantheline, mebeverine (antimuscarinics)

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82
Q

Antibiotics in IBD?

A

Metronidazole, ciprofloxacin

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83
Q

Main two drug groups for use in IBD?

A

Immunosuppressants - antibody therapy, immunosuppressants

Anti-inflammatory - steroids, aminosalicylates

84
Q

What other adjunct drugs are used in IBD?

A

Antispasmodics
Opioids
Laxatives

85
Q

What do aminosalicylates do in IBD treatment?

A

Maintain remission periods

86
Q

Examples of aminosalicylates?

A

Sulfasalazine - severe and others

mesalazine

Olsalazine - mild

Balsalazine

87
Q

Aminosalicylates S/E’s?

A

Nausea controlled through reduced dosing

Mouth ulcers

Loose bowels

Rash

88
Q

What do steroids do in IBD treatment?

A

Mainly used for acute attacks and to induce remission, can be used in maintenance but S/Es make this less suitable

89
Q

Two main oral steroids used in IBD?

A

Prednisolone

Budesonide

90
Q

S/Es of steroid treatment?

A

Osteoporosis

Diabetes

Muscle wasting

Cushings

91
Q

What do immunosuppressants do in IBD treatment?

A

Prevent relapse

92
Q

An example of immunosuppressants used in IBD?

A

Azathioprine (steroid dependent crohns)

Methotrexate

Calcineurin inhibitors: cyclosporin, tacrolimus.

93
Q

S/E of immunosuppressants used in IBD?

A

Nausea, vomiting, pneumonia, herpes and diabetes.

94
Q

Example of an antibody therapy drug used in IBD?

A

Infliximab - against inflammatory cytokines TNF, IL-12, IL-23

95
Q

Four main areas of antibiotic resistance?

A

Drug inactivators

Decreased accumulation

Altered binding site

Alternative pathways

96
Q

Two ways that drug resistance is increased in a population of bacteria?

A

Selection

Transference (with a plasmid)

97
Q

Three main categories of antibiotic targets?

A

Cell wall synthesis inhibitors

Nucleic acid synthesis inhibitors

Protein synthesis inhibitors

98
Q

Four main types of nucleic acid synthesis inhibitors?

A

Sulphonamides

Trimethoprim

Quinolones

Nitroimidazoles

99
Q

What do sulphonamides inhibit in nucleic acid synthesis, how does this prevent synthesis?

A

Dihydropteroate synthetase

Inhibits the formation of dihydropteroic acid from P-Amino benzoic acid

100
Q

What does trimethoprim inhibit in nucleic acid synthesis, how does this prevent synthesis?

A

Dihydrofolate reductase

Inhibits the formation of tetrahydrofolic acid

101
Q

What do quinolones inhibit in nucleic acid synthesis, how does this prevent synthesis?

A

Inhibit DNA gyrase and prevent the formation of DNA strands

102
Q

What do nitroimidazoles do in bacteria?

A

Cause strand breaks in the DNA.

103
Q

Examples of sulphonamides?

A

Sulfadiazine

Sulfamethoxazole

104
Q

Examples of quinolones?

A

Ciprofloxacin

Norfloxacin

105
Q

Example of nitroimidazoles?

A

Metronidazole

106
Q

resistance and S/Es of sulphonamides?

A

Widespread resistance to hospital acquired infection

S/Es: Hypersensitivity reactions, bone marrow suppression

107
Q

What is co-trimoxazole?

A

Combination of trimethoprim and sulfamethoxazole.

108
Q

Sulfonamides bacteriostatic or bacteriocidal?

A

Bacteriostatic

109
Q

Quinolones bacteriostatis or cidal?

A

Bacteriocidal

110
Q

Uses of Co-trimoxazole?

A

Pneumonia

Otitis media

Toxoplasmosis

111
Q

Trimethoprim uses?

A

Invasive salmonella

Respiratory tract infections

Prostatitis/UTI

112
Q

Quinolones first line uses?

A

Pyelonephritis

pseudomonas

Bacillary dysentry

Gastroenteritis (severe)

113
Q

First line uses of metronidazole?

A

Pelvic infections

Infected wounds

C. Diff colitis

114
Q

Why are the cell wall synthesis inhibitors called the β-lactams?

Why is this relevant to resistance?

What can be done to prevent this?

A

They contain the β-lactam ring

Some bacteria have developed resistance through the use of β-lactamase.

Can administer with Clavulanic acid (CA) to inhibit lactamase enzymes

115
Q

How do β-lactam antibiotics work?

A

They inhibit enzymes that cross-link peptidoglycan in cell walls

116
Q

What penicillin is β-lactamase resistant?

How does resistance develop to it?

A

Methicillin

Through altered binding site

117
Q

S/E of penicillin antibiotics?

What group is particularly at risk?

A

Hypersensitivity reactions

People with atopic allergies e.g. asthma, (shouldn’t

118
Q

First line uses of penicillins?

A

pseudomonas

meningitis

gonorrhoea

Bronchitis/pneumonia

119
Q

Four main groups of β-lactam antibiotics

A

Penicillins

Carbapenems

Monobactams

Cephalosporins

120
Q

Examples of penicillins?

A

Benzylpenicillin

Methicillin

Amoxicillin

121
Q

Examples of cephalosporins?

A

Cephuroxime

Cephalexin

Cephotaxime

122
Q

Cephalosporin uses?

A

UTI

Peritonitis

Septicaemia

Meningitis

123
Q

Carbapenem uses?

A

Pseudomonas

Abdominal infections

Community acquired pneumonia

124
Q

Carbapenem examples?

A

Imipenem

Meropenem

125
Q

Monobactam example?

A

Aztreonam

126
Q

Monobactam uses?

A

Gonorrhoea

Pseudomonas

Meningitis

H. influenzae

127
Q

Four main types of protein synthesis inhibitor antibiotics?

A

Aminoglycosides

Tetracycline

Macrolides

Chloramphenicol

128
Q

How do tetracyclines work?

A

Inhibit protein synthesis by blocking tRNA from binding

129
Q

Two examples of tetracyclines?

A

Tetracycline

Doxycycline

130
Q

How does chloramphenicol work?

A

Inhibits peptidyl transferase, no protein made

131
Q

How do aminoglycosides work?

A

Cause incorrect reading of mRNA

132
Q

Aminoglycoside examples?

A

Gentamicin

Streptomycin

neomycin

133
Q

How can resistance to aminoglycosides and chloramphenicol develop?

A

Reduced membrane permeability

Increased acetylation

Ribosomal mutation

134
Q

How can resistance to tetracycline develop?

A

Efflux

Ribosomal modification

Tetracycline modification

135
Q

Tetracycline uses?

A

Chlamydia

Plague

Cholera

136
Q

Aminoglycoside S/Es?

A

ototoxicity, nephrotoxicity

137
Q

Aminoglycoside uses?

A

Gram negative septicaemia

MRSA

Endocarditis

138
Q

Macrolide examples?

A

Erythromycin

Clarithromycin

Azithromycin

139
Q

Uses of macrolides?

A

Similar to penicillins in uses, used as alternative to penicillin in penicillin sensitive individuals

Otitis media

Resp. infection

Legionnaires

H. Pylori

140
Q

Chloramphenicol uses?

A

Conjunctivitis, Meningitis, H. influenza

141
Q

The four malaria plasmodium species?

A

Falciparum - malignant tertian malaria (blackwater fever)
- Causes 95% of malaria deaths

Vivax/ovale - Moderate ‘benign’ tertian
Causes dormant liver infections

Malariae - Mild quartan
- long term dormant liver parasites

142
Q

Difference in a tertian and a quartan malaria?

A

tertian - Fever on first and third days

Quartan - Fever on first and fourth days

143
Q

Four stages of malaria?

A
  1. Premonitory - lassitude
  2. Cold stage
  3. Hot stage
  4. Sweating
144
Q

Why did the eradication of malaria fail in the 70’s?

A

Resistance of Anopheles (mosquitos) to insecticides

Banning of DDT

Resistance of plasmodium (the malaria) to drugs

145
Q

Why did the eradication of malaria fail in the 70’s?

A

Resistance of Anopheles (mosquitos) to insecticides

Banning of DDT

Resistance of plasmodium (the malaria) to drugs

146
Q

Why did the eradication of malaria fail in the 70’s?

A

Resistance of Anopheles (mosquitos) to insecticides

Banning of DDT

Resistance of plasmodium (the malaria) to drugs

147
Q

Rapid acting blood schizonticides?

A

Chloroquine

Mefloquine

148
Q

General mechanism of rapid acting blood schizonticides?

A

Bind to haemin and concentrate 100 fold in infected RBCs and eliminate them

149
Q

Uses of Chloroquine?

A

In acute infection 3-4 days high dose course

Clinical prophylaxis: Weekly dose

150
Q

S/E of Chloroquine?

A

NVD, Retinopathy, hypersenitivity reaction

151
Q

Uses of Mefloquine?

S/E?

A

Used for chloroquine-resistant falciparum

Acute malaria: 3-4 day course

S/E: NVD, neuropsychiatric disorder

152
Q

Slow acting blood schizonticides?

A

Proguanil

Pyrimethamine

153
Q

Uses of slow acting blood schizonticides?

A

Prophylaxis only

Suppress the blood infection

Partly suppress the liver infection, but no effect on an established liver infection

154
Q

What are slow acting schizonticides mostly given with?

A

Sulphonamides

155
Q

Mechanism of action of the slow acting schizonticides?

A

Inhibit plasmodial DHF reductase

156
Q

Is pyrimethamine mostly given with a sulphonamide or without?

S/E’s?

A

Normally given with,

Severe skin reactions

Fatal hepatitis

157
Q

Is proguanil usually given with a sulphonamide or alone?

What’s it given with if it is, and what is the combination called?

A

Mostly given alone

Atovaquone, called malarone

158
Q

What tetracycline antibiotic can also be given for Mefloquine resistant falciparum?

S/Es?

A

Doxycycline

S/E’s include photosensitivity, sometimes severe

159
Q

Liver schizonticide? Uses?

A

Primaquine

Rapid cure, only agent that kills liver parasites

160
Q

S/Es of primaquine?

A

NVD and rarely cyanosis

161
Q

How is Glucose-6-dehydrogenase deficiency linked to primaquine?

A

Severe contraindication

Will cause:

  • Intravascular haemolysis
  • Severe anaemia

Have to test for it before administration of Primaquine

162
Q

How is Glucose-6-dehydrogenase deficiency linked to primaquine?

A

Severe contraindication

Will cause:

  • Intravascular haemolysis
  • Severe anaemia

Have to test for it before administration of Primaquine

163
Q

What do the tree stages of prevention mean, Primary, secondary and tertiary?

A

Primary: Preventing onset of disease, e.g. preventing people from smoking

Secondary: Detecting disease at an early stage so it can be controlled. e.g. screening

Tertiary: Minimising long term recurrence of disease.

164
Q

What do the tree stages of prevention mean, Primary, secondary and tertiary?

A

Primary: Preventing onset of disease, e.g. preventing people from smoking

Secondary: Detecting disease at an early stage so it can be controlled. e.g. screening

Tertiary: Minimising long term recurrence of disease.

165
Q

Screening methods for colorectal cancer?

A

Colonoscopy

Rectal examination

Barium enema

Faecal occult blood

166
Q

Screening methods for colorectal cancer?

A

Colonoscopy

Rectal examination

Flexible sigmoidoscopy

Barium enema

Faecal occult blood

167
Q

Advantages and disadvantages of colonoscopy to detect colorectal cancer?

A

Gold standard, will detect all cancer

Could increase prevalence

Expensive

Adverse effects

168
Q

Advantages and disadvantages of flexible sigmoidoscopy to detect colorectal cancer?

A

Detects about 60% of cancers

Less uncomfortable than colonoscopy

169
Q

Advantages and disadvantages of barium enema to detect colorectal cancer?

A

Cheaper with fewer complications than a colonoscopy

Invasive

Poor results in elderly

170
Q

Advantages and disadvantages of barium enema to detect colorectal cancer?

A

Cheaper with fewer complications than a colonoscopy

Invasive

Poor results in elderly

171
Q

Factors you have to consider when choosing an appropriate antibiotic?

A 
Spectrum
Orally active
Site of action
Adverse affects
Resistance
Pharmacokinetics
172
Q

Factors you have to consider when choosing an appropriate antibiotic?

A 
Spectrum
Orally active
Site of action
Adverse affects
Resistance
Pharmacokinetics
173
Q

Before diagnosis is officially made, a patient with possible pneumonia, pleuritic pain, fever and productive cough should be treated with what?

A

Amoxicillin

Or… co-amoxyclav/flucloxacillin

174
Q

Most common community acquired infection causing pneumonia?

A

Streptococcus

175
Q

Before diagnosis is officially made, a patient with possible pneumonia, pleuritic pain, fever and productive cough should be treated with what?

A

Amoxicillin

Or… co-amoxyclav/flucloxacillin

176
Q

Most common community acquired infection causing pneumonia?

A

Streptococcus

177
Q

What would you treat community acquired streptococcal pneumonia with?

A

Amoxicillin

Or… co-amoxyclav/flucloxacillin

178
Q

What would you treat community acquired streptococcal pneumonia with?

A

Amoxicillin

Or… co-amoxyclav/flucloxacillin

179
Q

Presumptive treatment for pneumonia symptoms, with abscesses at hospital acquired infection?

A

Co-amxyclav or flucloxacillin

180
Q

Likely infective organism for pneumonia symptoms, with abscesses at hospital acquired infection?

Therefore what is treatment?

A

Staphylococcus

Possible MRSA

Treatment has to include beta lactamase resistant antibiotics due to possible MRSA:

  • Quinolones
  • Cephalosporins
181
Q

31 yr old homosexual male with SOB and diffuse bilateral opacities on CXR, low PaO2. Possible diagnoses?

A

Pneumocystis carinii Pneumonia (PCP) infection (fungi infection)

HIV associated TB

182
Q

Treatment options for Pneumocystis carinii Pneumonia (PCP) infection, with possible HIV?

A

Co-trimoxazole for PCP, observed for allergy

183
Q

Differences seen in TB to PCP infection?

A

PCP shows hypoxia on exercise

CXR: PCP is bilateral reticular infiltrates, TB is Upper lobe rounded infiltrates.

TB sputum may contain blood

184
Q

Treatment for TB?

A

Streptomycin, ciprofloxacin, rifampicin, 5-ASA

185
Q

Treatment for TB?

A

Streptomycin, ciprofloxacin, rifampicin, 5-ASA

186
Q

Initial management of possible NVD infections (e.g. salmonella)?

A

ORT for 48 hours

187
Q

Initial management of possible NVD infections (e.g. salmonella)?

A

ORT for 48 hours

188
Q

Travellers diarrhoea treatment?

A

Ciprofloxacin and norfloxacin

189
Q

Travellers diarrhoea treatment?

A

Ciprofloxacin and norfloxacin

190
Q

Name for athletes foot?

A

Tinea pedis

191
Q

Name for fungal infection in nail bed and groin?

A

Nail bed: Tinea unguium

Groin: Tinea cruris

192
Q

Examples of antifungals?

A

Clotrimazole - lanosterol demthylase

Terbinafine - squalene epoxidase inhibitor

193
Q

Clotrimazole mechanism?

A

Lanosterol demthylase inhibitor

194
Q

Terbinafine mechanism?

A

Squalene epoxidase inhibitor

195
Q

Oral antifungal treatment for systemic infection?

A

Ketoconazole, Miconazole or fluconazole

196
Q

Contraindications of PPI on an antifungal?

A

In oral drugs absorption may be decreased due to less acidic stomach environment

197
Q

Contraindications of PPI on an antifungal?

A

In oral drugs absorption may be decreased due to less acidic stomach environment

198
Q

Infective organism in thrush?

A

Candida albicans

199
Q

Tingling in lips associated with sexual encounters, most likely?

A

Herpes simplex

200
Q

Herpes simplex treatment? Mechanism?

A

Acyclovir - viral thymidine kinase converts it to it’s active form which has affinity for viral DNA polymerase, incorporating itself into the viral DNA and stopping replication

201
Q

Herpes simplex treatment? Mechanism?

A

Acyclovir - viral thymidine kinase converts it to it’s active form which has affinity for viral DNA polymerase, incorporating itself into the viral DNA and stopping replication

202
Q

Herpes simplex treatment? Mechanism?

A

Acyclovir - viral thymidine kinase converts it to it’s active form which has affinity for viral DNA polymerase, incorporating itself into the viral DNA and stopping replication

203
Q

Laxative choices?

A

Senna

Magnesium hydroxide

204
Q

Drug to reduce diarrhoea and stomach cramps in travellers diarrhoea?

A

Loperamide

205
Q

ABCD for malaria prophylaxis?

A

Awareness of risk

Bites - reduce likelihood of bites from Anopheline mosquito (disk to dawn)

Chemoprophylaxis

Diagnosis

206
Q

ABCD for malaria prophylaxis?

A

Awareness of risk

Bites - reduce likelihood of bites from Anopheline mosquito (disk to dawn)

Chemoprophylaxis

Diagnosis

GI (11 decks)

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