WBR0759: Difference between revisions

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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{YD}} (Reviewed by {{YD}})
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Pharmacology
|MainCategory=Pharmacology
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|MainCategory=Pharmacology
|MainCategory=Pharmacology
|SubCategory=Vascular, General Principles
|SubCategory=Vascular, General Principles
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|MainCategory=Pharmacology
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|MainCategory=Pharmacology
|MainCategory=Pharmacology
|SubCategory=Vascular, General Principles
|SubCategory=Vascular, General Principles
|Prompt=A 45 year old male patient with no past medical history presents to the physician's office for hair loss. Upon further questioning, the patient explains that he has a strong family history of baldness. Physical examination shows male-pattern baldness with no evidence of skin disease. The physician prescribes a topical medication for hair loss. The patient asks if he can use the same active ingredient of the medication but as oral tablets instead of topical solution. The physician informs the patient that the oral form of the same medication has another indication. What is the most likely indication for the oral form of the prescribed topical solution?
|Prompt=A 45-year-old man with no past medical history presents to the physician's office for hair loss. Upon further questioning, the patient explains that he has a strong family history of baldness. Physical examination is remarkable for male pattern baldness with no evidence of skin disease. The physician prescribes a topical medication to reduce the patient's hair loss. The patient then asks if he can use the same drug in an oral preparation instead, but the physician explains that oral administration of the drug is indicated for another disease. What is the indication for the oral form of the prescribed topical solution?
|Explanation=Minoxidil is a potent antihypertensive medication that causes vasodilation. Although initially produced for its antihypertensive effects, it was then found to cause hair growth as a side effect. As such, it is now produced as a topical solution for the treatment of male-pattern baldness. Minoxidil has a powerful effect only when it is is continuously used topically. Patients who fail to adhere to its use will not benefit from hair growth; and hair that already grew with the help of minoxidil will fall again if the medication is discontinued.
|Explanation=Minoxidil is a potent vasodilator indicated for the management of hypertension. Although initially manufactured for its antihypertensive effects, it was then discovered to cause hair growth. Topical minoxidil is currently manufactured and indicated for male pattern baldness. Compliance with the topical agent is difficult because it requires daily application, whereas the sustained benefit is only observed if the drug is applied daily and consistently. Oral minoxidil is still used for severe refractory cases of hypertension; although its use has generally decreased given the availability of other potent and safer drugs and its association with serious cardiac adverse events.
 
Oral minoxidil is still used for severe refractory cases of hypertension; although its use has generally decreased due to its serious side effect profile, including cardiac adverse events.
 
Educational Objective: Topical minoxidil may be used for male-pattern baldness, whereas oral minoxidil may be used to treat refractory severe hypertension.
|AnswerA=Dyslipidemia
|AnswerA=Dyslipidemia
|AnswerAExp=Minoxidil is not used to treat dyslipidemia.
|AnswerAExp=Oral minoxidil is not used to treat dyslipidemia.
|AnswerB=Atopic dermatitis
|AnswerB=Atopic dermatitis
|AnswerBExp=Minoxidil is not used to treat atopic dermatitis.
|AnswerBExp=Oral minoxidil is not used to treat atopic dermatitis.
|AnswerC=Hypertension
|AnswerC=Hypertension
|AnswerCExp=Oral minoxidil is used to treat severe refractory hypertension.
|AnswerCExp=Oral minoxidil is used to treat severe refractory hypertension.
|AnswerD=Psoriasis
|AnswerD=Psoriasis
|AnswerDExp=Minoxidil is not used to treat psoriasis.
|AnswerDExp=Oral minoxidil is not used to treat psoriasis.
|AnswerE=Anemia
|AnswerE=Anemia
|AnswerEExp=Minoxidil is not used to treat anemia.
|AnswerEExp=Oral minoxidil is not used to treat anemia.
|EducationalObjectives=Topical minoxidil may be applied daily to treat male-pattern baldness. In contrast, oral minoxidil is indicated for severe refractory hypertension.
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=minoxidil, hypertension, antihypertensive, medication, side, effect, topical, solution, male, pattern, baldness, bald, hair, loss, growth
|WBRKeyword=Minoxidil, Hypertension, Male pattern baldness, Oral, Topical, Antihypertensive
|Approved=No
|Approved=Yes
}}
}}

Revision as of 23:12, 6 March 2015
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::Vascular, SubCategory::General Principles
Prompt [[Prompt::A 45-year-old man with no past medical history presents to the physician's office for hair loss. Upon further questioning, the patient explains that he has a strong family history of baldness. Physical examination is remarkable for male pattern baldness with no evidence of skin disease. The physician prescribes a topical medication to reduce the patient's hair loss. The patient then asks if he can use the same drug in an oral preparation instead, but the physician explains that oral administration of the drug is indicated for another disease. What is the indication for the oral form of the prescribed topical solution?]]
Answer A AnswerA::Dyslipidemia
Answer A Explanation AnswerAExp::Oral minoxidil is not used to treat dyslipidemia.
Answer B AnswerB::Atopic dermatitis
Answer B Explanation AnswerBExp::Oral minoxidil is not used to treat atopic dermatitis.
Answer C AnswerC::Hypertension
Answer C Explanation AnswerCExp::Oral minoxidil is used to treat severe refractory hypertension.
Answer D AnswerD::Psoriasis
Answer D Explanation AnswerDExp::Oral minoxidil is not used to treat psoriasis.
Answer E AnswerE::Anemia
Answer E Explanation AnswerEExp::Oral minoxidil is not used to treat anemia.
Right Answer RightAnswer::C
Explanation [[Explanation::Minoxidil is a potent vasodilator indicated for the management of hypertension. Although initially manufactured for its antihypertensive effects, it was then discovered to cause hair growth. Topical minoxidil is currently manufactured and indicated for male pattern baldness. Compliance with the topical agent is difficult because it requires daily application, whereas the sustained benefit is only observed if the drug is applied daily and consistently. Oral minoxidil is still used for severe refractory cases of hypertension; although its use has generally decreased given the availability of other potent and safer drugs and its association with serious cardiac adverse events.

Educational Objective: Topical minoxidil may be applied daily to treat male-pattern baldness. In contrast, oral minoxidil is indicated for severe refractory hypertension.
References: ]]

Approved Approved::Yes
Keyword WBRKeyword::Minoxidil, WBRKeyword::Hypertension, WBRKeyword::Male pattern baldness, WBRKeyword::Oral, WBRKeyword::Topical, WBRKeyword::Antihypertensive
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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