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Anatomy Lab > Psoriasis - Systemic Treatment > Flashcards

Psoriasis - Systemic Treatment Flashcards

1
Q

It is a Neoral 100mg/ml Suspension & 100 mg capsules

A

Cyclosporin A

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2
Q

Binds cyclo-philin producing a complex that blocks calcineurin which reducing the effect of the NFAT in T cells that results in inhibition of interleukin 2

A

Cyclosporin A

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3
Q

High-dose method for Cyclosporin A is

A

5 mg/kg daily, then tapered

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4
Q

Low-dose method for Cyclosporin A

A

2.5 mg/kg daily, increased every 2-4 wk up to 5 mg/kg daily, then tapered

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5
Q

When Cyclosporin A is dosed, it binds cyclo-philin producing a complex that blocks ____________

A

calcineurin

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6
Q

When Cyclosporin A is dosed, they Binds
___________ producing a complex that blocks calcineurin

A

cyclo-philin

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7
Q

It Binds cyclo-philin producing a complex that blocks calcineurin which reduces the effect of the ______ __ _________

A

NFAT in T cells

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8
Q

is a family of transcription factors shown to be important in immune response that are also involved in the development of cardiac, skeletal muscle, and nervous systems.

A

Nuclear factor of activated T-cells (NFAT)

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9
Q

One or more members of the NFAT family is expressed in most cells of the

A

immune system

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10
Q

Side effects of cyclosporin A are

A

Nephrotoxicity
Hypertension
Immuno-suppression
Neurotoxicity
Increased risk of malignancy

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11
Q

Contraindication of Cyclosporin A

A

Prior bone marrow depression
Pregnancy
Lactation
Renal abnormalities

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12
Q

Methotrexate is available on

A

2.5 mg tab & 50 mg/lm vial

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13
Q

It Blocks dihydrofolate reductase leading to inhibition of purine and pyrimidine synthesis which leads to accumulation of anti-inflammatory adenosine

A

Methotrexate

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14
Q

METHOTREXATE Blocks ___________ ___________ leading to inhibition of purine and pyrimidine synthesis→Leading to
accumulation of anti-inflammatory adenosine

A

dihydrofolate reductase

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15
Q

METHOTREXATE Blocks dihydrofolate reductase leading to inhibition of ______ & ___________ __________

A

purine and pyrimidine synthesis

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16
Q

METHOTREXATE Blocks dihydrofolate reductase leading to inhibition of purine and pyrimidine synthesis→Leading to
accumulation of anti-inflammatory ______________

A

Adenosine

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17
Q

METHOTREXATE Start with a test dose of _____ ___ and then gradually increase dose until a therapeutic level is
achieved

A

2.5 mg

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18
Q

average range of methotrexate, _______ ___ weekly; maximum, _______ ____ weekly

A

10-15 mg, 25- 30 mg

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19
Q

Side effects of methotrexate

A

Chronic use = hepatic fibrosis
Fetal abnormalities or death
Pulmonary fibrosis

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20
Q

You may not take methotrexate due to these conditions:

A

Liver toxicity
Pregnancy

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21
Q

Binds to retinoic acid receptors & May contribute to improvement by normalizing keratinization and proliferation of
the epidermis

A

ACITRETIN

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22
Q

Acitretin __ mg/cap

A

25

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23
Q

Acitretin Binds to _________ _____ receptors

A

Retinoic acid

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24
Q

Acitretin May contribute to improvement by normalizing _____________ and _______________ of the epidermis

A

keratinization & proliferation

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25
Q

The Acitretin dosage initiate at __________ mg daily

A

25-50

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26
Q

Acitretin side effects are:

A

(HALF-d)
Hepatotoxicity
Alopecia
Lipid abnormalities
Fetal abnormalities or death

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27
Q

Contraindications of Acitretin are

A

Severe infections
Malignancy

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28
Q

COMPLICATIONS of Acitretin

A

Depression
Fluid and electrolyte imbalance
Hypertension
Infection
Joint damage
Low self esteem
Metabolic syndrome
Stress

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29
Q

HEALTH EDUCATION

A

Apply medication cream or ointment
Avoid drinking alcohol and smoking
Cover the affected area over night
Eat healthy diet
Expose small amount of skin to sunlight
Take daily bath
Use moisturize

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30
Q

first line of defence against microbial infection as a physical barrier

A

Human skin

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31
Q

by secreting ____ ___, sebaceous fluid and fatty acids to inhibit growth of pathogens

A

low pH

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32
Q

by possessing its own normal flora, thus deterring colonization by other pathogenic organisms

A

Human skin

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33
Q

a bacterial infection of the skin and tissues beneath the skin.

A

Cellulitis

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34
Q

a deep infection of the hair follicle leading to abscess formation with accumulation of pus and necrotic tissue

A

Furunculosis

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35
Q

a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include: redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed

A

Abcess

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36
Q

Abcess Signs and symptoms of abscesses include

A

redness, pain, warmth, and swelling

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37
Q

Abscess swelling may feel ____________ when pressed

A

fluid-filled

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38
Q

involve microbial invasion of the
skin and underlying soft tissues

A

Skin and soft tissue infections (SSTIs)

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39
Q

The skin has an extremely diverse ecology of organisms that may
produce __________

A

infection.

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40
Q

Clinical manifestations of SSTIs are the culmination of a two-step
process involving

A

(1) invasion
(2) interaction of bacteria with host defences.

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41
Q

cardinal signs of SSTIs involve the features of inflammatory response, with other manifestations such as

A
  • bullae
  • fever
  • rapid progression of lesions
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42
Q

diagnosis of ______ is difficult because they may commonly masquerade as other clinical syndromes.

A

SSTIs

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43
Q

The selection of antimicrobial therapy is predicated on

A

clinical complications
disease severity
instrument of entry
knowledge of the potential pathogens

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44
Q
  • For uncomplicated mild to moderate infections, the ____ ______ suffices
A

oral route

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45
Q

Complicated severe infections, ____________ ______________ of ____________ is warranted.

A

intravenous administration of antibiotics

46
Q

SSTIs range from mild infections, such as ____________, to serious life threatening infections, such as _________ ________

A

pyoderma, necrotizing fasciitis

47
Q

minimum diagnostic criteria are:

A

edema
erythema,
pain / tenderness
warmth

48
Q

Bacteria, initially in low numbers, colonize different layers of the skin architecture

A

PATHOGENESIS

49
Q

As bacteria increase in number where the integumentary barrier is disrupted, invasion by these colonizing bacteria ensues and a______ develops

A

Skin and soft tissue infections (SSTIs)

50
Q

Involvement of pores in the epidermis may lead to

A

folliculitis,
furuncles/ carbuncles

51
Q

infection or inflammation of the hair follicles of the skin.

A

Folliculitis

52
Q

a painful infection that forms around a hair follicle and contains pus.

A
  • FURUNCLES
53
Q

Furuncles is also known as

A

boil

54
Q

collection of boils that develop under the skin

A

Carbuncle

55
Q

A furuncle starts as a

A

red lamp

56
Q

When bacteria infect hair follicles, the follicles can swell and turn into

A

boils & carbincles

57
Q

Infection of the superficial layers of skin is labelled

A

erysipelas,

58
Q

deeper infection involvement of the dermis and/or subcutaneous tissues is labelled

A

cellulitis

59
Q

a common, potentially serious bacterial skin infection. The affected skin appears swollen and red and is typically painful and warm to the touch.

A

Cellulitis

60
Q

Cellulitis usually affects the ______ __ ______ ____ but it can occur in the face, arms and other areas

A

Skin on lower legs

61
Q
  • involvement of yet deeper skin structures may lead to
A

fasciitis and myositis

62
Q

means inflammation of the muscles that you use to move your body. An injury, infection, or autoimmune disease can cause it.

A

Myositis

63
Q

Two specific kinds of myositis are

A

polymyositis and dermatomyositis.

64
Q

Causes muscle weakness, usually in the muscles closest to the trunk of your body.

A

Polymyositis

65
Q

For individuals with thick adipose tissues (eg, overweight or obese individuals), involvement of fat tissue causes

A

Panniculitis

66
Q

a group of diseases whose hallmark is inflammation of subcutaneous adipose tissue (the fatty layer under the skin – panniculus adiposus).

A

Panniculitis

67
Q

Symptoms of Panniculitis include

A

Tender skin nodules
Weight loss
Fatigue

68
Q

the fatty layer under the skin

A

panniculus adiposus

69
Q

a damaging immune response by the body to a substance, especially
pollen, fur, a particular food, or dust, to which it has become
hypersensitive.

A

Allergy

70
Q

an immune system response to a foreign substance that’s not
typically harmful to your body.

A

Allergy

71
Q

These foreign substances are called

A

allergens.

72
Q
  • Your immune system’s job is to keep you healthy by
A

fighting harmful pathogens.

73
Q

result of your immune system’s response to a substance.

A
  • Allergies
74
Q

A person becomes allergic when their body develops ___________ against a substance.

A

antigens

75
Q

a life-threatening reaction

A

anaphylaxis.

76
Q

Immune responses can be mild, from

A

coughing and a runny nose

77
Q

allergy is an immediate immune reaction of the body to allergens and
is mostly mediated by

A

IgE (Immunoglobulin E) antibodies

78
Q

Hypersensitivity reactions are categorized into four major types:

A

type I,
type II,
type III,
type IV.

79
Q

Type I, II, and III reactions are the result of

A

antibody actions

80
Q

type IV reactions involve

A

T cell lymphocytes
cell-mediated immune responses.

81
Q

a severe allergic reaction of rapid onset affecting many
body systems.

A

Anaphylaxis

82
Q

Anaphylaxis is due to the release of ____________ ________ & ____________ from mast cells and basophils, typically due to an immunologic reaction but sometimes non-immunologic mechanism.

A

inflammatory mediators and cytokines

83
Q

These allergic reactions are systemic or localized, as in allergic dermatitis.
The reaction is the result of
an antigen cross-linking with membrane-bound IgE antibody of a mast cell or basophil.

A

Type 1

84
Q

hypersensitivity, in the Gell and Coombs classification of allergic
reactions

A
  • Type II
85
Q

An antibody mediated process in which IgG and IgM antibodies are directed against antigens on cells or extracellular material

A
  • Type II hypersensitivity
86
Q

extracellular material

A

basement membrane

87
Q

antigens on cells (such as

A

circulating red blood cells

88
Q

characterized by tissue damage caused by the activation of complement in response to antigenantibody (immune) complexes that are deposited in tissues.

A

Type III, or immune-complex, reactions

89
Q

The clinical manifestations of type III hypersensitivity reactions relate
to the tissue deposition, for example

A

vasculitic (skin)
serum sickness (systemic)
nephritis (kidneys)
extrinsic allergic alveolitis (lungs)

90
Q

Is characterized by cell-mediated response rather than antibodies as
in other types of hypersensitivity reactions. Specifically, the T
lymphocytes are involved in the development of the sensitivity, hence
called cell-mediated hypersensitivity

A

Type IV hypersensitivity

91
Q

T lymphocytes are

A

white blood cells

92
Q

In this hypersensitivity, inflammation occurs when the sensitizing chemical comes in contact with the skin surface. T

A

contact hypersensitivity

93
Q

) These allergic reactions are systemic or localized, as in allergic dermatitis

A
  • Type I: Immediate Hypersensitivity (Anaphylactic Reaction)
94
Q
  • Type I: Immediate Hypersensitivity is also known as
A

(Anaphylactic Reaction)

95
Q

Type II of allergy is also known as

A

Cytotoxic Reaction

96
Q

Cytotoxic Reaction is

A

(Antibody-dependent)

97
Q

Type III of allergy is also knwon as

A

Immune Complex Reaction.

98
Q

Type IV of allergy is also knwon as

A

Cell-Mediated

99
Q

Cell-Mediated is also known as

A

(Delayed Hypersensitivity)

100
Q

Some common oral or injection treatments for skin conditions
include:

A
  • Antibiotics:
    Antifungal agents:
101
Q

These antibiotics are used to treat many skin conditions.

A

Oral antibiotics

102
Q
  • Common antibiotics include
A

dicloxacillin
erythromycin
tetracycline.

103
Q

Oral antifungal drugs for skin conditions include

A

fluconazole
itraconazole

104
Q
  • Most infections due to Gram-positive organisms can be treated with quite a small number of antibiotics. These 3 antibiotics should be enough to cover 90% of Gram-positive infections
A

Penicillin,
erythromycin
cloxacillin

105
Q

cephalosporins includes

A

ceftriaxone-cefotaxime,
ceftazidime

106
Q

fluoroquinolones includes

A

ciprofloxacin,
levofloxacin

107
Q

, aminoglycosides includes

A

gentamicin
amikacin

108
Q

broad-spectrum penicillins with or without β-lactamase inhibitors includes

A

amoxicillin-clavulanic acid, piperacillin-tazobactam

109
Q

are broad-spectrum antibiotics, active against both Gram-positive and Gram-negative bacteria.

A

Tetracyclines

110
Q

Tetracyclines use is decreasing to
increasing instances of

A

bacterial resistance

111
Q
  • Tetracyclines still find use in treatment of acne, urinary tract, and respiratory tract infections, as well as
A

chlamydia infections

Anatomy Lab (7 decks)

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