WBR0768
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| Author | [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Pulmonology, SubCategory::General Principles |
| Prompt | [[Prompt::A 27-year-old woman is brought to the emergency department (ED) with severe abdominal pain and nausea. Her temperature is 36.8 °C (98.24 °F), heart rate is 88/min, and blood pressure is 128/78 mmHg. Her husband arrives to the ED shortly and informs the physician that the patient attempted suicide and ingested more than 20 tables of acetaminophen 5 hours before admission. The physician promptly administers an antioxidant drug that regenerates glutathione and reduces the effect of acetaminophen toxicity. The administered drug is also indicated to manage which condition?]] |
| Answer A | AnswerA::Mucus plugging |
| Answer A Explanation | AnswerAExp::N-acetylcysteine is an antioxidant and mucolytic agent that is frequently used to manage mucus plugging in patients with cystic fibrosis and COPD. |
| Answer B | AnswerB::Nasal congestion |
| Answer B Explanation | AnswerBExp::N-acetylcysteine is not a decongestant. |
| Answer C | AnswerC::Exercise-induced asthma |
| Answer C Explanation | AnswerCExp::N-acetylcysteine is not generally used to treat exercise-induced asthma. |
| Answer D | AnswerD::Bronchoconstriction |
| Answer D Explanation | AnswerDExp::N-acetylcysteine is not generally used to treat bronchoconstriction. |
| Answer E | AnswerE::Gastoesophageal reflux disease (GERD) |
| Answer E Explanation | AnswerEExp::N-acetylcysteine is not generally used to treat GERD. |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::The patient is presenting with acetaminophen (paracetamol) toxicity. When patients with acetaminophen toxicity present late, it is not necessary to wait for the the serum concentration of acetaminophen, and administration of N-acetylcysteine prior to the return of serum concentration of acetaminophen is necessary. Symptoms of acetaminophen overdose are generally non-specific, and typical manifestations include abdominal pain and nausea. N-acetylcysteine is an antioxidant that regenerates glutathione and reduces the generation of toxic reactive oxygen species (ROS). It is used to reduce the effect of acetaminophen (paracetamol) toxicity. In addition, N-acetylcysteine is a mucolytic agent that is usually used to manage mucus plugging in patients with cystic fibrosis and chronic obstructive pulmonary disease (COPD). Educational Objective: N-acetylcysteine is an antioxidant and mucolytic agent that is frequently used to manage mucus plugging in patients with cystic fibrosis and COPD. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Acetaminophen, WBRKeyword::Paracetamol, WBRKeyword::Toxicity, WBRKeyword::Overdose, WBRKeyword::Suicide, WBRKeyword::N-acetylcysteine, WBRKeyword::Acetylcysteine, WBRKeyword::COPD, WBRKeyword::Antioxidant, WBRKeyword::Antidote, WBRKeyword::Glutathione, WBRKeyword::Reactive oxygen species, WBRKeyword::Mucolysis, WBRKeyword::Cystic fibrosis |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |