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Block 8
Azathioprine (Imuran)
Mechanism
Antimetabolite
Prodrug of 6-mercaptopurine (6-MP)
Inhibits Synthesis of Nucleic Acids
Indications
Autoimmune Disorders
Kidney Transplantation
Side Effects
Myelosuppression
Increased Toxicity with Allopurinol Use
Pancreatitis
Malignancy
3 mins
Chronic Lymphocytic Leukemia (CLL)
Signs and Symptoms
Age > 60 Years
B Cell Neoplasm
Smudge Cells
Often Asymptomatic
Cold IgM Autoimmune Hemolytic Anemia
Warm IgG Autoimmune Hemolytic Anemia
Richter's Transformation
3 mins
Cimetidine and Famotidine (H2 Receptor Blockers)
-tidine Suffix
Mechanism
H2 Receptor Blocker
Indications
Suppress Gastric Acid Secretion
Side Effects (All)
Pneumonia
Side Effects - Cimetidine
Anti-androgen Effects
CNS Changes
2 mins
Cromolyn (Mast Cell Stabilizers)
Mechanism
Mast Cell Stabilizer
Indications
Asthma Prophylaxis
Bronchial Inflammation
Allergic Rhinitis
Side Effects
Cough
Bronchospasm
Consideration
Fixed Schedule Administration
2 mins
Cytomegalovirus (CMV)
Characteristics
Enveloped
Double Stranded DNA
Herpesvirus 5
Diagnosis
Non Heterophile Antibodies
Owl's eye inclusions
Signs and Symptoms
Congenital TORCH infection
Mononucleosis
Pneumonia
AIDS retinitis and esophagitis
Infection in transplant recipients
2 mins
Epstein Barr Virus
Characteristics
Herpesvirus 4
Double Stranded DNA
Linear
Enveloped
Signs and Symptoms
Infectious Mononucleosis
Virus Attaches to CD21 in B Cells
Nasopharyngeal Carcinoma
Burkitt's Lymphoma
Hodgkin's Lymphoma
1 min
Epstein Barr Virus Mononucleosis
Mononucleosis
Fever
Hepatomegaly
Splenomegaly
Pharyngitis
Posterior Cervical Lymphadenopathy
Atypical Lymphocytes
Heterophile Antibodies
Rash Develops if treated with Ampicillin
Hodgkin's Lymphoma
2 mins
H2 Receptor Blocker
"-tidine" Suffix
Indications
Gastroesophageal Reflux Disease (GERD)
Peptic Ulcer
Mechanism
Block Histamine H2 Receptors
Parietal Cells
52 secs
H2 Receptor Blocker Side Effects
Side Effects
Decrease Creatinine Clearance
Cimetidine
Crosses Blood-Brain Barrier
Anti-Androgen
Inhibits Cytochrome P450
1 min
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
2 mins
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
4 mins
Hypersensitivity Type I
Previous Antigen Exposure
Immediate Reaction
IgE Cross-linking
Presensitized Mast Cells
Histamine Release
Vasodilation
Anaphylaxis
Allergies
Treatment
Epinephrine
1 min
Polyomavirus
Characteristics
Non-enveloped
Double-stranded DNA
Circular
Disease
BK Virus
Kidney Damage
JC Virus
Progressive Multifocal Leukoencephalopathy (PML)
HIV/AIDS
Oligodendrocyte
Demyelination of CNS
4 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
2 mins
Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
2 mins
Roseola
Exanthem
Herpesvirus 6
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
High Fevers Can Lead to Seizures
Diffuse Macular Rash After Fever
1 min
Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
2 mins
Steroid Hormones
Characteristics
Nuclear Membrane
Long-Lived and Slow-Acting
Cholesterol-Derived
Intracellular Receptors
DNA Transcription
Examples
Testosterone
Aldosterone
Estrogen
Cortisol
2 mins
Systemic Lupus Erythematosus (SLE) Mechanism, Treatment and Complications
Mechanism and Characteristics
Systemic Autoimmune Disease
9:1 female to male ratio
Treatment
Glucocorticoids
NSAIDS
Hydroxychloroquine
Cyclophosphamide
Complications
Lupus nephritis
Libman-Sacks Endocarditis
Secondary Antiphospholipid Antibody Syndrome
Other
Drug-induced lupus
2 mins
Varicella Zoster Virus (VZV)
Herpesvirus 3
Characteristics
Enveloped
Double Stranded DNA
Signs and Symptoms
Chickenpox
Pneumonia
Encephalitis
Trigeminal and Dorsal Root Ganglia
Shingles
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusion
Treatment
Acyclovir
2 mins
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