unit 5 Flashcards

Question

Name examples of autoimmune chronic diseases.

Answer 1

* Systemic lupus erythematosus (SLE) * Rheumatoid arthritis * Hashimoto thyroiditis * Type 1 diabetes mellitus * Multiple sclerosis

Answer 2

Dysregulated T-cell responses can lead to continuous inflammation, tissue damage, or failure to regulate immune tolerance.

Answer 3

They suppress excessive immune responses and maintain self-tolerance. Defects in Tregs can lead to autoimmunity.

Answer 4

* Immunosuppressants (e.g. methotrexate, corticosteroids) * Biologics (e.g. TNF inhibitors) * Lifestyle modifications to manage inflammation and symptoms

Answer 5

Through immunosurveillance — detecting tumour-specific antigens using innate and adaptive immunity. Tumour-infiltrating lymphocytes (TILs) are a positive sign of this. ## Footnote Immunoediting is a process through which the immune system interacts with cancer cells.

Answer 6

Immunoediting involves destroying or suppressing tumours, but resistant cells may survive. Tumours can suppress immunity by releasing TGF-β and IL-10, which inhibit T cells and NK cells. ## Footnote Immunoediting has phases of elimination, equilibrium, and escape.

Answer 7

Due to immunosuppression, which reduces the immune system's ability to detect and destroy early cancer cells. Risk is 2–30x higher. ## Footnote Immunosuppressive therapy is essential to prevent graft rejection.

Answer 8

Primary (PIDs): Genetic/congenital (e.g. SCID, IgA deficiency, DiGeorge) Secondary: Acquired from external factors (e.g. HIV, chemo, diabetes) ## Footnote Primary immunodeficiencies are often diagnosed in childhood.

Answer 9

HIV destroys CD4 T cells, severely weakening immune responses and increasing infection risk. ## Footnote CD4 T cells are crucial for coordinating the immune response.

Answer 10

Rapid response to injury/infection with redness, heat, swelling, pain, and loss of function due to increased blood flow and fluid. ## Footnote Acute inflammation is a protective response that aims to eliminate the initial cause of cell injury.

Answer 11

* Initiation – blood vessels dilate, leukocytes enter tissue * Amplification – cytokines (e.g. TNF-α, IL-1, IL-6) enhance response * Termination – repair via angiogenesis and fibroblasts ## Footnote Each phase is critical for the resolution of inflammation and tissue repair.

Answer 12

* Microbes (bacteria, viruses, fungi) * Tissue damage (burns, trauma) * Immune reactions (autoimmunity, hypersensitivities) ## Footnote Inflammation is a complex biological response to harmful stimuli.

Answer 13

Chronic is long-term, dominated by macrophages and lymphocytes, with less neutrophil activity. It occurs in persistent infections or autoimmune diseases. ## Footnote Chronic inflammation can lead to tissue damage and contribute to various diseases.

Answer 14

Th0 cells → Th1, Th2, Th17, or Treg based on cytokine signals: * Th1: cell-mediated defense * Th2: IgE/allergy * Th17: inflammation/autoimmunity * Treg: suppresses immune responses ## Footnote The differentiation of Th0 cells is influenced by the microenvironment and cytokine presence.

Answer 15

* Fibroblasts repair tissue by producing collagen * Angiogenesis restores blood flow to the healing area ## Footnote These processes are essential for tissue regeneration and healing.

Answer 16

Antihistamines & mast cell stabilisers Cyclo-oxygenase inhibitors (NSAIDs) Cysteinyl-leukotriene antagonists Glucocorticoids DMARDs (Disease-modifying antirheumatic drugs) Anticytokines and biopharmaceuticals T-cell activation inhibitors Lymphocyte proliferation inhibitors ## Footnote Each category serves distinct therapeutic roles in managing inflammation and immune responses.

Answer 17

Block H1 histamine receptors to reduce allergy symptoms. * Sedative: chlorphenamine, promethazine * Non-sedative: loratadine, fexofenadine, cetirizine ## Footnote Antihistamines are commonly used to treat allergic reactions.

Answer 18

Prevent mast cells from releasing histamine and inflammatory mediators. Examples: sodium cromoglicate, nedocromil sodium (used for asthma maintenance). ## Footnote Mast cell stabilisers are particularly effective in asthma management.

Answer 19

Inhibit COX-1 and COX-2 enzymes, reducing prostaglandin production. Examples: ibuprofen, aspirin, diclofenac ## Footnote NSAIDs are widely used for pain relief and inflammation reduction.

Answer 20

COX-1: found in most cells; protects stomach lining → inhibition causes GI issues COX-2: induced during inflammation → selective inhibitors (like celecoxib) reduce inflammation with fewer GI side effects but may increase heart risks ## Footnote Understanding the differences helps in selecting appropriate NSAIDs.

Answer 21

GI: nausea, ulcers, bleeding CV: hypertension, heart risks Kidneys: nephropathy, insufficiency Skin reactions Bronchospasm (esp. aspirin-sensitive pts) Liver and bone marrow suppression (rare) ## Footnote Awareness of side effects is crucial for safe NSAID use.

Answer 22

Oral: 75–150 mg/day in 2–3 doses Topical: for local pain; thin layer applied several times/day Max dose: 150 mg/day Use lowest effective dose for shortest time ## Footnote Diclofenac is effective for both systemic and localized pain relief.

Answer 23

Low dose: prevents heart attacks (blocks TXA2 in platelets) Avoided in children due to Reye’s syndrome, a serious brain/liver condition linked to aspirin use in viral fevers ## Footnote Aspirin's benefits must be weighed against its risks in pediatric populations.

Answer 24

Block leukotrienes (produced by 5-lipoxygenase), reducing bronchoconstriction and inflammation in asthma. Example: Montelukast ## Footnote CysLT antagonists are important in asthma management.

Answer 25

Disease-Modifying Antirheumatic Drugs used when NSAIDs are ineffective. They aim to slow or reverse autoimmune disease progression. Examples: methotrexate, sulfasalazine, chloroquine ## Footnote DMARDs are critical in the long-term management of autoimmune diseases.

Answer 26

Drugs that target specific immune mediators (like TNF-α or IL-6) to reduce inflammation in autoimmune diseases (e.g., rheumatoid arthritis, Crohn’s). ## Footnote These therapies represent a newer class of treatment options for autoimmune conditions.

Answer 27

T-cell inhibitors: block IL-2 production/mTOR (e.g., cyclosporine, tacrolimus, sirolimus) Lymphocyte inhibitors: interfere with DNA synthesis (e.g., azathioprine, mycophenolate mofetil, leflunomide) ## Footnote These inhibitors are often used in transplant medicine and autoimmune disease treatment.

Answer 28

Genetic material: DNA or RNA, single-stranded (ss) or double-stranded (ds) Small genome: codes only for replication Often rely on host cells to replicate ## Footnote None

Answer 29

Infection of host cells Local replication Spread Shedding – virus exits to infect new hosts ## Footnote None

Answer 30

Cellular tropism – which cells a virus targets Binding/entry ability Host immune defences Degree of cell damage ## Footnote None

Answer 31

Attachment – virus binds to host cell receptor Penetration – virus enters cell Uncoating – genetic material is released Replication – host replicates viral genome Assembly – new virus particles formed Release – viruses exit (by lysis or budding) ## Footnote None

Answer 32

Rhinoviruses: ssRNA, no envelope, many types → cause the common cold Coronaviruses: ssRNA, with envelope, crown-like surface → cause common cold & COVID-19 ## Footnote None

Answer 33

HIV targets CD4 T cells, lowering count within 2–6 weeks (flu-like symptoms) Long incubation (8–10 yrs untreated) Symptoms (e.g. weight loss, infections) appear when CD4 < 500 AIDS: CD4 < 200, life expectancy 1–3 years ## Footnote None

Answer 34

ssRNA genome Has envelope Uses reverse transcriptase to insert RNA into host DNA, making host cells produce viruses ## Footnote None

Answer 35

Causes vomiting & diarrhoea Highly contagious, can spread for weeks Survives up to 2 weeks on surfaces Common in schools and hospitals ## Footnote None

Answer 36

Aciclovir – herpes: inhibits viral DNA replication Maraviroc – HIV: blocks CCR5 receptor to stop entry Oseltamivir – flu: inhibits neuraminidase, prevents spread Raltegravir – HIV: blocks integration of viral DNA Zidovudine – HIV: inhibits reverse transcriptase Molnupiravir – COVID-19: introduces RNA errors, stops replication ## Footnote None

Answer 37

Inflammation of the meninges (brain coverings) caused by viruses, bacteria, or fungi. May occur with septicaemia (blood poisoning).

Answer 38

Bacteria enter the bloodstream → causes sepsis. Meningitis and septicaemia often occur together and can be life-threatening.

Answer 39

10% mortality 1 in 3 survivors have complications: * brain damage * hearing/sight loss * limb loss * scarring Common in children, especially <5 and teenagers.

Answer 40

Fever, poor feeding, vomiting, irritability, high-pitched cry, floppy, seizures, bulging fontanelle.

Answer 41

Press a glass on a rash — if it doesn’t fade (non-blanching), it's a medical emergency.

Answer 42

Common bacteria: * Neisseria meningitidis * Streptococcus pneumoniae * Group B Strep Urgent hospital transfer. Empiric treatment: IV cephalosporins (ceftriaxone/cefotaxime). Add dexamethasone if >3 months old. Add amoxicillin/ampicillin if Listeria suspected (elderly/immunocompromised).

Answer 43

Caused by Neisseria meningitidis (MenA, B, C, W, X, Y). May present with non-blanching rash. Treat urgently with benzylpenicillin if suspected. Close contacts may need antibiotics/vaccine.

Answer 44

More common, less fatal than bacterial. Causes: * Enteroviruses * herpesviruses * mumps Not usually contagious. Treatment: fluids, rest, pain/fever relief; antivirals only for suspected herpesvirus. Recovery in 7–10 days.

Answer 45

Affects immunocompromised individuals. Slower onset, milder symptoms. Treated with amphotericin + flucytosine.

Answer 46

Protect against pathogens causing meningitis: * MenACWY * MenB * pneumococcal * Hib * MMR No vaccine for Group B Strep (S. agalactiae).

Answer 47

Encephalitis = inflammation of brain tissue, usually viral, can be autoimmune or tick-borne. Meningitis affects brain coverings.

Answer 48

Infection → excessive cytokine release. Capillary dilation + fluid leak → edema. Hypotension → reduced organ perfusion. Anaerobic respiration → ↑ blood lactate. Outcome = multi-organ failure, death.

Answer 49

HPV → cervical, anal, penile, oropharyngeal cancer. Hepatitis B/C → liver cancer, lymphoma. H. pylori → gastric cancer.

Answer 50

When pathogens become resistant to treatment by antibiotics, antivirals, antifungals, etc. Caused by misuse or overuse of medications.

Answer 51

Superbugs = resistant pathogens. Examples: * MRSA (methicillin-resistant Staph aureus) * C. difficile (bowel infection).

Answer 52

* Modify antibiotic target site * Alter uptake * Inactivate antibiotic.

Answer 53

Combination of amoxicillin + clavulanic acid. Clavulanic acid = beta-lactamase inhibitor → prevents bacteria from destroying amoxicillin.

Answer 54

Organisational approach promoting careful, effective, and appropriate antimicrobial use to preserve future treatment efficacy.

Answer 55

Symptoms worsen after 7 days. Chest pain, breathlessness. Blood in sputum. Rash develops.

Answer 56

Age 65+ Chronic conditions (e.g. asthma, diabetes, kidney, heart disease) Immunocompromised Pregnant Carers, care home residents, healthcare workers.

Answer 57

Study of how genes affect individual drug response. Helps personalize treatment and identify resistance genes in pathogens.

Answer 58

Spirometry is a diagnostic test that evaluates lung health and is used to diagnose respiratory conditions like asthma, COPD, and other lung diseases. It measures inhalation and exhalation capabilities.

Answer 59

* Tidal Volume – Air inhaled/exhaled during normal breathing * Residual Volume – Air remaining in the lungs after exhaling * Inspiratory Reserve Volume – Extra air that can be inhaled after normal inhalation * Expiratory Reserve Volume – Extra air that can be exhaled after normal exhalation

Answer 60

Respiratory capacities are combinations of lung volumes, including: * Inspiratory Capacity * Functional Residual Capacity * Vital Capacity * Total Lung Capacity

Answer 61

Surfactant reduces surface tension in the alveoli to prevent them from collapsing during exhalation, aiding in efficient gas exchange and helping with lung compliance.

Answer 62

Premature babies often have low levels of surfactant, which leads to respiratory distress syndrome. Postnatal surfactant therapy is used to treat this condition.

Answer 63

With age, lung function declines due to: * Loss of elastic tissue * Ribcage calcification (reduced chest wall flexibility) * Weakened diaphragm and intercostal muscles * Reduced ciliary function in airways and fewer macrophages in alveoli

Answer 64

URTI is an infection of the nose, sinuses, pharynx, larynx, and large airways, typically caused by viruses or bacteria.

Answer 65

* Decongestants (e.g., pseudoephedrine) to reduce nasal swelling * Antihistamines for allergy-related symptoms * Analgesics like ibuprofen or paracetamol for pain and fever * Cough suppressants (e.g., dextromethorphan) and Expectorants (e.g., guaifenesin)

Answer 66

Decongestants are medications (e.g., phenylephrine, oxymetazoline) that constrict blood vessels in the nasal passages to reduce swelling and improve airflow.

Answer 67

Seek medical help if: * The patient has underlying conditions like heart disease or asthma * Severe symptoms like wheezing, chest pain, or coughing up blood occur * Symptoms persist beyond 3 weeks or worsen * There’s a high fever, confusion, or difficulty breathing

Answer 68

Type II alveolar cells secrete surfactant, a phospholipid that reduces surface tension and prevents alveolar collapse during expiration.

Answer 69

Sepsis involves: * Infection by an organism * Excessive cytokine release * Amplification of the immune response, leading to capillary dilation, increased permeability, and tissue edema * Hypotension, organ failure, and potentially death

Answer 70

Group B Streptococcus (Streptococcus agalactiae) is the main cause of bacterial meningitis in babies, particularly in those under 1 month old.

Answer 71

Viral meningitis is generally less severe than bacterial meningitis and is treated with supportive care such as fluids and symptom management for fever and pain.

Answer 72

* Meningococcal meningitis – Caused by Neisseria meningitidis * Pneumococcal meningitis – Caused by Streptococcus pneumoniae * Group B Streptococcal meningitis – Common in infants

Answer 73

Symptoms include: * High fever * Vomiting * Irritability * Poor feeding * Abnormal crying * Rash (which may not fade under pressure)

Answer 74

Immediate transfer to a hospital is critical. Antibiotics like benzylpenicillin are given as soon as possible, especially if meningococcal meningitis is suspected.

Answer 75

Bacterial meningitis is more severe, often fatal, and requires antibiotics. Viral meningitis is usually less severe but can still have long-term effects.

Answer 76

Bacteria can develop resistance through: * Modifying the target site of antibiotics * Altering antibiotic uptake * Inactivating the antibiotic

Answer 77

Antimicrobial stewardship is a healthcare approach that promotes the appropriate use of antibiotics to reduce the development of resistance and preserve their effectiveness.

Answer 78

Vaccines help protect against common pathogens that cause meningitis, such as Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae.

Answer 79

HPV is a virus that can lead to cancers such as cervical, anal, penile, and oropharyngeal cancers. It is sexually transmitted.

Answer 80

Superbugs are pathogens that have developed resistance to multiple antibiotics, making them harder to treat.

Answer 81

Symptoms of a URTI include: * Nasal congestion * Sore throat * Cough * Mild fever * Sneezing

Answer 82

* Antipyretics like paracetamol or ibuprofen for fever * Decongestants for nasal congestion * Hydration and rest to support the immune system

Answer 83

Decongestants should not be used in children, pregnant or breastfeeding women, or those with hypertension.

Answer 84

* Menthol * Eucalyptus oil * Camphor * Methyl salicylate * Peppermint oil

Answer 85

Cough suppressants like codeine or dextromethorphan reduce the urge to cough by acting on the brain’s cough center.

Answer 86

Antibiotics are not typically used for viral URTIs. They may be prescribed if a bacterial infection is confirmed.

Answer 87

Misusing antibiotics can contribute to antibiotic resistance, making infections harder to treat.

Answer 88

Long-term effects of viral meningitis can include headaches, fatigue, memory problems, and occasional cognitive difficulties.

Answer 89

Rhinitis refers to inflammation of the nasal mucous membranes, which can be caused by infections (viral or bacterial), allergens, or other irritants. It can be acute or chronic. ## Footnote N/A

Answer 90

* Acute Rhinitis – Usually caused by viral infections such as the common cold. * Chronic Rhinitis – Persistent symptoms that last for more than 12 weeks, often due to allergies or other underlying conditions. ## Footnote N/A

Answer 91

* Nasal congestion * Sneezing * Runny nose (rhinorrhea) * Facial pain or pressure (sinus pain) * Reduced sense of smell ## Footnote N/A

Answer 92

* High fever (over 38°C or 100.4°F) * Severe facial pain * Persistent symptoms lasting longer than 10 days * Unilateral (one-sided) symptoms * Presence of blood in nasal discharge ## Footnote N/A

Answer 93

* Symptomatic treatment: * Analgesics like acetaminophen or ibuprofen for pain. * Decongestants (nasal sprays or oral) for nasal congestion. * Rest, hydration, and humidified air to help relieve symptoms. ## Footnote N/A

Answer 94

Antibiotics should only be used for bacterial rhinitis or when there is a secondary bacterial infection (e.g., bacterial sinusitis). They are not recommended for viral infections. ## Footnote N/A

Answer 95

This condition occurs when a bacterial infection causes inflammation of the sinuses, often following a viral upper respiratory infection. Symptoms may include: * Facial pain or pressure * Nasal congestion * Fever * Thick, yellow/green nasal discharge ## Footnote N/A

Answer 96

* First-line treatment: * Antibiotics (e.g., amoxicillin-clavulanate). * Symptomatic treatment: * Analgesics (acetaminophen, ibuprofen). * Nasal saline irrigation or sprays. * Decongestants (if not contraindicated). ## Footnote N/A

Answer 97

Chronic rhinitis involves persistent inflammation of the nasal mucosa, often due to allergies, irritants, or nasal polyps. Management includes: * Antihistamines for allergic rhinitis. * Intranasal corticosteroids for inflammation. * Avoiding triggers such as allergens or irritants. ## Footnote N/A

Answer 98

* Pollen * Dust mites * Animal dander * Mold * Cockroach allergens ## Footnote N/A

Answer 99

Nasal corticosteroids help reduce inflammation in the nasal passages, making them effective for treating both allergic rhinitis and chronic rhinitis symptoms. They are usually the first-line treatment for chronic rhinitis. ## Footnote N/A

Answer 100

* Nasal polyps * Chronic sinus infections * Sleep disturbances * Impaired sense of smell ## Footnote N/A

Answer 101

* Viral rhinitis usually improves within 7-10 days with no fever or only mild fever. * Bacterial rhinosinusitis has more severe symptoms, such as persistent fever, purulent nasal discharge, and facial pain, lasting longer than 10 days. ## Footnote N/A

Answer 102

* Antihistamines (oral or intranasal). * Intranasal corticosteroids for inflammation. * Decongestants (short-term use). * Avoidance of known allergens. ## Footnote N/A

Answer 103

* Referral to a specialist (e.g., an ENT or allergist) might be necessary for further evaluation, especially if there are concerns of chronic sinusitis or nasal polyps. * Imaging (CT scan) may be used to evaluate sinus involvement. ## Footnote N/A

Answer 104

Acute viral rhinitis typically lasts for 7-10 days. If symptoms persist beyond 10 days or worsen, consider a bacterial cause. ## Footnote N/A

Answer 105

First-generation antihistamines cause sedation and drowsiness. Common side effects include dry mouth and blurred vision.

Answer 106

Chlorpheniramine is a common first-generation antihistamine used for allergic reactions.

Answer 107

Second-generation antihistamines are less sedating and have fewer central nervous system side effects.

Answer 108

Cetirizine, loratadine, and fexofenadine are common second-generation antihistamines.

Answer 109

They help relieve nasal symptoms of allergic rhinitis by blocking histamine receptors directly in the nasal passage.

Answer 110

Azelastine is a topical nasal antihistamine used to treat allergic rhinitis.

Answer 111

Intranasal corticosteroids reduce inflammation in the nasal passages, helping to control allergic rhinitis symptoms.

Answer 112

Fluticasone, budesonide, and mometasone are examples of intranasal corticosteroids.

Answer 113

Decongestants reduce nasal congestion by constricting blood vessels in the nasal mucosa, which decreases swelling.

Answer 114

Pseudoephedrine and oxymetazoline are commonly used decongestants.

Answer 115

Saline nasal sprays help moisten nasal passages and clear mucus, providing relief from nasal congestion.

Answer 116

Yes, saline nasal sprays are safe for most individuals, including pregnant women and those with respiratory conditions.

Answer 117

Cromolyn sodium prevents the release of histamine and other inflammatory chemicals from mast cells, helping to control allergic reactions.

Answer 118

First-line treatment includes antihistamines (oral or nasal) and corticosteroids, combined with decongestants for severe symptoms.

Answer 119

Avoiding allergens, using air purifiers, and saline nasal irrigation are helpful non-pharmacological treatments.

Answer 120

Saline nasal sprays, certain antihistamines like loratadine, and intranasal corticosteroids like budesonide are considered safe during pregnancy.

Answer 121

Oral decongestants, particularly pseudoephedrine, should be avoided during pregnancy due to potential risks to the fetus.

Answer 122

Common types include vasomotor rhinitis, hormonal rhinitis, and drug-induced rhinitis.

Answer 123

Vasomotor rhinitis is typically triggered by irritants like smoke, strong odors, or changes in weather, rather than allergens.

Answer 124

It is a type of non-allergic rhinitis where symptoms are triggered by environmental factors like temperature or air quality rather than allergens.

Answer 125

Management includes avoiding environmental triggers, using nasal saline sprays, and occasionally using intranasal steroids or antihistamines for relief.

Answer 126

Temperature changes, air pollution, and exposure to strong odors are common triggers of non-allergic rhinitis.

Answer 127

Common culprits include nasal decongestant sprays (when used longer than recommended), aspirin, and beta-blockers.

Answer 128

Symptoms include a runny nose, sore throat, cough, congestion, and sometimes mild fever.

Answer 129

Supportive treatments such as rest, hydration, and symptomatic relief with pain relievers and decongestants.

Answer 130

Influenza tends to have a more abrupt onset, with symptoms like high fever, body aches, chills, and fatigue, while the common cold has milder symptoms.

Answer 131

Oseltamivir (Tamiflu) and zanamivir are antiviral medications used to treat the flu.

Answer 132

Treatment includes antiviral medications (if prescribed early), rest, fluids, and fever management. Severe cases may require hospitalization.

Answer 133

These include avoiding allergens, using air filters, ensuring proper ventilation, and getting vaccinated for flu and pneumonia.

Answer 134

Yes, nasal corticosteroids are generally safe for long-term use when used correctly, but they may have side effects like nasal dryness and irritation.

Answer 135

Skin prick tests and blood tests (like the RAST test) are commonly used to diagnose specific allergens.

Answer 136

Asthma is a chronic inflammatory disease of the airways, leading to episodes of wheezing, shortness of breath, chest tightness, and coughing. Symptoms are often worse at night or in the early morning and may be triggered by allergens, irritants, respiratory infections, or exercise.

Answer 137

Inflammation: The airway lining becomes inflamed, leading to increased mucus production and airway swelling. Bronchoconstriction: Smooth muscle tightening occurs in the airways, causing narrowing and difficulty in breathing. Hyperresponsiveness: The airways become excessively responsive to triggers, leading to a heightened inflammatory response. Mucus Production: Overproduction of mucus contributes to airway obstruction.

Answer 138

Allergens: Dust mites, pollen, mold, pet dander. Respiratory Infections: Viral infections like the common cold or flu. Environmental Irritants: Smoke, air pollution, strong odors, chemical fumes. Exercise: Exercise-induced asthma may occur with physical activity. Weather: Cold, dry air or sudden changes in temperature can trigger asthma symptoms.

Answer 139

Medical History: Review of symptoms, family history of asthma or allergies. Spirometry: Measures airflow, specifically FEV1 (Forced Expiratory Volume in 1 second) and FVC (Forced Vital Capacity). FEV1/FVC ratio: A lower ratio suggests airway obstruction. Bronchodilator reversibility test: Evaluates how much airflow improves after using a bronchodilator. Peak Flow Monitoring: Measurement of how fast a patient can exhale.

Answer 140

Inhaled Corticosteroids (ICS): Reduce inflammation in the airways, preventing asthma attacks. Examples include fluticasone, budesonide. Long-Acting Beta-Agonists (LABAs): Help keep airways open. Used in combination with ICS. Examples include salmeterol and formoterol. Leukotriene Modifiers: Block the action of leukotrienes, chemicals that cause inflammation. Examples include montelukast and zafirlukast. Theophylline: A bronchodilator that relaxes the muscles around the airways.

Answer 141

Short-Acting Beta-Agonists (SABAs): Rapidly relieve acute bronchoconstriction. Examples include albuterol, levalbuterol. Anticholinergics: Reduce mucus production and help open the airways. Example: ipratropium bromide. Oral Corticosteroids: Used for severe exacerbations, e.g., prednisone.

Answer 142

Immediate Treatment: SABAs (e.g., albuterol) are used for rapid relief. Oral Corticosteroids may be given for moderate to severe exacerbations. Oxygen Therapy: Used if oxygen saturation levels are low. Monitoring: Continuous monitoring of symptoms and peak flow to determine if additional treatments are necessary. Hospitalization: In severe cases where symptoms do not improve with initial treatments.

Answer 143

Step 1: Intermittent Asthma – Use SABAs for quick relief as needed. Step 2: Mild Persistent Asthma – Add low-dose ICS or leukotriene modifiers. Step 3: Moderate Persistent Asthma – Increase ICS dose or add LABAs. Step 4: Severe Persistent Asthma – Use high-dose ICS and LABAs, consider biologics. Step 5: Very Severe Asthma – Add biologics (e.g., omalizumab) or oral corticosteroids.

Answer 144

Age-appropriate medications: Use medications suitable for children's age and weight. Inhaler technique: Proper use of inhalers or spacers is crucial for effective drug delivery. Frequent monitoring: Use peak flow meters to track symptoms and adjust treatment. Education: Teach children and parents how to recognize early signs of asthma attacks.

Answer 145

Worsens asthma symptoms: Smoking irritates the airways, leading to more frequent and severe asthma attacks. Reduces the effectiveness of asthma medications. Increases the risk of developing chronic obstructive pulmonary disease (COPD).

Answer 146

Allergic Rhinitis, Gastroesophageal Reflux Disease (GERD), Obesity, Sinusitis, Sleep Apnea ## Footnote These comorbidities can exacerbate asthma symptoms and complicate management.

Answer 147

Biologic therapies target specific immune system pathways for severe asthma not controlled by standard treatments. Examples include: * Omalizumab (targets IgE) * Mepolizumab and Benralizumab (target IL-5) * Dupilumab (targets IL-4 and IL-13) ## Footnote These therapies are tailored for specific asthma phenotypes.

Answer 148

Medication Management, Patient Education, Monitoring, Adherence Support, Collaborative Care ## Footnote Pharmacists play a critical role in ensuring effective asthma management and medication adherence.

Answer 149

Environmental Factors, Respiratory Infections, Allergens, Exercise, Irritants ## Footnote Identifying and avoiding these triggers is essential for asthma control.

Answer 150

Types include: * Metered-Dose Inhalers (MDIs) * Dry Powder Inhalers (DPIs) * Nebulizers Technique varies by type, ensuring proper inhalation is crucial.

Answer 151

Maintaining Asthma Control, Medications, Monitoring ## Footnote Keeping asthma under control is vital to prevent risks to both mother and fetus.

Answer 152

Coexisting Conditions, Polypharmacy, Inhaler Technique, Medication Choice ## Footnote Special considerations are necessary due to the complexity of treatment in older adults.

Answer 153

Inhaled Corticosteroids (ICS): Category C, Albuterol (SABA): Category C, Montelukast: Category B, Oral Corticosteroids: Category C ## Footnote Category B drugs are generally considered safer during pregnancy.

Answer 154

Omega-3 Fatty Acids, Vitamin D, Antioxidants, Avoidance of Triggers ## Footnote Certain dietary components may help improve asthma control.

Answer 155

They are used for prophylaxis of asthma by blocking leukotrienes, reducing bronchoconstriction and mucus secretion. ## Footnote Examples include Montelukast and Zafirlukast.

Answer 156

Administered orally. Common side effects include GI disturbance, dry mouth, headache. ## Footnote Side effects may vary by individual.

Answer 157

They stabilize antigen-sensitized mast cells, reducing calcium influx and mediator release. ## Footnote Useful in young patients with allergic disease and moderate asthma.

Answer 158

They reduce inflammation by inhibiting cytokine release. Side effects include oral candidiasis, hoarse voice, dysphonia. ## Footnote Regular use is essential for effectiveness.

Answer 159

They bind to free IgE, preventing it from binding to mast cells. ## Footnote Used in severe asthma requiring continuous corticosteroid treatment.

Answer 160

They reduce the viscosity of sputum, aiding expectoration and reducing exacerbations. ## Footnote This can lead to improved symptoms and quality of life.

Answer 161

Antibiotics like amoxicillin, clarithromycin, doxycycline. ## Footnote Treatment varies based on the causative organism and patient factors.

Answer 162

Preferred method for drug delivery to the lungs. Types include nebulizers, metered-dose inhalers (MDIs), soft mist inhalers (SMIs), dry powder inhalers (DPIs). ## Footnote Effective delivery is crucial for managing respiratory conditions.

Answer 163

Nebulizers: higher doses, useful in hospitals, but expensive and need power. DPIs: portable, require technique, moisture-sensitive. ## Footnote Each type has its specific use cases and limitations.

Answer 164

They improve drug delivery by reducing oropharyngeal deposition and aiding patient coordination. ## Footnote Spacers can enhance the effectiveness of MDIs for many patients.

Answer 165

Ease of use, patient capability, drug availability, device portability, cost, side effects, patient preferences. ## Footnote Personalization is key in effective asthma management.

Answer 166

Pneumonia risk factors include: * Asthma * Cancer * Heart disease * Diabetes * Recovery from cold/flu ## Footnote Individuals in these groups may be offered a pneumococcal vaccine.

Answer 167

When treating COPD, evaluate: * Choice of treatment (e.g., mucolytics, bronchodilators) * Context of exacerbations * Chronic cough ## Footnote Careful evaluation is essential for effective management.

Answer 168

Consider the following factors for asthma patients: * Age * Ability to use inhalers correctly * Need for combination therapy (e.g., B2-agonists with corticosteroids) ## Footnote These factors influence treatment effectiveness.

Answer 169

Patient education on inhaler use is crucial: * Correct use of device (MDI, DPI, nebulizer) * Understanding proper technique * Adherence to treatment ## Footnote Effective inhaler use enhances drug delivery.

Answer 170

MART combines: * Long-acting beta-agonist (LABA) * Corticosteroid ## Footnote This combination is used for both maintenance and acute treatment.

Answer 171

A fast-acting LABA, such as formoterol, provides: * Immediate bronchodilation ## Footnote It is essential for MART to be effective as reliever therapy.

Answer 172

Salmeterol is unsuitable for MART because: * It is not fast-acting enough for effective reliever therapy ## Footnote Fast action is necessary for reliever medications.

Answer 173

Steroid dosage during MART therapy: * Increases as condition worsens and more reliever doses are used * Decreases back to maintenance level as condition improves ## Footnote This adjustment helps manage symptoms effectively.

Answer 174

High-flow O2 should be given unless: * Patient has COPD * Hypoxic drive is present ## Footnote In these cases, lower oxygen concentrations are recommended.

Answer 175

The ideal particle size for beta-2 agonists is: * 2-5 microns ## Footnote This size ensures effective deposition in the proximal-distal airways.

Answer 176

The optimal particle size for inhaled corticosteroids is: * 1-5 microns ## Footnote This size ensures deposition throughout the respiratory tract.

Answer 177

Factors affecting deposition include: * Inhaler device * Inhalation technique * Particle size of the aerosol ## Footnote These factors are critical for effective drug delivery.

Answer 178

An MDI requires: * Slow and deep inhalation * Coordination to ensure medication reaches the lungs ## Footnote Proper technique minimizes oral deposition.

Answer 179

Using a spacer improves delivery by: * Reducing oropharyngeal deposition * Enhancing lung deposition ## Footnote This is especially beneficial for patients with inhaler coordination issues.

Answer 180

DPIs require: * Rapid, forcible inhalation ## Footnote This generates turbulent energy to disaggregate the powder into smaller particles.

Answer 181

Shaking an MDI ensures: * Uniform drug dose in the aerosol ## Footnote This is crucial for consistent medication delivery.

Answer 182

Smoking leads to: * Respiratory diseases * Cardiovascular issues * Cancer * Lower blood oxygen levels * Paralysis of cilia * Lung damage ## Footnote These factors contribute to COPD and lung cancer.

Answer 183

Tobacco smoke contains: * Carcinogens (e.g., polycyclic aromatic hydrocarbons) * Ammonia * Arsenic * Benzene * Cadmium * Carbon monoxide ## Footnote These compounds pose significant health risks.

Answer 184

Smoking during pregnancy increases the risk of: * Reduced oxygen supply to the baby * Miscarriage * Low birth weight * Sudden infant death syndrome (SIDS) * Nicotine withdrawal after birth ## Footnote These effects can have lasting implications for infant health.

Answer 185

Withdrawal symptoms include: * Irritability * Anxiety * Insomnia * Lack of concentration * Low mood ## Footnote Symptoms typically last for about two weeks.

Answer 186

Benefits of smoking cessation include: * Reduced risk of respiratory diseases * Lower cancer risk * Decreased cardiovascular diseases * Improved overall health * Increased life expectancy ## Footnote Quitting smoking has profound health benefits.

Answer 187

Methods to support smoking cessation include: * Nicotine replacement therapy (NRT) * Behavioral counseling * Acupuncture * Hypnotherapy * Avoiding triggers (e.g., ashtrays, lighters) ## Footnote These approaches can help individuals quit successfully.

Answer 188

E-cigarettes do not contain: * Carcinogens * Tar ## Footnote However, they may cause skin irritation or nausea and should be used cautiously.

Answer 189

A pharmacist's role includes: * Identifying patients * Providing education * Selecting appropriate products * Offering support in the smoking cessation cycle ## Footnote Pharmacists play a vital role in promoting smoking cessation.

Answer 190

Nicotine stimulates nicotinic receptors in the brain, which triggers the release of dopamine, causing pleasurable effects and reinforcing the addiction to nicotine.

Answer 191

Barriers include: * weight gain * social pressures * withdrawal symptoms * previous failed attempts * high costs of cessation aids * enjoyment of smoking.

Answer 192

Nicotine causes an increase in heart rate, blood pressure, and vasoconstriction, contributing to cardiovascular disease, including heart attacks and strokes.

Answer 193

NRT provides a controlled dose of nicotine to ease withdrawal symptoms, helping individuals quit smoking gradually by reducing cravings and withdrawal effects.

Answer 194

Nicotine patches provide a steady release of nicotine over 16 to 24 hours, helping to reduce cravings and withdrawal symptoms throughout the day.

Answer 195

E-cigarettes are battery-powered devices that vaporize a nicotine solution, delivering nicotine through inhalation without the harmful tar and carcinogens found in traditional cigarettes.

Answer 196

Side effects may include: * skin irritation * coughing * dry mouth * nausea E-cigarettes may also lead to a sense of dependence or continued smoking behavior.

Answer 197

Spacers help reduce the likelihood of the medication depositing in the oropharynx and improve the amount of drug reaching the lungs by allowing more time for inhalation.

Answer 198

Common challenges include: * patients not generating enough inhalation flow, leading to ineffective dose delivery * difficulties in disaggregating the powder particles for lung deposition.

Answer 199

Breath-holding helps the medication settle in the lungs and increases its effectiveness. Inhaling too quickly can lead to deposition in the mouth and throat instead of the lungs.

unit 5 Flashcards

(237 cards)