Lupus Nephritis Clinical Trials, Lupus Nephritis: Diagnosis and Management, Glomerulonephritis: Caus скачать в хорошем качестве

Lupus Nephritis Clinical Trials, Lupus Nephritis: Diagnosis and Management, Glomerulonephritis: Caus

A 20-year-old woman with a new diagnosis of lupus nephritis and a history of childhood bladder cancer, hypertrophic cardiomyopathy, and multiple allergies is preparing to start an add-on therapy clinical trial. With her current immunosuppressive regimen and complex past medical background, what steps should you consider before enrollment to minimize infectious risk? How can her risk factors and medication history inform your decision-making during evaluation for trial participation? VIDEO INFO Category: Lupus Nephritis Clinical Trials, Lupus Nephritis: Diagnosis and Management, Glomerulonephritis: Causes, Diagnosis, and Management, Nephrology: Kidney Disease Diagnosis and Management Difficulty: Easy - Basic level - Suitable for medical students Question Type: Prevention - Preventive measures and screening Case Type: Typical Presentation Explore more ways to learn on this and other topics by going to https://endlessmedical.academy/auth?h... QUESTION A 20-year-old woman with newly diagnosed lupus nephritis (ISN/RPS class III on biopsy) presents for counseling before joining an add-on therapy trial. Vitals: pulse 59 bpm, temperature 31.7 degreesC after walking in from freezing weather (quickly rewarmed; afebrile on repeat), respirations 22/min, blood pressure 110/55 mm Hg, oxygen saturation 100% on room air.... OPTIONS A. Update inactivated influenza and pneumococcal vaccines and verify hepatitis B immunity before randomization; avoid live vaccines after induction begins; document timing per CDC guidance. B. Administer live-attenuated zoster vaccine today for rapid protection, then start trial drugs within 24 hours to avoid delaying induction therapy. C. Give a 14-day course of broad-spectrum oral antibiotics to all participants after randomization to offset early pneumonia risk observed in prior trials. D. Defer all immunizations until after completion of induction therapy to prevent adverse-event attribution confounding during the first 3 months. CORRECT ANSWER A. Update inactivated influenza and pneumococcal vaccines and verify hepatitis B immunity before randomization; avoid live vaccines after induction begins; document timing per CDC guidance. EXPLANATION The correct answer is "Update inactivated influenza and pneumococcal vaccines and verify hepatitis B immunity before randomization; avoid live vaccines after induction begins; document timing per CDC guidance." Before intensifying immunosuppression for LN, ensure inactivated vaccines are up to date and hepatitis B immunity is verified, aligning with CDC recommendations and KDIGO 2024. Recombinant zoster vaccine is preferred when age-eligible and immunocompromised. Live vaccines should be avoided after induction starts. This 20-year-old on MMF, prednisone, and hydroxychloroquine is at increased infection risk; pre-trial vaccination reduces preventable early pneumonia and other infections. "Administer live-attenuated zoster vaccine today..." is incorrect; live zoster is contraindicated with imminent or ongoing immunosuppression, whereas recombinant zoster is non-live. "Give a 14-day course of broad-spectrum oral antibiotics to all participants..." is incorrect due to antimicrobial stewardship concerns and lack of evidence.... Further reading: Links to sources are provided for optional further reading only. The questions and explanations are independently authored and do not reproduce or adapt any specific third-party text or content. --------------------------------------------------- Our cases and questions come from the https://EndlessMedical.Academy quiz engine - multi-model platform. Each question and explanation is forged by consensus between multiple top AI models (i.e. Open AI GPT, Claude, Grok, etc.), with automated web searches for the latest research and verified references. Calculations (e.g. eGFR, dosages) are checked via code execution to eliminate errors, and all references are reviewed by several AIs to minimize hallucinations. Important note: This material is entirely AI-generated and has not been verified by human experts; despite stringent consensus checks, perfect accuracy cannot be guaranteed. Exercise caution - always corroborate the content with trusted references or qualified professionals, and never apply information from this content to patient care or clinical decisions without independent verification. Clinicians already rely on AI and online tools - myself included - so treat this content as an additional focused aid, not a replacement for proper medical education. Visit https://endlessmedical.academy for more AI-supported resources and cases. This material can not be treated as medical advice. May contain errors. ---------------------------------------------------