Methotrexate Side Effect - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 12-02-2011
drnrpatel's Avatar
Guest
 
Steps History: 1+CK+CS
Posts: 441
Threads: 153
Thanked 396 Times in 211 Posts
Reputation: 419
Drug Methotrexate Side Effect

A 24-year-old woman comes to your office with vaginal spotting 2 weeks after a missed menstrual period. Her past medical history is significant for pelvic inflammatory disease. She has never had surgery. She takes no medications and is allergic to penicillin. Examination demonstrates scant blood in the vaginal vault and minimal right adnexal tenderness. Laboratory evaluation reveals a beta-hCG value of 1600 mIU/mL. Blood type is O positive. Hematocrit is 39%. Pelvic ultrasound demonstrates nothing in the uterus and a right adnexal mass consistent with ectopic pregnancy. The decision is made to proceed with intramuscular methotrexate for medical treatment of the ectopic pregnancy. Which of the following is the most likely side effect from this treatment?

A. Alopecia
B. Cardiotoxicity
C. Infertility
D. Neutropenia
E. Stomatitis
Reply With Quote Quick reply to this message
The above post was thanked by:
bebix (12-03-2011), rise (12-03-2011)



  #2  
Old 12-02-2011
pass7's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 406
Threads: 30
Thanked 141 Times in 109 Posts
Reputation: 151
Default

D. Neutropenia
Reply With Quote Quick reply to this message
  #3  
Old 12-02-2011
jaimin's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 264
Threads: 15
Thanked 98 Times in 56 Posts
Reputation: 108
Default

Neutropenia and stomatitis both are common.
Reply With Quote Quick reply to this message
 
  #4  
Old 12-03-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 537
Threads: 80
Thanked 344 Times in 138 Posts
Reputation: 376
Default

neutropenia ...mucositis is common as well
Reply With Quote Quick reply to this message
  #5  
Old 12-03-2011
USMLE Forums Addict
 
Steps History: Not yet
Posts: 192
Threads: 0
Thanked 47 Times in 40 Posts
Reputation: 57
Default

I m with neutropenia...or stomatitis
Reply With Quote Quick reply to this message
  #6  
Old 12-03-2011
qurat21's Avatar
USMLE Forums Master
 
Steps History: 1 + CK
Posts: 623
Threads: 62
Thanked 288 Times in 186 Posts
Reputation: 298
Default

neutropenia.....
Reply With Quote Quick reply to this message
  #7  
Old 12-03-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 53
Threads: 2
Thanked 20 Times in 17 Posts
Reputation: 30
Default

neutropenia!!
Reply With Quote Quick reply to this message
  #8  
Old 12-03-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,261 Times in 881 Posts
Reputation: 3271
Default

Stomatitis!

- The neutrophil maturation and differentiation takes approximately 12 days
- Mucosal epithelium is very proliferative; the life of an average cell is 7- 10 days.
Reply With Quote Quick reply to this message
The above post was thanked by:
pass7 (12-04-2011)
  #9  
Old 12-03-2011
drnrpatel's Avatar
Guest
 
Steps History: 1+CK+CS
Posts: 441
Threads: 153
Thanked 396 Times in 211 Posts
Reputation: 419
Default

The correct answer is E. Ectopic pregnancy is the number one cause of pregnancy-related death in the first trimester. Methotrexate is a relatively new treatment for ectopic pregnancy. Before the use of methotrexate, management of ectopic pregnancy was completely surgical. Now, the ability to use methotrexate in certain cases gives patients and physicians the option of medical management. Numerous studies have demonstrated that methotrexate is safe and appropriate to treat patients with tubal pregnancy. As with any drug, however, there are risks and side effects associated with methotrexate use. Methotrexate is a folinic acid antagonist that functions by inhibiting dihydrofolic acid reductase. This inhibition interferes with the synthesis and repair of DNA. Actively proliferating tissues such as an ectopic pregnancy, buccal and intestinal mucosa, or the bone marrow thus are particularly sensitive to methotrexate. This sensitivity of actively proliferating tissue accounts for one of the main side effects of methotrexate therapy, stomatitis. Most often, however, methotrexate is well tolerated without significant symptoms. Those symptoms that do occur are usually mild. Together with stomatitis, patients should be cautioned that they might develop nausea and vomiting, diarrhea, gastrointestinal distress, and dizziness. They also should be instructed to avoid alcoholic beverages, vitamins with folic acid, nonsteroidal antiinflammatory medications, and exposure to direct sunlight.
Alopecia (choice A) is considered to be a rare side effect of methotrexate. In those rare cases in which it does develop, the alopecia is most often reversible.
Cardiotoxicity (choice B) is not considered to be a side effect of methotrexate. One of the most well known causes of chemotherapy-induced cardiotoxicity is doxorubicin (Adriamycin.)
There is no evidence that methotrexate administered to treat ectopic pregnancy leads to impairment of fertility (choice C).
Neutropenia (choice D) is a potential side effect of methotrexate. Severe neutropenia, however, is very rare.
Reply With Quote Quick reply to this message
The above post was thanked by:
MANIAKOS (12-04-2011), Mumu Rahman (12-03-2011), pass7 (12-04-2011), rise (12-03-2011), sonu.agarwall (12-04-2011)



Reply

Tags
Pharmacology-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Diagnosis and Treatment of Prochlorperazine Side Effect! ricko335 USMLE Step 1 Forum 12 04-21-2012 08:00 AM
The Most Common Side Effect of Metformin drnrpatel USMLE Step 2 CK Forum 6 10-17-2011 12:59 PM
Side Effect of Isotretinoin usmleman2020 USMLE Step 1 Forum 11 09-14-2011 06:47 PM
Side effect of an anti-hypertensive alaahoda2001 USMLE Step 2 CK Forum 0 06-24-2011 07:25 AM
Leukopenia Side Effect sam01 USMLE Step 1 Forum 4 06-29-2010 05:38 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)