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Year 3 Sem 1 > Week 7 > Flashcards

Week 7 Flashcards

1
Q

what should all patients be asked regardless of how much they smoke?

A

asked about their interest in quitting assessed if they are nicotine dependant, offer appropriate pharmacotherapy advised to quit offered referral to proactive telephone callback cessation service

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2
Q

smoking cessation guidelines?

A

ask and assess assess nicotine dependance by asking: - minutes till first cigarette after waking? - how many cigarettes a day? - withdrawal symptoms/ cravings in previous quit attempts?

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3
Q

some symptoms of nicotine withdrawal?

A

irritability insomnia anxiety poor concentration dysphoria/ depressed

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4
Q

NRT clinical suitability?

A

everyone, including CVD

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5
Q

varenicline clinical suitability?

A

not for children not in pregnancy not in people with psychiatric disorder decrease dose in renal impairment

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6
Q

bupropion clinical suitability?

A

not for current/ past seizures do not mix with drugs that lower seizure threshold not in concurrent monoamine oxidase inhibitors

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7
Q

moa of dependance and withdrawal of opiates?

A

increased mu opioid receptor internalization and degradation decreased officiation of u-opioid signal transduction hyper activation of adenylyl cyclase signalling = enhanced GABA release and increased gene transcription via activation of transcription factors

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8
Q

onset/ duration of withdrawal for opiates?

A

heroin onset= 8-24 hrs, duration= 4-10 days methadone onset = 12-48 hrs, duration= 10-20 days

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9
Q

withdrawal scale for opiates?

A

COWS, SOWS

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10
Q

substitution therapies for opiates?

A

clonidine buprenorphine methdone

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11
Q

opiate substitution: AIMS

A

decreased spread of BBV decrease injection related harms decrease crime rates improve engagement in tx

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12
Q

how does naloxone help with constripation?

A

binds to u opioid receptors in the gut

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13
Q

risk of opiates?

A

OD, respiratory depression, miscarriage risk in withdrawal, IVDU related harms leukoencephalopathy (smoked heroin)

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14
Q

risk mitigation of opiates?

A

avoid use in chronic pain lowest dose for shortest time avoid combination with other CNS depressants

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15
Q

which drug class can kill in intoxication and withdrawal?

A

benzodiazepines

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16
Q

withdrawal scale used for benzos?

A

CIWA-B

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17
Q

onset and duration of withdrawal for benzos?

A

short acting:1-2 days; 2-7 days long acting: 2-4 weeks; 2-8 weeks

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18
Q

what is common mucosal immune system?

A

priming of lymphocytes i none mucosal tissue can induce protective immunity at other mucosal surfaces important in vaccine development

19
Q

which lymphocytes are found in the GALT?

A

gamma-delta T cells CD8 alpha/beta T ell CD8 alpha/alpha T cells

20
Q

function of J chain?

A

attaches poly-Ig receptor and is responsible for transporting both IgA and IgM across epithelial surfaces into lumen

21
Q

what is oral tolerance?

A

a state of systemic hypo responsiveness induced by feeding protein

22
Q

how does an immune response cause MS?

A

T cells recognize myelin epitopes and activate macrophages to damage myelin by phagocytosis cytokines and toxic mediators released by T cells, microglia and macrophages cause myelin damage autoantibodies through binding to myelin and activating complement facilitate phagocytosis mediated by macrophages

23
Q

effects of estrogen and progesterone on immune response?

A

estrogen stimulates immune response progesterone dampens immune response

24
Q

how are NKC involved FRT?

A

host defence, implantation and pregnancy

25
Q

what does seminal fluid contain?

A

TGF-B, spermidine, PGs = other mediators with inhibitory unction on NKC, lymphocyte and complement function

26
Q

what MHC class do trophoblasts express?

A

modified; HLA-G

27
Q

3 strategies for the survival of conceptus?

A

reduced or modified transplantation Ag expression on trophoblast: don’t express classic MHCI modulation of maternal immune system to protect fetus from recognition, attack and suppression placenta is a bbarrier through which maternal effector lymphocytes cannot act

28
Q

grading system for BrCa?

A

nottingham grading system

29
Q

grading system for prostate cancer?

A

gleason scoring system

30
Q

what are the recommendations for genetic testing for hereditary cancer syndrome?

A

personal/ Fhx medical history that indicates inherited cancer risk test results can be adequately interpreted results provide info that will help guide medical care

31
Q

what is tumour grading?

A

histopathological description of tumour cells

32
Q

what is tumour staging?

A

the extent of cancer provides prognosis and tx plan

33
Q

what are some methods for laboratory detection of neoplasia?

A

H&E staining immunocytochemistry to confirm tumour histogenesis and subtype gene profiling techniques

34
Q

what are some examples of tumour marker?

A

alpha-fetoprotein PSA - PrCa and benign prostatic hyperplasia hCG carcinoembryonic Ag - colorectal cancer CA125 - ovarian Ca Ca15-3 - evaluate effect of tx in advanced BrCa

35
Q

what are paraneoplastic syndromes?

A

tumour associated syndromes where symptoms are not directly related to tumour or local hormonal

36
Q

what cells are in the lamina propria?

A

lymphocytes, DC, mast cells, macrophages, plasma cells, neutrophils etc

37
Q

how do integrin antagonists work in IBD?

A

inhibit a4b7 from binding to MADCAM1 in the intestines

38
Q

what controls class switching of B cell to IgA?

A

TGF-B

39
Q

key things about the brain endocrine immune system interactions:

A

immune responses are heavily regulated from the outputs of the CNS T cells under this influence and these mediators can change he type of immune response we have

40
Q

role of PGE2 in pregnancy?

A

potent suppressor of both antigen presentation and T cell expression of IL2

41
Q

how is innate immunity enhanced in pregnant women?

A

increase number of peripheral blood monocytes and granulocytes increased expression of Fc receptor on macrophages = increased phagocytosis increased concentration of estrogen = enhanced macrophage phagocytic activity

42
Q

some symptoms of cannabis withdrawal?

A

anger, aggressive, irritiable sleep disturbances (strange dream) anxiety, nervousness decreased appetite restlessness

43
Q

what is the use for immunocytochemistry?

A

to confirm tumour histogenesis and subtype o eg routine IHC evaluation of estrogen receptors & progesterone receptors and HER2 expression, Ki67 expression o prognosis and the selection of anti-cancer treatments

44
Q

molecular diagnostics of neoplasia?

A

• molecular histopathology using in-situ hybridization techniques • gene profiling technology

Year 3 Sem 1 (12 decks)

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