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|SubCategory=Neurology
|SubCategory=Neurology
|Prompt=A 35 year-old male comes to the emergency room for acute medical care due to a persistent erection, which he thought it would go away. He is very concerned because this  erection has lasted more than 6 hours. He usually has erections throughout the night and in the morning, but normally last a couple of minute. He denies any sexual encounter the night before.  The nurse practitioner meets the patient in the ER and starts asking health relevant questions.  Upon interrogation, he states he has an intense pain over his penis.  He recently was prescribed a medication to aid with sleep, which he has been taking for the last 6 weeks.  He has a history of depression.  His vitals are BP=126/70 mmHg, HR=87, RR=16, T=37 C.  The nurse practitioner communicates the information to the medical team.  They team is concerned that the drug prescribed to this patient to “aid with his sleep” is associated with his symptoms.  Which of the following is the mechanism of action of the drug most likely prescribed to this patient?
|Prompt=A 35 year-old male comes to the emergency room for acute medical care due to a persistent erection, which he thought it would go away. He is very concerned because this  erection has lasted more than 6 hours. He usually has erections throughout the night and in the morning, but normally last a couple of minute. He denies any sexual encounter the night before.  The nurse practitioner meets the patient in the ER and starts asking health relevant questions.  Upon interrogation, he states he has an intense pain over his penis.  He recently was prescribed a medication to aid with sleep, which he has been taking for the last 6 weeks.  He has a history of depression.  His vitals are BP=126/70 mmHg, HR=87, RR=16, T=37 C.  The nurse practitioner communicates the information to the medical team.  They team is concerned that the drug prescribed to this patient to “aid with his sleep” is associated with his symptoms.  Which of the following is the mechanism of action of the drug most likely prescribed to this patient?
|Explanation=Trazadone [http://www.wikidoc.org/index.php/Trazadone] is an atypical antidepressant used mainly to treat insomnia.  With high doses it can be used to treat depression.  An important side effect is priapism, which is a painful sustained penile erection.  It also causes sedation, nausea, and postural hypotension.   
|Explanation=[[Trazadone]] is an atypical antidepressant used mainly to treat insomnia.  With high doses it can be used to treat depression.  An important side effect is priapism, which is a painful sustained penile erection.  It also causes sedation, nausea, and postural hypotension.  It acts by inhibiting serotonin reuptake primarily
It acts by inhibiting serotonin reuptake primarily
<br>
 
<font color="MediumBlue"><font size="4">'''Educational Objective:''' </font></font> Trazadone is an atypical antidepressant, which is used to treat insomnia. It acts by inhibiting serotonin reuptake primarily.  Its typical side effect is  [http://www.wikidoc.org/index.php/Priapism priapism]
Educational objective: Trazadone is an atypical antidepressant, which is used to treat insomnia. It acts by inhibiting serotonin reuptake primarily.  Its typical side effect is  [http://www.wikidoc.org/index.php/Priapism priapism]
'''References:''' First Aid 2013, page 476
 
Tags: #Pharmacology #Psychiatry
References: First Aid 2013 page 476
 
|AnswerA=Inhibits serotonin reuptake
|AnswerA=Inhibits serotonin reuptake
|AnswerAExp=Correct
|AnswerAExp=Correct
 
|AnswerB=<font color="Green">'''Correct.'''</font> Inhibits NE reuptake
|AnswerB=Inhibits NE reuptake
|AnswerBExp=<font color="red">'''Incorrect.'''</font> [[Maprotiline]] is an atypical antidepressant which acts by blocking NE reuptake.  It can cause sedation as a side effect.
 
|AnswerBExp=B. Maprotiline is an atypical antidepressant which acts by blocking NE reuptake.  It can cause sedation as a side effect.
 
|AnswerC=Serotonin receptor agonist
|AnswerC=Serotonin receptor agonist
 
|AnswerCExp=<font color="red">'''Incorrect.'''</font> [[Buspirone]] used to treat general anxiety disorder, acts by stimulating setononin (5-HT1a) receptors.  It does not cause sedation, addiction or tolerance.
|AnswerCExp=C. Buspirone used to treat general anxiety disorder, acts by stimulating setononin (5-HT1a) receptors.  It does not cause sedation, addiction or tolerance.
 
|AnswerD=Alpha-2 receptor antagonist
|AnswerD=Alpha-2 receptor antagonist
 
|AnswerDExp=<font color="red">'''Incorrect.'''</font> [[Mirtazapine]] is an atypical antidepressant, which acts blocking the alpha-2 receptors in the presynaptic neurons increasing the release of NE and serotonin.  It causes sedation; therefore it can be used in depressed patients with insomnia. Also causes an increase in the appetite leading to weight gain (this could be beneficial in elderly or anorexic patients).
|AnswerDExp=D. Mirtazapine is an atypical antidepressant, which acts blocking the alpha-2 receptors in the presynaptic neurons increasing the release of NE and serotonin.  It causes sedation; therefore it can be used in depressed patients with insomnia. Also causes an increase in the appetite leading to weight gain (this could be beneficial in elderly or anorexic patients).
 
|AnswerE=GABA receptor moduling
|AnswerE=GABA receptor moduling
|AnswerEExp=E. Different drugs act by increasing the opening of GABA channels such as benzodiazepines and barbiturates.
|AnswerEExp=<font color="red">'''Incorrect.'''</font> Different drugs act by increasing the opening of GABA channels such as [[benzodiazepines]] and [[barbiturates]].
|RightAnswer=A
|RightAnswer=A
|Approved=Yes
|Approved=Yes
}}
}}
{{WBRImage|||Explanation}}
{{WBRImage|||Explanation}}

Revision as of 05:00, 9 September 2013

 
Author PageAuthor::Gonzalo Romero
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Behavioral Science/Psychiatry, MainCategory::Pharmacology
Sub Category SubCategory::Neurology
Prompt [[Prompt::A 35 year-old male comes to the emergency room for acute medical care due to a persistent erection, which he thought it would go away. He is very concerned because this erection has lasted more than 6 hours. He usually has erections throughout the night and in the morning, but normally last a couple of minute. He denies any sexual encounter the night before. The nurse practitioner meets the patient in the ER and starts asking health relevant questions. Upon interrogation, he states he has an intense pain over his penis. He recently was prescribed a medication to aid with sleep, which he has been taking for the last 6 weeks. He has a history of depression. His vitals are BP=126/70 mmHg, HR=87, RR=16, T=37 C. The nurse practitioner communicates the information to the medical team. They team is concerned that the drug prescribed to this patient to “aid with his sleep” is associated with his symptoms. Which of the following is the mechanism of action of the drug most likely prescribed to this patient?]]
Answer A AnswerA::Inhibits serotonin reuptake
Answer A Explanation AnswerAExp::Correct
Answer B [[AnswerB::Correct. Inhibits NE reuptake]]
Answer B Explanation [[AnswerBExp::Incorrect. Maprotiline is an atypical antidepressant which acts by blocking NE reuptake. It can cause sedation as a side effect.]]
Answer C AnswerC::Serotonin receptor agonist
Answer C Explanation [[AnswerCExp::Incorrect. Buspirone used to treat general anxiety disorder, acts by stimulating setononin (5-HT1a) receptors. It does not cause sedation, addiction or tolerance.]]
Answer D AnswerD::Alpha-2 receptor antagonist
Answer D Explanation [[AnswerDExp::Incorrect. Mirtazapine is an atypical antidepressant, which acts blocking the alpha-2 receptors in the presynaptic neurons increasing the release of NE and serotonin. It causes sedation; therefore it can be used in depressed patients with insomnia. Also causes an increase in the appetite leading to weight gain (this could be beneficial in elderly or anorexic patients).]]
Answer E AnswerE::GABA receptor moduling
Answer E Explanation [[AnswerEExp::Incorrect. Different drugs act by increasing the opening of GABA channels such as benzodiazepines and barbiturates.]]
Right Answer RightAnswer::A
Explanation [[Explanation::Trazadone is an atypical antidepressant used mainly to treat insomnia. With high doses it can be used to treat depression. An important side effect is priapism, which is a painful sustained penile erection. It also causes sedation, nausea, and postural hypotension. It acts by inhibiting serotonin reuptake primarily


Educational Objective: Trazadone is an atypical antidepressant, which is used to treat insomnia. It acts by inhibiting serotonin reuptake primarily. Its typical side effect is priapism References: First Aid 2013, page 476
Educational Objective:
References: ]]

Approved Approved::Yes
Keyword
Linked Question Linked::
Order in Linked Questions LinkedOrder::


Image [[WBRImage::|]] Caption WBRImageCaption::no-display Position [[WBRImagePlace::Explanation|]]