Terms Used

Question 1

Diffuse idiopathic skeletal hyperostosis

Answer 1

-10% of men and 8% of women over the age of 65
- associated with obesity, hypertension and type 2 diabetes mellitus
- florid new bone formation along the anterolateral aspect of at least four contiguous vertebral bodies
- usually an asymptomatic radiographic finding
- can cause back pain or pain at peripheral sites, such as the heel, in association with calcaneal spur formation
Fig. 24.67 Diffuse idiopathic skeletal hyperostosis (DISH). Anteroposterior X-ray of the thoracic spine showing right-sided, flowing new bone joining more than four contiguous vertebrae. The disc spaces are preserved.

Question 2

Vitamin A

Answer 2

• vitamin A may improve the outcome in uncomplicated disease of measles
• Pre-formed retinol is found only in foods of animal origin
• Vitamin A can also be derived from carotenes, which are present in green and coloured vegetables and some fruits. - Carotenes provide most of the total vitamin A in the UK and constitute the only supply in vegans.
• Vitamin A can also be derived from carotenes, which are present in
• green and coloured vegetables and some fruits.

Question 3

Retinol- name two derivates and their function

Answer 3

• Retinol is converted to several other important molecules:
  • 11-cis-retinaldehyde is part of the photoreceptor complex in rods of the retina.
  • Retinoic acid induces differentiation of epithelial cells by binding to specific nuclear receptors, which induce responsive genes. In vitamin A deficiency, mucus-secreting cells are replaced by keratin-producing cells.
  • Retinoids are necessary for normal growth, fetal development, fertility, haematopoiesis and immune function.

Question 4

Vitamin A negative effects

Answer 4

• liver- Chronic overdose of vitamin A can damage the sinusoids and trigger local fibrosis that can result in portal hypertension.
• Repeated moderate or high doses of retinol can cause liver damage, hyperostosis and teratogenicity
• Women in countries where deficiency is not endemic are therefore advised not to take vitamin A supplements in pregnancy
• Liver is the richest source of folate but an alternative source (e.g. leafy vegetables) is advised in early pregnancy because of the high vitamin A content of liver (p. 712)
• ## idiopathic intracranial hypertension: A number of drugs may be associated, including tetracycline, vitamin A and retinoid derivatives.

Question 5

What causes cysticercosis?

Answer 5

Taenia solium

Question 6

Which infectious organisms are treated with albendazol?

Answer 6

Albendazole is used for 
- hookworm, 
ascariasis, 
threadworm, 
Strongyloides infection, 
trichinellosis, 
Taenia solium (cysticercosis) and 
hydatid disease

Question 7

Give two examples of benzimidazoles.

Answer 7

albendazole

mebendazole

Question 8

What can you treat with mebendazole?

Answer 8

Mebendazole is used for
 hookworm, 
ascariasis, 
threadworm and 
whipworm.

Question 9

Which drug is the drug of choice for schistomiasis?

Answer 9

Praziquantel
It is the drug of choice for schistosomiasis and is also used in
T. saginata,
T. solium (cysticercosis) and
fluke infections (Clonorchis, Paragonimus) and in
echinococcosis.

Question 10

How does praziquantel work?

Answer 10

It is administered orally and is well ababsorbed.

Praziquantel increases membrane permeability to Ca2+, causing violent contraction of worm muscle.

Question 11

What are adverse effects of praziquantel?

Answer 11

Adverse effects are usually mild and transient, and include nausea and abdominal pain.

Question 12

Which disease can you get with undercooked pork?

Answer 12

Under-cooked pork Taenia solium (cysticercosis)

Question 13

Which worm infections can cause myositis?

Answer 13

Myositis is a feature of trichinosis (trichinellosis) and cysticercosis, while periorbital oedema is found in trichinosis.