Rheumatology

Question 1

Antibiotics and methotrexate?

Answer 1

Trimethoprim has anti-folate activity, as does methotrexate, therefore, they should never be co-prescribed, as their effects can lead to severe bone marrow aplasia and pancytopenia, which may be fatal.

Question 2

What antibodies are associated with drug-induced lupus?

Answer 2

ANA
Antihistone antibodies are associated with drug-induced lupus

NOT dsNDA

Question 3

Drugs that can cause drug-induced lupus

Answer 3

Procainamide
hydralazine

Isoniazid
Minocycline
Phenytoin

Question 4

Vasculitis that causes kidney pathology but no lung pathology

Answer 4

Systemic vasculitic symptoms in the absence of pulmonary symptoms/signs suggests a diagnosis polyarteritis nodosa

Question 5

What infection is polyarteritis nodosa associated with?

Answer 5

Hep B

Question 6

Drugs that can cause osteoporosis

Answer 6

Anastrozole
Steroids

Question 7

When commencing urate lowering therapy (allopurinol) what should also be prescribed

Answer 7

When commencing ULT, colchicine cover should be co-prescribed for up to 6 months from initiation. If colchicine is unsuitable, NICE recommends considering NSAID cover as an alternative.