PPD positive - 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 10-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 706 Times in 379 Posts
Reputation: 716
Question PPD positive

A health care worker is starting residency with five other PPD positive residents . All of the residents are started on isoniazid .She develops bilateral joint pain in hands and feet ,pleuritic chest pain and a rash

Which of the following is the most likely explanation why she is the only one to have this reaction?

A. Alcoholism
B. Decreased acetylation rate
C. Decreased renal clearance
D. P450 mutation
E. Tobacco smoking

Add reasoning and also explain what is happening to the patient
__________________
"Don't Forget they need us too"
Reply With Quote Quick reply to this message
The above post was thanked by:
roodiemd (10-13-2012)



  #2  
Old 10-03-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 456 Times in 289 Posts
Reputation: 466
Default

B. Decreased acetylation rate

may be she is slow acetylator of INH.....slow metabolism of drug and thus side effects.......drug induced lupus is happpening to patient .......
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message
The above post was thanked by:
drsmart (10-03-2012)
  #3  
Old 10-03-2012
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,316 Times in 706 Posts
Reputation: 1331
Default

Slow acetylators will invariable develop Lupus wannabe syndrome, the others dont because they are normal.
This is step 1 stuff, i remember the french guy talking about this a lot.

Also remember SLE wannabe syndrome doesnt affect the kidney.
Reply With Quote Quick reply to this message
The above post was thanked by:
K06100 (10-03-2012)
  #4  
Old 10-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,867
Threads: 149
Thanked 2,086 Times in 1,046 Posts
Reputation: 2106
Default

Quote:
Originally Posted by XpaezX View Post
Also remember SLE wannabe syndrome doesn't affect the kidney.
and the Brain............
__________________
A man doesn't know what he knows until he knows what he doesn't know.
“What is man? He's just a collection of chemicals with delusions of grandeur.”
Reply With Quote Quick reply to this message
The above post was thanked by:
K06100 (10-03-2012), XpaezX (10-03-2012)
  #5  
Old 10-04-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 706 Times in 379 Posts
Reputation: 716
Default

Answer B

This patient has drug induced lupus .This presents with after the use of drugs such as hydralazine, quinidine procainamide,phenytoin and D penicillamine. This occurs in patients with decreased acetylation rate.acetylation allows isoniazid to be excreted If it is not acetylated then it builds up and u get adverse effect
__________________
"Don't Forget they need us too"
Reply With Quote Quick reply to this message



Reply

Tags
Infectious-Diseases, 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
Calculating the Positive Predictive Value? samstar USMLE Step 2 CK Forum 6 10-12-2013 03:18 PM
The risk of HLA DR4 positive. bebix USMLE Step 1 Forum 6 07-03-2011 08:42 PM
When is PPD test considered positive? aghammoud85 USMLE Step 2 CK Forum 5 06-15-2011 12:13 PM
A kid with a positive Chvostek response! bebix USMLE Step 1 Forum 15 06-02-2011 11:47 AM
His wife does not know that he's HIV Positive! tinhi USMLE Step 1 Forum 9 05-17-2011 06:23 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)