1. A 40-year-old woman is diagnosed with systemic lupus erythematosus. You discuss treatment options and decide to start hydroxychloroquine. What laboratory tests and monitoring are required prior to starting this medication?
a. complete blood cell count with differential and glucose-6-phosphate dehydrogenase
b. complete blood cell count with differential and complete metabolic profile
c. ophthalmology evaluation and glucose-6-phosphate dehydrogenase
d. b and c
2. Two months ago you saw a 30-year-old woman with a history of severe atopic dermatitis. She had been using topical steroids with not much improvement. You decided to start a systemic medication. Within 1 month of drug initiation, she called your office to tell you that she is much better but has noticed unwanted hair on her face lately. Which medication is most likely implicated?
a. cyclosporine
b. dapsone
c. hydroxychloroquine
d. methotrexate
3. A 70-year-old man with type 2 diabetes mellitus who drinks 10 cans of beer per week presents to the emergency department with a 3-day history of diffuse tense bullae and pruritus on the legs and trunk. Direct immunofluorescence displayed linear deposition of IgG and C3 at the dermoepidermal junction, confirming your clinical diagnosis. What is the best long-term treatment option for this patient?
a. combination of oral steroids plus methotrexate
b. oral steroids and mycophenolate mofetil
c. oral steroids only
d. topical steroids only
4. A 45-year-old Venezuelan man presents with painful nodules on his bilateral lower legs. A biopsy demonstrates acid-fast bacilli, and a multidrug regimen is initiated for erythema nodosum leprosum. Which of the following is the mechanism of action of the treatment that is US Food and Drug Administration approved for this condition?
a. inhibits chemotaxis
b. inhibits dihydrofolate reductase
c. inhibits tumor necrosis factor α
d. suppresses T-cell function and B-cell antibody production
5. A patient consults her physician because of several side effects from a medication she started 2 weeks ago due to erythematous to violaceous papules on the legs from palpable purpura. She reports diarrhea, abdominal pain, and fatigue. Which medication is she taking?
a. azathioprine
b. colchicine
c. dapsone
d. methotrexate