Sickle Cell Question - drjiggy

[ArchivalUser]

When i took the nbme test, i remember seeing a question on sickle cell in regards to preventing further crisis from occurring. Some books say give hydroxyurea, some say folic acid. When do you give each (in what case should you answer folic acid and in what case should you answer hydroxyurea??) Thanks!

[ArchivalUser]

i know for sure u don't give hydroxyurea in pregnancy- contraindicated so lets say for example that one parent has sickle cell dz and the other has trait, then a pregnant woman should be offered genetic counseling not hydroxyurea...u don't necessarily recommend folic acid for prevention of SCD coz it is for NTDs..as far as i know
U can give hydroxyurea to adults or children to prevent further crisis- correct me if i am wrong

[ArchivalUser]

hydroxyurea is indicated in repetitive painfull crisis, it's act by keeping Hb in fetal form (HbF) so no sicling. Folic acid is indicated in all patients with SCD since the RBC turn over is constant, the body is easly depleted of the storage of folic acid and often these patients present with MCV > 100. ( megaloblastic anemia). In case of megaloblastic anemia in a SCD patient, the cause is more often folate deficiency (usmle question), since B12 storage last longer. I whish it help

[ArchivalUser]

Folic acid- to prevent the occurence of aplastic crisis
Hydroxyurea- to prevent the painful episodes which occur very frequently.

[ArchivalUser]

drjiggy
Can u explain ur answer to NBME3 Blo2 Q17
Why u chose schizoaffective disorder rather than
major depressive disorder with psychotic features???

[ArchivalUser]

hey gradmd,

i put that because the guy didnt have more than 4 symptoms of major depression. They just told you he was depressed. I was boggling my mind between whether that meant major depression or just some symptoms of depression, so you may be right about "major depressive disorder with psychotic features" as the answer.

[ArchivalUser]

ok say folic acid for aplastic crisis and hydroxyurea for painful crisis..thanks guys!!

[ArchivalUser]

i think u r right. MDD need 5 symptoms for Dx