A 55-year-old male nonsmoker with multiple myeloma refractory to chemotherapy was admitted to the hospital for autologous stem-cell transplantation. On completion of the 3-day infusion of a keratinocyte growth factor analog before transplantation, an asymptomatic, white, adherent plaque developed, coating the tongue. Culture revealed normal oral flora, without candida.
See the picture below
http://i35.tinypic.com/1zf087m.gif
Which one of the following medications is most likely to be responsible for this finding?
1. Amiodarone
2. Cinacalcet
3. Lithium
4. Palifermin
5. Trastuzumab
no google..lol..okz okt3
lemme guess
1&3 not an analog of keratinocyte growth factor
5 trastuzumab came across this in step 1 immunology..its an monoclonal antibody
left wit 2 & 4 will go for 2..my guesses usually go wrong..lol
I love your honesty
dr strider, only YOU can google now to check your answer
since we are just 2 here, I will post the answer for you
The correct answer is
4. Palifermin
Palifermin, a recombinant keratinocyte growth factor, is used for the prevention of oral mucosal injury induced by cytotoxic therapy in patients undergoing hematopoietic stem-cell transplantation. Palifermin stimulates the proliferation and differentiation of epithelial cells. The white tongue is commonly observed in patients treated with palifermin and most likely reflects transient, protective mucosal thickening.
Thanks for trying.
hey thanks okt3..my guess is wrong again
just saw it on wiki..Palifermin costs approximately 5,000 Euros per treatment for a 70 kg patient.
omg!that's a large sum..i wish i never get a BMT ;P
good site
now m one among the correct response out of 57602 total responses..
your approach is good, 50/50, I did the same mistake because never hear about palifermin and missed so I posted here just FYI(not usmle) but general CK
thank you guys for interesting discussion
i really like ur posts okt3,
u wont remember me i,m a silent member < u helped me in some qs when i was doing step1 about 8 months ago
i remember ur answer for my qs about receptors for HCL secretions really helpped me alot
Thank you again