Untitled Quiz

Module No. 8: Management of Infectious Diseases

• Influenza is a contagious viral infection, causing mild to severe symptoms and potential life-threatening complications, even in healthy children and adults.
• Transmission occurs via inhalation of respiratory droplets when an infected person coughs or sneezes.
• Clinical signs and symptoms of influenza include rapid fever onset, myalgia, headache, malaise, nonproductive cough, sore throat, and rhinitis. Nausea, vomiting, and otitis media are also common in children.
• The gold standard for diagnosis is RT-PCR or viral culture. Rapid influenza diagnostic tests (RIDTs), direct (DFA), or indirect (IFA) fluorescence antibody tests, and RT-PCR assay can also be used.
• Appropriate infection control measures (hand hygiene, respiratory etiquette, contact avoidance) are critical in preventing influenza spread.
• Annual vaccination is recommended for persons aged six months or older, and caregivers of children under six months.
• Neuraminidase inhibitors (oseltamivir and zanamivir) are the only antiviral drugs available for treatment and prophylaxis of influenza.

Pneumonia

• Pneumonia is an infection inflaming air sacs in one or both lungs, filling with fluid/pus.
• Symptoms include cough with phlegm or pus, fever, chills, and difficulty breathing.
• A variety of organisms (bacteria, viruses, and fungi) can cause pneumonia.
• Clinical presentation includes high fever, chills, clamminess, blueness, cough, sputum or phlegm, shortness of breath, pleuritic chest pain, hemoptysis, fatigue, and aches.
• Diagnosis involves sputum tests, blood tests, and chest X-ray/CT scan.
• Pneumonia classifications and risk factors include community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). Another type is ventilator-associated pneumonia (VAP). Risk factors include age, chronic diseases, smoking, and alcohol abuse.

Module No. 9: Management of Oncologic Disorders

• Cancer is caused by genetic changes in genes controlling cell function (growth and division). These changes can result from errors in cell division, environmental factors (e.g., chemicals in tobacco), or inherited factors.
• Cancer's development involves proto-oncogenes (genes that stimulate cell growth and division), tumor-suppressor genes (that slow cell growth and division), and DNA repair genes (that repair damaged DNA).
• Cancer types include breast cancer, colorectal cancer, lung cancer, lymphomas, and prostate cancer.
• Clinical presentations of cancer include lumps/swelling, unusual bleeding, weight loss, sores that don't heal, mouth/tongue ulcers, changes in toilet habits, bloating, trouble swallowing, indigestion, heartburn, and changes in the breast.
• Cancer diagnosis methods include PET scans, ultrasounds, X-rays, biopsies, lab tests, MRIs, and CT scans.
• Tumor markers are substances used in cancer detection, diagnosis, and monitoring. Examples include CA125 (ovarian cancer), α-fetoprotein (AFP), and prostate-specific antigen (PSA).
• TNM staging system is used for evaluating tumor, node, and metastasis involvement.
• Cure, prolonging survival, and providing palliative care/pain relief are treatment goals in cancer patients.
• Common treatment forms include surgery, radiation therapy, chemotherapy, bone marrow transplant, immunotherapy, hormone therapy, targeted drug therapy, cryoablation, and radiofrequency ablation. Combining therapies is a common approach, including primary, adjuvant, neoadjuvant, and palliative care.
• Survival depends on tumor type, disease extent, and therapy received. The terms "complete response" and "remission" indicate the absence of disease after treatment, not necessarily a cure.
• The cell cycle, including G0, G1, S, G2, and M phases, is relevant to cancer treatment.
• Cell growth kinetics, such as growth fraction, cell cycle time, and tumor doubling time, affect treatment effectiveness.
• Tumor cell burden is the total number of tumor cells in the body, impacting clinical detection. Chemotherapy impacts this burden.
• Chemotherapy agents can be categorized based on their action in the cell cycle (phase-specific vs. phase-nonspecific).
• Objectives of chemotherapy vary, including remission induction, consolidation/intensification, maintenance, adjuvant chemotherapy, neoadjuvant chemotherapy, and palliative therapy for solid tumors or salvage therapy after treatment failure.
• Chemotherapy dosing and administration strategies. Dosage can be weight, body surface area (BSA), or area under the concentration versus time curve (AUC). Adjustments for kidney or liver dysfunction may be necessary to prevent toxicity. Combination chemotherapy is generally more effective than single agent therapy.
• Various miscellaneous agents in cancer treatment can include retinoic acid derivatives, arsenic trioxide, bortezomib, thalidomide and lenalidomide, and biological response modifiers.
• Additional treatment modalities include surgery (diagnostic/therapeutic), radiation therapy, autologous and allogeneic hematopoietic stem cell transplantation. Syngeneic transplants occur between identical twins.
• Examples of drugs acting in different ways include alkylating agents (cyclophosphamide, cisplatin), antimetabolites (methotrexate, 5-Fluorouracil, 6-Mercaptopurine), vinca alkaloids (vincristine, vinblastine), podophyllotoxins (etoposide), camptothecins (irinotecan), taxanes (paclitaxel, docetaxel), anthracyclines (doxorubicin, daunorubicin), tyrosine kinase inhibitors (Imatinib), growth factor receptor inhibitors (trastuzumab), vascular endothelial growth factor (VEGF) inhibitors (bevacizumab), and proteasome inhibitors (bortezomib).
• Hormone agonists and antagonists (e.g., prednisone, tamoxifen) are used in endocrine therapies for certain cancers.

Breast Cancer

• Breast cancer originates from breast tissue. Primary/localized breast cancers are confined to a localized lesion, whereas advanced/metastatic breast cancers (MBC) are those detected in distant sites.
• Symptoms of breast cancer can include nipple discharge, lumping or thickening, visible lumps, dimpling, pulled-in nipple, skin texture changes/arm pit pain, and skin irritation.
• Diagnosis methods include manual examination, ultrasonography, mammography, and biopsies.
• Prognostic factors include age at diagnosis, ethnicity, tumor size, presence/number of axillary lymph nodes, and hormone receptors (ER, PR), and HER2/neu overexpression.
• Treatment goals for early/locally advanced disease are curative (adjuvant therapy). Neoadjuvant therapy is given to eradicate micrometastatic disease, determine prognosis, and possibly preserve breast tissue. Palliation is the treatment goal for metastatic breast cancer.
• Treatment approaches for early breast cancer include breast-conserving therapy (BCT) and simple or total mastectomy. Systemic adjuvant therapy, utilizing chemotherapy regimens (e.g., AC, TC, FAC, TAC), follows definitive local treatment (surgery, radiation), and is intended to cure.
• Adjuvant biologic therapy (e.g., trastuzumab) is given to reduce recurrence risk for HER2-positive early-stage breast cancers, alongside endocrine therapy utilizing hormone-blocking agents.
• Treatment for locally advanced breast cancer often involves neoadjuvant and primary chemotherapy regimens, followed by surgery and adjuvant radiation therapy. If HER2-positive, trastuzumab and pertuzumab are often included.
• Treatment for metastatic breast cancer (MBC) focuses on palliation, aiming to control the disease and its symptoms without a cure. Bone-modifying agents (e.g., bisphosphonates, denosumab) may be added to decrease skeletal-related events. There are multiple treatment regimens; some include combination therapies with different agents.