Chemotherapy: busulfan pulmonary toxicity: 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 · Chemotherapy: busulfan pulmonary toxicity

Sample item

A man with chronic myeloid leukaemia on long-term oral therapy develops dry cough, breathlessness, fine basal crackles and skin hyperpigmentation. Which drug is the likely cause?

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

The answer and the reasoning

B. Busulfan

Busulfan causes pulmonary fibrosis (busulfan lung), skin hyperpigmentation and prolonged marrow suppression. It is used in chronic myeloid leukaemia and in conditioning before stem cell transplant. Imatinib causes oedema, and hydroxyurea causes mucocutaneous effects.

Option by option

  • A. Melphalan

    Melphalan is used in myeloma and does not typically cause this pattern.

  • B. Busulfan (correct)

    Correct. Pulmonary fibrosis and hyperpigmentation are characteristic of busulfan.

  • C. Hydroxyurea

    Hydroxyurea causes myelosuppression and skin ulceration, not pulmonary fibrosis.

  • D. Imatinib

    Imatinib causes fluid retention and muscle cramps.

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, Busulfan. Busulfan causes pulmonary fibrosis (busulfan lung), skin hyperpigmentation and prolonged marrow suppression.

Why is "Melphalan" not the answer?

Melphalan is used in myeloma and does not typically cause this pattern.

Why is "Hydroxyurea" not the answer?

Hydroxyurea causes myelosuppression and skin ulceration, not pulmonary fibrosis.

Why is "Imatinib" not the answer?

Imatinib causes fluid retention and muscle cramps.

What concept does this question test?

It tests Chemotherapy: busulfan pulmonary toxicity in Pharmacology. It is used in chronic myeloid leukaemia and in conditioning before stem cell transplant. Imatinib causes oedema, and hydroxyurea causes mucocutaneous effects.

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 Chemotherapy: busulfan pulmonary toxicity?

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.