AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
I have this question in the exam but they ask a "negative question"?
Is HLA a screening test for this disease?
What is the name of this disease ?
Attached Files:
back_about.jpg (7 KB, 20 downloads)
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Remember they seldom want you to do any genetic disease testings i.e. HLA testings except breast cancer in exam. because it is very expensive and you don't know what to do with it and Hunington's disease do have a genetic test but you are opening a situation of Pandora Box !!!!!!
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Even HHC, the most common genetic disease, the screening test is iron binding saturation and ferritin test !!!!
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
More X-ray
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
X-ray
Attached Files:
E$$00012.jpg (11 KB, 11 downloads)
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Late complications ???
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
What are the systemic complications of this disease??
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| docofthebigapple
Forum Senior
Topics: 25
Posts: 185
|
spondilitis spine.
Usually men in 30s 40s.
Hla b27 positive.
Complications are fractures spine on trivial efforts or trauma.
I don't know if it is recommended for screening.
Edited by docofthebigapple on 06/01/06 - 04:58 PM
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
How Common is ankylosing spondylitis?
It affects between 150,000 and 300,000 Canadians (as many as 1 in 100)
Men develop AS three times more often than women, but women have a longer delay in diagnosis.
People of any age can develop AS, but it usually appears between the ages of 15 and 40.
It affects men three times more than women !!!
It occurs in young adult men in mid to late 20's to mid 30's
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
It can occur in teen but most young adult men come to the office c/o of lower back pain
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Ankylosing Spondylitis
Medications
Biologic agents: Such as Infliximab or Etanercept (Remicade or Enbrel)
Methotrexate(Rheumatrex)
Sulfasalazine
Infliximab (remicade) and Enbrel cost $15,000-$20,000 a year $$$$$$$$$$
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Try less expensive drugs first before you start pt on Remicade or Embrel (over $15,000/yr)
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| Alina T
Forum Elite
Topics: 17
Posts: 388
|
This reminds me of another q of yours, in which you gave TNF modifiers to a patient with RA just because her friend was doing good on them (before trying any other less expensive DMARDS).....Sorry, no ofense, it just popped in my head....
___________________
There are 3 types of people: those who make things happen, those who watch things happen, and those who wonder what happened.
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
RA is a much debilitating disease and is a chronic disease and much more serious than AK.
There is a major difference in management clinically with RA and AS.
I would recommend Remicade and Embrel for RA if the pt progressively getting worse but not in the case of AS.
AS affects men men in their 20s. So I would NEVER start any TNF modifers on AS !
(There is a major difference between AS and RA in term of management using the newest agents and tehre are many new TNF modifers coming down and they are very expensive. )
Thank you for asking and I am no ANGEL !!
But I would not start any AS patients on Remicaid or Embrel but RA is a totally different clinical disease process.
Any question is welcome and I am NOT perfect !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Despite the website of remicade recommend AS, I have not seen many young men in their 20 with AS on Remicade !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
There is a question in the Board exam asking which medication is most expensive (not about TNF modifers) but about Plavix for a month (30 days)
Plavix is a much common drug and widely used than TNF modifers such as Remicade or Embrel and is also very expensive,
(I am very surprised people read my posts and remembered what I said in RA and AS)
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
RA affects more women than men and the pharmaceutical companies target female patients directly on women's journals (in supermarkets aisles) and encourage them to ask the doctors about Remicade !!
But the pharmaceutical companies did not target young men in Men's magazines about Remicade and tell men to come to the office to ask for Remicade !!!
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| Alina T
Forum Elite
Topics: 17
Posts: 388
|
hmm... the link I found on the internet and posted there says that you should still try MTX first. but that's just them...
___________________
There are 3 types of people: those who make things happen, those who watch things happen, and those who wonder what happened.
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
You are absolutely right. MTX should be tried first unless this is a female patient and is expecting !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Can you provide me with the link ?
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
|
| |
| | | | | | | | | | | | | | | | | | | | |
