question regarding the gentleman with joint pain and nail pitting.
After seeing the rheumatologist, the patient recalls he has had three family members who have developed NASH at a young age. He undergoes a liver ultrasound showing mild fatty liver.
He has a PPD which is negative, and his risk factors for TB are evaluated and felt
To be low. He is Canadian born, never incarcerated, and has not travelled to any endemic TN areas.
The rheumatologist decides to treat him with some Indomethacin, and an STD screen is convincingly negative.
The rheumatologist begins him on treatment and indicates to him this medication will require a visit to the eye specialist before it is begun.
What medication is he started on?
1: Methotrexate
2: Infliximab
3: Prednisone
4: Hydroxychloroquine
Correct. Hydroxychloroquine is the correct answer.
But look deeper. This is how questions are written. There are several things in this stem screaming out that methotrexate is the wrong drug. What statements are those ?
There are statements in this question designed to waste your time. What are they?
There is a medication on here that is not first line, and you don’t have nearly enough information to pick this answer. It is however a drug used in autoimmune disease. This is distraction by virtue of familiarity. What answer option am I referring too?
When answering questions in a practice format - always think why is this right and why are these other options wrong.
Thanks everyone