Australian Medical Exam Preparation

Discussion AMC MCQ Exam, AMC Clinical exam
HomeHome  FAQFAQ  SearchSearch  RegisterRegister  Log in  

Share | 


Go down 

Points : 48369
Join date : 2013-12-26

PostSubject: Question-110   Fri Apr 04, 2014 7:22 am

Couple presented for preconceptional councelling.He is taking medicine for RA.What should be your advice?

a.Stop methotrxate and continue hydroxychloroquine
b.stop both
c.stop hydroxychloroquine and continue methotraxte
d.continue both
Back to top Go down

Points : 44050
Join date : 2014-06-07
Age : 51
Location : WA

PostSubject: Re: Question-110   Mon Jun 16, 2014 4:21 pm

Acceptable contraception for female patients with RA includes condoms, combined oral contraceptives (OCPs), use of the vaginal ring, or an intrauterine device. Studies have shown that oral contraceptives have little to no effect on the outcome of RA.[16] Men may use condoms to prevent conception until proper preconception planning has occurred.

Patients with chronic pain due to RA may use DMARDs and non-steroidal anti-inflammatory (NSAIDS) to decrease pain. The most common DMARDs used to treat RA include methotrexate, sulfasalazine, hydroxychloroquine, and leflunomide. Both methotrexate and leflunomide are pregnancy category X, while sulfasalazine and hydroxychloroquine are generally considered safe to use during pregnancy.[18] Patients wanting to conceive should understand that they must discontinue DMARDS at least 3 months (methotrexate) and up to 2 years (leflunomide) prior to conception due to the long tissue half-life of DMARDS that can pose a risk of harm to the fetus.[19,20] Female patients taking DMARDs during pregnancy should only do so after careful consideration of the risks versus benefits. Additionally, the lowest effective dose of prednisone is also considered safe to treat RA symptoms during the second and third trimesters of pregnancy.[20] If medications that affect sperm or egg production are going to be used, it may be advisable to counsel male and female patients on preserving sperm or eggs for future planned pregnancies.NSAIDS are generally safe until the third trimester and should then be discontinued, while Tylenol is considered to be safe during pregnancy to relieve pain. All women should be counseled not to become pregnant during active RA disease and should optimize their health prior to conception for the best pregnancy outcome.[19]

Patients with RA can successfully conceive children when they have a clear understanding of the risks. With proper preconception counseling and care, patients lessen the risks and prevent complications of RA during pregnancy.
Return to Article
Journal for Nurse PractitionersPregnancy, Fertility, and Contraception Risk in the Context of Chronic Disease
Sandra McNaughton, David Farley, Robert Staggs, Diane Heinz, Wendy Gray
Journal for Nurse Practitioners. 2008;4(5):370-376. Correct answer is A
Back to top Go down
Masoud Mostafaee

Points : 40957
Join date : 2014-10-02

PostSubject: Re: Question-110   Fri Oct 03, 2014 3:37 am

Back to top Go down

Points : 40252
Join date : 2014-11-03

PostSubject: Re: Question-110   Wed Nov 05, 2014 2:16 pm

Back to top Go down

Points : 43855
Join date : 2014-06-05
Location : Australia

PostSubject: Re: Question-110   Sun Nov 09, 2014 1:29 am

He (the husband) is taking the RA medications. Not sure how it will affect his partner's pregnancy.
Back to top Go down

Points : 40252
Join date : 2014-11-03

PostSubject: Re: Question-110   Tue Nov 18, 2014 11:44 am

Hydroxychloroquine s safe to continue during pregnancy but methotrxate should be taken off.
Back to top Go down
Sponsored content

PostSubject: Re: Question-110   

Back to top Go down
Back to top 
Page 1 of 1

Permissions in this forum:You cannot reply to topics in this forum
Australian Medical Exam Preparation :: AMC MCQ Exam-
Jump to: