04 Aug What is the most likely etiology of her symptoms?
A 32-year-old female is being treated with methotrexate for a recently diagnosed choriocarcinoma of the ovary, and presents with complaints of oral mucosal ulcers. The patient recalls being advised not to take folate-containing vitamins during therapy. An uncomplicated surgical exploration was performed 5 weeks ago with removal of the affected ovary. The patient has been taking methotrexate for 2 weeks and has never had any of the above symptoms before. On examination, patient was afebrile and appeared ill. Several mucosal ulcers were seen in her mouth. The patient also had some upper abdominal
tenderness. Her platelet count is decreased at 60,000/mm3 (normal 150,000 to
450,000/mm3).
- What is the most likely etiology of her symptoms?
- What is the biochemical explanation of her symptoms?
- What part of the cell cycle does methotrexate act on?
Required words: 100 – 150
