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IPT: Derm > Block 1 > Flashcards

Block 1 Flashcards

1
Q

What is the uvea?

A

Middle layer of eye; contains pupil, iris, and lens

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2
Q

What is the macula?

A

Area of retina responsible for vision

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3
Q

Anterior chamber of the eye has _____ humor while the posterior chamber has _____ humor.

Which one is continually replaced?

A

Anterior - aqueous

Posterior - vitreous

Anterior is replaced

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4
Q

Stye disorder affects what?

A

Margin of eye (inflammation)

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5
Q

What is blepharitis?

A

Eyelid inflammation

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6
Q

What is chalazion?

A

Blockage/swelling of oil glands of eyelid

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7
Q

What is glaucoma?

A

Impairment of drainage of aqueous humor; causes retina and ocular nerve damage

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8
Q

What is keratoconjunctivis sicca?

A

Dry eye syndrome; lack of tears to keep eye moist

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9
Q

What is the purpose of the vestibular window of the ear?

A

Separates air from fluid-filled environment

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10
Q

What is the purpose of the cochlea?

A

Hearing; contains hair cells which are hearing receptors

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11
Q

What is the purpose of the vestibular system?

A

Balance

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12
Q

What is Meniere’s disease?

A

Immune rxn to inner ear

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13
Q

What causes motion sickness?

A

Excessive stimulation of vestibular system

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14
Q

What is the typical first symptom of Parkinson’s and Alzheimer’s disease?

A

Decreased sense of smell

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15
Q

What is the purpose of turbinates?

A

Bony structure that humidifies and warms air

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16
Q

What is the purpose of paranasal sinus?

A

Produces mucus which is drained into nasal cavity

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17
Q

What is anosmia?

A

Lack of sense of smell usually caused by trauma

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18
Q

What is maxillary sinusitis?

A

Mucus drainage pattern which follows gravity

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19
Q

What is keratitis?

A

Corneal inflammation; maybe due to chlamydia and Vit. A deficiency

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20
Q

What is macular degeneration?

A

Bilateral central vision loss

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21
Q

What are the polar/nonpolar layers of the eye?

A

Nonpolar - Polar - Nonpolar

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22
Q

What are the two main injection types of ocular RX?

A

Periocular and intraocular

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23
Q

What is a peribulbar injection?

A

Under the eye

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24
Q

What is a retrobulbar injection?

A

Behind the eye

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25
Q

What is a intravitreal injection?

A

Back of the eye

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26
Q

What is an intracameral injection?

A

Front of the eye

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27
Q

Special utility of a topical eye ointment?

A

Convenient + relatively safe

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28
Q

Limitations of a topical eye ointment?

A

Compliance + nasal/systemic toxicity

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29
Q

Special utility of periocular eye injections?

A

Anterior segment infections + other stuff

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30
Q

Limitations of periocular eye injections?

A

Toxicity and mechanical trauma

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31
Q

Special utility of intracameral eye injections?

A

Anterior segment surgery or infections

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32
Q

Limitations of intracameral eye injections?

A

Short duration of action + toxicity

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33
Q

Special utility of intravitreal eye injections?

A

Wet AMD

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34
Q

Limitations of intravitreal eye injections?

A

Retinal toxicity?

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35
Q

Which type of eye application can treat Wet AMD?

A

Intravitreal

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36
Q

Which type of eye application has issues with compliance?

A

Topical

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37
Q

Which type of eye application has issues with nasal or systemic toxicity?

A

Topical

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38
Q

How does aqueous humor leave the eye?

A
  1. Trabecular outflow

2. Uveoscleral outflow

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39
Q

What is the purpose of the aqueous humor?

A

Provides metabolic need of anterior segment of the eye

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40
Q

What is the difference between open and closed angle glaucoma?

A

Open - bigger angle between cornea and iris

Closed - smaller angle between cornea and iris - treat by cutting part of iris

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41
Q

Which drug classes lower aqueous humor production?

A

Alpha-2 adrenergic agonists
Beta blockers
Carbonic anhydrase inhibitors

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42
Q

Which drug classes increase aqueous outflow?

A

Prostaglandins (w/wo NO donor)
Cholinergics
Rho Kinase inhibitors

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43
Q

(T/F) Most prostaglandins are prodrugs

A

False; All prostaglandins = prodrug

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44
Q

MOA of prostaglandins + eye?

A

Increase uveoscleral outflow w/o affect aqueous production

This is done by increasing matrix metalloproteinases in human ciliary muscle cells and induce relaxation of ciliary muscles

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45
Q

What special about Bimatoprost’s MOA vs other prostaglandins?

A

Increases trabecular outflow and somewhat stimulates aqueous humor production

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46
Q

Which ocular drug class is the most efficacious agent to lower IOP?

A

Prostaglandins

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47
Q

What are some general AE of prostaglandins?

A

Enophthalmos
Darkening of iris color
Hypertrichosis

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48
Q

What is enophthalmos?

A

Sunken eye due to loss of periorbit fat

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49
Q

What is hypertrichosis?

A

Increase length, thickness, pigmentation of eyelashes

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50
Q

When do beta blocker IOP Rx work?

A

During waking hours

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51
Q

What medication works during waking hours for IOP?

A

Beta blockers

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52
Q

Which beta blocker for IOP is selective for B1 receptor?

A

Betaxolol

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53
Q

What is special about Betaxolol compared to other beta blockers for IOP?

A

Selective for B1 receptor

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54
Q

AE of beta blockers for IOP?

A

Ocular
Cardiovascular
Pulmonary
Neurological

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55
Q

What is the dosing schedule for beta blockers + IOP?

A

BID

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56
Q

What is the dosing schedule for prostaglandins + IOP?

A

QD at night

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57
Q

Which beta blockers for IOP should not be used with CV problems?

A

Timolol and Betaxolol

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58
Q

Which beta blockers for IOP should not be used with respiratory issues?

A

Timolol

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59
Q

Which IOP Rx should you be concerned with sulfur allergies?

A

Carbonic anhydrase inhibitors

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60
Q

Which IOP Rx is an additive to beta blockers or prostaglandins?

A

Carbonic anhydrase inhibitors

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61
Q

What is the dosing schedule for carbonic anhydrase inhibitors?

A

BID or TID

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62
Q

Which IOP Rx is less efficacious during sleep?

A

Carbonic anhydrase inhibitors and beta blockers

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63
Q

AE of carbonic anhydrase inhibitors?

A

Blurred vision
Ocular discomfort
Unusual or bitter taste

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64
Q

Which receptors are involved in angiogenesis?

A

VEGFR-1 and VEGFR-2

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65
Q

Alpha-2 agonists (increase/decrease) cAMP levels

A

decrease

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66
Q

Which IOP Rx may be neuroprotective?

A

Alpha-2 agonists

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67
Q

What is the dosing schedule of alpha-2 agonists?

A

BID or TID

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68
Q

What are some benefits of alpha-2 agonists beside reduce IOP?

A

Neuroprotective properties

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69
Q

AE of alpha-2 agonists?

A

Allergy-like rxn and 30% of patients

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70
Q

Cholinergic MOA + primary open angle glaucoma?

A

Opens up trabecular meshwork and/or Schlemm’s canal by ciliary muscle contraction

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71
Q

Cholinergic MOA + primary angle-closure glaucoma?

A

Opens up trabecular meshwork outflow by flattening iris by contracting iris sphincter aka miosis

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72
Q

What is the dosing schedule for cholinergics?

A

BID, TID, QID

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73
Q

Which IOP Rx can be dosed QID?

A

Cholinergics

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74
Q

AE of cholinergics?

A 
Miosis (pupil constriction)
Induced myopia (cant focus on far objects)
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75
Q

What is the only Rho Kinase Inhibitor in the US?

A

Netarsudil (Rhopressa)

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76
Q

Which IOP Rx should be dosed QD at night?

A

Prostaglandins

ROCK inhbitors

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77
Q

What is the dosing schedule for ROCK inhibitors?

A

QD at night

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78
Q

AE of ROCK inhibitors?

A

Conjunctival hyperemia, eye discomfort and pain

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79
Q

Which IOP Rx lose efficacy over time?

A

All of them after prolonged use

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80
Q

Which Rx are anti-VEGF?

A 
Beovu
Eylea
Avastin
Macugen
Lucentis

BLAME

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81
Q

What is the only prostaglandin with a NO donor?

A

Latanoprostene bunod (Vyzulta)

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82
Q

MOA of prostaglandin with a NO donor?

A

NO converts to cGMP which might cause tissue relaxation

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83
Q

AE of Lucentis?

A

Conjunctival hyperemia + eye pain

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84
Q

Which anti-VEGF causes conjunctival hyperemia?

A

Lucentis + Eylea

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85
Q

Which anti-VEGF binds to both VEGF-A and placental growth factor?

A

Eylea; only one that binds to placental growth factor

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86
Q

How is Eylea produced?

A

In recombinant chinese hamster ovary cells

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87
Q

Which anti-VEGF is produced in recombinant chinese recombinant ovary cells

A

Eylea

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88
Q

AE of Eylea?

A

Conjunctival hyperemia and eye pain

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89
Q

What are the layers of the tear film?

A

Lipid
Aqueous
Mucous

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90
Q

Lipid
Aqueous
Mucous

Which one reduces evaporation?

A

Lipid

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91
Q

Lipid
Aqueous
Mucous

Anchors aqueous layer to ocular surface

A

Mucous

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92
Q

Lipid
Aqueous
Mucous

Contains cornea repair proteins

A

Aqueous

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93
Q

Which prescription Rx are used for dry eyes?

A

Restasis and Xiidra

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94
Q

AE of cyclosporine?

A

Eye burning sensation

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95
Q

MOA of Xiidra?

A

LFA-1 antagonist

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96
Q

AE of Xiidra?

A

Conjunctival hyperemia

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97
Q

MOA of Pataday?

A

H1 antagonist; mast cell inhibitor

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98
Q

What is the relation between using corticosteroids and IOP?

A

Corticosteroids can increase IOP, therefore induce glaucoma and cause cataract formation

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99
Q

What is mydriasis?

A

Pupil dilation

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100
Q

What is cycloplegia?

A

Paralysis of accommodation

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101
Q

What are the types of dry eye syndrome or keratoconjunctivitis sicca?

A
  1. Aqueous deficient

2. Evaporative dry eye

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102
Q

How would you treat dry eye?

A
  1. Lid hygiene
  2. Punctal plugs
  3. Scleral lenses
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103
Q

What is the best pharmacologic treatment for dry eye?

A

Xiidra; BID

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104
Q

What is one of the most common risk factors for infectious keratitis?

A

Contact lens

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105
Q

Which auto-immune conditions can cause anterior uveitis?

A

UCRAP

Ulcerative colitis
Chron's Disease
Reiter's Syndrome
Ankylosing Spondylitits
Psoriatic Arthritis
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106
Q

Which infections can cause anterior uveitis?

A

Syphilis
Tuberculosis
Lyme Disease
Herpes / Zoster

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107
Q

What is a major sign of infectious keratitis?

A

Corneal infiltrate

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108
Q

Corneal infiltrate is a sign for which condition?

A

Infectious keratitis

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109
Q

Pink eye is known as…

A

adenoviral conjunctivitis

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110
Q

When should you only recommend tetrahydrozoline (Visine) for eye conditions?

A

For quick cosmetic changes (dont use longer than 3 days)

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111
Q

Herpetic (HSV) Conjunctivitis is found in what age group?

A

Children

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112
Q

Herpetic (HZV) conjunctivitis is found in what age group?

A

Ppl over 60

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113
Q

Which Rx is known to cause increased risk of lens swelling and angle closure crisis?

A

Topiramate

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114
Q

What causes Chalazion?

A

Obstruction and/or inflammation of meibomian gland; results in lipopgranuloma formation

Associated w/ rosacea and posterior blepharitis

This condition looks like a nodule under the eyelid.

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115
Q

What condition is known as obstruction and/or inflammation of meibomian gland?

A

Chalazion

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116
Q

What causes Hordeolum?

A

S. aureus

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117
Q

Which eye condition is caused by S. aureus?

A

Hordeolum

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118
Q

What does Hordeolum look like?

A

Like a Chalazion, there is a nodule but with an infection

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119
Q

Which condition is known to have facial flushing, tearing, dry eye?

A

Ocular roasacea

120
Q

Which condition is known to have itching, tearing, flaking, crusting rash?

A

Contact Dermatitis

121
Q

What kind of compress should you apply on Chalazion?

A

Warm compress

122
Q

What kind of compress should you apply on Hordeolum?

A

Warm compress

123
Q

What kind of compress should you apply on Contact Dermatitis?

A

Cold compress

124
Q

Which condition should you apply cold compress? Warm?

A

Cold - Contact dermatitis

Warm - Chalazion + Hordeolum

125
Q

What are some signs of Vernal keratoconjunctivitis?

A

Ropy discharge, Horner-Trantas dot (collection of eosinophils on cornea)

126
Q

What condition is associated with Horner-Trantas dot?

A

Vernal Keratoconjunctivitis

127
Q

What are some signs of Atopic keratoconjunctivitis?

A

Milky edema, thickened lids, corneal neovascularization

128
Q

Which condition is associated with milky edema, thickened eyelids, or corneal neovascularization?

A

Atopic keratoconjunctivitis

129
Q

Which conjunctivitis condition is common amongst contact lens wearers?

A

Giant Papillary Conjunctivitis

130
Q

Whats the difference between the signs of viral vs bacterial conjunctivitis?

A

Viral - watery

Bacterial - milky

131
Q

What is the most common cause of conjunctivitis in children under 3?

A

Bacterial conjunctivitis

132
Q

What are risk factors of aminoglycoside-induced ear damage?

A 
Large dose
Elevated blood levels
Long duration (>10 days)
133
Q

Signs of aminoglycoside-induced ear damage?

A

Tinnitus

Hearing loss w/ higher frequency (>4000 Hz)

134
Q

How would you prevent aminoglycoside-induced ear damage?

A

Monitor serum levels and renal function

Hearing evaluation before, during and after therapy

Avoid noisy environments for 6 months after therapy completion

Neomycin is the most likely candidate to cause the damage (tobramycin being the least)

135
Q

Which platinum-based chemotherapy is most ototoxic?

A

Cisplatin

136
Q

How do platinum-based chemotherapies cause ototoxicity?

A

Free radial production and cell death to outer hair cells

Damages stria vascularis

137
Q

Platinum-based chemotherapies cause (reversible/irreversible) ototoxic damage

A

Irreversible

138
Q

Diuretics cause (reversible/irreversible) ototoxic damage

A

Reversible

139
Q

How do loop diuretics cause ototoxicity?

A

Changes in ionic gradients between perilymph and endolymph which leads to edema of stria vascularis

140
Q

What is vertigo?

A

Illusion of movement

Spinning sensation

141
Q

What is disequilibrium?

A

Impaired balance and gait

142
Q

What is a presyncopal episode?

A

Feeling faint or loss of consciousness

143
Q

What is lightheadedness?

A

Not described by vertigo, disequilibrium or presyncopal episode

Disconnected from teh environment

144
Q

Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness

Which one is a spinning sensation?

A

Vertigo

145
Q

Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness

Which one has impaired balance and gait?

A

Disequilibrium

146
Q

Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness

Which one has a feeling of imminent faint or loss of consciousness?

A

Presyncopal episode

147
Q

Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness

Which one describes symptoms that don’t fit the other 3; disconnected from the environment?

A

Lightheadedness

148
Q

Brief (seconds)
Intermediate (minutes)
Hours

Where does benign paroxysmal positional vertigo go?

A

Brief

149
Q

Brief (seconds)
Intermediate (minutes)
Hours

Where does orthostatic hypotension go?

A

Brief

150
Q

Brief (seconds)
Intermediate (minutes)
Hours

Where does transient ischemic attack go?

A

Intermediate

151
Q

Brief (seconds)
Intermediate (minutes)
Hours

Where does migraine-associated vertigo go?

A

Intermediate or Hours

152
Q

Brief (seconds)
Intermediate (minutes)
Hours

Where does Meniere’s disease go?

A

Hours

153
Q

How is orthostatic hypotension measured?

A

Systolic decrease by ≥20
Diastolic decrease by ≥10

Pulse increase by 30bpm

154
Q

What are some key features of benign paroxysmal positional vertigo?

A

Provoked by change in head position relative to gravity

155
Q

What causes benign paroxysmal positional vertigo?

A

Free-floating otoconia (calcium carbonate crystals) dislodged from macula and moved into canals

Very brief (<1min)

156
Q

What are some key features of Meniere’s disease?

A

Hearing loss and aural symptoms

157
Q

What is the first-line therapy for chronic orthostatic hypotension?

A

Fludrocortisone

158
Q

What are some key features of migraine-associated vertigo?

A

Motion sensitivity

159
Q

What are the initial Tx plans for Meniere’s disease?

A

Diuretics and sodium restriction

160
Q

How would you Tx benign paroxysmal positional vertigo?

A

Repositioning maneuvers

161
Q

How would you Tx migraine-associated vertigo?

A

Prophylaxis Rx of migraine

Anti-emetics at time of attack

162
Q

How would you Tx motion-related dizziness?

A

Anticholinergics (scopolamine)
Antihistamine (meclizine)
Antiemetics (prochlorperazine)

163
Q

Epidermis
Dermis
Hypodermis

Which one consists of keratinocytes?

A

Epidermis

164
Q

Epidermis
Dermis
Hypodermis

Which one is collagen based?

A

Dermis

165
Q

Epidermis
Dermis
Hypodermis

Which one consists of lipocytes?

A

Hypodermis

166
Q

Epidermis
Dermis
Hypodermis

Which one can proliferate in the stratum corneum?

A

Epidermis

167
Q

What is a corneocyte?

A

Keratinocytes (epidermis) that have reached the outer layer and sloughed off

168
Q

What is a melanocyte?

A

Makes melanin

169
Q

What is a langerhans cell?

A

Antigen presenting DC

170
Q

What is a merkel cell?

A

Transmit sensory info from skin to sensory nerves

171
Q

Corneocyte
Melanocyte
Langerhans cell
Merkel cell

Which one are keratinocytes that have reached the outer layer?

A

Corneocyte

172
Q

Corneocyte
Melanocyte
Langerhans cell
Merkel cell

Which one transmits sensory info from skin to sensory nerves?

A

Merkel cell

173
Q

What are some drugs that can cause photosensitivity?

A 
NSAIDs
Antifungal (terbinafine, griseofulvin)
ABx
Amiodarone (Cordarone)
Isotretinoin
Diuretics

Not All Antibiotics Can induce Drug-related photosensitivity

174
Q

What is a distinguishing factor of a macule?

A

Different color from surrounding skin

175
Q

What is a distinguishing factor of a papule?

A

Superficial and solid; smaller than a nodule

176
Q

What is a distinguishing factor of a nodule?

A

Superficial or under skin; larger than a papule

177
Q

What is a distinguishing factor of a vesicle?

A

Fluid-filled

Spherical shaped

178
Q

What is a distinguishing factor of a pustule?

A

Raised
Pus filled
Yellow, green, white

179
Q

What is a distinguishing factor of an abscess?

A

Not always visible

Under dermis or subcutaneous tissue

180
Q

What is a distinguishing factor of a plaque?

A

Fuzzy looking

Pink, white, yellow, brown

181
Q

What is a distinguishing factor of lichenification?

A

Thickening of epidermis

Tree bark looking

182
Q

What is the hair follicle cycle?

A

Catagen
Telogen
Anagen
Exogen

183
Q

Catagen
Telogen
Anagen
Exogen

Hair stops growing, but cellular activity continues

A

Catagen

184
Q

Catagen
Telogen
Anagen
Exogen

No growth or activity in hair bulb

A

Telogen

185
Q

Catagen
Telogen
Anagen
Exogen

Hair is actively growing

A

Anagen

186
Q

Catagen
Telogen
Anagen
Exogen

Hair is removed from bulb

A

Exogen

187
Q

Nail Plate
Nail Matrix
Nail Folds
Nail Bed

Specialized epithelium consisting of keratinocytes which generates the nail plate

A

Matrix

188
Q

Nail Plate
Nail Matrix
Nail Folds
Nail Bed

Develops from the nail bed

A

Plate

189
Q

Nail Plate
Nail Matrix
Nail Folds
Nail Bed

Covers the plate and bed

A

Fold

190
Q

Nail Plate
Nail Matrix
Nail Folds
Nail Bed

Connects to plate to maintain adhesion

A

Bed

191
Q

What are the first-gen H1 antihistamines?

A 
Diphenhydramine
Promethazine
Meclizine
Hydroxyzine
Chlorpheniramine
192
Q

Where is histamine synthesized? Stored?

A

Both are via mast cells

193
Q

TM presents to your pharmacy complaining of dizziness. She feels more sleepy than
usual and not able to engage in her every day activities. She recently started a
medication for her nerve pain. She denies any other issues. Labs are within normal
limits. Her medications include: gabapentin, metformin, levothyroxine, and
loratadine. Which of the following medications is the most likely cause of her
dizziness?

A. Gabapentin
B. Metformin
C. Levothyroxine
D. Loratadine

A

A. Gabapentin

194
Q

A patient complains of the room spinning around and ringing in her ears. The
episodes last for hours and has been affecting her daily activities. Which of the
following is most likely the diagnosis?

A. Meniere’s disease
B. Benign paroxysmal positional vertigo
C. Orthostatic hypotension
D. Motion-related sickness

A

A. Meniere’s disease

195
Q

A patient complains of the room spinning around and ringing in her ears. The
episodes last for hours and has been affecting her daily activities. Which of the
following is the best treatment option for this patient?

A. Repositioning maneuvers
B. Diuretics
C. Midodrine
D. Meclizine

A

B. Diuretics

196
Q

First Gen H1 antihistamines are (hydrophilic/hydrophobic)

A

Hydrophobic

197
Q

Second Gen H1 antihistamines are (hydrophilic/hydrophobic)

A

Hydrophilic

198
Q

What are the second gen H1 antihistamines?

A

“Leave the AC and set time for dine”

LEVocetirizine 
AZELastine 
CETirizine
BepostiTINE  
....aDINE (Loratadine, desloratadine, etc)
199
Q

What are the current pharmacotherapy targets for histamine receptors?

A

H1 and H2

200
Q

First Gen or Second Gen H1 receptor antagonists

Has antimuscarinic effects

A

First Gen

201
Q

First Gen H1 receptor antagonists block what CNS system?

A

PNS

202
Q

Do First Gen H1 receptor antagonists have any effect on sneezing?

A

Yes

203
Q

Do First Gen H1 receptor antagonists have any effect on congestion?

A

Nope

204
Q

Do First Gen H1 receptor antagonists have any effect on sinus pressure?

A

Nope

205
Q

Do First Gen H1 receptor antagonists have any effect on conjunctivitis?

A

Yes

206
Q

Second Gen H1 receptor antagonists are less effective in treating what compared to first gen?

A

Rhinorrhea

207
Q

What second gen H1RA got removed from the market? For what reason?

A

Terfenadine; cardiotoxicity

208
Q

What Rx is the active metabolite of Terfenadine?

A

Fexofenadine

209
Q

Which second gen H1RA is most likely to produce the most sedation?

A

Cetirizine and Levocetirizine

210
Q

What is the active metabolite of hydroxyzine?

A

Cetirizine and its R-enantiomer Levocetirizine

211
Q

When do antihistamines work best?

A

BEFORE exposure to allergen

212
Q

First Gen or Second Gen H1 receptor antagonists

Selective for H1 receptor

A

Second gen

213
Q

First Gen or Second Gen H1 receptor antagonists

Excellent CNS penetration

A

First gen

214
Q

First Gen or Second Gen H1 receptor antagonists

Has paradoxical CNS effect aka dizziness, fatigue

A

First gen

215
Q

First Gen or Second Gen H1 receptor antagonists

Lack of selectivity with regards to receptors

A

First gen

216
Q

What other receptors do first gen H1RAs target?

A

Muscarinic, serotonin, and adrenergic receptors

217
Q

First Gen or Second Gen H1 receptor antagonists

Which one is used to treat motion sickness?

A

First gen (meclizine) via muscarinic receptor antagonism

218
Q

First Gen or Second Gen H1 receptor antagonists

Which one is used to treat insomnia?

A

First gen via muscarinic receptor antagonism

219
Q

If COX is inhibited via an NSAID, what pathway is followed?

A

Shifts towards the leukotriene pathway leading to allergic rhinitis

220
Q

Leukotrienes result from action of ______ on formation of arachidonic acid

A

5-lipoxygenase

221
Q

Montelukast competes with ______ leukotriene for ______ receptor

A

Cysteinyl leukotrienes

CysLT1 receptor

222
Q

Cromolyn MOA

A

*prevents degranulation/release of histamines and leukotrines

Thought to block calcium influx into mast cells

223
Q

Omalizumab MOA

A

Binds to IgE to prevent it from binding to IgE receptor

224
Q

Zileuton MOA?

A

Inhibits 5-lipoxygenase thus blocking formation of all leukotrienes

Inhibits CYP1A2 + CYP3A4

225
Q

Zileuton AE?

A

Elevated hepatic enzyme levels + jaundice

226
Q

Which type of hypersensitivity has IgE immune reactants?

A

I

227
Q

Which type of hypersensitivity has IgG immune reactants?

A

II and III

228
Q

Which type of hypersensitivity has T cell immune reactants?

A

IV

229
Q

Which type of hypersensitivity has soluble antigen form?

A

I, III, and IV (also has cell-bound)

230
Q

Which type of hypersensitivity has cell-bound antigen form?

A

II and IV (also has soluble)

231
Q

Which type of hypersensitivity involves in complement cell lysis?

A

II

232
Q

Which type of hypersensitivity has AB/antigen complexes that cause tissue damage?

A

III

233
Q

Onset of rxn + type I hypersensitivity?

A

Immediate

234
Q

Onset of rxn + type II hypersensitivity?

A

Hours to days

235
Q

Onset of rxn + type III hypersensitivity?

A

2 - 3 weeks (longest one)

236
Q

Onset of rxn + type IV hypersensitivity?

A

2 - 3 days

237
Q

Type I - IV hypersensitivity

Autoimmune hemolytic anemia?

A

II

238
Q

Type I - IV hypersensitivity

Goodpasture syndrome?

A

II

239
Q

Type I - IV hypersensitivity

Rh incompatibility?

A

II

240
Q

Type I - IV hypersensitivity

Lupus?

A

III

241
Q

Type I - IV hypersensitivity

Serum sickness?

A

III

242
Q

Type I - IV hypersensitivity

Glomerulonephritis?

A

III

243
Q

Type I - IV hypersensitivity

Rheumatoid arthritis?

A

III

244
Q

Type I - IV hypersensitivity

Contact dermatitis?

A

IV

245
Q

Type I - IV hypersensitivity

T1DM?

A

IV

246
Q

Type I - IV hypersensitivity

TB skin test?

A

IV

247
Q

Type I - IV hypersensitivity

Seasonal hay fever?

A

I

248
Q

What could you use for eyelash hypotrichosis?

A

Bimatoprost (Latisse)

249
Q

What is the use of Bimatoprost (Latisse) for?

A

Eyelash growth

Can cause change in iris pigmentation

250
Q

What is hirsutism?

A

Male-type hair growth in females

251
Q

What can you use to treat hirsutism?

A

Eflornithine (Vaniqua) cream

252
Q

What is the use of Eflornithine (Vaniqua) cream for?

A

Hirsutism

253
Q

What is the most common classification of nail disorders?

A

Distal and lateral subungal

254
Q

If there is a superficial nail condition, what is the first line therapy?

A

Topical therapy

255
Q

If there is a mild to moderate nail condition, what is the first line therapy?

A

Oral terbinafine and/or topical therapy

256
Q

If there is a mild to moderate nail condition, what is the alternative therapy?

A

Oral itraconazole or fluconazole and/or topical therapy

257
Q

If there is a severe nail condition, what is the first line therapy?

A

Oral terbinafine

258
Q

If there is a severe nail condition, what is the alternative therapy?

A

Oral itraconazole or fluconazole

259
Q

When should terbinafine be used for nail conditions?

A

First line for Mild, moderate, or severe conditions

NOT to be used for superficial conditions

260
Q

When should itraconazole or fluconazole be used for nail conditions?

A

Alternative therapy for Mild, moderate, or severe conditions

261
Q

When should topical therapy be used for nail conditions?

A

First line for superficial conditions

Alternative for mild, moderate conditions

262
Q

Terbinafine
Itraconazole
Fluconazole

Contraindicated in liver disease?

A

All 3

263
Q

Terbinafine
Itraconazole
Fluconazole

Contraindicated in CrCl<50?

A

Terbinafine

264
Q

Terbinafine
Itraconazole
Fluconazole

Do not mix with acid suppressors..?

A

Itraconazole

265
Q

Terbinafine
Itraconazole
Fluconazole

Which one is dose adjusted in renal impairment?

A

Fluconazole

266
Q

Terbinafine
Itraconazole
Fluconazole

Which one causes QT prolongation?

A

Fluconazole

267
Q

What causes clubbing of the nails?

A

Often pulmonary

268
Q

What causes koilonychia?

A

Iron deficiency

269
Q

In the pathophysiology for miniaturization of terminal hairs, testosterone is converted to dihydrotestosterone via what enzyme?

A

5-alpha reductase

270
Q

Compared to people who are not balding, those who are balding have higher _________ levels

A

dihydrotestosterone

271
Q

Minoxidil is androgen (dependent/independent)

A

independent

272
Q

Finasteride is androgen (dependent/independent)

A

dependent

273
Q

When should you consider ending treatment when using minoxidil?

A

After 4 months with no new results

274
Q

Minoxidil MOA?

A

Vasodilation by relaxing arteriolar smooth muscle

275
Q

Finasteride MOA?

A

Inhibits 5 alpha reductase

276
Q

Montelukast MOA?

A

LTD4-RECEPTOR antagonist

277
Q 
. Histamine is formed by the decarboxylation of histidine by the enzyme L-histidine decarboxylase predominantly in which of the following cells?
A. Mast cells
B. White blood cells
C. Nerves cells
D. Renal cells
E. Pancreatic cells
A

A. Mast cells

278
Q

. Which of the following is true about the second-generation H1 antihistamines in comparison with the first-generation H1 antihistamines?
A. Second-generation H1 antihistamines are generally bigger and more hydrophilic
B. Second-generation H1 antihistamines are less selective for H1 receptor
C. Second-generation H1 antihistamines are less potent and far more-sedating
D. Second-generation H1 antihistamines generally have a shorter half-life

A

A. Second-generation H1 antihistamines are generally bigger and more hydrophilic

279
Q 
Given that an antihistamine contains a carboxylic acid functional group, it most likely belongs to which of the following categories of antihistamine?
A. First-generation H1 antihistamine
B. Second-generation H1 antihistamine
C. H2 antihistamine
D. H3 antihistamine
E. H4 antihistamines
A

B. Second-generation H1 antihistamine

280
Q 
. Several newer second-generation H1 antihistamines are biotransformation products of older antihistamines by which class of enzymes in the liver? 
A. Cytochrome P450s
B. Dehydrogenases
C. Phosphatases
D. Racemases
E. Transaminases
A

A. Cytochrome P450s

281
Q

Histamine has a ______ amine group

A

primary

282
Q

Histamine-1 antagonist have a ______ amine group

A

tertiary

283
Q

Type I hypersensitivity is ____ mediated

A

IgE

284
Q

Type II hypersensitivity is _____ mediated

A

Cytotoxic/AB

285
Q

Type III hypersensitivity is _______ mediated

A

immune complex/IgG/IgM

286
Q

Type IV hypersensitivity is ______ mediated

A

Delayed or Cell-mediated (T cells)

287
Q

What is the purpose of an outer root sheath for hair?

A

Protects the growing hair

288
Q

What is the purpose of a dermal papilla?

A

Supplies blood vessels and sensory nerves

289
Q

Where does growing hair originate?

A

Hair bulb

290
Q

How can you prevent loop diuretics from damaging the ear?

A
  1. Lowest dose

2. Avoid rapid rates

291
Q

Major symptoms of vernal keratoconjunctivitis?

A

Severe itching

292
Q

Who is more likely to get vernal keratoconjunctivitis?

A

Children; Associated w/ family history of atopy

293
Q

Who is more likely to get atopic keratoconjunctivitis?

A

Adults; Associated w/ family history of atopy

294
Q

How does gonococcal conjunctivitis present?

A

Most common in sexually active adults or in infants via vaginal birth

Severe purulent discharge

295
Q

What is the leading cause of blindness worldwide?

A

Trachoma (serotypes A-C)

IPT: Derm (2 decks)

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