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Retired NBME 20 Answers

nbme20/Block 4/Question#11 (reveal difficulty score)
A 37-year-old man who is HIV positive comes ...
Nortriptyline ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—strugglebus(189)
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Hydrocodone/Methadone can lead to dependence--you avoid in long term use. NSAIDs you also avoid due to partial ineffectiveness in neuropathic pain as well as ulcer risk. TCA's are known to treat neuropathic pain very well (i.e. diabetes, ART therapy)

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champagnesupernova3  Drugs for neuropathic pain: TCAs, gabapentin and pregabalin +1
mangotango  SNRIs +
mangotango  also SNRIs* +1
zevvyt  methadone isn't a pain med(even though it's an opiate), it's used for opiate addiction. And hydrocodone is used for "moderate" pain and this person is in "severe" pain. +
shakakaka  Drugs for neuropathic pain: TCA, SNRI, Anticonvulsant, Opioids, Lidocaine, Capsaicin +1



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