Cardiovascular: procainamide-induced lupus: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Cardiovascular: procainamide-induced lupus

Sample item

A man treated with procainamide for ventricular arrhythmia for 18 months develops arthralgia, pleuritis and positive anti-histone antibodies. What should be done?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Stop procainamide, as drug-induced lupus usually resolves after withdrawal

Procainamide, hydralazine and isoniazid can cause drug-induced lupus with anti-histone antibodies, more often in slow acetylators, and renal and CNS involvement is rare. Withdrawal usually leads to resolution.

Option by option

  • A. Increase the dose of procainamide

    A higher dose will worsen it.

  • B. Switch to hydralazine

    Hydralazine is another cause of drug-induced lupus.

  • C. Continue and add high-dose cyclophosphamide

    Immunosuppression is not needed.

  • D. Stop procainamide, as drug-induced lupus usually resolves after withdrawal (correct)

    Correct. Withdrawal is usually curative.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Stop procainamide, as drug-induced lupus usually resolves after withdrawal. Procainamide, hydralazine and isoniazid can cause drug-induced lupus with anti-histone antibodies, more often in slow acetylators, and renal and CNS involvement is rare.

Why is "Increase the dose of procainamide" not the answer?

A higher dose will worsen it.

Why is "Switch to hydralazine" not the answer?

Hydralazine is another cause of drug-induced lupus.

Why is "Continue and add high-dose cyclophosphamide" not the answer?

Immunosuppression is not needed.

What concept does this question test?

It tests Cardiovascular: procainamide-induced lupus in Pharmacology. Withdrawal usually leads to resolution.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular: procainamide-induced lupus?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.