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56 Cards in this Set
- Front
- Back
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which deficiencies are common in the heroin dependent population?
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pyroxidine, folate and thiamine
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what is the general mechanism of intra-uterine death in heroin users?
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repeated hypoxic episodes secondary to maternal withdrawal and chorioamnionitis on a background of chronic nutritional inadequacy and cigarette smoking
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t/f... there are no specific congenital malformations attributable to opioids
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true
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when does foetal acquisition of maternal bacterial or viral infection occur?
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3rd trimester or during birth
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how is neonatal abstinence syndrome diagnosed?
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by exclusion of other causes of CNS irritability and with a background of recent opioid use
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what are some causes of CNS irritability in a newborn which may present in a similar way to neonatal abstinence syndrome?
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inability to feed, hypoglycaemia, intracerebral haemorrhage or infection
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which valve is commonly involved in acute staphylococcal bacterial endocarditis associated with the injection of bacterially contaminated drugs?
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tricuspid
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for which infection (in IVDUs) is PCR reliable enough to assess clearance of the infection?
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Hep C
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t/f... pupils will be dilated in opioid intoxication
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false, pin-point pupils are characteristic of opioid intoxication
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how is depressed breathing treated in opioid intoxication?
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naloxone (opioid antagonist)
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t/f... opioid withdrawal is life threatening
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false, this is rarely the case
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when will a heroin dependent user experience withdrawal symptoms?
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8-16 hours after the last dose
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what are the symptoms of heroin withdrawal?
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yawning, sweats, runny eyes and nose, hot and cold flushes, muscle and joint pain, restlessness, insomnia, nausea, vomiting and diarrhoea
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what is the half life of methadone?
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15-25 hours
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what is the difference between naltrexone and naloxone?
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both are opioid antagonists but naltrexone has a half life of over 12 hours compared with naloxone which has a half life of 20 minutes
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what percentage of women have experienced an episode of domestic violence whilst in a married or defacto relationship?
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23%
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are younger or older women more at risk of violence from their partner?
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younger women
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what percentage of reported cases of domestic violence involve men as the perpetrator and women as the victim?
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85-97%
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what percentage of Australian adults drink alcohol?
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82%
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what percentage of Australians smoke?
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20%
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1 in how many adults identify themselves as ex-smokers?
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1 in 4
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what is the most frequently used illicit drug in Australia?
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cannabis
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what is the mechanism of respiratory depression with opiates?
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decreased sensitivity to raised PCO2
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t/f... opiates are very effective for neuropathic pain
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false, they are effective for acute and chronic pain but not neuropathic
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what is the half life of morphine?
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2-3 hours
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what is the bioavailability of morphine?
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20-30%
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what conjugates morphine?
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glucuronic acid
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what is the oral bioavailability of codeine?
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50%
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which opioid receptor mediates dysphoria?
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kappa
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what is the incubation period of Hepatitis A?
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3-4 weeks
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what percentage of the world's population is infected with hepatitis C?
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1%
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what is the incubation period of hep C?
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5-8 weeks
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what are the principle mediators of innate response to viruses?
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type I interferons
NK cells cytokines (TNF, IFN-gamma, IL-1, IL-2) |
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how do thpe I IFNs inhibit viral replication?
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inducing an antiviral state
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what do NK cells recognise?
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cells that fail to express MHC CLass I molecules
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which cytokines activate NK cells?
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IL-12, IL-15
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when is antibody-dependent cell mediated cytotoxicity effective in virus infection?
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intracellular phase
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when are antibodies effective against viruses?
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extracellular phase
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what are the principle effector cells involved in clearing established viral infections?
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cytotoxic T lymphocytes
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how do CTLs eliminate intracellular viruses?
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lysis of infected cells
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when is T cell cytotoxicity at its peak after viral infection?
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7-8 days
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what are the most common blood borne viruses in Australia?
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hep B, hep C, HIV
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t/f... IgG to hep A remains positive for life
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true
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which serological marker indicates Hep B viraemia?
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HBsAg
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which serological marker indicates either past infection or vaccination against Hep B?
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HBsAb
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what does HBcAB indicate?
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past infection with Hep B
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what does Hep C antibody indicate?
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past or current infection
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what percentage of people infected with Hep C develop liver cancer?
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4%
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what percentage of people resolve Hep C infection?
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15%
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which genotype of hep C will have poorer treatment response, 1 or 3?
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1
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where is bilirubin conjugated?
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liver
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what is the percentage relapse after detoxification?
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>90%
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what might opioid antagonists induce?
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severe withdrawal symptoms
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what are the opioid antagonists?
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naloxone, naltrexone
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why is diazepam used to treat benzo withdrawal?
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long acting
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why is buprenorphine safer in overdose?
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partial agonist
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