WBR0728

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Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pharmacology
Sub Category SubCategory::Gastrointestinal
Prompt [[Prompt::A 48 year old male patient presents to the physician's office complaining of heartburn. Following appropriate work-up, he is diagnosed with gastro-esophageal reflux disease (GERD). The patient informs the physician that he has recently been using over-the-counter aluminum hydroxide, which has been effectively relieving his symptoms. Chronic use of aluminum hydroxide is associated with which of the following conditions?]]
Answer A AnswerA::Diarrhea
Answer A Explanation AnswerAExp::Magnesium-based antacids are associated with diarrhea.
Answer B AnswerB::Hyporeflexia
Answer B Explanation AnswerBExp::Magnesium-based antacids are associated with hyporeflexia.
Answer C AnswerC::Hemorrhoids
Answer C Explanation AnswerCExp::Aluminum-based antacids are associated with constipation, which might predispose to hemorrhoids.
Answer D AnswerD::Hyperkalemia
Answer D Explanation AnswerDExp::Generally, antacids are associated with hypokalemia, not hyperkalemia.
Answer E AnswerE::Cardiac arrest
Answer E Explanation AnswerEExp::Although very rare, magnesium-based antacids are associated with cardiac arrest.
Right Answer RightAnswer::C
Explanation [[Explanation::Aluminum-based antacids, such as aluminum hydroxide, are indicated for GERD. Although they are over-the-counter medications, they are not free of side effects. In comparison to other antacids, aluminum-based antacids are known to commonly cause constipation, which might predispose to hemorrhoids. As such, physicians must be cautious in allowing patients with hemorrhoids to use aluminum-based antacids because of their potential exacerbation.

Educational Objective: Aluminum hydroxide is associated with constipation, which might predispose to hemorrhoids.
Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::antacid, WBRKeyword::magnesium, WBRKeyword::aluminum, WBRKeyword::hydroxide, WBRKeyword::hemorrhoids, WBRKeyword::constipation, WBRKeyword::side, WBRKeyword::effect, WBRKeyword::GERD, WBRKeyword::gastroesophageal, WBRKeyword::reflux, WBRKeyword::disease, WBRKeyword::heartburn
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