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  #1  
Old 10-09-2011
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Question Rheumatology Q?

For several years, a hypertensive 65-year-old female has been treated with chlorthoalidone, atenolol and hydralazine. Her BP has been well-controlled on this regimen. Over the past two months, she has experienced malaise, along with diffuse joint pains that involve symmetric sites in the fingers, hands, elbows, and knees. A pleural friction rub is noted on examination. Laboratory testing shows that the patient has mild anemia and leukopenia, with a negative rheumatoid factor and positive ANA titer of 1:640. Which one of the following would be the most appropriate initial treatment?

A) Discontinue the thiazide diuretic and switch to a loop diuretic such as furosemide (Lasix)
B) Discontinue the hydralazine.
C) Begin Tx with Prednisone 40 mg po qd
D) Treat with hydroxychloroquine (Plaquenil) 400 mg qd.
E) Obtain renal function studies and anticipate that renal Bx will be needed.
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Old 10-09-2011
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B) Discontinue the hydralazine
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  #3  
Old 10-10-2011
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Default b

hydrlazine causes SLE like effect
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Originally Posted by m82_ghasemi View Post
For several years, a hypertensive 65-year-old female has been treated with chlorthoalidone, atenolol and hydralazine. Her BP has been well-controlled on this regimen. Over the past two months, she has experienced malaise, along with diffuse joint pains that involve symmetric sites in the fingers, hands, elbows, and knees. A pleural friction rub is noted on examination. Laboratory testing shows that the patient has mild anemia and leukopenia, with a negative rheumatoid factor and positive ANA titer of 1:640. Which one of the following would be the most appropriate initial treatment?

A) Discontinue the thiazide diuretic and switch to a loop diuretic such as furosemide (Lasix)
B) Discontinue the hydralazine.
C) Begin Tx with Prednisone 40 mg po qd
D) Treat with hydroxychloroquine (Plaquenil) 400 mg qd.
E) Obtain renal function studies and anticipate that renal Bx will be needed.
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m82_ghasemi (10-10-2011)
 
  #4  
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I m with b too....SLE like syndrome
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Old 10-10-2011
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b. drug induced.
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B) Discontinue the hydralazine.
drug induce sle
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