Pharmacology Quiz: Antifungals and Diphtheria

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Questions and Answers

What is the characteristic blood picture of Agranulocytosis?

Thrombocytosis with eosinophilia

Anemia with thrombocytopenia

Leukocytosis with increased blast cells

Leucopenia with relative lymphocytosis (correct)

Which of the following is NOT a symptom of Acute Leukaemia?

Reduced appetite and weight loss (correct)

Necrotic ulcers and membrane on bleeding swollen gums

Enlarged liver

Fever and sore throat

What is the primary treatment for severe fungal infections?

Antitoxin and systemic penicillin

Antibiotics and erythromycin

Topical nystatin suspension

Systemic antifungal agent (correct)

What is the primary mode of transmission of HIV?

Sexual contact and blood transfusion Signup and view all the answers

What is the causative agent of diphtheria?

Corynebacterium diphtheriae Signup and view all the answers

What is the primary goal of treatment in Agranulocytosis?

To eliminate the causative factor Signup and view all the answers

What is a complication of severe diphtheria?

Myocarditis and neuritis Signup and view all the answers

What is a type of systemic antifungal agent?

Polyene macrolides Signup and view all the answers

What is the significance of bone marrow aspiration in the diagnosis of Acute Leukaemia?

It is diagnostic of the condition Signup and view all the answers

What is the term for a marked reduction of neutrophils in the blood?

Agranulocytosis Signup and view all the answers

What is the oropharyngeal manifestation of AIDS?

All of the above Signup and view all the answers

What is the primary treatment for diphtheria?

Antitoxin and systemic penicillin Signup and view all the answers

What is the primary cause of infectious mononucleosis?

Viral transmission through Epstein-Barr virus Signup and view all the answers

What is a common complication of infectious mononucleosis in seriously ill patients?

Fungal infection of the oral cavity Signup and view all the answers

What is the characteristic finding on examination of the tonsils in patients with infectious mononucleosis?

A characteristic plaque Signup and view all the answers

What is the purpose of the rapid latex haemagglutination (monospot) test in patients with infectious mononucleosis?

To detect the presence of heterophil antibodies Signup and view all the answers

What is the treatment of choice for patients with infectious mononucleosis who develop secondary bacterial infection?

Antibiotics (excluding amoxicillin) Signup and view all the answers

What is the primary goal of treatment in patients with fungal infections of the oral cavity and pharynx?

To treat the underlying disease or cause Signup and view all the answers

Study Notes

Fungal Infections

Antibiotics should be stopped and topical nystatin suspension prescribed for fungal infections.
Systemic antifungal agents include Polyene macrolides (e.g. amphotericin B), Azoles (e.g. ketoconazole, miconazole, itraconazole, and fluconazole), and Allylamines (e.g. terbinafine).

Diphtheria

Diphtheria is caused by Corynebacterium diphtherae and disseminated by droplet transmission.
Incubation period is up to 4 days, and the disease mostly affects the fauces.
In moderate to severe cases, a grayish membrane appears on the tonsils and pharyngeal wall, leading to gross oedema of the pharynx and stertorous breathing.
Treatment includes antitoxin and systemic penicillin or erythromycin.

Pharyngitis associated with Blood Diseases

Agranulocytosis

Agranulocytosis is a marked reduction of neutrophils in the blood due to depression of the bone marrow by cytotoxic drugs, chloramphenicol, or irradiation.
Clinical picture includes extensive ulcerations and false membrane formation on the tonsils, pharyngeal, and buccal mucosa.
Investigations include blood picture showing Leucopenia and bone marrow aspiration.
Treatment involves stopping the causative drug, isolation to avoid infection, antibiotics, and fresh blood transfusion.

Acute Leukaemia

Acute Leukaemia is characterized by an increase in the number of white cells with the appearance of immature cells in the peripheral blood.
Clinical picture includes intercurrent infection, fever, sore throat, necrotic ulcers, membrane on bleeding swollen gums and enlarged tonsils, anaemia, and generalized lymphadenopathy.
Investigations include blood picture showing marked leukocytosis with increased blast cells, anaemia, and thrombocytopenia, and bone marrow aspiration.
Treatment involves isolation of the patient, fresh blood transfusion, antibiotics, and cytotoxic drugs, and bone marrow transplantation.

Acquired Immuno-Deficiency Syndrome (AIDS)

AIDS is caused by Human Immuno-Deficiency Virus (HIV) that invades T lymphocytes causing impaired immunity.
Mode of transmission includes sexual contact and blood transfusion.
Otolaryngological manifestations include oral candidiasis, herpetic ulcers, and oropharyngeal ulcers.
Diagnosis is based on the presence of atypical T lymphocytes in the blood, and heterophil antibodies are detected by the rapid latex haemagglutination (monospot) test.
Treatment is supportive, and antibiotics are indicated if secondary bacterial infection supervenes.

Fungal Infections in Immunocompromised Patients

Fungal infections are common in immunocompromised patients, especially those with cancer, asthma, or taking steroid inhalers.
Candidal infection of the oral cavity and pharynx is not uncommon, especially in seriously ill and debilitated patients.
Fungal infection is the most common cause of failure with tracheo-oesophageal voice prostheses.
Infection of the oesophagus with candida may cause marked odynophagia.
Treatment involves treating the underlying disease or cause of the infection.

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Description

This quiz covers the treatment of fungal infections with antifungal agents, including polyene macrolides, azoles, and allylamines, as well as the causes and management of diphtheria.