20. Systemic Retinoids

Question 1

Past q

Isotretinoin is 9-cis retinoids acid

Answer 1

F

13-cis retinoic acid

Question 2

The primary form of dietary vitamin A in humans is retinyl ester

Answer 2

T

Question 3

Retinal Ester is found in plants

Answer 3

F
Found in animal and meat products
Eggs and milk

Question 4

Retinal in the 11-isomer and 11-trans isomer is important in the biochem reaction of visual function

Answer 4

T

Question 5

Vitamin A cannot be synthesized in vivo by human body so must be acquired through diet

Answer 5

T

Question 6

Past q

Acitretin is a poly aromatic retinoid

Answer 6

F: monoaromatic

Question 7

Past q

High levels of retinoids are excreted in semen

Answer 7

F

Question 8

Alcohol directly enhances re-esterification of acitretin to etretinate

Answer 8

F

Indirectly

Question 9

What are the non aromatic retinoids ?

Answer 9

Tretinoin

Isotretinoin

Question 10

Oral bioavailability of systemic retinoids increases with food

Answer 10

T

Question 11

What are the mono aromatics retinoids ?

Answer 11

Etretinate

Acitretin

Question 12

Poly aromatic retinoids are :

Answer 12

Alitretinoin
Tazarotene
Bexarotene
Adapalene

Question 13

Isotretinoin and Acitretin are relatively water soluble

Answer 13

T

Question 14

Acitretin is safer than etretinate for women of childbearing potential as etretinate is 50x more Lipophilic

Answer 14

T

Question 15

Magnitude of hypertriglyceridaemia is greatest for Acitretin of all the retinoids

Answer 15

False

Bexarotene

Question 16

Elimination of Bexarotene is primarily by the HPB route

Answer 16

True

Question 17

Fexofenadine is not metabolized by the liver

Answer 17

T

Excreted essentially unchanged

Question 18

Co admin of fexofenadine with macrolides and azoles (Cyp3a4 inhibitors) is contraindicated

Answer 18

F

No interaction or QT seen

Question 19

Cetirizine is the most sedating of second generation H1 antihistamines

Answer 19

T

Question 20

90% or more of patients treated with Bexarotene develop hypothyroidism

Answer 20

F

70%

Question 21

90% or more of patients treated with Bexarotene develop hypothyroidism

Answer 21

F

70%

Question 22

Bexarotene is a ligand that is highly specific for RXR receptors

Answer 22

T

Question 23

Isotretinoin caused hypertriglyceridaemia in 20% treated individuals

Answer 23

T

Question 24

Hypertriglyceridaemia occurs in 70-100% of Bexarotene pt with CTCL

Answer 24

T

Question 25

Retinoids reduce lymphocyte proliferation by up to 80%

Answer 25

F

20-30%

Question 26

Teratogenicity occurs in about half of cases if exposed to retinoids in first TM

Answer 26

T

Question 27

Myalgias occur in 50% pt on Isotretinoin

Answer 27

F

15%

Question 28

DISH syndrome occurs in up to 26% pt on Isotretinoin and 30% for etretinate

Answer 28

T

Question 29

Isotretinoin associated with only mild transaminase elevations in 15% patients
Worse in Acitretin

Answer 29

T

Question 30

Spontaneous abortions occur in one third of pregnancies in which mother is exposed to retinoids in the first trimester

Answer 30

T

Question 31

Liver derangement is least pronounced in Bexarotene

Answer 31

T

Question 32

Pseudo tumor cerebri is most common with Acitretin

Answer 32

F

Isotretinoin

Question 33

Blapharoconjunctivitis is seen in pt on Acitretin and Isotretinoin

Answer 33

T

Question 34

Premature epiphyseal closure may occur therefore consider risk v benefit in pre adolescents on retinoids

Answer 34

T

Question 35

Isotretinoin and acitretin are completely cleared from the body within 1 week

Answer 35

F

One month