SPOTTERS

Chart 1
 Chart 1
What is this condition?
 phocomelia ( seal like limbs )
Which trimester exposure causes this deformity?
Why?
 1st trimester ,18 to 55 days when organogenesis
takes place.
What are the other uses of the above drug?
 erythema nodosum leprosum , multiple myeloma ,
melanoma , aids related cachexia ,GVHD , RA.
Name any 4 teratogenic drugs.
 androgens , progestogens, ACE inhibitors , lithium
,antithyroid drugs , indomethacin .
Which vitamin prevents neural tube defects?
 folic acid , 5mg starting from the periconceptional
period till delivery of the fetus.
 
Chart 2
Yellowish discoloration of teeth following antibiotic
therapy
Chart 2
Yellowish discoloration of teeth following antibiotic
therapy
 Name the drug causing this condition.
 Tetracyclines .

 2) How is it caused?
 Tetracyclines have chelating property .calcium- tetracycline chelate gets
deposited in developing teeth and bone .

 3) In which age group is the drug contraindicated

 the drug is contraindicated in children below 8 years of age

 4) What advice will you give to a patient taking this drug orally?
 milk ,iron preparation , antacids , sucralfate , calcium and other metals
reduce absorption of tetracyclines. When taking together.

 5) Which drug of this group is safe in renal failure?

 Doxycycline.
Chart 3
Chart 3
 What is this condition?
 Scurvy.

 2) Which vitamin deficiency causes this condition?

 Vitamin C.

 3) What is the daily requirement of this vitamin?

 60 mg/day.

 4) What are the other uses of this vitamin?

  Post operatively to enhance wound healing and scar strength
  To enhance iron absorption in anemia.
  To acidify urine in urinary tract infection.

 5) What are the other antioxidants?

 Vitamin E,Beta carotene,selenium,zinc
Chart 4
Chart

4
What is this condition?
Rickets.
2. What is it due to?
Vitamin D deficiency
3. What is this condition in adults known as?
Osteomalacia.
4. How will you treat?
Alfa calcidol 1-2 microgram/day.
5. What is the daily requirement of this vitamin?
10-30mg/day.
Chart 5
Chart 5
1) What is DMARD?
Disease Modifying Anti Rheumatic Drugs.
2) Name 4 DMARDS.
Etanrecept, Infliximab, Methotrexate, Cyclosporin, Auranofin, d-
Penicillamine, Sulfasalazine, Chloroquine.
3) Which anti-malarial is used in the management of this
disease?
Chloroquine.
4) Write the M.O.A of methotrexate.
Dihydrofolate reductase inhibitor - inhibits cytokine production,
chemotaxis and cell-mediated immune reaction.
5) Write 2 ocular side effects of steroids.
Glaucoma, posterior subcapsular cataract.
Chart 6
Chart 6
1) What is this condition
Gum hypertrophy
2) Which anti-epileptic drug causes this side effect?
Phenytoin
3) What is the reason for this side effect?
Phenytoin inhibits collagenase resulting in overdeposition
of gingival collagen fibres causing gum hypertrophy
4) Name two calcineurin inhibitors which cause this.
Cyclosporine, tacrolimus
5) Mention 2 uses of calcineurin inhibitors.
Auto immune disorders-RA, uveitis , after organ
transplantation to prevent graft rejection
CHART 7
CHART 7
1) Mention the hormones involved in positive calcium
balance
Parathormone, calcitriol, estrogen
2) Effect of parathormone in kidney.
Parathormone increases calcium and decreases phosphate
reabsorption from DCT in kidney
3) Name 2 SERMs used in the treatment of
osteoporosis.
Tamoxifen, Raloxifene
4) Role of bisphosphonates in osteoporosis.
Bisphosphonates decrease bone resorption by accelerating
apoptosis of osteoclasts , and causing disruption of
cytoskeleton and ruffled borderof osteoclasts
5) Write the dietary factors that inhibit calcium
absorption.
Phytates ,phosphates and oxalates in diet reduce calcium
absorption
CHART 8
CHART 8
1) What is this condition?
Hirsuitism

2) Name 2 immuno suppressants which cause this condition.

Cyclosporine, tacrolimus

3) Name 2 hormonal agents causing this condition.

Androgens, glucocorticoids

4) Which drug is used topically for male pattern baldness?

Minoxidil

5) Drugs used to treat this condition.

Anti androgen-flutamide, estrogen, gluco corticoid synthesis
inhibitors-aminoglutethimide,metyrapone
Chart 9
Chart 9
1) What is this condition?
Gouty arthritis

2) Name 2 ATT drugs causing hyperuricemia.

Pyrazinamide, ethambutol

3) Name 2 uricosuric drugs.

Probenacid, sulfinpyrazine

4) Name the synthesis inhibitors.

Allopurinol,oxpurinol,febuxostat

5) What are the NSAIDs to be avoided in this patient?

Aspirin-cannot be tolerated for long term use in chronic gout,
tolmetin
Chart 10
Chart 10
 1) What is this condition?
 Fixed Drug Eruption.

 2) How will you treat?

 avoid the drug causing this, topical steroid creams like betamethasone
cream can be applied ,in severe cases systemic steroids are given.

 3) Name the antibiotic which commonly causes this condition.

 Sulphonamides.

 4) What is Steven-johnson syndrome?

 Severe fatal exudative erythema multiforme affecting skin and mucous
membranes causing exfoliation of skin and mucous membrane

 5) Name 2 fluroquinolones causing photo toxicity.

 lomefloxacin , pefloxacin
Chart 11
Chart 11
1) Which groups of drugs commonly cause alopecia?
Anticancer drugs.

2) Drugs used in the treatment of alopecia.

Minoxidil, Finasteride.

3) Fungal infection causing alopecia and its treatment.

Tenia capitis. Terbinafine, Griseofulvin.

4) Name 4 topical anti-fungal agents.

Terbinafine, Clotrimazole , Ketoconazole, Miconazole.

5) Name the antifungal drug given systemically to treat

dermatophytoses.
Griseofulvin.
Chart 12
Chart 12
 1. What is the diagnosis?
 Cleft lip.

 2. Name the drugs causing this condition.

 Phenytoin.

 3. What peri-conceptional prophylaxis is given to prevent neural

tube defects?
 Folic acid.

 4. What is fetal hydantoin syndrome?

 When phenytoin used during pregnancy, can produce foetal Hydantoin
syndrome—hypoplastic phalanges, cleft palate , hare Lip, microcephaly.

 5. Write 4 features of fetal alcohol syndrome.

 Growth retardation, mental retardation, flattened face, Microcephaly.
Chart 13
Chart 13
1. What is this condition?
Oral candidiasis.

2. Name 2 immunosuppressants causing this condition?

Glucocorticoids, cyclosporine

3. Name 2 drugs used topically to treat this condition.

Nystatin, Amphotericin B.

4. How will you treat candidiasis in immunocompromised

patient?
Oral Flucanozole.

5. Write MOA of triazoles.

Inhibits ergosterol synthesis.
Chart 14
Chart
1.what is14
this condition?
Dwarfism.
2.what is it due to?
Growth hormone deficiency
3.How will you treat?
Recombinant human growth hormone-0.025 mg/Kg/day
daily or 1.5 mg/kg/month.
4.what are the other uses of this hormone?
Treat muscle wasting in AIDS patients,short bowel
syndrome and absorption syndrome to improve intestinal
growth and function anabolic effect to improve muscle
mass by athletes
5.what is peg-visomant?
Growth hormone antagonist.
used to treat GH adenomas ,acromegaly and gigantism.
Chart 15
Chart 15
1. What is this condition?
scabies
2. Topical agents used for this condition.
5% permethrin ointment and 10%GBHC (Gamma benzene
hexachloride) lotion.
3. Advice to be given to the patient.
 Should be applied all over the body below neck
 not to be applied over mucous membrane and eyes
 all family members should take treatment simultaneously
 To be repeated after 7 days.
4. Which anti helminthics can be used to treat this
condition?
Ivermectin
5. Which topical agent is more prone for systemic toxicity?
GBHC
Chart 16
Chart 16
 1. What is this condition?
 Crushing’s syndrome.

 2. Name the drug causing this condition.

 Chronic coricosteroid therapy.

 3. What is the effect of chronic treatment with the drug on bone?

 Osteoporosis, fractures ,avascular necrosis

 4. What are the metabolic derangements seen in this patient?

 Hyperkalemia, hypochloremic alkalosis, hypertension, hyperglycemia, fluid
retention and dilutional hyponatremia

 5. What are the drugs used to treat this condition?

 ACTH and prednisolone ????
 Both adrenals are removed, and replacement with hydrocortisone or
prednisolone
 Drugs that inhibit cortisol synthesis (e.g. ketoconazole, metyrapone)
Chart 17
Chart 17
1. Identify this condition.
Goitre

2. What micronutrient deficiency causes this condition?
iodine

3. What hormone disorder causes this condition?

Thyroxine

4. Name the thiomide derivative used in this condition.
Carbimazole, methimazole and propylthiouracil.

5. What is the role of beta blockers?
Reduce symptoms due to sympathetic overactivity
reduce HR, tremors , anxiety and hypertension.
Chart 18
Chart 18
1. What is this disease?
Hansen's disease.

2. Name the drugs used to treat the disease.

Rifampicin, dapsone, and clofazamine

3. Which drug used in the treatment of the above disease is

contraindicated in G6PD deficiency?
Dapsone.

4. What is the cutaneous side effect of clofazamine?

Brown to black discolouration of skin.

5. Drugs to treat Erythema nodosum leprosum?

Corticosteroids and thalidomide