WBR0362

Author	PageAuthor::Neeraja Danda M.B.B.S
Exam Type	ExamType::USMLE Step 2 CK
Main Category	MainCategory::Internal medicine
Sub Category	SubCategory::Cardiovascular
Prompt	[[Prompt::A 56 year old male presented to his physician’s office for his regular physical check up.He was discharged from the hospital one month prior after undergoing angioplasty for Unstable angina. Now he is on Clopidogrel, atenolol, Lipitor , Lisinopril and Nitrates.Today he asks whether he can resume his sexual activity and how long he should wait between taking his Nitrates and Sildenafil. What is your response?]]
Answer A	AnswerA::He can resume his sexual activity but should stop both nitrates and Sildenafil.
Answer A Explanation	AnswerAExp::'''Incorrect''' There is no need to stop both Nitrates and Sildenafil.
Answer B	AnswerB::He can only resume sexual activity after 3 months of angioplasty
Answer B Explanation	AnswerBExp::'''Incorrect''' He can resume sexual activity immediately if he does not have any symptoms now
Answer C	AnswerC::He can resume his sexual activity , and can take Sildenafil after 4 hours of taking nitrates
Answer C Explanation	AnswerCExp::'''Incorrect''' Sildenafil and Nitrates should never be combined
Answer D	AnswerD::He has to undergo Exercise stress testing again to check if he can resume his sexual activity
Answer D Explanation	AnswerDExp::'''incorrect''' Exercise stress testing is not needed at this point of time to resume sexual activity
Answer E	AnswerE::He can resume his sexual activity and should not combine Sildenafil and Nitrates
Answer E Explanation	AnswerEExp::Patient can participate in sexual activity immediately post myocardial infarction if he is totally symptom free. Sildenafil and nitrates should never be combined as the risk of hypotension is greater.
Right Answer	RightAnswer::E
Explanation	[[Explanation::Patient can participate in sexual activity immediately post myocardial infarction if he is totally symptom free. Sildenafil and nitrates should never be combined as the risk of hypotension is greater because both are vasodilators. Educational Objective: Patients post myocardial infarction can resume sexual activity immediately if they are symptom free. Sildenafil and Nitrates should not be combined as the risk of hypotension is increased with the combination References: Page 74 Master the boards Step 2 CK Second edition Educational Objective: References: ]]
Approved	Approved::Yes
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