Pharmacology

Question 1

GORD

Answer 1

Reflux of acidic contents into oesophagus.
Symptoms: Burning sensation.
Worse when bending.
Causes: Weak sphincter, Increased abdominal pressure; Pregnant, Obese.

Question 2

Gastritis

Answer 2

Inflammation of stomach lining.
NSAIDs
Alcohol

Question 3

Peptic Ulceration

Answer 3

H. pylori infection --> Gastritis --> Ulceration
Symptoms: 
Sharp stabbing pain-precise.
Vomiting blood
Nausea

Question 4

Dyspepsia warning signs

Answer 4

Over 55
Tarry stools
Weight loss
Trouble swallowing
Vomiting blood

Question 5

Cephalic phase

Answer 5

Anticipation of food
Parasympathetic --> 
Ach --> 
Acid Release -->
Gastrin Release

Question 6

Gastric Phase

Answer 6

Distension by food (eaten)
Ach, Histamine, Gastrin released.
Ach --> Acid release
       --> Pepsinogen release --> Peptide fragments                        -->Stimulate G cells--> More acid release.
       --> Mucus release
Histamine --> Acid release.
Gastrin --> Acid release.

Question 7

Intrinsic factor

Answer 7

Produced by parietal cells.
Promotes vitamin B12 absorption.
Vitamin B12 cofactor in blood cell production.

Question 8

Saliva production

Answer 8

Parasympathetic–>Ach–>Muscarinic –> Enzyme secretion
–>Vasodilation
Vasodilation caused by
BRADYKININ

Question 9

Acetylcholine

Answer 9

Vagus nerve –> Ach –> M3 –> PHOSPHOLIPASE –> Ca2+ = Proton Pump Activated

Question 10

Histamine

Answer 10

Histamine –> H2 –> α unit unbinds –> GDP –> GTP
–> Adenylyl Cyclase
Adenylyl Cyclase –> AMP –> cAMP
cAMP phosphorylates proton pump.

Question 11

Gastrin

Answer 11

Released by antral cells.
CCK2 receptors
Ca2+–> Proton pump activated

Question 12

Arachidonic acid

Answer 12

Cell membrane (released by Phospholipase A2) –> Arachidonic acid –> (Cox pathway) Prostaglandins

Question 13

Prostaglandins

Answer 13

PGE2 and PGI2 inhibit cAMP increase
Supress proton pump
ALSO: Pain, inflammation etc

Question 14

NSAIDs

Answer 14

Stop COX –> Stop prostaglandins –> increase acid
–> stop pain etc
Aspirin: Not for pain, inflammation etc. Use for antiplatelet

Question 15

Antacids

Answer 15

Sodium bicarbonate
Magnesium hydroxide (Diarrhea) + Aluminium hydroxide (constipation)

Question 16

Alginates

Answer 16

Raft forming

Alginic acid + saliva = viscous foam

Question 17

H2 receptor antagonists

Answer 17

Cimetidine (Inhibits CYP450)
Ranitidine (Zantac)
Famotidine

-Best given at night

Question 18

EC50

Answer 18

Concentration of agonist that gives 50% response.

Question 19

PPI’s

Answer 19

Omeprazole (OTC)
Pantoprazole (OTC)
Lansoprazole

• Avoid prolonged use; rebound acid hypersecretion
• Bind to cysteine residues in proton pump

Question 20

Prostaglandin analogues

Answer 20

Misoprostol
Inhibit cAMP rise
Suppress acid release.

Question 21

H. pylori treatment

Answer 21

Triple Therapy:
2 Antibiotics: 
Clarithromycin (Drug interactions)
Amoxicillin (Penicillin allergy?)
Metronidazole (NO ALCOHOL)

1PPI

Question 22

Erythropoiesis

Answer 22

• Production of RBC
• Controlled by Erythroprotein (EPO)
• Released by peritubular cells in kidney

Question 23

Reticulocyte

Answer 23

• Immature RBC

- Retic count elevated when more erythropoiesis; Bleeding?

Question 24

Fe2+

Answer 24

1. From diet
2. Fe3+ produced by mucousal cells of duodenum.
3. Bind to apoferritin
4. Releaseed into blood, binds to transferrin.
5. Iron to bone marrow.
6. Iron to Hb.

Question 25

WBC

Answer 25

Neutrophils-Phagocytosis Eosinophils-Parasite Basophils-Histamine Lymphocytes-Antibodies Production: Colony stimulating factors (proteins)

Question 26

Haematocrit

Answer 26

Packed cell volume | % volume that is RBC

Question 27

Mean corpuscular volume

Answer 27

Volume of individual RBC | Measured in fl=10-15 of a litre

Question 28

Blood Groups

Answer 28

A: A antigens, B antibodies B: B antigens, A antibodies AB: AB antigens O: No antigens but a + b antibodies

Question 29

Rhesus D

Answer 29

- Mother Rhesus -ve - Child Rhesus +ve - Mother produces antibodies against Rhesus D - Antibodies attack 2nd child.

Question 30

Anaemia symptoms

Answer 30

Shortness of breath Weakness Lethargy Tachycardia-Higher heart rate as thin blood

Question 31

Iron deficient anaemia

Answer 31

Microcytic (smaller RBC) | Causes: Diet (rare), Menstruation, Pregnancy

Question 32

Megaloblastic anaemia

Answer 32

Macrocytic (larger RBC) Defective DNA synthesis, bone marrow contains megaloblasts. VitB12/Folate deficiency.

Question 33

Pernicious anaemia

Answer 33

Lack of intrinsic factor for B12 absorption | Autoimmune disease

Question 34

Haemolytic anaemia

Answer 34

Higher rate of RBC destruction | Spherocytosis: Genetic, Abnormal reduction in RBC membrane protein, cells fragile.

Question 35

Sickle Cell anaemia

Answer 35

Genetic Abnormal Hb, RBC=Sickle shape Block microcirculation, causes haemolytic anaemia

Question 36

Aplastic anaemia

Answer 36

Insufficient production of RBC, WBC + Platelets Tired, Bleeding, Infections Causes: Viral, drugs

Question 37

Polycythaemia

Answer 37

``` Higher RBC Higher blood viscosity Causes: Primary-Bone marrow Secondary-More EPO; Altitude, smoking ```