Divine Intervention Episode 6

20 in 20 (Pharmacology Cases)
Some MS4
1
Gynecomastia in a patient being treated for peptic
ulcer disease.
2
Seizures in a patient with a history of severe
pruritus between the finger webs.
3
What is the preventive measure that could have
been taken in a patient presenting with an ejection
fraction of 25% 3 months after chemotherapeutic
treatment of a lymphoma?
4
Prevention of secondary hemochromatosis in a
patient with a history of beta thalassemia major.
5
Rapidly progressive neurological deficits (over
weeks) and somnolence in a patient who was
recently started on a drug. Oligoclonal bands have
previously been found with CSF studies in this
patient.
6
Severe hypotension and adrenal hemorrhage in a
patient lost to follow up after receiving a 2 year
prescription of some drug. Flow cytometry of a
blood sample from this patient revealed an absence
of GPI anchors.
7
Management of a patient who presents with a WBC
of 52k. Leukocyte alkaline phosphatase is decreased.
8
Patient with a history of an apple core lesion
detected on abdominal CT fails to respond to
therapy with an inhibitor of the epidermal growth
factor receptor.
9
Foot drop in a patient recently placed on some kind
of chemotherapeutic regimen.
10
Reduced DLCO and AST/ALT elevations in a
patient with a history of a “snowstorm” appearance
detected on a pelvic US.
11
Flushing and myoclonus in a patient who recently
started oral antibiotic therapy against a gram +ve,
catalase +ve, and coagulase +ve organism. This
patient has a history of generalized anxiety disorder.
12
Severe vomiting and flushing in a chronic alcoholic
with recent treatment for C. Difficile colitis.
13
Hb of 5, WBC of 500, and Plt count of 20k (all
abnormal) in a patient treated for a Monospot -ve
mononucleosis like syndrome.
14
Severe epigastric pain radiating to the back in a
patient recently started on some kind of
pharmacotherapy. This patient has a history of
inconsistent condom use.
15
Severe diarrhea, full body rash, and abdominal pain
in a patient who was recently started on
pharmacologic management for HIV. This patient
died 3 days after presentation.
16
Drug of choice (DOC) in the management of a
diabetic presenting with very high fevers and severe
sinus tenderness.
17
Afferent pupillary defect in a patient with a recent
history of hemoptysis with a CXR showing a right
upper lobe cavitary infiltrate.
18
Neonate in a developing country is unresponsive on
presentation. He was rushed to the hospital by
ambulance. A review of his chart reveals a
medication error. This child was treated with a
dihydrofolate reductase inhibitor for some
congenital infection.
19
Rising pCO2 in a patient being treated with
amikacin for an aggressive Pseudomonas infection.
An EMG reveals a reduced amplitude of
contraction with phrenic nerve stimulation.
20
Hb of 4.5, Plt count 15k, and WBC of 500 in a child
with a history of somnolence and nuchal rigidity.
CSF studies revealed very low levels of glucose,
elevated protein levels, a preponderance of
neutrophils and gram -ve diplococci that ferment
maltose and glucose. Adult presentation???