reminds me of a recent uworld question for step 2 (10146) - I made cards for that was on cyanide poisoning, but had bolded explanations for an incorrect answer on methemoglobinemia. Dapsone and topical/local anesthetics were both bolded in the explanation (nitrates was also included non-bolded). note:1484950591778 tests specifically that benzocaine is a local anesthetic that can cause methemoglobinemia, but uworld and amboss seems to just say the class overall. no cards currently test dapsone and local/topical anesthetics in general as causes, which makes me want to reformat this to include them somehow with the cloze
UTD - “In a series of 138 cases of methemoglobinemia, dapsone accounted for 42 percent, with a mean methemoglobin level of 7.6 percent (range 2 to 34 percent)” “Topical anesthetics, especially benzocaine spray, are a common cause of methemoglobinemia [60,75,76]” UpToDate
if we want to incorporate these changes, having trouble finding the right text and way to specifically incorporate dapsone with the sulfa classes. The question is is dapsone a sulfa drug? Well, kinda sorta…amboss says “Structurally different from sulfonamides but a similar mechanism of action”…UTD has “Cross-reactivity may occur in patients with a history of a hypersensitivity reaction to sulfonamide antibiotics (eg, sulfamethoxazole/trimethoprim)”…and another UTD has “However, reactions to nonantimicrobial sulfonamides (eg, diuretics, sulfonylureas, and others) and sulfones (eg, dapsone) will be briefly addressed as well” making it seem like dapsone is distinctly different here
great in depth suggestions and changes. i think it is super beneficial and wide scope