salmonella
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NBME2
a 45 y/o man who is undergoing dialysis for chronic renal failure starts receiving erythropoietin therapy. He has a history of type 1 diabetes mellitus, peripheral neurophathy and well-controlled hypertenstion. Exacerbation of which of the following is mostlikely to occure in this pt?
chronic renal insufficiency
diabetes mellitus
hypertesntion
osteitis fibrosa cystica
peripheral
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| oldkidontheblock
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Hypertension?
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| rock
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DM ?
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| sprint123
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It is hypertension...Treatment with erythropoietin is known to cause hypertension
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| salmonella
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thaks all ,can u rule out other choices please
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| mms
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30-35% of the dialysis patients that receive recombinant erythropoietin develop arterial hypertension.
Did you understand by wich mechanism? Could you explain please?
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| rock
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oh...right...erythropoietin can cause HTN...now i wont forget it.
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| oldkidontheblock
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Whats the answer and mechanism salmonella?
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| rock
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yu were right about HTN oldkid...not sure about the mechanism though...it has probably something to do with NO and thus there is no vasodilator activity
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| salmonella
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dont kDose dependent increases in blood pressure or worsening of existing hypertension are seen in 30-35% of patients, particularly during the first 3 months of treatment. This requires treatment with attention to fluid status and the use of antihypertensive medication. Moderate dose dependent increases in platelet counts within the normal range have also been reported.1,2
Shunt thromboses may occur in dialysis patients receiving epoetin therapy. Early shunt revision or prophylaxis against thrombosis is recommended.4,5,7 Patients with pre-existing vascular disease need to be monitored closely since thromboembolic events have occurred in patients with renal failure receiving epoetin. No causal relationship has however been demonstrated.5,8
Side effects which have been observed occasionally include; transient increases in serum potassium and phosphate levels, seizures, hypertensive crisis, skin reactions and palpebral oedema. Isolated cases of anaphylactoid reactions have been observed. Flu-like symptoms occur in 5% of patients on initiating therapy but resolve with continued treatment.3,7
now mech but this is what i learnt
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