Do not take this question paper out of the examinations room. Do not turn over until you are told to do so by the Invigilator.

Transcription

1 UNIVERSITY OF EAST ANGLIA School of Pharmacy Main Series UG Examination APPLIED IMMUNOLOGY AND INFECTIOUS DISEASES PHA-3EMY Time allowed: 2 hours Answer FOUR of the FIVE questions. Use a SEPARATE answer book for EACH question. Each question has the same value. The marks distribution is shown as a percentage for each section of the question. Answer all parts of each of the individual questions you select. This paper consists of 6 pages in total. Dictionaries are not permitted in this examination. Notes are not permitted in this examination. Do not take this question paper out of the examinations room. Do not turn over until you are told to do so by the Invigilator. (PHA-3EMY) Module contact: Dr Anja Mueller, PHA Copyright of the University of East Anglia Version 2

2 2 Answer FOUR of the FIVE questions. Use a SEPARATE answer book for EACH question. 1. Answer ALL parts to. With respect to rheumatoid arthritis: Describe the underlying inflammatory processes that are important in the development of rheumatoid arthritis. [30%] Mrs Sutherland is a regular patient in your pharmacy. She brings in a prescription from the GP for diclofenac 50 mg three times a day for her rheumatoid arthritis (RA). (b) Describe the mechanism of action of non-steroidal anti-inflammatory medicines such as diclofenac and discuss their role in the treatment of RA. [30%] Discuss the clinical issues associated with the use of this group of medicines. [20%] In the last decade, understanding of the biological molecules involved in these inflammatory chronic states has led to the development of novel therapeutic approaches. Describe the mode of action of TWO of these agents. [20%]

3 3 2. Answer ALL parts to. You are developing modern dressings and engineering products to replace traditional treatments for chronic and burn wounds. Describe the types of modern hydrocolloid, alginate, hydrogel and biological dressings. Include in your answer the materials from which they are produced, and where appropriate provide an example for each product. [50%] You are a pharmacist independent prescriber running a skin management clinic. Mrs Helen Stevenson is 56 years old and has recently been diagnosed with chronic plaque psoriasis. On examination you find that Helen s psoriasis is affecting her elbows and knees. You notice from Helen s records that the following prescription was generated by her GP 6 weeks ago: Clobetasol propionate 0.05% cream 100g use twice a day You can see that Helen s psoriasis remains uncontrolled as the area affected is increasing in size. (b) Describe the pathophysiology of psoriasis [10%] After discussion you establish that Helen has been using the clobetasol cream regularly as prescribed for the last 6 weeks. Describe the changes that should be made to the treatment of Helen s psoriasis [20%] Describe any investigations that should be carried out and additional information that should be captured from Helen to: identify any triggers/exacerbating factors of her psoriasis determine Helen s risk of further co-morbidities [20%] TURN OVER

4 4 3. Answer ALL parts to. Mr Patel is 24 years old and has been treated for asthma since childhood. His current medication is terbutaline 500 micrograms up to four times a day when required and budesonide 200 micrograms twice a day. His symptoms are usually well controlled but he is known to have exacerbations brought on when visiting his Mum by exposure to her cats hair. The complement activation is a major part of the innate immune system. Explain the different ways in which the complement system can be activated and discuss the possible outcomes of an activation. [40%] (b) Describe the rationale and method of action for Mr Patel s current asthma treatment. [20%] Mr Patel attends his routine asthma review. He is found to have worsened symptoms and is using his terbutaline inhaler multiple times a day. In relation to the BTS guidelines, recommend an appropriate course of action. [40%]

5 5 4. Answer ALL parts to. Discuss how the exposure to an allergen can lead to a type 1 hypersensitivity reaction. Use a diagram to illustrate your answer. [25%] (b) Discuss the main differences between type 1 and type 4 hypersensitivity reactions. Use a diagram to illustrate your answer. [15%] What are the pharmacological mode(s) of action of 1 st and 2 nd generation antiallergic drugs. Discuss benefits and shortcomings of each type of drug. [20%] Discuss the mechanism(s) of action of corticosteroids for the treatment of allergic rhinitis, outline when and how they should be used and give an overview of any side effects caused by them. [40%] TURN OVER

6 6 5. Answer ALL parts to (e). Cystic fibrosis (CF) is an autosomal recessive condition with an incidence of approximately 1 in 3500 births in Europe and North America. Describe in detail the structure and function of the functional cystic fibrosis transmembrane conductance regulator (CFTR) protein in epithelial cells. [20%] (b) Describe how the ΔF508 mutation in the CFTR gene causes CF. [15%] Briefly outline the mechanism of action of Pulmozyme and describe how the drug is administered to patients. [15%] Mrs Robinson is a 65 year old lady who has was admitted to hospital due to a chest infection. She is also diagnosed with COPD and started on a salbutamol inhaler and given oxygen and antibiotics until her infection has cleared. Describe how a patient is diagnosed with COPD. Consider both patient and spirometry characteristics which contribute to the diagnosis [20%] (e) Discuss the clinical features of the two main disease components which form part of COPD. [30%] END OF PAPER