Which of the following clients experiencing an abnormally low neutrophil count (neutropenia) could have developed this as a side effect to his or her medical regimen? A client with:
A) Diagnosed infectious mononucleosis with a high Epstein-Barr virus count being treated with NSAIDs
B) Kostmann syndrome receiving G-CSF, a granulocyte colony–stimulating factor
C) Hyperthyroidism being treated with propylthiouracil to maintain normal metabolic rate
D) Psoriasis, a skin infection, being treated with methotrexate to suppress the immune system
Ans: C
Feedback:
A number of drugs, such as chloramphenicol (an antibiotic), phenothiazines (antipsychotic agents), propylthiouracil (used in the treatment of hyperthyroidism), and phenylbutazone (used in the treatment of arthritis), may cause idiosyncratic depression of bone marrow function. Many cases of neutropenia are drug related, often caused by chemotherapeutic drug suppression of bone marrow function. The Epstein-Barr virus causes mononucleosis, whereas Kostmann syndrome is a less common cause of neutropenia. Skin infections are often a result of neutropenia, not a cause.
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