Paeds Cases · clinical-pharmacology-and-therapeutics
Build a precision-prescribing plan for a child starting azathioprine — OSCE
OSCE clinical-decision and communication station: building a TPMT and NUDT15-guided thiopurine plan for a child with newly diagnosed Crohn disease, ordering the right tests, translating the result into a phenotype, defending the dose action, and explaining the result and the plan to the family in plain language.
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Study tools
Target exams
MRCPCH ClinicalRACP DCERCPSC Pediatrics
Prompt
A ten-year-old girl with newly diagnosed moderate Crohn disease is to start azathioprine. The gastroenterology registrar has asked for your precision-prescribing plan before the first dose. Her TPMT result has just returned as a poor metaboliser, and her NUDT15 result is pending. You have eight minutes to state the tests to order, defend the action a poor-metaboliser result demands, plan the monitoring, and explain the result and the plan to the family in plain language.
Candidate brief
You have eight minutes to build a precision-prescribing plan for a ten-year-old starting azathioprine for Crohn disease. Use a structured approach: name the tests to order, defend the action a TPMT poor-metaboliser result demands, plan the monitoring, and communicate the result and the plan to the family in plain language. [1]
References2ShowHide
- [1]Relling MV, Schwab M, Whirl-Carrillo M Clinical Pharmacogenetics Implementation Consortium Guideline for Thiopurine Dosing Based on TPMT and NUDT15 Genotypes: 2018 Update. Clinical pharmacology and therapeutics, 2019.PMID 30447069
- [11]Maillard M, Nishii R, Yang W Additive effects of TPMT and NUDT15 on thiopurine toxicity in children with acute lymphoblastic leukemia across multiethnic populations. Journal of the National Cancer Institute, 2024.PMID 38230823