JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY HYDERABAD Pharm. D III Year PHARMACOTHERAPEUTICS - II Previous Question Paper (April/May - 2019 - R08)

Clinical manifestations of leukemia result from bone marrow failure and infiltration of organs. Common symptoms include fatigue, pallor, and dyspnea due to anemia; fever and recurrent infections due to neutropenia; and petechiae, ecchymosis, or bleeding gums due to thrombocytopenia. Patients may also present with bone pain, lymphadenopathy, hepatosplenomegaly, and night sweats.

Treatment is primarily based on chemotherapy, often administered in phases: induction (to achieve remission), consolidation (to eliminate residual cells), and maintenance. Targeted therapies like tyrosine kinase inhibitors (e.g., imatinib) are used for specific genetic mutations (e.g., Philadelphia chromosome). Stem cell or bone marrow transplantation is a curative option for eligible patients, while supportive care includes blood transfusions, antibiotics for infections, and management of tumor lysis syndrome.

Osteoarthritis is characterized by joint pain that worsens with activity and improves with rest, morning stiffness lasting less than 30 minutes, crepitus, and limited range of motion. Physical examination may reveal bony enlargements such as Heberden's nodes (distal interphalangeal joints) and Bouchard's nodes (proximal interphalangeal joints).

Treatment focuses on pain management and functional improvement. Non-pharmacological interventions include physical therapy, weight loss, and assistive devices. Pharmacological management begins with acetaminophen or topical NSAIDs. Oral NSAIDs are used for moderate to severe pain, often with gastroprotection. Intra-articular injections of corticosteroids or hyaluronic acid may provide symptomatic relief. In advanced cases where conservative therapy fails, surgical options like joint arthroplasty are considered.