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Med 3011 > TIN > Flashcards

TIN Flashcards

1
Q

nsaids m of a and side effects

A

inhibit cox enzymes - reduce PG, thromboxanes - mediating pain. cox1 - side effects, cox 2 therapeutic.
adverse - dyspepsia, nausea and vom, CV, renal, nephro, bronchospasm

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2
Q

corticosteroids and side effects

A

glucocorticoid intracellular receptor bind - trigger gene process - inhibit genes for CK, Th, fibroblast, osteoblast, COX2, NO, histamine, IgG.
reduced response to infection, osteoporosis, hyperglycaemia, muscle wasting, CNS efect.

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3
Q

osteoarthritis explain

A

degenerate joint disease - non-inflammatory affecting weight bearing jts, loss of articular cartilage and forming thick subchondral bone, wear and tear factors. factors include pain, jt stiffness, joint deformation, reduced range of motion

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4
Q

explain rheumatoid arthritis

A

autoimmune causing swollen painful joints due to inflammation of synovium and erosion of cartilage and bone.

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5
Q

5-aminosalicylates

A

scavenge toxic oxygen metabolites produced by neutrophils. side effects are gi, malaise, headache

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6
Q

TNF alpha antagonists

A

bind to TNF alpha and inhibit- inhibiting leukocyte migration. adverse - infection, injection reaction, headache, autoantibody, malignancy, lymphoproliferative.

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7
Q

Rituximab

A

Anti CD20 monoclonal antibody.. bind to CD20 on B cell and lyse. adverse is infection, muscle pain, weakness, infusion

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8
Q

Abatercept

A

bind to CD80/86 on APC. Prevent full T cell activation and reduce cytokines. adverse effects - infection, infusion and malignancy.

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9
Q

methotrexate - 2 mechanisms explain

A

for anti-inflammatory, inhibits enzymes in purine metabolis - increasing adenosine thus inhibit T cell, B cell. for RA. teratogenic. for cancer, inhibit dihydrofolate reductase reducing tetrofolate and interfere with DNA synthesis.

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10
Q

explain gout

A

increased plasma urate - painful intermittent arthritis due to accumulation of sodium urate in synovial jts, inflammatory response leads to neutrophils etc. in the joint .- release ros and proteolytic enzymes

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11
Q

colchinine

A

inhibit neutrophil migration, chemotaxis, adhesion and phagocytosis.

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12
Q

integrin antagonist

A

IgG monoclonal antibody - against alpha4beta7 integrin on leukocytes. inhibit T cell adhesion to MADCAM in GI and preventing GI inflammation

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13
Q

leukotriene receptor antagonist

A

leukotriene cysL1 antagonist, blocking leurkotrienes in lung and therefore reducing bronchoconstriction.

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14
Q

pyridamine.purine analogue (fluorouracil)

A

inhibit thymidylate synthetase- false nucleotide inhibiting synthesis

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15
Q

alkylating agents and platinum compounds

A

produce reactive chemical groups forming covalent bonds with DNA, can form cross bridges.

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16
Q

vinca alkaloids

A

bind to B tubulin and prevent polymerisation

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17
Q

taxanes

A

freeze microtubules in non-functional polymerised state

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18
Q

topoisomerase 1 inhibitors

A

inhibit this, accumulation of breaks and cell death (this enzyme enables supercoiled DNA to uncoil, replicate, repair and transcribe)

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19
Q

anthracyclines

A

intercation of DNA, top 2 inhibition 0 accumulation of dna breaks

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20
Q

podophyllotoxins

A

top 2 inhibition

21
Q

antiandrogens

A

inhibit competitively androgens at receptors - cytoproterone has prostegerone effects reducing testorernce but does cause impotence, flushes, reduced libido

22
Q

gnrh analogue

A

inhibit this secretion from pituitary long term

23
Q

aromatase inhibitors

A

aromatase converts androstenedione and testosterone to estriol and estradiol, but this causes hot flush, vaginal dry, weakness, headache. not before menopause.

24
Q

serms (tamoxifen)

A

compete with oestrogen for receptor. anti-oestrogen can be cardioprotective, can agonise elsewhere

25
Q

TK inhibitors

A

involved in signalling in proliferation - angiogenesis, invasion, metastasis, small molecules all end in ib

26
Q

mTOR inhibitors

A

inhibit growth pathways - inhibiting angiogenesis, tumour cell proliferation and growth.

27
Q 
trastuzumab
ipilimumab
cetuximab
bevacizumab
rituximab
nivolumab
A 
HER 2 antibody
Bind to CTLA4 - prevent inactivation of T cells.
Anti EGFR antibody
Anti VEGFR antibody
CD20 antidody - lyse abnormal B cells
anti PD1 - stop rpogrammed death of CTLs
28
Q

risk factors breast cancer

A

age, female, family, oes exposure, OCP, HRT, obesity and alcohol

29
Q

3 types of breast cancer best to worst

A

ER+ve, HER2 -ve
HER2+ve
Triple negative

30
Q

how does breast cancer present

A

screening, palpable mass, skin tenderness

31
Q

investigations for breast cancer

A

mammogram, ultrasound, core biopsy, histopathology.

32
Q

Rx for breast cancer

A

Early - surgery, radiotherapy. can give targeted therapy, chemo usually only if young high grade. locally advanced need neoadjuvant chemo first. metastatic just symptomatic relief.

33
Q

3 types of NSCLC and explain

A

adenocarcinoma - most common from mucosal cell of bronchial epithelium
squamous cell carcinoma - more aggressive
large cell - more undifferentiated

34
Q

where do SCLC come from and how present

A

system disease, from neuroendocrine cells.

35
Q

presentation of lung cancr

A

dry cough, haemophytis, wheeze, recurrrent pneumonia and dyspnoea.

36
Q

Ix for lung cancer

A

chest x ray, CT and abdo,

37
Q

Rx lung cancer

A

sc: limited chemo and radiation
nsc: surgery, chemo if sprad to lymph nodes

38
Q

progression of GI cancer

A

normal -> dysplasia -> polyp -> invasion to submucosa.

39
Q

Cx of bowel cancer

A

change in bowel habits, anaemia, rectal bleed, bowel obscturction

40
Q

Ix bowel cancer

A

colonoscopy, biopsy, CT abdomen.

41
Q

Rx bowel cancer

A

early - surgery, locally advanced - surgery and neoadjuvant chemo, stage 4 is incurable but can do chemo

42
Q

how does radiotherapy work

A

breaking bonds in DNA - cell chekcpoints then kill

43
Q

adverse effect of radiotherapy

A

local tissue damage in fast turnover - GI, BM, epidermis, tissue damae to non-proliferating more serious. fibrosis, scarring, telangie.

44
Q

how to pronounce death

A
  1. look and listen to breath for 2 mins, 2, listen to chest for 2 mins, listen to heart for 2 mins, feel for pulse, light in pupils, response to pain, re-check ID.
45
Q

signs of hereditary cancer

A

successive generations, younger age, multiple cancer, both organs, not usually in that gender.

46
Q

why genetic counselling

A

guide treatment, inherited cancer risk, can be interpreted

47
Q

explain grading and srtaging

A

Graded on differentiation GX, G0-G4

TMN staging Tx,0-4 on size, Nx,0-3 on lymph nodes, Mx,0-1 on metz. can be collated to stage 0-4.

48
Q

side effect of cytotoxic antineoplastics

A

myelosuppression, reduced wound healing, alopecia, GI damage, sterility, teratogenicity

Med 3011 (1 decks)

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