Step 3 - Musculoskeletal - Inpatient Medicine

USMLE / COMLEX - Step 3 > Musculoskeletal & Rheumatologic > USMLE/COMLEX 3 - Prep Questions

Q. A 47-year-old woman with rheumatoid arthritis is hospitalized for treatment failure. She has been under treatment with methotrexate and glucocorticoid for the past six months; however, she still has a moderate-activity disease, and her joint findings are aggravating. The rheumatologist decided to admit her for more evaluations and add infliximab to her treatment protocol. You start the infusion of the first dose of infliximab at a rate of 20 mg/hour. After two hours, the patient developed nausea, pruritus, headache, and scattered skin rashes. The vital signs are normal. The lungs are clear. What is the best decision for her?

No intervention is required, and continue the infusion at the same rate
Continuing the infliximab, plus administering IV diphenhydramine and oral acetaminophen
Stopping the infliximab, administering IV diphenhydramine and oral acetaminophen, and after two hours, starting the infliximab infusion at 10 mg/hour
Stopping the infliximab, administering methylprednisolone, and after two hours, starting the infliximab infusion at the previous rate
Stopping the infliximab, administering IV diphenhydramine and oral acetaminophen, and changing to another biologic DMARD
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