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MBBS > 203 UG - Disease & Pharmacology > Flashcards

203 UG - Disease & Pharmacology Flashcards

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1
Q

Diuretics

A

Thiazide/thiazide-like diuretics - Hydrochlorothiazide

Loop diuretics - Frusemide

Potassium sparing diuretics - Spironolactone

Amiloride

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2
Q

Thiazide/thiazide-like diuretics

A

Hydrochlorothiazide

First line in HT

  • Block the Na+ and Cl- cotransporter (NCC) in the distal convoluted tubule

AE: Hypokalaemia and metabolic alkalosis

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3
Q

Loop diuretics

A

Frusemide

  • Inhibit NaCl reabsorption by the Na+/K+/2Cl–
    Cotransporter (NKCC2) in the thick ascending limb (TAL) of loop of Henle
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4
Q

Potassium-sparing diuretics

A

Spironolactone

  • Aldosterone/mineralocorticoid receptor antagonists in the late distal and cortical collecting tubules
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5
Q

MOA of Amiloride

Diuretics

A

Inhibition of Na+ influx through the epithelial Na+ channels (ENaC) channels in the luminal membrane

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6
Q

Treatments for Lower Urinary Tract Symptoms

A

Alpha1-blockers - Prazosin
5α-reductase inhibitor - Finasteride
Anticholinergic agents - Oxybutynin
Beta-3 adrenergic agonist - Mirabegron

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7
Q

Treatments for Prostate cancer

A

Androgen deprivation therapy

  • Luteinizing hormone-releasing hormone (LHRH) analogs - Goserelin
  • LHRH agonist monotherapy; LHRH agonist with 1st-generation anti-androgen - Flutamide
  • LHRH antagonist - Degarelix
  • Second-generation anti-androgens - Abirateroneacetate
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8
Q

Treatments for Testicular Cancer

A

Cisplatin

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9
Q

Treatments for Bladder/urothelial Cancer

A

Intravesical chemotherapy or BCG, immunotherapy

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10
Q

Treatments for Renal Cancer

A

Sunitinib – multikinase inhibitor

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11
Q

Platinum Analogs and its AE

A

Cisplatin - Nausea, vomiting, nephrotoxicity

Carboplatin - Myelosuppression

Oxaliplatin - Laryngopharyngeal dysesthesias

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12
Q

What is checkpoint inhibitor therapy?

A

For cancer

Targets immune checkpoints which are key regulators of the immune system.

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13
Q

Drugs used in checkpoint inhibitor therapy

A

Pembrolizumab - Humanized immunoglobulin G4 mAb to programmed death-1 (PD-1) receptor.

Nivolumab - PD-1 mAb

Atezolizumab - PD-L1 mAb

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14
Q

Cystitis

A

Lower UTI
infection confined to the bladder

膀胱炎

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15
Q

Pyelonephritis

A

Upper UTI
infection involving the ureters +/ kidneys

腎盂腎炎

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16
Q

Infection vs colonisation

UTI

A

Infection – the presence of bacteria and immune cells, i.e. evidence of active infection.

Colonization – the presence of bacteria, evidence that bacteria have established a symbiotic relationship with the host.

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17
Q

Complicated UTI

A

UTI complicated by

  • systemic symptoms
  • urinary structural abnormality/stones
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18
Q

Bacteriuria

A

Bacteria present in urine
- doesn’t always mean infection

細菌尿

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19
Q

Why do women have a higher risk of having UTI than men?

A
  • short wide urethra
  • proximity of urethra to anus
  • increased risk with sexual activity, pregnancy
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20
Q

Routes of infection of UTI

A 
Ascending infection (common)
Bloodstream (uncommon)
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21
Q

If a person has no infection, where do we normally find pathogens in the urinary tract?

A

Lower end of urethra

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22
Q

Most common cause of uncomplicated UTI

A

E. coli

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23
Q

Important virulence factor for uropathogenic bacteria

A

Gram-negative coliform

Express flagella for motility & pilli for attachment

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24
Q

______ is a key mediator of gram-negative bacteria virulence

A

Lipopolysaccharide

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25
Virulence factor of Proteus sp. infection-causing urolithiasis
Urease production - breaks down urea to form ammonia, which increases urinary pH - precipitation of salts.
26
Urolithiasis
The presence of calculi (precipitated salts) anywhere along the course of the urinary tracts 尿石症
27
Presence of which 3 UTI symptoms suggest an involvement of upper urinary tract infection
Fever Loin pain Rigors
28
UTI symptoms
Dysuria (pain passing urine) Frequency of urination Nocturia Haematuria Fever Loin pain Rigors
29
When should we give catheterized patients antibiotics?
Only if there's supporting evidence of UTI
30
Asymptomatic bacteriuria in pregnancy is usually?
Treated with antibiotics If left untreated: - 20-30% progress to pyelonephritis - may lead to intra-uterine growth retardation (IUGR) of premature labor
31
Ideal antibiotic for uncomplicated lower UTI should be:
Excreted in urine in high concentration Oral Inexpensive Few side effects
32
How long should gentamicin be prescribed? | complicated UTI or pyelonephritis
Maximum 3 days - bc narrow TI - may cause toxicity
33
Vertically transmitted pathogens | "TORCHES pathogens"
``` Toxoplasmosis Other (Hep B, VZV, HIV, parvovirus B19, enterovirus, LCV) Rubella Cytomegalovirus HErpes simplex virus Syphilis. ```
34
Congenital/ in utero/ transplacental infections
Passage of microbiological pathogens from mother to foetus during development. - Via transversing the placenta.
35
Perinatal infections
Infection of the neonate via maternal blood/ infected birth canal during birth.
36
Postnatal infections
Infection of the neonate via the normal routes (airborne, droplet, bodily fluids, fecal-oral)
37
What characterizes cytomegalovirus?
Blueberry muffin rash
38
Gonorrhoea presentation
Mucopurulent urethral discharge - white, creamy, thick *Neisseria gonorrhoeae
39
Chlamydia presentation
``` Urethral discharge (milky) - watery, milky ``` *Chlamydia trachomatis
40
Reiter's syndrome
Can't see Can't pee (urethritis) Can't climb a tree - relates conjunctivitis, urethritis & arthritis
41
What characterizes primary syphilis?
Chancre lesion
42
Is bacterial vaginosis an STI?
No | - but will increase chances of getting STI (chlamydia, trichomoniasis, HIV)
43
Normal vagina pH
4 - 4.5
44
What is the most common viral STI?
Human papilloma virus
45
HPV presentation
Anogenital warts
46
What is the feature of bacterial vaginosis which Trichomnas vaginalis infection?
Presence of endosymbionts
47
Candida albicans
30% of females colonised w small numbers
48
Candida albicans infection presentation
Intensely itchy white vaginal discharge 白色念珠菌
49
Normal vaginal flora contains high levels of?
Lactobacillus spp.
50
Definition of infertility
Failure to achieve a clinical pregnancy after 12 months of more of regular unprotected sexual intercourse (in absence of a known reason) in a couple who have never had a child
51
Follicular phase
When follicle matures
52
Luteal phase
When corpus luteum degenerates 黃體期
53
Anovulatory infertility
When ovaries do not release an oocyte during a menstrual cycle
54
How does hypogonadotropic hypogonadism cause anovulatory infertility?
Lack of GnRH → decreased FSH & LH → follicles do not develop → no ovulation
55
How does hypergonadotropic hypogonadism cause anovulatory infertility?
Over-active hypothalamic-pituitary axis → too much GnRH, FSH or LH → follicles do not develop properly → no ovulation
56
How does hyperprolactinemia cause anovulatory infertility?
Increased release of prolactin → negative feedback - inhibits GnRH, FSH, LH → decrease FSH & LH → no ovulation
57
Polycystic ovarian syndrome
Multiple cysts covering the surface of ovaries → hyperandrogenism → decreases ovulation
58
Premature ovarian failure
Depletion of follicles
59
Luteal phase defects
Abnormality in corpus luteum → insufficient progesterone production
60
Endometriosis
Presence of endometrial glands outside uterine cavity
61
Most cases of recurrent genital herpes are caused by?
HSV-2
62
SERM for breast cancer
Tamoxifen
63
Tamoxifen act as an ______ on oestrogen receptors in mammary tissue; Tamoxifen act as an ______ on oestrogen receptors in bone.
antagonist; agonist

MBBS (28 decks)

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