WBR1017
| Author | [[PageAuthor::Ogheneochuko Ajari, MB.BS, MS [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Renal |
| Prompt | [[Prompt::A 35- year old female patient develops hypertension and creatinuria after 6 months of a drug therapy. Urinalysis is negative for proteinuria. A biopsy shows ischemic damage to the glomeruli and some tubular damage. Which of the following is the most likely causative agent?]] |
| Answer A | AnswerA::Penicillin G |
| Answer A Explanation | AnswerAExp::Incorrect. Penicillin G causes acute hypertensive interstitial nephritis |
| Answer B | AnswerB::Gentamicin |
| Answer B Explanation | AnswerBExp::Incorrect. Gentamicin causes acute tubular necrosis, which mainly involves the kidneys |
| Answer C | AnswerC::Cyclosporin |
| Answer C Explanation | AnswerCExp::Correct. See explanation. |
| Answer D | AnswerD::Naproxen |
| Answer D Explanation | AnswerDExp::Incorrect. Naproxen may cause chronic analgesic nephropathy but would manifest first as papillary necrosis |
| Answer E | AnswerE::Cyclophosphamide |
| Answer E Explanation | AnswerEExp::Incorrect. Cyclophosphamide causes cystitis |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation::Cyclosporine is an immunosuppressant used in selected autoimmune disorders and suppresses organ rejection after transplantation. It binds to cyclophilins and the complex blocks the differentiation and activation of T-cells by inhibiting calcineurin, which prevents the production of IL-2 and its receptors. It causes nephrotoxicity and hypertension. Other effects of cyclosporine include; hyperlipidemia, hyperglycemia, tremor, hirsutism and gingival hyperplasia.
Reference: First AID for the USMLE Step 1 2013 pg 209 |
| Approved | Approved::Yes |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |