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EVAR for AAA — RACP Adult Medicine MCQ

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HardCardiologyEVAR for AAARACP Adult Medicine

On day 7 of ATRA/arsenic treatment for APML, a patient develops fever, weight gain, hypoxaemia, bilateral infiltrates and rising creatinine. Cultures are pending. What is the most important immediate treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Give dexamethasone 10 mg intravenously twice daily immediately

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as D · D = shown as E

B is correct. This is APML differentiation syndrome; high-dose IV dexamethasone begins at the earliest clinical suspicion without waiting for imaging or cultures, alongside infection assessment and decisions about holding ATRA/ATO in severe disease. A and E dangerously delay treatment. C worsens capillary leak. D diuresis alone does not suppress the inflammatory syndrome.

Reference: eviQ, Acute promyelocytic leukaemia differentiation syndrome: https://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/prophylaxis-and-treatment/1752-acute-promyelocytic-leukaemia-differentiation