Block 1 Flashcards
(295 cards)
1
Q
What is the uvea?
A
Middle layer of eye; contains pupil, iris, and lens
2
Q
What is the macula?
A
Area of retina responsible for vision
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
4
Q
Stye disorder affects what?
A
Margin of eye (inflammation)
5
Q
What is blepharitis?
A
Eyelid inflammation
6
Q
What is chalazion?
A
Blockage/swelling of oil glands of eyelid
7
Q
What is glaucoma?
A
Impairment of drainage of aqueous humor; causes retina and ocular nerve damage
8
Q
What is keratoconjunctivis sicca?
A
Dry eye syndrome; lack of tears to keep eye moist
9
Q
What is the purpose of the vestibular window of the ear?
A
Separates air from fluid-filled environment
10
Q
What is the purpose of the cochlea?
A
Hearing; contains hair cells which are hearing receptors
11
Q
What is the purpose of the vestibular system?
A
Balance
12
Q
What is Meniere’s disease?
A
Immune rxn to inner ear
13
Q
What causes motion sickness?
A
Excessive stimulation of vestibular system
14
Q
What is the typical first symptom of Parkinson’s and Alzheimer’s disease?
A
Decreased sense of smell
15
Q
What is the purpose of turbinates?
A
Bony structure that humidifies and warms air
16
Q
What is the purpose of paranasal sinus?
A
Produces mucus which is drained into nasal cavity
17
Q
What is anosmia?
A
Lack of sense of smell usually caused by trauma
18
Q
What is maxillary sinusitis?
A
Mucus drainage pattern which follows gravity
19
Q
What is keratitis?
A
Corneal inflammation; maybe due to chlamydia and Vit. A deficiency
20
Q
What is macular degeneration?
A
Bilateral central vision loss
21
Q
What are the polar/nonpolar layers of the eye?
A
Nonpolar - Polar - Nonpolar
22
Q
What are the two main injection types of ocular RX?
A
Periocular and intraocular
23
Q
What is a peribulbar injection?
A
Under the eye
24
Q
What is a retrobulbar injection?
A
Behind the eye
25
What is a intravitreal injection?
Back of the eye
26
What is an intracameral injection?
Front of the eye
27
Special utility of a topical eye ointment?
Convenient + relatively safe
28
Limitations of a topical eye ointment?
Compliance + nasal/systemic toxicity
29
Special utility of periocular eye injections?
Anterior segment infections + other stuff
30
Limitations of periocular eye injections?
Toxicity and mechanical trauma
31
Special utility of intracameral eye injections?
Anterior segment surgery or infections
32
Limitations of intracameral eye injections?
Short duration of action + toxicity
33
Special utility of intravitreal eye injections?
Wet AMD
34
Limitations of intravitreal eye injections?
Retinal toxicity?
35
Which type of eye application can treat Wet AMD?
Intravitreal
36
Which type of eye application has issues with compliance?
Topical
37
Which type of eye application has issues with nasal or systemic toxicity?
Topical
38
How does aqueous humor leave the eye?
1. Trabecular outflow
| 2. Uveoscleral outflow
39
What is the purpose of the aqueous humor?
Provides metabolic need of anterior segment of the eye
40
What is the difference between open and closed angle glaucoma?
Open - bigger angle between cornea and iris
Closed - smaller angle between cornea and iris - treat by cutting part of iris
41
Which drug classes lower aqueous humor production?
Alpha-2 adrenergic agonists
Beta blockers
Carbonic anhydrase inhibitors
42
Which drug classes increase aqueous outflow?
Prostaglandins (w/wo NO donor)
Cholinergics
Rho Kinase inhibitors
43
(T/F) Most prostaglandins are prodrugs
False; All prostaglandins = prodrug
44
MOA of prostaglandins + eye?
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
45
What special about Bimatoprost's MOA vs other prostaglandins?
Increases trabecular outflow and somewhat stimulates aqueous humor production
46
Which ocular drug class is the most efficacious agent to lower IOP?
Prostaglandins
47
What are some general AE of prostaglandins?
Enophthalmos
Darkening of iris color
Hypertrichosis
48
What is enophthalmos?
Sunken eye due to loss of periorbit fat
49
What is hypertrichosis?
Increase length, thickness, pigmentation of eyelashes
50
When do beta blocker IOP Rx work?
During waking hours
51
What medication works during waking hours for IOP?
Beta blockers
52
Which beta blocker for IOP is selective for B1 receptor?
Betaxolol
53
What is special about Betaxolol compared to other beta blockers for IOP?
Selective for B1 receptor
54
AE of beta blockers for IOP?
Ocular
Cardiovascular
Pulmonary
Neurological
55
What is the dosing schedule for beta blockers + IOP?
BID
56
What is the dosing schedule for prostaglandins + IOP?
QD at night
57
Which beta blockers for IOP should not be used with CV problems?
Timolol and Betaxolol
58
Which beta blockers for IOP should not be used with respiratory issues?
Timolol
59
Which IOP Rx should you be concerned with sulfur allergies?
Carbonic anhydrase inhibitors
60
Which IOP Rx is an additive to beta blockers or prostaglandins?
Carbonic anhydrase inhibitors
61
What is the dosing schedule for carbonic anhydrase inhibitors?
BID or TID
62
Which IOP Rx is less efficacious during sleep?
Carbonic anhydrase inhibitors and beta blockers
63
AE of carbonic anhydrase inhibitors?
Blurred vision
Ocular discomfort
Unusual or bitter taste
64
Which receptors are involved in angiogenesis?
VEGFR-1 and VEGFR-2
65
Alpha-2 agonists (increase/decrease) cAMP levels
decrease
66
Which IOP Rx may be neuroprotective?
Alpha-2 agonists
67
What is the dosing schedule of alpha-2 agonists?
BID or TID
68
What are some benefits of alpha-2 agonists beside reduce IOP?
Neuroprotective properties
69
AE of alpha-2 agonists?
Allergy-like rxn and 30% of patients
70
Cholinergic MOA + primary open angle glaucoma?
Opens up trabecular meshwork and/or Schlemm's canal by ciliary muscle contraction
71
Cholinergic MOA + primary angle-closure glaucoma?
Opens up trabecular meshwork outflow by flattening iris by contracting iris sphincter aka miosis
72
What is the dosing schedule for cholinergics?
BID, TID, QID
73
Which IOP Rx can be dosed QID?
Cholinergics
74
AE of cholinergics?
```
Miosis (pupil constriction)
Induced myopia (cant focus on far objects)
```
75
What is the only Rho Kinase Inhibitor in the US?
Netarsudil (Rhopressa)
76
Which IOP Rx should be dosed QD at night?
Prostaglandins
| ROCK inhbitors
77
What is the dosing schedule for ROCK inhibitors?
QD at night
78
AE of ROCK inhibitors?
Conjunctival hyperemia, eye discomfort and pain
79
Which IOP Rx lose efficacy over time?
All of them after prolonged use
80
Which Rx are anti-VEGF?
```
Beovu
Eylea
Avastin
Macugen
Lucentis
```
BLAME
81
What is the only prostaglandin with a NO donor?
Latanoprostene bunod (Vyzulta)
82
MOA of prostaglandin with a NO donor?
NO converts to cGMP which might cause tissue relaxation
83
AE of Lucentis?
Conjunctival hyperemia + eye pain
84
Which anti-VEGF causes conjunctival hyperemia?
Lucentis + Eylea
85
Which anti-VEGF binds to both VEGF-A and placental growth factor?
Eylea; only one that binds to placental growth factor
86
How is Eylea produced?
In recombinant chinese hamster ovary cells
87
Which anti-VEGF is produced in recombinant chinese recombinant ovary cells
Eylea
88
AE of Eylea?
Conjunctival hyperemia and eye pain
89
What are the layers of the tear film?
Lipid
Aqueous
Mucous
90
Lipid
Aqueous
Mucous
Which one reduces evaporation?
Lipid
91
Lipid
Aqueous
Mucous
Anchors aqueous layer to ocular surface
Mucous
92
Lipid
Aqueous
Mucous
Contains cornea repair proteins
Aqueous
93
Which prescription Rx are used for dry eyes?
Restasis and Xiidra
94
AE of cyclosporine?
Eye burning sensation
95
MOA of Xiidra?
LFA-1 antagonist
96
AE of Xiidra?
Conjunctival hyperemia
97
MOA of Pataday?
H1 antagonist; mast cell inhibitor
98
What is the relation between using corticosteroids and IOP?
Corticosteroids can increase IOP, therefore induce glaucoma and cause cataract formation
99
What is mydriasis?
Pupil dilation
100
What is cycloplegia?
Paralysis of accommodation
101
What are the types of dry eye syndrome or keratoconjunctivitis sicca?
1. Aqueous deficient
| 2. Evaporative dry eye
102
How would you treat dry eye?
1. Lid hygiene
2. Punctal plugs
3. Scleral lenses
103
What is the best pharmacologic treatment for dry eye?
Xiidra; BID
104
What is one of the most common risk factors for infectious keratitis?
Contact lens
105
Which auto-immune conditions can cause anterior uveitis?
UCRAP
```
Ulcerative colitis
Chron's Disease
Reiter's Syndrome
Ankylosing Spondylitits
Psoriatic Arthritis
```
106
Which infections can cause anterior uveitis?
Syphilis
Tuberculosis
Lyme Disease
Herpes / Zoster
107
What is a major sign of infectious keratitis?
Corneal infiltrate
108
Corneal infiltrate is a sign for which condition?
Infectious keratitis
109
Pink eye is known as...
adenoviral conjunctivitis
110
When should you only recommend tetrahydrozoline (Visine) for eye conditions?
For quick cosmetic changes (dont use longer than 3 days)
111
Herpetic (HSV) Conjunctivitis is found in what age group?
Children
112
Herpetic (HZV) conjunctivitis is found in what age group?
Ppl over 60
113
Which Rx is known to cause increased risk of lens swelling and angle closure crisis?
Topiramate
114
What causes Chalazion?
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.
115
What condition is known as obstruction and/or inflammation of meibomian gland?
Chalazion
116
What causes Hordeolum?
S. aureus
117
Which eye condition is caused by S. aureus?
Hordeolum
118
What does Hordeolum look like?
Like a Chalazion, there is a nodule but with an infection
119
Which condition is known to have facial flushing, tearing, dry eye?
Ocular roasacea
120
Which condition is known to have itching, tearing, flaking, crusting rash?
Contact Dermatitis
121
What kind of compress should you apply on Chalazion?
Warm compress
122
What kind of compress should you apply on Hordeolum?
Warm compress
123
What kind of compress should you apply on Contact Dermatitis?
Cold compress
124
Which condition should you apply cold compress? Warm?
Cold - Contact dermatitis
Warm - Chalazion + Hordeolum
125
What are some signs of Vernal keratoconjunctivitis?
Ropy discharge, Horner-Trantas dot (collection of eosinophils on cornea)
126
What condition is associated with Horner-Trantas dot?
Vernal Keratoconjunctivitis
127
What are some signs of Atopic keratoconjunctivitis?
Milky edema, thickened lids, corneal neovascularization
128
Which condition is associated with milky edema, thickened eyelids, or corneal neovascularization?
Atopic keratoconjunctivitis
129
Which conjunctivitis condition is common amongst contact lens wearers?
Giant Papillary Conjunctivitis
130
Whats the difference between the signs of viral vs bacterial conjunctivitis?
Viral - watery
Bacterial - milky
131
What is the most common cause of conjunctivitis in children under 3?
Bacterial conjunctivitis
132
What are risk factors of aminoglycoside-induced ear damage?
```
Large dose
Elevated blood levels
Long duration (>10 days)
```
133
Signs of aminoglycoside-induced ear damage?
Tinnitus
| Hearing loss w/ higher frequency (>4000 Hz)
134
How would you prevent aminoglycoside-induced ear damage?
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
Which platinum-based chemotherapy is most ototoxic?
Cisplatin
136
How do platinum-based chemotherapies cause ototoxicity?
Free radial production and cell death to outer hair cells
Damages stria vascularis
137
Platinum-based chemotherapies cause (reversible/irreversible) ototoxic damage
Irreversible
138
Diuretics cause (reversible/irreversible) ototoxic damage
Reversible
139
How do loop diuretics cause ototoxicity?
Changes in ionic gradients between perilymph and endolymph which leads to edema of stria vascularis
140
What is vertigo?
Illusion of movement
| Spinning sensation
141
What is disequilibrium?
Impaired balance and gait
142
What is a presyncopal episode?
Feeling faint or loss of consciousness
143
What is lightheadedness?
Not described by vertigo, disequilibrium or presyncopal episode
Disconnected from teh environment
144
Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness
Which one is a spinning sensation?
Vertigo
145
Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness
Which one has impaired balance and gait?
Disequilibrium
146
Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness
Which one has a feeling of imminent faint or loss of consciousness?
Presyncopal episode
147
Vertigo
Disequilibrium
Presyncopal episode
Lightheadedness
Which one describes symptoms that don't fit the other 3; disconnected from the environment?
Lightheadedness
148
Brief (seconds)
Intermediate (minutes)
Hours
Where does benign paroxysmal positional vertigo go?
Brief
149
Brief (seconds)
Intermediate (minutes)
Hours
Where does orthostatic hypotension go?
Brief
150
Brief (seconds)
Intermediate (minutes)
Hours
Where does transient ischemic attack go?
Intermediate
151
Brief (seconds)
Intermediate (minutes)
Hours
Where does migraine-associated vertigo go?
Intermediate or Hours
152
Brief (seconds)
Intermediate (minutes)
Hours
Where does Meniere's disease go?
Hours
153
How is orthostatic hypotension measured?
Systolic decrease by ≥20
Diastolic decrease by ≥10
Pulse increase by 30bpm
154
What are some key features of benign paroxysmal positional vertigo?
Provoked by change in head position relative to gravity
155
What causes benign paroxysmal positional vertigo?
Free-floating otoconia (calcium carbonate crystals) dislodged from macula and moved into canals
Very brief (<1min)
156
What are some key features of Meniere's disease?
Hearing loss and aural symptoms
157
What is the first-line therapy for chronic orthostatic hypotension?
Fludrocortisone
158
What are some key features of migraine-associated vertigo?
Motion sensitivity
159
What are the initial Tx plans for Meniere's disease?
Diuretics and sodium restriction
160
How would you Tx benign paroxysmal positional vertigo?
Repositioning maneuvers
161
How would you Tx migraine-associated vertigo?
Prophylaxis Rx of migraine
| Anti-emetics at time of attack
162
How would you Tx motion-related dizziness?
Anticholinergics (scopolamine)
Antihistamine (meclizine)
Antiemetics (prochlorperazine)
163
Epidermis
Dermis
Hypodermis
Which one consists of keratinocytes?
Epidermis
164
Epidermis
Dermis
Hypodermis
Which one is collagen based?
Dermis
165
Epidermis
Dermis
Hypodermis
Which one consists of lipocytes?
Hypodermis
166
Epidermis
Dermis
Hypodermis
Which one can proliferate in the stratum corneum?
Epidermis
167
What is a corneocyte?
Keratinocytes (epidermis) that have reached the outer layer and sloughed off
168
What is a melanocyte?
Makes melanin
169
What is a langerhans cell?
Antigen presenting DC
170
What is a merkel cell?
Transmit sensory info from skin to sensory nerves
171
Corneocyte
Melanocyte
Langerhans cell
Merkel cell
Which one are keratinocytes that have reached the outer layer?
Corneocyte
172
Corneocyte
Melanocyte
Langerhans cell
Merkel cell
Which one transmits sensory info from skin to sensory nerves?
Merkel cell
173
What are some drugs that can cause photosensitivity?
```
NSAIDs
Antifungal (terbinafine, griseofulvin)
ABx
Amiodarone (Cordarone)
Isotretinoin
Diuretics
```
Not All Antibiotics Can induce Drug-related photosensitivity
174
What is a distinguishing factor of a macule?
Different color from surrounding skin
175
What is a distinguishing factor of a papule?
Superficial and solid; smaller than a nodule
176
What is a distinguishing factor of a nodule?
Superficial or under skin; larger than a papule
177
What is a distinguishing factor of a vesicle?
Fluid-filled
| Spherical shaped
178
What is a distinguishing factor of a pustule?
Raised
Pus filled
Yellow, green, white
179
What is a distinguishing factor of an abscess?
Not always visible
| Under dermis or subcutaneous tissue
180
What is a distinguishing factor of a plaque?
Fuzzy looking
| Pink, white, yellow, brown
181
What is a distinguishing factor of lichenification?
Thickening of epidermis
| Tree bark looking
182
What is the hair follicle cycle?
Catagen
Telogen
Anagen
Exogen
183
Catagen
Telogen
Anagen
Exogen
Hair stops growing, but cellular activity continues
Catagen
184
Catagen
Telogen
Anagen
Exogen
No growth or activity in hair bulb
Telogen
185
Catagen
Telogen
Anagen
Exogen
Hair is actively growing
Anagen
186
Catagen
Telogen
Anagen
Exogen
Hair is removed from bulb
Exogen
187
Nail Plate
Nail Matrix
Nail Folds
Nail Bed
Specialized epithelium consisting of keratinocytes which generates the nail plate
Matrix
188
Nail Plate
Nail Matrix
Nail Folds
Nail Bed
Develops from the nail bed
Plate
189
Nail Plate
Nail Matrix
Nail Folds
Nail Bed
Covers the plate and bed
Fold
190
Nail Plate
Nail Matrix
Nail Folds
Nail Bed
Connects to plate to maintain adhesion
Bed
191
What are the first-gen H1 antihistamines?
```
Diphenhydramine
Promethazine
Meclizine
Hydroxyzine
Chlorpheniramine
```
192
Where is histamine synthesized? Stored?
Both are via mast cells
193
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. Gabapentin
194
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. Meniere’s disease
195
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
B. Diuretics
196
First Gen H1 antihistamines are (hydrophilic/hydrophobic)
Hydrophobic
197
Second Gen H1 antihistamines are (hydrophilic/hydrophobic)
Hydrophilic
198
What are the second gen H1 antihistamines?
"Leave the AC and set time for dine"
```
LEVocetirizine
AZELastine
CETirizine
BepostiTINE
....aDINE (Loratadine, desloratadine, etc)
```
199
What are the current pharmacotherapy targets for histamine receptors?
H1 and H2
200
First Gen or Second Gen H1 receptor antagonists
Has antimuscarinic effects
First Gen
201
First Gen H1 receptor antagonists block what CNS system?
PNS
202
Do First Gen H1 receptor antagonists have any effect on sneezing?
Yes
203
Do First Gen H1 receptor antagonists have any effect on congestion?
Nope
204
Do First Gen H1 receptor antagonists have any effect on sinus pressure?
Nope
205
Do First Gen H1 receptor antagonists have any effect on conjunctivitis?
Yes
206
Second Gen H1 receptor antagonists are less effective in treating what compared to first gen?
Rhinorrhea
207
What second gen H1RA got removed from the market? For what reason?
Terfenadine; cardiotoxicity
208
What Rx is the active metabolite of Terfenadine?
Fexofenadine
209
Which second gen H1RA is most likely to produce the most sedation?
Cetirizine and Levocetirizine
210
What is the active metabolite of hydroxyzine?
Cetirizine and its R-enantiomer Levocetirizine
211
When do antihistamines work best?
BEFORE exposure to allergen
212
First Gen or Second Gen H1 receptor antagonists
Selective for H1 receptor
Second gen
213
First Gen or Second Gen H1 receptor antagonists
Excellent CNS penetration
First gen
214
First Gen or Second Gen H1 receptor antagonists
Has paradoxical CNS effect aka dizziness, fatigue
First gen
215
First Gen or Second Gen H1 receptor antagonists
Lack of selectivity with regards to receptors
First gen
216
What other receptors do first gen H1RAs target?
Muscarinic, serotonin, and adrenergic receptors
217
First Gen or Second Gen H1 receptor antagonists
Which one is used to treat motion sickness?
First gen (meclizine) via muscarinic receptor antagonism
218
First Gen or Second Gen H1 receptor antagonists
Which one is used to treat insomnia?
First gen via muscarinic receptor antagonism
219
If COX is inhibited via an NSAID, what pathway is followed?
Shifts towards the leukotriene pathway leading to allergic rhinitis
220
Leukotrienes result from action of ______ on formation of arachidonic acid
5-lipoxygenase
221
Montelukast competes with ______ leukotriene for ______ receptor
Cysteinyl leukotrienes
CysLT1 receptor
222
Cromolyn MOA
*prevents degranulation/release of histamines and leukotrines
Thought to block calcium influx into mast cells
223
Omalizumab MOA
Binds to IgE to prevent it from binding to IgE receptor
224
Zileuton MOA?
Inhibits 5-lipoxygenase thus blocking formation of all leukotrienes
Inhibits CYP1A2 + CYP3A4
225
Zileuton AE?
Elevated hepatic enzyme levels + jaundice
226
Which type of hypersensitivity has IgE immune reactants?
I
227
Which type of hypersensitivity has IgG immune reactants?
II and III
228
Which type of hypersensitivity has T cell immune reactants?
IV
229
Which type of hypersensitivity has soluble antigen form?
I, III, and IV (also has cell-bound)
230
Which type of hypersensitivity has cell-bound antigen form?
II and IV (also has soluble)
231
Which type of hypersensitivity involves in complement cell lysis?
II
232
Which type of hypersensitivity has AB/antigen complexes that cause tissue damage?
III
233
Onset of rxn + type I hypersensitivity?
Immediate
234
Onset of rxn + type II hypersensitivity?
Hours to days
235
Onset of rxn + type III hypersensitivity?
2 - 3 weeks (longest one)
236
Onset of rxn + type IV hypersensitivity?
2 - 3 days
237
Type I - IV hypersensitivity
Autoimmune hemolytic anemia?
II
238
Type I - IV hypersensitivity
Goodpasture syndrome?
II
239
Type I - IV hypersensitivity
Rh incompatibility?
II
240
Type I - IV hypersensitivity
Lupus?
III
241
Type I - IV hypersensitivity
Serum sickness?
III
242
Type I - IV hypersensitivity
Glomerulonephritis?
III
243
Type I - IV hypersensitivity
Rheumatoid arthritis?
III
244
Type I - IV hypersensitivity
Contact dermatitis?
IV
245
Type I - IV hypersensitivity
T1DM?
IV
246
Type I - IV hypersensitivity
TB skin test?
IV
247
Type I - IV hypersensitivity
Seasonal hay fever?
I
248
What could you use for eyelash hypotrichosis?
Bimatoprost (Latisse)
249
What is the use of Bimatoprost (Latisse) for?
Eyelash growth
Can cause change in iris pigmentation
250
What is hirsutism?
Male-type hair growth in females
251
What can you use to treat hirsutism?
Eflornithine (Vaniqua) cream
252
What is the use of Eflornithine (Vaniqua) cream for?
Hirsutism
253
What is the most common classification of nail disorders?
Distal and lateral subungal
254
If there is a superficial nail condition, what is the first line therapy?
Topical therapy
255
If there is a mild to moderate nail condition, what is the first line therapy?
Oral terbinafine and/or topical therapy
256
If there is a mild to moderate nail condition, what is the alternative therapy?
Oral itraconazole or fluconazole and/or topical therapy
257
If there is a severe nail condition, what is the first line therapy?
Oral terbinafine
258
If there is a severe nail condition, what is the alternative therapy?
Oral itraconazole or fluconazole
259
When should terbinafine be used for nail conditions?
First line for Mild, moderate, or severe conditions
NOT to be used for superficial conditions
260
When should itraconazole or fluconazole be used for nail conditions?
Alternative therapy for Mild, moderate, or severe conditions
261
When should topical therapy be used for nail conditions?
First line for superficial conditions
Alternative for mild, moderate conditions
262
Terbinafine
Itraconazole
Fluconazole
Contraindicated in liver disease?
All 3
263
Terbinafine
Itraconazole
Fluconazole
Contraindicated in CrCl<50?
Terbinafine
264
Terbinafine
Itraconazole
Fluconazole
Do not mix with acid suppressors..?
Itraconazole
265
Terbinafine
Itraconazole
Fluconazole
Which one is dose adjusted in renal impairment?
Fluconazole
266
Terbinafine
Itraconazole
Fluconazole
Which one causes QT prolongation?
Fluconazole
267
What causes clubbing of the nails?
Often pulmonary
268
What causes koilonychia?
Iron deficiency
269
In the pathophysiology for miniaturization of terminal hairs, testosterone is converted to dihydrotestosterone via what enzyme?
5-alpha reductase
270
Compared to people who are not balding, those who are balding have higher _________ levels
dihydrotestosterone
271
Minoxidil is androgen (dependent/independent)
independent
272
Finasteride is androgen (dependent/independent)
dependent
273
When should you consider ending treatment when using minoxidil?
After 4 months with no new results
274
Minoxidil MOA?
Vasodilation by relaxing arteriolar smooth muscle
275
Finasteride MOA?
Inhibits 5 alpha reductase
276
Montelukast MOA?
LTD4-RECEPTOR antagonist
277
```
. 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. Mast cells
278
. 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. Second-generation H1 antihistamines are generally bigger and more hydrophilic
279
```
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
```
B. Second-generation H1 antihistamine
280
```
. 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. Cytochrome P450s
281
Histamine has a ______ amine group
primary
282
Histamine-1 antagonist have a ______ amine group
tertiary
283
Type I hypersensitivity is ____ mediated
IgE
284
Type II hypersensitivity is _____ mediated
Cytotoxic/AB
285
Type III hypersensitivity is _______ mediated
immune complex/IgG/IgM
286
Type IV hypersensitivity is ______ mediated
Delayed or Cell-mediated (T cells)
287
What is the purpose of an outer root sheath for hair?
Protects the growing hair
288
What is the purpose of a dermal papilla?
Supplies blood vessels and sensory nerves
289
Where does growing hair originate?
Hair bulb
290
How can you prevent loop diuretics from damaging the ear?
1. Lowest dose
| 2. Avoid rapid rates
291
Major symptoms of vernal keratoconjunctivitis?
Severe itching
292
Who is more likely to get vernal keratoconjunctivitis?
Children; Associated w/ family history of atopy
293
Who is more likely to get atopic keratoconjunctivitis?
Adults; Associated w/ family history of atopy
294
How does gonococcal conjunctivitis present?
Most common in sexually active adults or in infants via vaginal birth
Severe purulent discharge
295
What is the leading cause of blindness worldwide?
Trachoma (serotypes A-C)
