WBR0501: Difference between revisions

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|MainCategory=Pathology, Pathophysiology, Pharmacology, Physiology
|MainCategory=Pathology, Pathophysiology, Pharmacology, Physiology
|SubCategory=Cardiology, Endocrine
|SubCategory=Cardiology, Endocrine
|MainCategory=Pathology, Pathophysiology, Pharmacology, Physiology
|MainCategory=Pathology, Pathophysiology, Pharmacology, Physiology
|MainCategory=Pathology, Pathophysiology, Pharmacology, Physiology
|MainCategory=Pathology, Pathophysiology, Pharmacology, Physiology
|MainCategory=Pathology, Pathophysiology, Pharmacology, Physiology
Line 21: Line 22:
|SubCategory=Cardiology, Endocrine
|SubCategory=Cardiology, Endocrine
|Prompt=A 56-year-old male is treated chronically with an antiarrhythmic drug.  After several months the patient comes to the clinic complaining of difficulty with concentration, constipation, decreased libido and hair loss. On physical exam the doctor notices a bluish coloration of the skin that catches the physician attention, as it is the first time seeing this unique physical sign. Which of the following changes in the cardiac cell action potential mostly correlates to the drug being used?
|Prompt=A 56-year-old male is treated chronically with an antiarrhythmic drug.  After several months the patient comes to the clinic complaining of difficulty with concentration, constipation, decreased libido and hair loss. On physical exam the doctor notices a bluish coloration of the skin that catches the physician attention, as it is the first time seeing this unique physical sign. Which of the following changes in the cardiac cell action potential mostly correlates to the drug being used?
|Explanation='''Overall explanation:''' This patient is receiving an anti-arrhythmic which is causing hypothyroidism represented by: difficulty concentrating, constipation, decreased libido and hair loss. Amiodarone typically causes thyroid problems and bluish discolorations of the skin.
|Explanation=This patient is receiving an anti-arrhythmic which is causing hypothyroidism represented by: difficulty concentrating, constipation, decreased libido and hair loss. Amiodarone typically causes thyroid problems and bluish discolorations of the skin.
<br>
 
<font color="MediumBlue"><font size="4">'''Educational Objective:'''</font></font>
Amiodarone causes hypothyroidism and bluish skin discoloration if used long term.
[[File:Anti-arrhytmic.png|center|600px]]
[[File:Anti-arrhytmic.png|center|600px]]
<br>'''References:'''First Aid for STEP 1 2013, cardiology chapter
|AnswerA=Decreases conduction velocity, increases the ERP and PR interval.
|AnswerA=Decreases conduction velocity, increases the ERP and PR interval.
|AnswerAExp=<font color="red">'''Incorrect.'''</font> This mechanism corresponds to calcium channel blockers.
|AnswerAExp=This mechanism corresponds to calcium channel blockers.
|AnswerB=Decreases the AP duration, acts preferably on ischemic and depolarized ventricular tissue.
|AnswerB=Decreases the AP duration, acts preferably on ischemic and depolarized ventricular tissue.
|AnswerBExp=<font color="red">'''Incorrect.'''</font> This mechanism corresponds to class IB sodium channel blockers.
|AnswerBExp=This mechanism corresponds to class IB sodium channel blockers.
|AnswerC=Increases the AP duration & ERP. Increases the QT interval. Increases the Phase III.
|AnswerC=Increases the AP duration & ERP. Increases the QT interval. Increases the Phase III.
|AnswerCExp=<font color="Green">'''Correct.'''</font> This mechanism of action corresponds to Amiodarone
|AnswerCExp=This mechanism of action corresponds to Amiodarone
|AnswerD=Increases AP duration, increases ERP, increases QT interval. Acts on both atria and ventricle.
|AnswerD=Increases AP duration, increases ERP, increases QT interval. Acts on both atria and ventricle.
|AnswerDExp=<font color="red">'''Incorrect.'''</font>  This mechanism corresponds to class IA sodium channel blockers.
|AnswerDExp=This mechanism corresponds to class IA sodium channel blockers.
|AnswerE=Decreases SA and AV nodal activity. Increases the PR interval. Decreases the slope of phase 4.
|AnswerE=Decreases SA and AV nodal activity. Increases the PR interval. Decreases the slope of phase 4.
|AnswerEExp=<font color="red">'''Incorrect.'''</font>  This corresponds to the mechanism of action of the beta blockers.
|AnswerEExp=This corresponds to the mechanism of action of the beta blockers.
|EducationalObjectives=Amiodarone causes hypothyroidism and bluish skin discoloration if used long term.
|References=First Aid 2013 page 303
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=Amiodarone
|WBRKeyword=Amiodarone
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 19:43, 14 September 2014
Author [[PageAuthor::Gonzalo A. Romero, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pathology, MainCategory::Pathophysiology, MainCategory::Pharmacology, MainCategory::Physiology
Sub Category SubCategory::Cardiology, SubCategory::Endocrine
Prompt [[Prompt::A 56-year-old male is treated chronically with an antiarrhythmic drug. After several months the patient comes to the clinic complaining of difficulty with concentration, constipation, decreased libido and hair loss. On physical exam the doctor notices a bluish coloration of the skin that catches the physician attention, as it is the first time seeing this unique physical sign. Which of the following changes in the cardiac cell action potential mostly correlates to the drug being used?]]
Answer A AnswerA::Decreases conduction velocity, increases the ERP and PR interval.
Answer A Explanation AnswerAExp::This mechanism corresponds to calcium channel blockers.
Answer B AnswerB::Decreases the AP duration, acts preferably on ischemic and depolarized ventricular tissue.
Answer B Explanation AnswerBExp::This mechanism corresponds to class IB sodium channel blockers.
Answer C AnswerC::Increases the AP duration & ERP. Increases the QT interval. Increases the Phase III.
Answer C Explanation AnswerCExp::This mechanism of action corresponds to Amiodarone
Answer D AnswerD::Increases AP duration, increases ERP, increases QT interval. Acts on both atria and ventricle.
Answer D Explanation AnswerDExp::This mechanism corresponds to class IA sodium channel blockers.
Answer E AnswerE::Decreases SA and AV nodal activity. Increases the PR interval. Decreases the slope of phase 4.
Answer E Explanation AnswerEExp::This corresponds to the mechanism of action of the beta blockers.
Right Answer RightAnswer::C
Explanation [[Explanation::This patient is receiving an anti-arrhythmic which is causing hypothyroidism represented by: difficulty concentrating, constipation, decreased libido and hair loss. Amiodarone typically causes thyroid problems and bluish discolorations of the skin.
File:Anti-arrhytmic.png

Educational Objective: Amiodarone causes hypothyroidism and bluish skin discoloration if used long term.
References: First Aid 2013 page 303]]

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