WBR1017
| Author | [[PageAuthor::Ogheneochuko Ajari, MB.BS, MS [1] (Reviewed by Yazan Daaboul, M.D.)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Renal |
| Prompt | [[Prompt::A 35-year-old woman develops hypertension and creatinuria approximately 6 months following drug therapy. Urinalysis is negative for proteinuria. Renal biopsy demonstrates ischemic damage to the glomeruli with evidence of tubular damage. Which of the following is the most likely causative agent?]] |
| Answer A | AnswerA::Penicillin G |
| Answer A Explanation | AnswerAExp::Penicillin G is typically associated with acute hypertensive interstitial nephritis. |
| Answer B | AnswerB::Gentamicin |
| Answer B Explanation | AnswerBExp::Gentamicin is typically associated with acute tubular necrosis. |
| Answer C | AnswerC::Cyclosporin |
| Answer C Explanation | AnswerCExp::Correct. See explanation. |
| Answer D | AnswerD::Naproxen |
| Answer D Explanation | AnswerDExp::Naproxen is typically associated with chronic analgesic nephropathy but usually manifests first as papillary necrosis. |
| Answer E | AnswerE::Cyclophosphamide |
| Answer E Explanation | AnswerEExp::Cyclophosphamide is typically associated with cystitis. |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation::Cyclosporine is an immunosuppressant recommended among patients with autoimmune disorders and for the suppression of organ rejection following transplantation. It binds to cyclophilins, whereby the formed complex blocks the differentiation and activation of T-cells by inhibiting calcineurin. Subsequently, calcineurin prevents the production of IL-2 and its receptors. Cyclosporine is typically associated with nephrotoxicity and hypertension. Other adverse effects of cyclosporine include hyperlipidemia, hyperglycemia, tremor, hirsutism, and gingival hyperplasia. Educational Objective: |
| Approved | Approved::Yes |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |