每日一题_2023.05.19

A 3-year-old boy is brought to his pediatrician’s office because his parents noticed worsening protrusion of his abdomen. After thorough imaging studies and histopathologic confirmation of Wilms tumor, the physician prescribes a medication that acts by causing arrest of the cell cycle during metaphase. However, the parents are concerned about the use of that medication because of what they have read about its adverse effects. Which adverse effect are the parents most likely concerned about?

一名3岁的男孩被带到他的儿科医生的办公室，因为他的父母注意到他的腹部日益突出。在全面的影像学检查和组织病理学确诊肾母细胞瘤后，医师处方一种药物，其作用是在中期引起细胞周期停滞。然而，家长们对这种药物的使用感到担忧，因为他们读到过它的不良反应。父母最担心的不良影响是什么?

(A) Cardiotoxicity毒性

(B) Hemorrhagic cystitis 出血性膀胱炎

(C) Hyperglycemia高血糖

(D) Pulmonary fibrosis 肺纤维化

(E) Neurotoxicity神经毒性

答案解析：

该患者患肾母细胞瘤，这是一种儿童肾母细胞瘤，可采用MOPP方案治疗，其中包括植物生物碱长春新碱(Oncovin)。长春新碱通过抑制微管聚合来阻止细胞分裂，从而阻止有丝分裂纺锤体的形成并引起中期阻滞。它具有神经毒性的副作用，表现为反射消失、周围神经炎、肌无力和麻痹性肠梗阻。MOPP方案是指氮芥、长春新碱、丙卡巴肼、泼尼松。

正确答案：E