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Channel Posts
| 2 | 5- human papillomavirus (HPV) --cervical cancers,
6- Epstein-Barr virus -- lymphomas
7- hepatitis B virus -- liver cancers
8- aniline -- bladder cancer
9- benzene -- leukemia
10- Anticancer agents such as the alkylating agents (eg, melphalan), anthracyclines (eg, doxorubicin), and epipodophyllotoxins (eg, etoposide) can cause secondary malignancies (eg, leukemias) years after therapy has been completed. | 1 297 |
| 3 | كيسات Depressive Disorders
1- SSRIs
🟡 firstline antidepressants because of their relative safety in overdose and improved tolerability compared with earlier agents
🟢 Any antidepressant that enhances serotonergic activity can be associated with serotonin syndrome
🔵 Citalopram and escitalopram may to an increase in QT interval at doses above 40 mg/day.
2- SNRI
🟡 Venlafaxine may have a slight efficacy advantage compared to other antidepressants
🟢 adverse effects hyperhidrosis.
3- Antidepressants with Mixed Serotonin Effects
a) Mirtazapine : option for patients experiencing sexual dysfunction with other antidepressants
b) Levomilnacipran : for fibromyalgia
c) Trazodone : causes Priapism
d) nefazodone : Do not give with liver disease or elevated serum transaminases.
e) Vilazodone : for depressed patients with anxiety
f) vortioxetine : for depressed patients with cognitive difficulties
4- Bupropion : contraindicated in patients with bulimia or anorexia nervosa, due to a higher risk for seizures. It causes less sexual dysfunction than SSRIs
5- Monoamine Oxidase Inhibitors
🟣 Isocarboxazide, phenelzine, and tranylcypromine nonselective inhibitors of MAOA and MAOB
🟡 Selegiline, available as a transdermal patch for treatment of major depression, inhibits brain MAOA and MAOB but has reduced effects on MAOA in the gut
6- Tricyclic Antidepressants
🔴 Desipramine carries an increased risk of death in patients with a family history of sudden cardiac death, cardiac dysrhythmias, or cardiac conduction disturbances
7- Ketamine
🟤 treatment resistant depression (TRD)
⚫ Intranasal esketamine is FDA approved and requires supervised, in-clinic self administration (1–3 sprays in each nostril per session) followed by 2 hours of in- clinic observation.
8- Brexanolone : FDA approved for postpartum depression
9- Fluoxetine and escitalopram are FDA approved for patients below 18 years of age
10- The SSRIs are often considered first choice antidepressants for older patients | 1 079 |
| 4 | كيسات ANXIETY DISORDERS
1- Paroxetine should be avoided in pregnancy (cardiovascular malformation risk)
2- SSIR and SNRIs and TCA
يسببون jitteriness syndrome
3- fluoxetine, sertraline, or citalopram for pregnant
4- Intermediateor short acting benzodiazepines are preferred for chronic use in older patients
5- Benzodiazepine teratogenic “floppy baby syndrome,” and neonatal withdrawal
6- Diazepam and clorazepate (high lipophilicity. They have rapid antianxiety effects, but a shorter duration of effect
7- Lorazepam and oxazepam ( are less lipophilic, have a slower onset, but a longer duration of action. They are not recommended for immediate relief of anxiety )
8- حتى نقطع Benzodiazepine نقلل 25% كل اسبوع لمدة اسبوعين يعني نقلل 50% (اول اسبوعين ) بعدها نقلل 1/8 كل 4-7 ايام
9- pregabalin use to reduce withdrawal symptoms during the benzodiazepine taper
10- Buspirone
is an option for patients who fail other anxiolytic therapies or patients with a history of unhealthy alcohol or substance use. It does not provide rapid or “as needed” antianxiety effects.
11- Benzodiazepines are more effective for somatic and autonomic symptoms of GAD
12- antidepressants are more effective for the psychic symptoms (eg, apprehension and worry | 636 |
| 5 | كيسات ANXIETY DISORDERS
1- Paroxetine should be avoided in pregnancy (cardiovascular malformation risk)
2- SSIR and SNRIs and TCA
يسببون jitteriness syndrome
3- fluoxetine, sertraline, or citalopram for pregnant
4- Intermediateor short acting benzodiazepines are preferred for chronic use in older patients
5- Benzodiazepine teratogenic “floppy baby syndrome,” and neonatal withdrawal
6- Lorazepam, Oxazepam (high lipophilicity. They have rapid antianxiety effects, but a shorter duration of effect
7- Lorazepam and oxazepam ( are less lipophilic, have a slower onset, but a longer duration of action. They are not recommended for immediate relief of anxiety )
8- حتى نقطع Benzodiazepine نقلل 25% كل اسبوع لمدة اسبوعين يعني نقلل 50% (اول اسبوعين ) بعدها نقلل 1/8 كل 4-7 ايام
9- pregabalin use to reduce withdrawal symptoms during the benzodiazepine taper
10- Buspirone
is an option for patients who fail other anxiolytic therapies or patients with a history of unhealthy alcohol or substance use. It does not provide rapid or “as needed” antianxiety effects.
11- Benzodiazepines are more effective for somatic and autonomic symptoms of GAD
12- antidepressants are more effective for the psychic symptoms (eg, apprehension and worry | 64 |
| 6 | كيسات ALZHEIMER DISEASE
1- Cholinesterase Inhibitors
a) Donepezil, rivastigmine, and galantamine for mild to moderate AD
b)donepezil for severe AD
2- N Methyl D Aspartate (NMDA) Receptor Antagonist
Memantine combination with a cholinesterase inhibitor and is indicated for moderate to severe AD
3- Anti amyloid Monoclonal Antibody
aducanumab, lecanemab, donanemab, and gantenerumab
aducanumab for cognitive impairment (MCI)
4- SSIR (sertraline and citalopram) for depression
5- carbamazepine, lamotrigine, pregabalin, and gabapentin, may be alternatives for agitation, | 618 |
| 7 | الادوية الي تسبب الادفرس افكت (كل سنة درجة لو درجتين حرامات يضيعن )
1- Nausea and vomiting
(Agents with a “high” emetic risk cause emesis in more than 90% of cases if not given any prophylaxis (such as cisplatin)
2- Mucositis
taxanes, anthracyclines, platinum analogues, methotrexate, and the fluoropyrimidines.
مرات يجيبون اسماء من عوائل الادوية ركزوا بيهم
3- Febrile neutropenia (FN)
common adverse effect after administration of cytotoxic chemotherapy
4- Hemorrhagic cystitis
Alkylating agents (cyclophosphamide and ifosfamide) | 604 |
| 8 | of the following are effective strategies to prevent hemorrhagic cystitis in patients receiving cyclophosphamide or ifosfamide, EXCEPT: | 649 |
| 9 | A 70-year-old man with refractory hemorrhagic cystitis reports severe pain unrelieved by NSAIDs. What is the next best step in pain management? | 699 |
| 10 | A patient with hemorrhagic cystitis complains of severe bladder spasms. Which of the following medications is most appropriate to relieve her symptoms | 578 |
| 11 | A patient with cyclophosphamide-induced cystitis continues to have hematuria despite local therapies. Which of the following systemic options is most appropriate? | 527 |
| 12 | كيسات بروستات مهمة
CRPC = castration resistant prostate cancer
1- patients with metastatic CRPC with symptomatic primary bone metastases
(Radium223)
2- metastatic CRPC with BRCA1 and BRCA2
(olaparib and rucaparib)
3- improves survival in CRPC
( Docetaxel, combined with prednisone )
4- improves progression free and overall survival in patients previously treated with docetaxel and prednisone
(Cabazitaxel with prednisone)
5- patients with metastatic castration naïve prostate cancer or metastatic CRPC
(Abiraterone)
6- non-metastatic CRPC.
(Darolutamide)
7- non-metastatic CRPC, as well as metastatic castration naïve and metastatic CRPC
(Enzalutamide) | 593 |
| 13 | What is the most appropriate next step in her adjuvant treatment? | 593 |
| 14 | case :
A 45-year-old woman with HER2-positive breast cancer receives neoadjuvant therapy with trastuzumab, pertuzumab, and chemotherapy. At the time of surgery, residual invasive disease is found in the breast tissue | 642 |
| 15 | A 52-year-old woman is diagnosed with invasive ductal carcinoma of the breast. Her tumor measures 2.3 cm . Which of the following drug combinations is most appropriate as part of her adjuvant chemotherapy regimen? | 642 |
| 16 | FCR | 552 |
| 17 | A 59-year-old man is newly diagnosed with (CLL). Genetic testing shows an IgVH-mutated CLL without TP53 mutation. He has excellent performance status and no significant comorbidities. What is the most appropriate first-line treatment? | 607 |
| 18 |  Outcome evaluation
اهم شغلة لازم نقيس BCR-ABL1
1- خلال 3 او 6 اشهر يكون 10% معناها نستمر بالعلاج وفعال
2- خلال 12 شهر تكون نسبة 0.1%
وكذلك نستمر على العلاج
اذا لا النسب مختلفة
1- Assess medication adherence
2- Evaluate drug interactions Consider mutational analysis
3- Consider changing to alternate TKI
Additional options:
Ponatinib if T315ł mutation, evaluate for allogeneic HSCT or clinical trial
هذا شرح التيبل بنهاية CML | 541 |
| 19 | A 60-year-old man with CP CML has failed therapy with multiple tyrosine kinase inhibitors (TKIs). He is now intolerant to further TKIs. Molecular analysis shows a T315I mutation. Which of the following treatment options is most appropriate at this stage? | 500 |
| 20 | TKI
1- ponatinib for T315I mutation
2- imatinib and dasatinib side effect of pleural effusions
3- nilotinib side effects QT prolongation
4- ponatinib side effects arterial thrombotic events | 477 |
