Toxicology and antidotes: trientine in Wilson disease: 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 · Toxicology and antidotes: trientine in Wilson disease

Sample item

A woman with Wilson disease on penicillamine develops fever, rash and a lupus-like syndrome, and the drug is stopped. Which copper chelator is a suitable alternative?

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

The answer and the reasoning

B. Trientine

Trientine is a copper chelator that increases urinary copper excretion and is used when penicillamine is not tolerated. Zinc salts are another alternative, acting by blocking intestinal absorption of copper. Deferasirox is an iron chelator.

Option by option

  • A. Hydroxocobalamin

    Hydroxocobalamin binds cyanide to form cyanocobalamin.

  • B. Trientine (correct)

    Correct. Trientine chelates copper and is used in penicillamine intolerance.

  • C. Deferasirox

    Deferasirox chelates iron and is used in transfusional iron overload.

  • D. Sodium thiosulfate

    Sodium thiosulfate is a cyanide antidote that provides sulfur for rhodanese.

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 B, Trientine. Trientine is a copper chelator that increases urinary copper excretion and is used when penicillamine is not tolerated.

Why is "Hydroxocobalamin" not the answer?

Hydroxocobalamin binds cyanide to form cyanocobalamin.

Why is "Deferasirox" not the answer?

Deferasirox chelates iron and is used in transfusional iron overload.

Why is "Sodium thiosulfate" not the answer?

Sodium thiosulfate is a cyanide antidote that provides sulfur for rhodanese.

What concept does this question test?

It tests Toxicology and antidotes: trientine in Wilson disease in Pharmacology. Zinc salts are another alternative, acting by blocking intestinal absorption of copper. Deferasirox is an iron chelator.

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 Toxicology and antidotes: trientine in Wilson disease?

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.