Modified-5-mid-exam-part (1).pdf. yggfd slapstick fit

Shoebox hjRegarding the superior orbital fissure, which is INCORRECT? a) its common tendinous ring binds the SOF content of nerves and muscles to the contents of the optic canal b) c) d) the origin of levator palpebrae superioris is its bony upper margin lacrimal, frontal and trochlear nerves pass through it the oculomotor, abducens and nasociliary nerves lie within the cone of the extraocular muscles 2) Regarding the extraocular muscles: a) b) c) d) they all arise from a common tendinous ring around the superior orbital fissure the rectus muscles all pass laterally to their point of insertion because of the angle of the orbital apex within the skull the superior oblique muscle passes through the trochlear, a fibrocartilage loop attached to the frontal bone lateral margin, just behind the orbital margin except for superior oblique, all nerve supply to muscles enter from their optic side 3) 4) With regards to eye movement, which is INCORRECT? a) the medial and lateral rectus evoke simple horizontal movement only b) the inferior oblique turns the eye down and out c) the superior rectus turns the eye up and in d) the inferior rectors and superior oblique together produce vertical down gaze Which is INCORRECT? a) b) c) d) in a 4th cranial nerve paralysis, the affected eye lies slightly inturned in a 6th cranial nerve palsy, the lateral rectus is affected in a 3rd nerve palsy, levator palpebrae is affected in an oculomotor nerve palsy the eye looks down and out 5) With regards to the retina, which is CORRECT? a) b) c) d) the retina covers the inner surface of the choroids and is light sensitive everywhere except at the corneal area the optic disc contains retina that is completely free of blood vessels and is yellowish in colour the optic disc and fovea are of similar size the fovea contains no blood vessels or cones, but a high concentration or rods 6) The nasal septum consists of: a) b) c) d) e) the maxilla the vomer and ethmoid bones the sphenoid and ethmoid bones the frontal, zygoma and maxilla the vomer and palatine bones 7) The ophthalmic artery: a) b) c) d) e) is a branch of the ECA enters through the superior orbital fissure does not penetrate the meninges of the optic nerve forms an anastomoses between ECA and ICA is an end artery 8) Regarding the carotid sheath: a) b) c) d) e) arisa cervicalis lies behind the IJV is free to move in the neck contains the vagus and phrenic ???? the sympathetic trunk lies outside the sheath the CCA lies lateral to the IJV 9) The contents of the jugular foramen include: a) b) c) d) e) superior petrosal sinus internal jugular vein vagus nerve hypoglossal nerve all of the above 10) The sensory innervation of the auricle of the ear includes:a) b) c) d) e) auricolotermporal nerve (V3) great auricular nerve (C2) facial nerve via tympanic plexus (VII) auricular branch of vagus (X) all of the above 11) Regarding the abducent nerve (CN V1): a) the nucleus lies in the medulla b) supplies superior oblique muscle c) d) e)

1. Alaakhader
AliaShatnawi
Saraomar
5

2. SkinPharmacology
Dr.AliaShatanawi

3. DrugsforPsoriasis
•BiologicAgents:
–Etanercept:
•DimericfusionproteinofTNFreceptorlinkedto
the FcportionofhumanIgG
.1
•approvedforthetreatmentofpsoriasis,psoriatic
arthritis andankylosingspondylitis (type of arthritis that
causes inflammation in the joints and ligaments of the spine.)in
adults
They are usually immunoglobulins

4. Anti-inflammatoryAgents
•TopicalCorticosteroids:
–Hydrocortisone.
–PrednisoloneandMethylprednisolone.
–DexamethasoneandBetamethasone.
–Triamcinolone. Can be given as intralesional
injection that can treat keloids scars
–Fluocinonide. Can be used as inhalers, causes anti-
inflammatory actions.
As we know it is the first
choice of treatment for the
mild psoriasis
Corticosteroids work on inhibit
phospholipase A2 which
prevents the arachidonic acid
formation which central
component of inflammatory
pathways.

5. Anti-inflammatoryAgents
•TopicalCorticosteroids:
–Absorption:
•%1ofhydrocortisoneappliedtotheventral
forearm.
•0.14timesofhydrocortisoneappliedtothe
plantarfoot.
•0.83timesofhydrocortisoneappliedtothe
palm.
•3.5timesofhydrocortisoneappliedtothescalp.
•6timesofhydrocortisoneappliedtothe
forehead.
•9timesofhydrocortisoneappliedtothevulvar
skin.
The doctor said to skip this
slide it basically emphasizes
the percentage of
absorption of
hydrocortisone applied to
different regions of the skin
of different thicknesses.

6. Anti-inflammatory Agents
•Topical Corticosteroids:
–Absorption:
•Absorption increased with inflammation.
Inflammation can induce changes in blood flow to the
affected area. During inflammation, blood vessels in the
region dilate, leading to increased blood flow to the site. This
increased blood flow can enhance drug absorption by
delivering a greater amount of the drug to the area, thereby
facilitating its uptake into the bloodstream
This causes a lot of systemic side effects in our body if it is
absorbed a lot.
•Increasing the concentration does not
proportionally increase the absorption.
Howeverthepenetrationincreases
•Can be given by intralesional injection.
intralesional injection

7. Anti-inflammatoryAgents
•TopicalCortcosteroids:
–Dermatologicdisordersveryresponsivetosteroids:
•Atopicdermatitis.
•Seborrheicdermatitis.
•Lichensimplexchronicus.
•Pruritusani.
•Allergiccontactdermatitis.! Corticosteroidswork by suppressing the immune system
and reducing inflammation in the affected skin.
•Eczematousdermatitis.
•Psoriasis

8. Anti-inflammatoryAgents
•TopicalCortcosteroids:
–AdverseEffects:
•Suppressionofpituitary-adrenalaxis.
•Systemiceffects.
•Skinatrophy.
•Erythema.
•Pustules.
•Acne.
•Infections.
•Hypopigmentation.
•Allergiccontactdermatitis. !
adrenocorticotropic hormone (ACTH),
which stimulates the adrenal glands to
produce cortisol. And it is regulated
through a negative feedback mechanism.
So, When cortisol levels in the body are
low, we release ACTH.
When we take cortisone externally,
itinterferes with this normal feedback
mechanism and causes suppression of
the normal functioning of the pituitary-
adrenal axis.
ةدايزلل هتحرش ةروتكدلا سب بولطم شم اذه
حر الله ءاش نا سبهذخونمادقل.
While steroids are commonly used to treat allergic
contact dermatitis, there is a risk of developing an
allergic reaction to the steroid itself.
Although it is topical administration, but it
can cause systemic side effects.
Focusontheside
effectswhichare
relatedtoskin
It Suppressesthe
immunitywich
increasesthe
infections.

9. AgentsaffectingPigmentation
•Hydroquinone.
•Monobenzone.
•Monobenzonemaybetoxicto
melanocytes resultingin
permanentdepigmentation.
•Mequinol
–Reducehyperpigmentationofskinby
inhibitingtheenzymetyrosinasewhich
willinterferewithbiosynthesisof
melanin. But it is reversible unlike Monobenzone.
.
Affect melanocytes
Increasing the excretion of melanin
from the melanocytes. It may also
cause destruction of melanocytes
and permanent depigmentation
-google

10. Agents affecting Pigmentation
•Trioxsalen.
•Methoxsalen.
–Are psoralens used for the repigmentation of
depigmented macules of vitiligo .
–Must be photoactivated by long-wave-length
ultraviolet light (320-400nm) to produce a beneficial
effect.
–They intercalate with DNA. Methoxsalen molecules insert
themselves in between the base pairs of the DNA double helix, this
may cause mutations in DNA that leads to cancer.
–Can cause cataract and skin cancer.
Increase pigmentation
Psoralens: drugs that
get activated when
exposed to ultraviolet
light.
Vitiligo: قاهب, condition
characterized by
depigmented macules
on the skin.

11. TrichogenicandAntitrichogenicAgents
1.Minoxidil(Rogaine:)
–Designedasanantihypertensiveagent.
–Effectiveinreversingtheprogressiveminiaturization
ofterminalscalphairsassociatedwithandrogenic
alopecia.
–Vertexbaldingismoreresponsivethanfrontalbalding.
Tip to memorize:
Min = men
= balding
رعشلا ةفاثك جلاعل ةيودأو علصلا جلاعل ةيودأ دئازلا
"Trichogenic" refers to hair growth. The term is derived from
the Greek word "trichos" = hair, and "genic” =generating.
Minoxidil is potassium ??????
+
channel opener. By opening the potassium ??????
+
channels in the blood
vessels, it may hyperpolarize the cell membranes and inhibit calcium channels. Which causes
relaxation and vasodilation of blood vessels and increase the blood flow to hair follicles.
Q: what is the suspected systemic side effect to minoxidil?
Ans: hypotension.

12. TrichogenicandAntitrichogenicAgents
1.Minoxidil.
2.Finasteride(Propecia:)
–5ά-reductaseinhibitorwhichblockstheconversionof
testosteronetodihydrotestosterne.
–Oraltablets. It causes systemic effects.
–Cancausedecreasedlibido,ejaculationdisorders,and
erectiledysfunctionrelatedtosexualfunction

13. TrichogenicandAntitrichogenicAgents
1.Minoxidil.
2.Finasteride.
3.Eflornithine:
–Isanirreversibleinhibitorofornithinedecarboxylase,
therefore,inhibitspolyaminesynthesis.Polyamines
areimportantincelldivisionandhairgrowth.
–Effectiveinreducingfacialhairgrowthin30%of
womenwhenusedfor6months.
Tip to memorize:
Eflornithine = ornithine
decarboxylase inhibitor

14. V1