(Cureus)—A 40-year-old woman with hx of HIV, coronary artery disease, peripheral vascular disease, and polysubstance abuse presented with critical limb ischemia of the right leg. The patient received a femoral artery stent, and apixaban 2.5 mg bid was started. The patient returned with low back pain 1 week postdischarge, and a CT scan demonstrated a large retroperitoneal hematoma.
Meds: clopidogrel, darunavir/cobicistat, abacavir/dolutegravir/lamivudine, atorvastatin, isosorbide dinitrate, and hydralazine.
Which drug combo could have caused the hematoma?
Meds: clopidogrel, darunavir/cobicistat, abacavir/dolutegravir/lamivudine, atorvastatin, isosorbide dinitrate, and hydralazine.
Which drug combo could have caused the hematoma?
clopidogrel and atorvastatin
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clopidogrel and darunavir/cobicistat
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apixaban and abacavir/dolutegravir/lamivudine
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apixaban and darunavir/cobicistat
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(Cancer Rep)—A 62-year-old woman with DM, dyslipidemia, HTN, renal impairment, and HR-positive, HER-2 negative metastatic breast cancer presented with a 1-wk hx of progressive dyspnea, intermittent epigastric pain, and nausea approximately 2mo after starting ribociclib. Admission labs: BUN 56 mg/dL, Cr 2.8 mg/dL, sodium 133 mEq/L, potassium 5.6 mEq/L, chloride 102 mEq/L, bicarbonate 6 mEq/L, CPK 715 U/L, glucose 217 mg/dL, lactate 13.7 mmol/L, pH 7.12, pCO2 20.8 mm Hg, Po2 66.8 mm Hg, anion gap 25.
The patient was diagnosed with severe lactic acidosis and acute respiratory failure.
Meds: metformin, glipizide, losartan, amlodipine, simvastatin, ribociclib, fulvestrant.
Which drug combo could have caused the lactic acidosis?
The patient was diagnosed with severe lactic acidosis and acute respiratory failure.
Meds: metformin, glipizide, losartan, amlodipine, simvastatin, ribociclib, fulvestrant.
Which drug combo could have caused the lactic acidosis?
ribociclib and metformin
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metformin and simvastatin
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fulvestrant and losartan
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amlodipine and glipizide
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(epocrates)—The absorption of the oral antifungal itraconazole is sensitive to changes in gastric pH. For example, gastric acid suppressors such as H2-receptor antagonists and proton pump inhibitors commonly result in a decrease in itraconazole absorption, and hence a potential decrease in efficacy.
Which formulation of itraconazole has been linked w/ increased systemic exposure when co-administered w/ acid suppressors?
Which formulation of itraconazole has been linked w/ increased systemic exposure when co-administered w/ acid suppressors?
itraconazole 100-mg capsule
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itraconazole 10-mg/mL solution
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itraconazole 200-mg tablet
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itraconazole 65-mg capsule
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(BMJ)—A woman in her 80s had a persistent, mildly itchy lesion on her R chest x3y in an area frequently exposed to sun in the summer, when she’d usually wear vests. The lesion improved only slightly with topical steroids and antifungals. Exam: annular red plaque with crusts and scales. Potassium hydroxide test negative. What’s the dx?
Porokeratosis of Mibelli
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Basal cell carcinoma
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Chronic eczema
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Bowen disease
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Tinea corporis
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(BMJ)—A nonsmoking man in his 30s had asymptomatic tongue lesions found during a derm eval. PMHx: psoriasis, no alcohol misuse. Exam: thick, scaly red plaques on scalp, back, and limbs. Tongue: reddish area with absent papillae; branching fissures. What’s the dx?
Erythematous candidiasis
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Leukoplakia
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Erythroplakia
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Lichen planus
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Geographic tongue
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