A 51 years old male is on d4T + 3TC+NVP. He has been on this combination for six weeks. He reports some numbness in both feet for two weeks, he has no pain.
a) Which drug is responsible(1mark) ---------------------------------
b) would you change the drugs. If yes write the combination(2marks)
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c) what are the other side effects the patient may experience from the combination above(2marks)
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A 4 years old child commences alternate first line therapy with AZT+3TC+NVP. The Hb drops from a baseline of 9.0 to 5.1 after 4weeks.
a) which drug is most likely to be responsible(1mark) --------------------------------------
b) write the mechanism of action of that drug(2marks)
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c) what are the other side effects of that drug(2marks)
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Mention the mechanisms of resistance to antibiotics (5marks)
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Mention 4 classes of penicillin with one example from each class(5marks)
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Augmentin is a brand name of (amoxicillin +Clavulanic acid) used in the treatment of UTI. Explain why amoxicillin +Clavulanic acid are combined(5marks)
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Give reasons why tetracycline is contraindicated in pregnancy(5marks)
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Mention drug of choice for treatment of un complicated malaria according to the current treatment guideline of Tanzania (include dose and administration schedule) (5marks)
14.a) Explain the meaning of Disulfiram- like effect(3marks)
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b) Mention drugs which cause Disulfiram like effect (at least 2drugs) (2marks)
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SECTION E: GUIDED ESSAY QUESTIONS (30 MARKS)
Instructions:
This section consists of Two (2) questions which are supposed to be answered in a narrative way.
Bulleting and numbering is NOT ALLOWED
Write your answers in the blank pages of this question paper.
Each question should start on a new page
Tuberculosis is a chronic airborne infection caused by mycobacterium tuberculosis also known acid fast baccili, less frequent it can be caused by mycobacterium avium and mycobacterium africanus. Briefly explain TB treatment in Tanzania (intensive and continuous phase).
A 21 years old female is presented on your clinic with fever, headache and convulsion .on examination she was semi conscious, pale, jaundice, and febrile(39), after emergency investigation RBG=2.5mmol/l and MRDT positive
What is the most likely diagnosis?
Briefly explain the management to the patient
From your knowledge of Anti-protozoans (1 mark each)
What is the mechanism of action of piperazine? ………………………………………………………………………………………………………………………………………………………………………………………………………………
Explain the mechanism of action of disulfiram like effect associated with taking metronidazole and alcohol. ………………………………………………………………………………………………...……………………………………………………………………………………………………
Mention the objectives of antimalarial drugs. ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
What is the mechanism of action of levamisole? …………………………………………………………………………………………….
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Mechanism of resistance of benzimidazole. …………………………………………………………………………………………………………………………………………………………………………………………
From your knowledge of Anti-retrovirals.
What is the advantage of using DTG over EFV? ( 2.5marks)
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Mention two Intragrase Inhibitors. ………………………………………………………………………………………………………………………………………………………………………………
Augmentin is a brand name of Amoxicillin + Clavulanic acid used in the treatment of Urinary Tract Infection. State why amoxicillin and Clavulanic acid are combined (5 marks)
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With one example in each, list four classes of antimicrobial agents affecting bacterial protein synthesis (protein synthesis inhibitors antibiotics) (5 marks)
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12. Write the dose of Artemether Lumefantrine based on body weight. (5 marks)
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Why the half life of Atazanavir is almost doubled when co-administered with ritonavir? (5 marks)
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List three mechanisms by which bacteria may display antibiotic resistance. (5 marks)
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Explain why the dose of parenteral Artesunate is higher in children (3mg/kg) compared to that administered in adult (2.4mg/kg) in treatment of complicated malaria. (5 marks)
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SECTION E: GUIDED ESSAY QUESTIONS 30 MARKS
Instructions:
This section consists of Two (2) questions which are supposed to be answered in a narrative way
Bulleting and numbering is NOT ALLOWED
Write your answers on the blank pages of this question paper.
Each question should start on a new page.
16. Briefly explain the four pharmacokinetic parameters.
17. Discuss the MOA, PK properties, therapeutic indications, and adverse effects of the following major drugs used for fungal infections:
Griseofluvin
Nystatin
Fluconazole.
