๐—”๐—ฅ๐—ข๐—ก ๐—ฆ๐—ง๐—จ๐——๐—ฌ
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ุจุณู… ุงู„ู„ู‡ ุงู„ุฑุญู…ู† ุงู„ุฑุญูŠู…

ุงู„ู„ู‡ู… ุตู„ ุนู„ู‰ ู…ุญู…ุฏ ูˆุขู„ ู…ุญู…ุฏ

ู…ุญุชูˆู‰ ุงู„ู‚ู†ุงุฉ:
ุดุฑูˆุญุงุช ุตูŠุฏู„ุฉ
ุนุถูˆูŠุฉ ู…ุฑุญู„ุฉ ุซุงู†ูŠุฉ ูƒูˆุฑุณ ุซุงู†ูŠ
ูุงุฑู…ุง ู…ุฑุญู„ุฉ ุซุงู„ุซุฉ ูƒูˆุฑุณ ุซุงู†ูŠ
ูุงุฑู…ุง ู…ุฑุญู„ุฉ ุฑุงุจุนุฉ ูƒูˆุฑุณ ุงูˆู„
ูุงุฑู…ุง ู…ุฑุญู„ุฉ ุฑุงุจุนุฉ ูƒูˆุฑุณ ุซุงู†ูŠ
ุนู„ุงุฌูŠุงุช ู…ุฑุญู„ุฉ ุฎุงู…ุณุฉ

ู„ู„ุชูˆุงุตู„:

@AronX2bot
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A 60-year-old patient with relapsed, refractory Hodgkin's Lymphoma has poor performance status and is not a candidate for high-dose chemotherapy and HSCT.

Which class of agents is explicitly mentioned as an approved option for such patients?
Anonymous Quiz
20%
a) Anti-CD20 monoclonal antibodies (e.g., rituximab)
8%
b) PI3K inhibitors (e.g., idelalisib)
15%
c) Radioimmunoconjugates (e.g., 90Y-ibritumomab tiuxetan)
53%
d) PD-1 pathway inhibitors (e.g., nivolumab)
4%
e) Oral alkylating agents (e.g., chlorambucil)
โค3
Which of the following unique toxicities are associated with the ABVD regimen?
Anonymous Quiz
51%
A. Pulmonary fibrosis
6%
B. Hemorrhagic cystitis
3%
C. Hepatic encephalopathy
3%
D. Osteopenia
37%
E. All of the above
๐Ÿ˜ข5โค4
โค6
A pathologist is differentiating between Hodgkin's Lymphoma (HL) and Non-Hodgkin's
Lymphoma (NHL).

Which of the following statements accurately reflects a key
pathological distinction?

a) HL is derived from a monoclonal proliferation of B or T lymphocytes, while NHL is characterized by the Reed-Sternberg cell.

b) Both HL and NHL are characterized by the presence of Reed-Sternberg cells.

c) NHL is a term covering all lymphoproliferative malignancies except HL, which is distinguished by the Reed-Sternberg cell.

d) HL is a B-cell malignancy, whereas NHL always involves T-cell proliferation.

e) The diagnosis of both HL and NHL relies on the presence of B-symptoms.
โค6๐Ÿ‘3
Staging of lymphoma

Stage I
ุงุฐุง ู…ุฌู…ูˆุนุฉ ูˆุงุญุฏุฉ ู…ู† ุงู„ุนู‚ุฏ ุงูˆ ุนู‚ุฏุฉ ูˆุงุญุฏุฉ
ุงูˆ ุนุถูˆ ู„ู…ูุงูˆูŠ ูˆุงุญุฏ ู…ุตุงุจ

Stage II

ุงุฐุง ุนู‚ุฏุชูŠู† ุงูˆ ุงูƒุซุฑ ุงูˆ ู…ุฌู…ูˆุนุชูŠู† ู…ู† ุงู„ุนู‚ุฏ ุจุณ ุจุดุฑุท ุงู†ู‡ ูƒู„ู‡ุง ุจู†ูุณ ุงู„ุฌู‡ุฉ ู‡ู…ูŠู†ู‡ ููˆู‚ ุงูˆ ุชุญุช ุงู„ุญุฌุงุจ ุงู„ุญุงุฌุฒ

ู…ุซู„ุง ุงู„ุนู‚ุฏ ุงู„ู…ุตุงุจุฉ ุจุงู„ุฑู‚ุจุฉ ูˆุชุญุช ุงู„ุงุจุท ู‡ู†ุง ู…ุฌู…ูˆุนุชูŠู† ูˆุงุซู†ูŠู†ู‡ู† ููˆู‚ ุงู„ุญุฌุงุจ ุงู„ุญุงุฌุฒ

Stage III
ู…ุฌู…ูˆุนุชูŠู† ุงูˆ ุงูƒุซุฑ ู…ู† ุงู„ุนู‚ุฏ ุงู„ู„ู…ูุงูˆูŠุฉ ู…ุตุงุจุฉ ู„ูƒู† ุจุดุฑุท ุงู†ู‡ ุชูƒูˆู† ููˆู‚ ูˆุชุญุช ุงู„ุญุฌุงุจ ุงู„ุญุงุฌุฒ
ุงูˆ
ู…ุฌู…ูˆุนุฉ ู…ู† ุงู„ุนู‚ุฏ ููˆู‚ ุงู„ุญุฌุงุจ ุงู„ุญุงุฌุฒ ูˆูˆูŠุงู‡ู† ุงู„ุทุญุงู„ ู…ุตุงุจ

ุทุจุนุง ู…ุตุงุฏุฑ ู‡ูˆุงูŠ ู…ุฎุชู„ูุฉ ุจู‡ุฐู‡ ุงู„ู…ุฑุญู„ุฉ ุจุณ ุงู„ุงุตุญ ุงู„ูŠ ูƒุชุจุชู‡ ูˆู‡ู…ูŠู†ู‡ ู†ูุณ ุงู„ู…ุตุฏุฑ


Stage IV
ุงู†ุชุดุงุฑ ุจุนูŠุฏ
ุชู†ุชู‚ู„ ู‡ุฐู‡ ุงู„ุฎู„ุงูŠุง ู…ู† ุงู„ุฏู… ุงู„ู‰ ุงุนุถุงุก ุฎุงุฑุฌ ุงู„ุฌู‡ุงุฒ ุงู„ู„ู…ูุงูˆูŠ
ู…ุซู„ุง ุจ ุงู„ bone marrow ุŒ lungุŒ liver

ุงุฐุง ู…ูˆุฌูˆุฏุฉ ุงู„ B symptoms ู†ุถูŠู ุงู„ุฑู…ุฒ B ู…ุน ุงุณู… ุงู„ู…ุฑุญู„ุฉ

ุงุฐุง ู…ุง ู…ูˆุฌูˆุฏุฉ ู†ุฎู„ูŠ A

ุงุฐุง ุงู„ุงุตุงุจุฉ ู…ู†ุชุดุฑุฉ ุฎุงุฑุฌ ุงู„ุนู‚ุฏ ุงู„ู„ู…ูุงูˆูŠุฉ local extension ูŠุนู†ูŠ ุงู…ุชุฏุช ู„ู„ุงู†ุณุฌุฉ ุงู„ู…ุฌุงูˆุฑุฉ ู…ุซู„ุง ู„ู„ุฌู„ุฏ ุงูˆ ุงู„ุนุถู„ุงุช ู†ุฎู„ูŠ ุงู„ุฑู…ุฒ E

ุงู…ุง ุงู„ุฑู…ุฒ X ูู…ุนู†ุงู‡ุง bulky
ุงุฐุง ุญุฌู… ุงู„ูˆุฑู… ุงูƒุจุฑ ู…ู† ุซู„ุซ ุนุฑุถ ุงู„ุตุฏุฑ ุงูˆ ุงุฐุง ุงุญุฏ ุงุจุนุงุฏ ุงู„ูˆุฑู… (ุทูˆู„ ุŒ ุนุฑุถ ุŒ ุงุฑุชูุงุน) ุฌุงู† ุงูƒุซุฑ ู…ู† 10cm ู†ุถูŠู ุงู„ุฑู…ุฒ X

#Lymphoma
โค15
The patient with 2 swollen lymph nodes on the above diaphragm side also has B-symptoms, with a lymph node diameter of 15 cm.

ุดู†ูˆ ุงู„ู…ุฑุญู„ุฉุŸ
โค8
The International Prognostic Factors Score (IPS) for advanced NHL lists seven adverse prognostic factors.

Which of the following correctly pairs a factor with its threshold value as listed in the text?
Anonymous Quiz
8%
a) Hemoglobin <12.0 g/dL
11%
b) Age โ‰ฅ60 years
61%
c) Serum albumin <4 g/dL
7%
d) Lymphocyte count > 600 cells/mmยณ
13%
e) Female gender
A patient with advanced, bulky Stage II follicular lymphoma is being evaluated.

The management of advanced indolent lymphoma is controversial because standard approaches are not curative What is the median time to relapse mentioned for these patients?
Anonymous Quiz
17%
a) 18-36 years
3%
b) 60-80 months
58%
c) 18-36 months
20%
d) 18-36 weeks
1%
e) 12-15 years
โค2
A 68-year-old patient is diagnosed with Stage I follicular lymphoma (an indolent NHL).

According to the treatment guidelines, what is the standard, potentially curative treatment option for this patient?
Anonymous Quiz
24%
a) Watchful waiting
7%
b) High-dose chemotherapy with autologous HSCT
54%
c) Loco-regional radiation therapy (RT)
10%
d) R-CHOP chemotherapy for 6 cycles
5%
e) Single-agent oral cyclophosphamide
A patient is about to receive their first dose of rituximab for follicular lymphoma.

Which of the following is the standard pretreatment regimen recommended 30 minutes before the infusion to mitigate common adverse effects?
Anonymous Quiz
3%
a) Intravenous diphenhydramine 50 mg and oral lorazepam 1 mg
86%
b) Oral acetaminophen 650 mg and oral diphenhydramine 50 mg
7%
c) Intravenous methylprednisolone 125 mg and oral ondansetron 8 mg
2%
d) Oral ibuprofen 400 mg and famotidine 20 mg
1%
e) Subcutaneous epinephrine 0.3 mg and albuterol nebulizer.
A 65-year-old patient is diagnosed with diffuse large B-cell lymphoma (DLBCL), stage I,
with no adverse risk factors. According to the treatment guidelines for localized aggressive
lymphoma, what is a standard treatment option for this patient?
Anonymous Quiz
12%
a) 6-8 cycles of R-CHOP with no RT.
13%
b) Loco-regional RT alone, followed by watchful waiting.
66%
c) 3 or 4 cycles of R-CHOP followed by loco-regional RT.
7%
d) High-dose chemotherapy with autologous HSCT.
2%
e) Single-agent rituximab maintenance for 2 years.
Which of the following is a chemotherapy regimen utilized in the treatment of
relapsed diffuse large B-cell lymphoma?
Anonymous Quiz
34%
A. rCHOP
9%
B. MOPP
14%
C. Stanford V
39%
D. ESHAP
5%
E. rCEOP
โค2๐Ÿ’ฏ1
Standard chemotherapy for front-line treatment for advanced (stage III/IV) diffuse large B-cell lymphoma is:
Anonymous Quiz
5%
A. m-BACOD
17%
B. Rituximab + bendamustine
5%
C. CHOP
73%
D. Rituximab + CHOP
MCQs Notat - Lymphoma.pdf
309.3 KB
โ€ข ุงุณุฆู„ุฉ MCQs ุชุฎุต ุฌุงุจุชุฑ Lymphoma [ุงุณุฆู„ุฉ ุงู„ู…ุตุฏุฑ ุงู„ู…ุนุชู…ุฏ + ุงุณุฆู„ุฉ ุงุถุงููŠุฉ ุจู†ู…ุท ุงู„ุงู…ุชุญุงู† ุงู„ุชู‚ูˆูŠู…ูŠ] ุงู„ุญู„ูˆู„ ุจู†ู‡ุงูŠุฉ ุงู„ู…ู„ู.

#ู…ู„ูุงุช_ู†ูˆุชุงุช_ุงู„ูˆุฒุงุฑูŠุฉ | ุนู„ุงุฌูŠุงุช .
ุนุฐุฑุงู‹ ุจุณ ู…ุง ู†ุญู„ู„ ู…ุดุงุฑูƒุฉ ุงู„ู…ู„ูุงุช ู…ุน ุงุฎูุงุก ุงุณู… ุงู„ู‚ู†ุงุฉ (@Notatbkop) ูˆุดูƒุฑุงู‹ .
โค14
Notat || ู†ูˆุชุงุช
MCQs Notat - Lymphoma.pdf
ูˆู‡ุฐุง ุงู„ู…ู„ู ูŠููŠุฏูƒู… ู‡ูˆุงูŠ ุจูŠู‡ ุงุณุฆู„ุฉ ู…ุฑุชุจุฉ ูˆุจู†ู…ุท ุงู„ูˆุฒุงุฑูŠ
โค13
Forwarded from Pharmacy Topics (Qabas Hashim)
images.pdf
1.1 MB
Quize MCQ 45 point
Lymphoma
Luekemia
โค13
Pharmacological Therapy of Insomnia

โญ• Anti Histamine

๐Ÿซ† Diphenhydramine, doxylamine and pyrilamine

ู‡ุงูŠ ุงู„ุงุฏูˆูŠุฉ ุชุณุจุจ ู…ุดุงูƒู„ ุฎุตูˆุตุง ููŠ ูƒุจุงุฑ ุงู„ุณู† ูˆุงู„ุณุจุจ ู‡ูˆ ุงู†ู‡ ุชู…ุชู„ูƒ anticholinergic effect

ู ุงู†ุชุจู‡ูˆุง ุงุฐุง ุงุฌุงูƒู… ูƒูŠุณ ู…ุฑูŠุถ ุนู†ุฏู‡
Arrhythmia, glaucoma, BPH



โญ• Anti Depressants

๐Ÿซ† Amitriptyline, Doxepin, nortriptyline

ู‡ุฐู†ูŠ ูŠุนุชุจุฑู† ุจุฏูŠู„ ู„ู„ BZD ุฎุตูˆุตุง ุงุฐุง ุงู„ู…ุฑูŠุถ ุนู†ุฏู‡ depressionุŒ pain, history of substance use disorder or unhealthy substance use

ูˆู‡ู…ูŠู†ู‡ ูƒู„ู‡ู… ุนุฏู‡ู… ู…ุดุงูƒู„ ู„ุงู† ุนุฏู‡ู… ู‡ุฐุง ุงู„ุชุฃุซูŠุฑ ุงู„ู€ anticholinergic effect ูู‡ู…ูŠู†ู‡ ู†ู†ุชุจู‡ ุจุงู„ูƒูŠุณุงุช ุฎุตูˆุตุง ุงู„ูŠ ุนุฏู‡ู… arrhythmia ู„ุงู† ูŠุฃุซุฑู† ุนู„ู‰ ุงู„ cardiac conduction

Low dose doxepin โž” sleep maintenance insomnia
ุงู„ุณุจุจ ู„ุงู† ูŠู…ุชู„ูƒ long half life


๐Ÿซ† Mirtazapine
ู‡ุฐุง ู‡ู…ูŠู†ู‡ ูŠู…ุชู„ูƒ long half life ู„ุฐู„ูƒ ุงุตู„ุง ูŠุณุจุจ ุชุฃุซูŠุฑ ุงุณู…ู‡ hangover effect ุชุฃุซูŠุฑู‡ ูŠุณุชู…ุฑ ุญุชู‰ ุงู„ู†ู‡ุงุฑ ูุญุชู‰ ุจุงู„ู†ู‡ุงุฑ ุงู„ู…ุฑูŠุถ ูŠูƒูˆู† ู…ู†ุนุณ
daytime sedation

ูŠุณุจุจ ุฒูŠุงุฏุฉ ุจุงู„ูˆุฒู† ุจุณุจุจ ุชุฃุซูŠุฑู‡ ุนู„ู‰ ุงู„ู‡ุณุชุงู…ูŠู†

๐Ÿซ† Trazodone
ุงูƒูˆ ูฃ ุญุงู„ุงุช ุงู†ุทูŠู‡ ุจูŠู‡ุง:
ุงู„ูŠ ุชุตูŠุฑ ุนุฏู‡ู… insomnia ุจุณุจุจ:
SSRI, Bupropion, unhealthy substance use

ุงู†ุชุจู‡ูˆุง ุงุฐุง ุงู„ู…ุฑูŠุถ ุฌุงูŠ ูŠุงุฎุฐ ุงุฏูˆูŠุฉ ุชุฃุซุฑ ุน ุงู„ุณูŠุฑูˆุชูˆู†ูŠู† ูˆุชุฒูŠุฏ ู…ุณุชูˆูŠุงุชู‡ ูู…ุง ุงุฎุชุงุฑู‡ ู„ุงู† ุฑุญ ูŠูƒูˆู† ุงูƒูˆ risk ู„ู„ serotonin syndrome

ุจุงู„ุฃุถุงูุฉ ุงู†ู‡ ูŠุณุจุจ priapism (painful erection)
๏ปฟ

โญ• DORA

๐Ÿซ† Suvorexant 10-20mg, Lemborexant 5-10mg

ู†ู†ุทูŠู‡ู… ู„ู„ู…ุฑูŠุถ ุงู„ูŠ ุนู†ุฏู‡ ุตุนูˆุจุฉ ููŠ ุจุฏุก ุงู„ู†ูˆู… difficulty initiating sleep ุงูˆ ู„ู„ุญูุงุธ ุนู„ู‰ ุงู„ู†ูˆู… maintaining sleep

ุชุณุชุฎุฏู… ุจุญุฐุฑ ู„ู„ู…ุฑูŠุถ ุงู„ูŠ ุนู†ุฏู‡ depression ู„ุงู† ุชุฒูŠุฏ ู…ู† ุงู„ุฃููƒุงุฑ ุงู„ุงู†ุชุญุงุฑูŠุฉ

ูŠุณุจุจู† narcolepsy ุงู„ู†ูˆู… ููŠ ูˆู‚ุช ุงูˆ ู…ูƒุงู† ุบูŠุฑ ู…ู†ุงุณุจ
๏ปฟ


โญ• Melatonin receptor agonist

๐Ÿซ† Ramelteon 8mg

ู…ู†ุงุณุจ ู„ู„ู…ุฑูŠุถ ุงู„ูŠ ุนู†ุฏู‡
COPD ุงูˆ Sleep apnea

Valerian: herbal product 300-600mg



๏ปฟโญ• Benzodiazepines

Estazolam, Flurazepam, Quazepam, Temazepam, Triazolam 'ETTFQุฅุชูู‚'

๐Ÿซ† Triazolam
Short duration of action
ูุนุงู„ูŠุชู‡ ู‚ุตูŠุฑุฉ ุฌุฏุง ู„ุงู† ุจุณุฑุนุฉ ูŠุฑูˆุญ ู„ู„ cns ูˆูŠู†ุทูŠ ุชุฃุซูŠุฑู‡ ูˆูŠุฎู„ุต ู…ูุนูˆู„ู‡ ุทุจุนุง ู‡ุฐุง ุจุณุจุจ ุงู„ lipophilicity ุงู„ุนุงู„ูŠุฉ

ูˆุงุฐุง ู‚ุตูŠุฑ ู…ุง ุฑุญ ูŠู†ุทูŠ ูุงุฆุฏุฉ ู„ู„ุญูุงุธ ุนู„ู‰ ุงู„ู†ูˆู… ุจุณ ู…ู…ูƒู† ู†ุณุชูุงุฏ ู…ู†ู‡ ุญุชู‰ ู†ุจุฏูŠ ุงู„ู†ูˆู… ู„ุงู† ุชุฃุซูŠุฑู‡ ุณุฑูŠุน

๐Ÿซ† Flurazepam, Quazepam
Long duration of action

ูˆู„ู‡ุฐุง ุงู„ุณุจุจ ู…ุง ู†ุณุชุฎุฏู…ู‡ู… ูƒุฎุท ุงูˆู„
ู„ุงู† ู…ุนู†ุงู‡ุง ุงู„ู…ุฑูŠุถ ุจุงู„ู†ู‡ุงุฑ ุฑุญ ูŠูƒูˆู† ู…ู†ุนุณ ูˆู…ุง ู…ุฑูƒุฒ hangover effect

ูู…ู…ูƒู† ุชุณุจุจ falls and hip fracture ุงู„ู…ุฑูŠุถ ูŠุทูŠุญ ูˆูŠุชูƒุณุฑ

ู ู†ุชุฌู†ุจู‡ู† ุจุงู„ู…ุฑุถู‰ ูƒุจุงุฑ ุงู„ุณู†

๐Ÿซ† Lorazepam, Oxazepam, Temazepam

ู‡ุฐู†ูŠ ู†ูƒุฏุฑ ู†ูƒูˆู„ ูุชุฑุฉ ุนู…ู„ู‡ู… ู…ุชูˆุณุทุฉ ู ู…ู†ุงุณุจุงุช ู„ูƒุจุงุฑ ุงู„ุณู†
๏ปฟ

โญ• Z drugs

Ezopiclone, Zolpidem, Zaleplon

ุนุฏู‡ู… ูู‚ุท Hypnotic effect ุŒ ุงู‚ู„ ุงุซุงุฑ ุฌุงู†ุจูŠุฉ ู…ู† ุงู„ benzodiazepines

๐Ÿซ† Zolpidem
ุจุฏุงูŠุฉ ุชุฃุซูŠุฑู‡ ุณุฑูŠุนุฉ ุฎู„ุงู„ 15 ุงู„ู‰ 30 ุฏู‚ูŠู‚ุฉ

ูุชุฑุฉ ุนู…ู„ู‡ 6 ุงู„ู‰ 8 ุณุงุนุงุช

ูŠููŠุฏ ู„ุจุฏุก ุงู„ู†ูˆู… ูˆู„ู„ุญูุงุธ ุนู„ู‰ ุงู„ู†ูˆู… ุจุณ ู…ูˆ ุงุญุณู† ู…ู† ุงู„ zaleplon ู„ุจุฏุก ุงู„ู†ูˆู…

5mg โž” female, older, pt with liver impairment
10mg โž” male

๐Ÿซ† Zaleplon
ู…ูุนูˆู„ู‡ ุณุฑูŠุน ุฌุฏุง ุงุณุฑุน ู…ู† ุงู„ zolpidem ูˆุงู„ Half life ู…ุงู„ุชู‡ ุชู‚ุฑูŠุจุง ุณุงุนุฉ

ู ู‡ุฐุง ูŠููŠุฏู†ู‡ ุญุชู‰ ู†ุจุฏูŠ ุงู„ู†ูˆู… ู…ุง ุฑุญ ูŠููŠุฏ ู„ู„ุญูุงุธ ุนู„ู‰ ุงู„ู†ูˆู… ู„ุงู†ู‡ ูุชุฑุฉ ุนู…ู„ู‡ ู‚ุตูŠุฑุฉ ุฌุฏุง.
Dose 10mg (5mg in older)


๐Ÿซ† Ezopiclone
ู‡ุฐุง ุชุฃุซูŠุฑู‡ ุณุฑูŠุน rapid onset ูˆูุชุฑุฉ ุนู…ู„ู‡ 6 ุณุงุนุงุช

ูŠููŠุฏ ู„ุจุฏุก ุงู„ู†ูˆู… ูˆู„ู„ุญูุงุธ ุนู„ู‰ ุงู„ู†ูˆู… ุจุณ ู…ูˆ ุงุญุณู† ู…ู† ุงู„ zaleplon ู„ุจุฏุก ุงู„ู†ูˆู…

ูˆู…ู…ูƒู† ุงู„ู…ุฑูŠุถ ูŠุณุชู…ุฑ ุนู„ูŠู‡ 6 ุงุดู‡ุฑ
๏ปฟ

#insomnia
โค25๐Ÿ‘2๐Ÿ’ฏ2
A 72-year-old man with a history of BPH presents with worsening urinary retention and difficulty initiating urination.

He is newly diagnosed with schizophrenia and requires antipsychotic treatment.

Which antipsychotic medication is contraindicated in this patient?


ู…ู‡ู…

ุงูƒูˆ ูƒู… ุนู„ุงุฌ ู…ู† ุงู„ antipsychotic ู…ู…ู†ูˆุนุฉ ู„ู…ุฑูŠุถ ุงู„ู€
Arrhythmia, BPH, and Glaucoma

ุดู†ูˆ ู‡ุงูŠ ุงู„ุงุฏูˆูŠุฉุŸ ูˆู„ูŠุด ู…ู…ู†ูˆุนุฉ

#schizophrenia
โค8๐Ÿ‘1