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Retired NBME 18 Answers

nbme18/Block 1/Question#28 (reveal difficulty score)
A 51-year-old woman with Graves disease ...
Agranulocytosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—azibird(279)
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Agranulocytosis (rare side effect of PTU) commonly presents with acute pharyngitis.

"Symptoms of anti thyroid drug-induced agranulocytosis do not differ from those of other causes of agranulocytosis. High fever and sore throat are the most frequent signs. Acute pharyngitis and other infections in the oral cavity are the most common clinical diagnoses at presentation." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318340/

"The most common presentations were fever (92%) and sore throat (85%). Initial clinical diagnoses were acute pharyngitis (46%), acute tonsillitis (38%), pneumonia (15%) and urinary tract infection (8%)." https://www.ncbi.nlm.nih.gov/pubmed/10627862

The word ulcerating threw me off and I started thinking about noninfectious causes of inflammation. Agranulocytosis leads to infection, keep it simple.

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cassdawg  FA2020 pg250- drugs that cause agranulocytosis Dapsone, Clozapine, Carbamazepine, Propyltiouracil, Methimazole, Colchicine, Ganiciclovir (Drugs Can Cause Pretty Major Collapse of Granulocytes) +1



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