Question of the Week # 152

152) A 34 year old woman with history of recently diagnosed Rheumatoid Arthritis presents to your office for follow up. She reports much improvement in her symptoms after starting Ibuprofen for pain. She was also started on Hydroxychloroquine 3 weeks ago. Which of the following is most appropriate in monitoring her therapy?

A)     Liver function tests every month

B)      Complete Blood Count every 3 months

C)      Serum Creatinine every week

D)     Ophthalmologic evaluation every year

E)      Hydroxychloroquine serum levels every month

15 Responses

  1. d

  2. D,opthalmologic exam every year to check for retinopathy

  3. d

  4. D

  5. dddddddddd

  6. D

  7. d

  8. ddd

  9. D

  10. why d?

  11. A..

    • why A

  12. Ocular side effects have included double vision; visual disturbances (blurred vision and focusing or accommodation difficulty); decreased visual acuity; color-vision defects; nyctalopia; scotomatous vision with field defects of paracentral, pericentral ring types, and typically temporal scotomas, e.g., difficulty in reading with words tending to disappear, seeing half an object, misty vision, and fog before the eyes; pigmentary retinopathy; corneal deposits; keratopathy; decreased corneal sensitivity; corneal edema; and reversible corneal opacities. Retinopathy may be dose-dependent and irreversible retinal damage has been reported in patients receiving long-term or high-dose therapy.

    Retinal damage is more frequent in patients receiving the drug in high doses for prolonged periods, as in collagen vascular disease. If ocular changes are diagnosed early enough and the drug is discontinued, these changes may be reversible. Onset of retinopathy may be delayed and may actually occur after the last dose of chloroquine.

  13. Answer : D

  14. A

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