Midterm 3 Flashcards by Justin Moody

Promethazine

H1 blocker
anticholinergic
Antinausea for motion sickness
treats meniere’s

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Dexxamethasone

long acting steroid
inject into ear to reduce fluid
treats meniere’s

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Antibiotics for Otitis Media

Amoxicillin
Amoxicillin + clavulanate
Cefaclor

Second level drugs: trimethoprim (sulfa)
Macrolides

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Incorrect statement concerning open angle glaucoma

Associated with rapid closure of drainage canals for the aqueous humor
Accounts for 90% of the glaucoma cases
African Americans are especially vulnerable
Diabetes and high blood pressure are risk factors

Not associated with rapid closure of drainage canals

Subtle, slow closure

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Which is not a risk factor for cataracts

Diabetes
Arthritis
Aging
Construction worker

Arthritis

Treatment for cataracts is surgical removal

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Correct statements concerning Ag-related Macular degeneration

Occurs in 90% of patients older than 80
Almost never occurs in patients less than 50
Antioxidant treatment is very effective in preventing this condition
Progress of disease is fast if hemorrhage and fluid buildup are associated
Associated with loss of peripheral vision
Bevacizumab is used to treat the wet form of this disorder
Most common cause of severe loss of sight in patients older than 60

Almost never occurs in patients less than 50
Progress of disease is fast is hemorrhage and fluid buildup are associated
Bevacizumab is used to treat the wet form of this disorder
Most common cause of severe loss of sight in patients older than 60

Occurs in 10% of patients older than 80
Antioxidant treatment is minimally effective in preventing AMD
Associated with loss of central vision

Other: Smoking is a risk factor, associated with polymorphisms, No treatment for dry AMD

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How predictive of breast cancer is mammography

25%
50
85
99

85%

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Palpation gets how much breast cancer (that mammography doesn’t)

10%

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Incorrect statement concerning breast carcinoma

50% chance to be the diagnosis of a lump found in breast of 23 year-old female
More likely to occur in women with a history of breast cysts
No apparent racial link
BRCA 1 and 2 are the most common genes associated with this condition

not 50% chance to be the diagnosis in 23 year old

Rare before 25 years (or before menopause)

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Incidence of breast carcinoma by age 70

30% incidence by age 70

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Which of the following are the survival rates for breast cancers classified as stage O and stage IV respectively

40% and 86%
99 and 5
55 and 10
92 and 13

92% and 13%

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Obesity has been determined to be a link in which of the following

cervical cancer and breast cysts
endometrial polyps and endometrial adenocarcinoma
endometrial polyps and endometritis
ovarian cysts and ovarian carcinoma

endometrial polyps and endometrial adenocarcinoma

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Endometrial Polyps occur when

late menopause
hypertension
Obesity

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Cervical cancers risks

HPV - multiple sex partners
immunosuppression
early age of first sexual contact
oral contraception for more than 5 years
nicotine use

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Breast cyst age

20-40
fibrolytic changes
doesn’t really occur after menopause
can calcify/look like cancer

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Endometrial adenocarcinoma risks

obesity
Diabetes
Hypertension

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Endometritis risks

IUDs

infection

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Ovarian cysts/masses (neoplastic)/cancer

contraceptives can decrease risk
treatment is total hysterectomy and surrounding tissue, chemotherapy
most are sporadic

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Non-steroidal synthetic estrogen

steroidal

non steroidal - diethylstillbesterol

Steroidal - ethinyl estradiol

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Which is not an effect of diethylstillbesterol

Increases CNS excitability
Maintains skin elasticity
Increases pigmentation around the eyes
Increases bone adsorption

does not increase bone adsorption
decreases bone adsorption

also: sexual maturity
increased endometrial and uterine growth
Increase blood coagulability

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Which of the following characteristics differ between progestins and ethinylestradiol

Used in oral contraception
Contraindicated in patients with severe heart disease
When used in combination the reduction in ovulation approaches 100%
Effects are blocked by tamoxifen

Effects are blocked by tamoxifen - blocks estrogen only

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Effects of progestins

Increase aldosterone, increase Na and water retention, increase BP and blood volume
Increase fat deposition
decrease CNS excitability
Increase body temp

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Clinical uses of progestins

Replacement therapy
Oral contraception
Long-term ovarian suppression - endometriosis and such

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contraindications of progestins

Breast cancer

Severe hypertension or heart disease

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Clinical uses of estrogen

Primary hypogonadism | Postmenopausal - smallest dose

Adverse effects of estrogen

``` postmenopausal bleeding nausea hypertension hyperpigmentation increases some cancers (breast and endometrial) ```

Contraindications for estrogen

Liver disease Breast/endometrial cancers thrombolytic disorders

Used to treat breast cancers

Tamoxifen | blocks actions of estrogen

Morning after pill

MIfepristone | blocks progesterone and glucocorticoid receptor

Suppresses ovarian function

Danazol masculinizing effect treats endometriosis treats fibrous changes in breast

Ovulation - inducing druge

Clomiphene

Minipill

progesterone only | fewer side effects, less effective

Autoimmune disorder often associated with ulcers and carditis

Rheumatoid arthritis

pyogenic infections often caused by staph aureus

osteomyelitis

can result in kyphosis and scoliosis

osteoporosis

due to tissue wear and tear and present in most people older than 65

osteoarthritis

type 1 collagen and dentin deficiency

osteogenesis imperfecta

prevented by consuming citrus fruit

scurvy

Non-steroidal synthetic estrogen | steroidal

non steroidal - diethylstillbesterol | Steroidal - ethinyl estradiol

Which is not an effect of diethylstillbesterol Increases CNS excitability Maintains skin elasticity Increases pigmentation around the eyes Increases bone adsorption

does not increase bone adsorption decreases bone adsorption also: sexual maturity increased endometrial and uterine growth Increase blood coagulability

Which of the following characteristics differ between progestins and ethinylestradiol Used in oral contraception Contraindicated in patients with severe heart disease When used in combination the reduction in ovulation approaches 100% Effects are blocked by tamoxifen

Effects are blocked by tamoxifen - blocks estrogen only

Effects of progestins

Increase aldosterone, increase Na and water retention, increase BP and blood volume Increase fat deposition decrease CNS excitability Increase body temp

Clinical uses of progestins

Replacement therapy Oral contraception Long-term ovarian suppression - endometriosis and such

contraindications of progestins

Breast cancer | Severe hypertension or heart disease

Clinical uses of estrogen

Primary hypogonadism | Postmenopausal - smallest dose

Adverse effects of estrogen

``` postmenopausal bleeding nausea hypertension hyperpigmentation increases some cancers (breast and endometrial) ```

Contraindications for estrogen

Liver disease Breast/endometrial cancers thrombolytic disorders

Used to treat breast cancers

Tamoxifen | blocks actions of estrogen

Morning after pill

MIfepristone | blocks progesterone and glucocorticoid receptor

Suppresses ovarian function

Danazol masculinizing effect treats endometriosis treats fibrous changes in breast

Ovulation - inducing druge

Clomiphene

Minipill

progesterone only | fewer side effects, less effective

Autoimmune disorder often associated with ulcers and carditis

Rheumatoid arthritis

pyogenic infections often caused by staph aureus

osteomyelitis

can result in kyphosis and scoliosis

osteoporosis

due to tissue wear and tear and present in most people older than 65

osteoarthritis

type 1 collagen and dentin deficiency

osteogenesis imperfecta

prevented by consuming citrus fruit

scurvy

Carisoprodol

muscle relaxant | can develop dependence, sedative

abnormal keratization located deep in dermia

dyskeratosis

elevated dome or flat topped less than 5mm

papule

flat and circumscribed discolored area less than 5mm

macule

Effective against VSV

Famcyclovir longer lasting than acyclovir thymidine kinase dependent

Correct statements concerning acne vulgaris and its treatment Its inflammatory state typically consists of opened comedones known as blackheads It is usually associated with increased testosterone activity in both males and females Abscesses form from ruptured sebaceous glands Associated with trapped fungus in the sebaceous glands Salicylic acid is used for treatment due to its ability to dry and destroy the sebaceous gland Benzoyl peroxide is effective in treatment of acne due to its keratolytic effects Isotretinoin is a very effective systemic treatment for long-term improvement of acne The most serious side effect of isotretinoin treatment is dry skin

corrected wrong answers: Inflammatory state i is closed comodones and white heads Associated with trapped bacteria, not fungus Salicylic acid only opens gland by removing keratin, does not destroy gland (Retinol destroys) Most serious side effect of isotretinoin is birth defects

elevated dome more than 5 mm

nodule

traumatic breakage of skin (from scratching)

excoriation

Which best describes uticaria

hypersensitivity-related hives in response to antigens such as pollens and drugs mediated by IgE

Cellular memory of a reaction to an antigen such that future repeated exposures causes increased dermatitis reaction

Allergic contact dermatitis

Wide range of reactions to infections and drugs including blisters and necrosis with varying severities of expression

Erythema multiforma

Delayed hypersensitive reaction that can be pruritic, edematous and oozing

Eczematous dermatitis

Select the incorrect statement concerning psoriasis Caused by use of NSAIDS Treated by immunosuppressant drugs Associated with well-marked pink to salmon colored plaques Can be accompanied by increased hear attacks

not caused by NSAIDS caused by auto-rejection, or environmentally induced epidermal acnthosis- hyperplasia treated with NSAIDS and immunosuppressant drugs

the leading cause of cancer-induced death in USA

lung cancer

Which of the following is the most common expression of skin cancer basal cell carcinoma squamous cell carcinoma non-metastatic melanoma metastatic melanoma

basal cell carcinoma - least aggressive, slow growing, no metastasis squamous cell - 2nd most common, usually no metastasis, red scaly plaques, locally aggressive Metastatic - most rare, most aggressive, metastasizes

Which of the following is least likely to be associated with high doses of COX 1 and 2 non-selective, treating inflammatory disorders ``` diabetes hypertension altered liver functions asthma renal insufficiency ```

diabetes others: tinnitus, nausea, bleeding

Which of the following muscle relaxants is classified as a desensitizing nicotinic ganglionic blocker ``` succinylcholine dantrolene baclofen D-tubocurarine carisoprodol ```

Succinylcholine - depolarizes by desensitizing, fast acting, causes twitch not inhibited by acetylcholinesterase inhibitor

Alters Ca trafficking

Dantrolene | muscle relaxant

Baclofen

Non-depolarizing, GABA B agent | muscle relaxant

D-tubocurarine

Inhibited by acetylcholinesterase inhibitor competitive for ACh, blocks nicotinic receptor muscle relaxant

Carisoprodol

muscle relaxant | can develop dependence, sedative

Non-thymidine kinase dependent antiviral

Foscarnet

Correct statement concerning liver disorders - Obstruction caused by gallstones can result in cholecystitis - Viral infections are the #1 cause of hepatotoxicity - Fibrosis is more likely to result in cirrhosis than steatosis - Most hepatotoxic events occur around the central hepatic vein - There is a cure for hepatitis C, but no immunization - Hep A and E viruses cause both an acute and chronic hepatitis - Fatty liver disease and resulting cirrhosis is caused entirely by alcoholism - Wilson's disease is a hepatitis caused by a calcium metabolic defect

Wrong answers corrected Drugs are #1 cause of hepatotoxicity - not virus Hep A and E cause only acute, not chronic (BCD are both) Fatty liver disease and resulting cirrhosis caused by alcoholism, diabetes and obesity Wilson's disease is a copper metabolic defect, not calcium

Most effective for herpes 1 and 2 | less on VZV

Acyclovir | thymidine kinase dependent

Effective against VSV

Famcyclovir longer lasting than acyclovir thymidine kinase dependent

Cellular mechanisms that result in tumors

Inhibit apoptosis Stimulates growth factor oncogenes Stimulates production of telomerases to prevent cellular senescence Suppresses the P53 gene Increases angioneogenesis by enhancing release of vascular endothelial growth factor

Ames test

determines the carcinogenic properties of a chemical by measuring the bacterial DNA responses to substance

typically found in younger patients and associated with Reed Sternberg cells

Hodgkin's lymphoma

a very aggressive non-Hodgkin's lymphoma of B lymphocytes with a poor prognosis

Burkitt's lymphoma

associated with elevated HCG

Choriocarcinoma

mesenchymal cancer typically found in AIDS patients

Kaposi's sarcoma

Malignant tumors of columnar cells and able to form glands

adenoid carcinoma

the leading cause of cancer-induced death in USA

lung cancer

Correct statements concerning cancer treatments - Imatinib is a tyrosine hydroxylase inhibitor used to treat multiple types of cancer such as myelogenous leukemia - Cyclophosphamide is a nitrosourea that is used to treat brain tumors because of its ability to pass through the blood brain barrier - Methyltrexate is a folic acid analog that interferes with the formation of key DNA in cancer cells such as those associated with breast cancer - Vincristine is a natrual product that interferes with tubulin polymerization - Doxorubicin is a form of 5-fluorouracil that inibits thymidine synthases - The secondary cancer most likely to occur as a complication of cancer treatment with alkylating agents is myelogenous leukemia - Stage I breast cancers only have an approximate 10% cure rate

wrong statements corrected Cyclophosphamide is not a nitrosourea Procarbazine is nitrosourea that passes BBB and treats brain tumors (and Hodgkin's lymphoma) Doxorubicin is an anti-biotic that treats cancer, forms free radicals Bleomycin too Stage I breast cancers have 92% survival/cure rate State IV has 10%

Cyclophosphamide

Alkylating agent treats: Leukemia, Hodgkin's, Breast cancer, Multiple myeloma Transfers alkyl group to cell parts like DNA, breaks DNA

Which is most common cancer in children

Acute lymphoblast leukemia (ALL)

most common G.I. malignancy

Colorectal cancer

Multiple myeloma

Plasma cell malignancy | Most commonly in bone marrow

Most common acute leukemia of adult

Acute myelogenous leukemia

Identify the incorrect statements concerning gastrointestinal disorders - Infectious esophagitis can be associated with infection by the cytomegalovirus (herpes and candida included) - Barrett esophagus can be associated with reflux esophagitis - Chronic gastritis is most often caused by herpes simplex virus - Hirschprung disease is a congenital defect associated with auto-immune gastritis - Celiac sprue can be associated with enamel defects and delayed eruption of teeth - Crohn's disease is associated with an expression of intestinal inflammation that is more consistently expressed throughout the intestines than ulcerative colitis - Invasive colonic adenocarcinoma is responsible for 15% of all cancer deaths in the USA - Reflux esophagitis is most likely to occur in young adults

Wrong answers corrected: Chronic gastritis is caused by H. pylori, not herpes hirschsprung disease is a congenital defect of G.I. innervation, not auto-immune Crohn's disease is associated with intestinal inflammation that is more patchy, not consistent Reflux esophagitis is more common in older adults

More one Chronic gastritis, celiac, chrohns, irritable bowel

Correct statements concerning drugs used to treat G.I. and liver disorders - Aluminum salts are not very effective in the treatment of GERD - Cimetidine and ranitidine are OTC H1 blockers used to treat acid reflux - Omeprazole is a proton pump inhibitor often combined with H2 blockers to treat peptic ulcer disease - Prevpac is primarily used to treat severe diarrhea - Bisacodyl is a fast acting smooth muscle stiumlant used to treat constipation - Loperamine is principally used to treat stomach cramps - Irritable bowel syndome is a common disorder in young adults primarily treated by relieving symptoms - Crohn's disease is treated with antiviral medications such as acyclovir - If exposed to HBV, a dentist should immediately begin treatment with the HBV vaccine series - Linaclotide is FDA-approved to treat the diarrhea associated with irritable bowel syndrome

Wrong answers corrected Cimetidine and ranitidine are H2 blockers, do treat acid reflux Prevpac is used to treat peptic ulcer disease caused by H. pylori Loperamine is used to treat diarrheas, not cramps Crohn's disease is treated with anti-inflammatories and antibiotics Linaclotide is FDA-approved to treat Constipation associated with irritable bowel syndrome

Treatment for Crohn's

Mess on the Metro with Cortney | Mesalamine, metronidazole, corticosteroids

Cimetidine

H2 blocker treats GERD drowsiness

Rantidine

H2 blocker treats GERD drowsiness

Docusate

causes diarrhea, water retention, stool softener

Atropine

anti-cholinergic treats diarrhea and nerve gas

Loperamide

treats diarrhea | mild opioid

Bismuth subsalicylate

Peptobismal | treats diarrhea

Midterm 3 Flashcards

(109 cards)