Delusional
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Posts: 226
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1. WAt's the best screening test or sensitive test for SLE?
A...ANA is positive in 97% of patients with SLE
2. Wat's the most specific test for SLE?
A...Anti-ds DNA and Anti-sm occur only in lupus therefore specific
3. WAt r the drugs causing lupus?
A...popular ones are (3 Cardiovascular drugs) hydralazine, methyldopa, procainemide , (2 antiepilipic) primidone, phenytoin......and one antiinfective Isoniazid
4. Where do u find anti-smooth muscle antibodies?
A...Autoimmune Hepatitis
5. Wat is the supplement that u shud give in a pt. on MTX?
A....Folate
6.Y does RA/rheumatoid arthritis get better in an HIV pt.?
A... Rheumatoid athritis is caused by immunoligical attack on the joints.....and immnuity esp CD4 is disturbed in HIV patinets....
7.Wat r the 2 bad prognostic factors for RA?
There are many but mainly high RF titre and Rheumatoid nodules ....
8.Wat does presence of anti centromere antibodies in a pt. of CREST suggest?
A.... :oops: Better prognosis :oops: cuz frankly i have no clue
9.Which is the only COX 1 NSAID which can be used in a pt. of renal failure?
A...I have no clue 
10.Which test confirms the diagnosis of a myopathy? which test is the first to be ordered in a suspected pt. of myopathy?
A...Biopsy confirms and EMG is first test....
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| smitha
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Those were gr8 answers delusional......... 
Now, coming to some others which i wud like to add.....
3..... drugs causing lupus, REMEMBER: "HIP" or ("HIMPPP"....according to urs), but HIP r quite enuf coz these MLEs give u drug induced lupus mostly based on that......Hydralazine, INH, Procainamide.
4.....Yes, auto immune or LUpoid hepatitis.
6......Absolutely correct.......to be precise, T cells increased in RA but decreased in HIV, so, RA gets better with HIV(well, guys for true, i don't think anybody's willing to take HIV for getting better with RA, r u? )
8......Yes, anicentromere abs......better prognosis, for sure(did good here delusional, though didn't have a clue......sometimes i guess this intuition of getting correct is quie essential for us in USMLEs )
9......SULINDAC is the only COX1 NSAID u can give a pt. with renal failure.
10......The first test u order for a pt. with suspected myopathy is CREATINE KINASE & ALDOLASE.
Thanx delusional...........
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| shirish_sss
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HI GUYS. YOU ALL R DOING GREAT JOBS :lol: :lol:
I WOULD LIKE TO CONFIRM ABOUT YOUR QUESTION ON METHTREXATE.
WHICH SUPPLEMENT SHOULD BE GIVEN TO A PT. TAKING METHOTREXATE.
THE ANSWER WOULD BE LEUCOVORIN RATHER THAN FOLATE.
CUZ THE TWO R DIFFERENT.
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| smitha
Forum Elite
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Yes sirish........ Leucovorin is also a supplement that shud/can be given with MTX. Leucovorin is nothing but, "folinic acid", as everybody knows.....
The issue of supplementing folic acid or folinic acid(leucovorin), depends now, on the condition in which ur treating the pt. Both r for reducing the systemic toxicity of MTX, which r hepatotoxicity, nephrotoxicity, BM supression etc.
While ur giving IT/intrathecal tx of MTX or IV , u need to start even leucovorin/folinicacid to reduce it's systemic toxicity, within 4 hrs of the completion of the tx.Here, the "leucovorin rescue"(rescue.......rescue ofthe body's tissue), for the tissues is definitely preferred as suplementation rather than folic acid.Folic acid, on the other hand, wud be preferred probably in conditions like Rheumatoid arthritis wherein u give it along with MTX, 1mg/day ..........
Hope that was clear...........but anyway, thanx shirish for reminding the forum about leucovorin rescue etc.........
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| shirish_sss
Forum Senior
Topics: 32
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YES SMITA
YOU ARE TOTALLY CORRECT.
I WOULD LIKE TO ADD A PIECE OF SMALL INFORMATION TO THIS.
WHEN YOU R TREATING A PATIENT FOR MALIGNANCY WITH METHOTREXATE ALMOST ALL CELLS OF THE BODY ARE AFFECTED AND DNA SYNTHESIS STOPS IN ALMOST ALL OF THEM.
BUT THE CLUE TO GIVING FOLINIC ACID i.E. ACTIVATED FORM OF FOLIC ACID OR TETRAHYDROFOLATE AS IT IS ALSO CALLED IS THAT
THE NORMAL CELLS OF THE BODY HAVE A MECHANISM TO ACTIVELY TRANSPORT FOLINIC ACID IN WHEREAS TUMOUR CELLS DO NOT HAVE.
SO THEY R RESCUED BUT THE TUMOUR CELLS DIE OUT.
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| smitha
Forum Elite
Topics: 53
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Thanx a lot shirish once again..........that was a gr8 xplanation & ya, now i remember it from my basics.....
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| smitha
Forum Elite
Topics: 53
Posts: 236
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source: my own qs, reference from kaplan , CMDT
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