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(Created page with "{{WBRQuestion |QuestionAuthor=Gonzalo A. Romero, M.D. [mailto:gromero@wikidoc.org] |ExamType=USMLE Step 1 |MainCategory=Embryology, Microbiology, Pharm...")
 
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|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|Prompt=A 2-year-old girl is brought to the pediatrician because her mother is concerned about her teeth being darker than usual, even though she has been brushing her daughter’s kid consistently. She states that at week 8 of pregnancy, she developed a ring-like rash in the leg after a camping trip, for which she took leftover antibiotic from her brother when he develop a similar rash after a boy-scout excursion into the rural Connecticut. Which of the following mechanism of action corresponds to the mostly drug used?  
|Prompt=A 2-year-old girl is brought to the pediatrician because her mother is concerned about her teeth being darker than usual, even though she has been brushing her daughter’s kid consistently. She states that at week 8 of pregnancy, she developed a ring-like rash in the leg after a camping trip, for which she took leftover antibiotic from her brother when he developed a similar rash after a boy-scout excursion into rural Connecticut. Which of the following mechanisms of action corresponds to the most likely drug used?  
|Explanation=The clinical vignette describes a patient who delivered a child who developed discolored teeth.  She took an antibiotic during pregnancy to treat Lyme’s disease.  The treatment of choice of Lyme disease is tetracycline, which is contraindicated in pregnancy due to bone and teeth malformation.  The mechanism of action of tetracycline is to inhibit the protein synthesis by binding the 30s ribosomal subunit and preventing the aminoacyl-tRNA attachment.
|Explanation=The clinical vignette describes a patient who delivered a child who currently has discolored teeth.  She took an antibiotic during pregnancy to treat Lyme’s disease.  The treatment of choice of [[Lyme]] disease is [[tetracycline]], which is contraindicated in pregnancy due to bone and teeth malformation.  Tetracycline, specifically doxycycline inhibits the protein synthesis by binding to the 30s ribosomal subunit and preventing the aminoacyl-tRNA attachment.
Educational objective:  tetracycline use during pregnancy is associated with teeth discoloration (teratogenic)
Educational objective:  tetracycline use during pregnancy is associated with teeth discoloration (teratogenic)


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|RightAnswer=A
|RightAnswer=A
|WBRKeyword=Teratogen
|WBRKeyword=Teratogen
|Approved=No
|Approved=Yes
}}
}}

Revision as of 12:46, 25 September 2013

 
Author [[PageAuthor::Gonzalo A. Romero, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Embryology, MainCategory::Microbiology, MainCategory::Pharmacology
Sub Category SubCategory::Infectious Disease
Prompt [[Prompt::A 2-year-old girl is brought to the pediatrician because her mother is concerned about her teeth being darker than usual, even though she has been brushing her daughter’s kid consistently. She states that at week 8 of pregnancy, she developed a ring-like rash in the leg after a camping trip, for which she took leftover antibiotic from her brother when he developed a similar rash after a boy-scout excursion into rural Connecticut. Which of the following mechanisms of action corresponds to the most likely drug used?]]
Answer A AnswerA::Prevents attachment of aminoacyl-tRNA
Answer A Explanation AnswerAExp::Correct
Answer B AnswerB::Inhibits the formation of initiation complex
Answer B Explanation [[AnswerBExp::This is the mechanism of action of aminoglycosides used for gram negative rod infections]]
Answer C AnswerC::Blocks translocation
Answer C Explanation AnswerCExp::This is the mechanism of action of macrolides, used to treat atypical pneumonias (Mycoplasma, Chlamydia, Legionella), URiI, STDs, gram-positive cocci (streptococcal infections in patients allergic to penicillin), and Neisseria
Answer D AnswerD::Require 02 for uptake;
Answer D Explanation AnswerDExp::This refers to aminoglycosides
Answer E AnswerE::Inhibit peptidyl-transferase action
Answer E Explanation [[AnswerEExp::This is the mechanism of action of chloramphenicol]]
Right Answer RightAnswer::A
Explanation [[Explanation::The clinical vignette describes a patient who delivered a child who currently has discolored teeth. She took an antibiotic during pregnancy to treat Lyme’s disease. The treatment of choice of Lyme disease is tetracycline, which is contraindicated in pregnancy due to bone and teeth malformation. Tetracycline, specifically doxycycline inhibits the protein synthesis by binding to the 30s ribosomal subunit and preventing the aminoacyl-tRNA attachment.

Educational objective: tetracycline use during pregnancy is associated with teeth discoloration (teratogenic)
Educational Objective:
References: ]]

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