Bone tumours: methotrexate rescue in osteosarcoma: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone tumours: methotrexate rescue in osteosarcoma

Sample item

An osteosarcoma regimen includes high-dose methotrexate. Which agent is given afterwards to rescue normal cells from life-threatening toxicity?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Leucovorin

Leucovorin (folinic acid) bypasses the dihydrofolate reductase block caused by methotrexate and rescues normal marrow and mucosa. Serum methotrexate levels guide how long it is continued, with hydration and urine alkalinisation to clear the drug.

Option by option

  • A. Leucovorin (correct)

    Correct. Folinic acid restores reduced folate and rescues normal cells from methotrexate.

  • B. Dexrazoxane

    Dexrazoxane protects the heart from anthracycline cardiomyopathy.

  • C. Mesna

    Mesna protects the bladder from ifosfamide and cyclophosphamide.

  • D. Amifostine

    Amifostine is a cytoprotectant used with cisplatin and radiotherapy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Leucovorin. Leucovorin (folinic acid) bypasses the dihydrofolate reductase block caused by methotrexate and rescues normal marrow and mucosa.

Why is "Dexrazoxane" not the answer?

Dexrazoxane protects the heart from anthracycline cardiomyopathy.

Why is "Mesna" not the answer?

Mesna protects the bladder from ifosfamide and cyclophosphamide.

Why is "Amifostine" not the answer?

Amifostine is a cytoprotectant used with cisplatin and radiotherapy.

What concept does this question test?

It tests Bone tumours: methotrexate rescue in osteosarcoma in Orthopaedics. Serum methotrexate levels guide how long it is continued, with hydration and urine alkalinisation to clear the drug.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone tumours: methotrexate rescue in osteosarcoma?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.