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Methotrexate pneumonitis — RCPSC IM MCQ

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HardRheumatologyMethotrexate pneumonitisRCPSC IM

A patient has ANCA-associated vasculitis with diffuse alveolar hemorrhage, red-cell casts and rapidly rising creatinine. Infection has been assessed and specialist care is available. Which induction principle is appropriate?

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

Reveal the answer and explanation

Correct answer: A — Start glucocorticoids with rituximab or cyclophosphamide induction

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

A is correct: life- or organ-threatening ANCA vasculitis requires urgent specialist-led induction with glucocorticoids plus rituximab or cyclophosphamide. B, C and E are inadequate. D risks irreversible organ injury.

Reference: Canadian Rheumatology Association, Clinical Guidelines: https://rheum.ca/resources/publications/