American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What condition may result from the use of Silver sulfadiazine in patients with G6PD deficiency?

1. Thrombocytopenia

2. Methemoglobinemia

3. Acidosis

4. Hyperkalemia

The correct answer is: Methemoglobinemia

Silver sulfadiazine, an antibacterial agent commonly used in the management of burns, can lead to methemoglobinemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. This condition arises because individuals with G6PD deficiency have an impaired ability to regenerate reduced glutathione, which is crucial for the detoxification of reactive oxygen species. When exposed to oxidizing agents such as silver sulfadiazine, these patients may experience an increase in methemoglobin levels due to the drug's oxidative effects. Methemoglobinemia occurs when the iron in hemoglobin is oxidized to the ferric form (Fe3+), rendering it unable to effectively carry oxygen. The risk of methemoglobinemia is particularly pertinent in patients with G6PD deficiency because their already compromised oxidative stress response can lead to a significant elevation in methemoglobin levels. Clinicians need to be vigilant about this potential complication and monitor G6PD-deficient patients closely when administering silver sulfadiazine. Other conditions listed, such as thrombocytopenia, acidosis, and hyperkalemia, are not direct complications associated with silver sulfadiazine in the context of G6PD deficiency.