Antihypertensives: hydralazine-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 · Antihypertensives: hydralazine-induced lupus

Sample item

A 55-year-old man on hydralazine for several months develops fever, arthralgia, pleuritic chest pain and a facial rash. Antinuclear antibody is positive. Which antibody is most characteristic of this drug-induced condition?

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

The answer and the reasoning

D. Anti-histone antibody

Hydralazine, procainamide and isoniazid can cause drug-induced lupus, especially in slow acetylators. Anti-histone antibodies are present in most cases, whereas anti-dsDNA and anti-Smith antibodies are typically absent, and renal and central nervous system involvement are uncommon. The condition resolves on stopping the drug.

Option by option

  • A. Anti-Smith antibody

    Anti-Smith is highly specific for idiopathic systemic lupus.

  • B. Anti-centromere antibody

    Anti-centromere is associated with limited cutaneous systemic sclerosis.

  • C. Anti-double-stranded DNA antibody

    Anti-dsDNA is characteristic of idiopathic systemic lupus with nephritis.

  • D. Anti-histone antibody (correct)

    Correct. Anti-histone antibodies are the serological hallmark of drug-induced lupus.

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, Anti-histone antibody. Hydralazine, procainamide and isoniazid can cause drug-induced lupus, especially in slow acetylators.

Why is "Anti-Smith antibody" not the answer?

Anti-Smith is highly specific for idiopathic systemic lupus.

Why is "Anti-centromere antibody" not the answer?

Anti-centromere is associated with limited cutaneous systemic sclerosis.

Why is "Anti-double-stranded DNA antibody" not the answer?

Anti-dsDNA is characteristic of idiopathic systemic lupus with nephritis.

What concept does this question test?

It tests Antihypertensives: hydralazine-induced lupus in Pharmacology. Anti-histone antibodies are present in most cases, whereas anti-dsDNA and anti-Smith antibodies are typically absent, and renal and central nervous system involvement are uncommon. The condition resolves on stopping the drug.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Antihypertensives: hydralazine-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.