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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
Line 8: Line 8:
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|SubCategory=Pulmonology, General Principles
|SubCategory=Pulmonology, General Principles
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|MainCategory=Pharmacology
Line 20: Line 21:
|MainCategory=Pharmacology
|MainCategory=Pharmacology
|SubCategory=Pulmonology, General Principles
|SubCategory=Pulmonology, General Principles
|Prompt=A 27 year old female patient is brought to the emergency department (ED) with severe abdominal pain and nausea. Her vital signs show a temperature of 36.8 degrees C (98.24 degrees F), a heart rate of 88 bpm, and a blood pressure measuring 128/78 mmHg. Her husband arrives to the ED shortly and informs the physician that the patient had ingested more than 20 tables of acetaminophen 5 hours before admission in an attempt to commit suicide. The physician decides to administer a medication to reduce the effect of toxicity. What is another indication for the same medication to be used for this patient's condition?
|Prompt=A 27-year-old woman is brought to the emergency department (ED) with severe abdominal pain and nausea. Her temperature is 36.8 °C (98.24 °F), heart rate is 88/min, and blood pressure is 128/78 mmHg. Her husband arrives to the ED shortly and informs the physician that the patient attempted to commit suicide and ingested more than 20 tables of acetaminophen 5 hours before admission. The physician decides to administer a drug to reduce the effect of acetaminophen toxicity. What is another indication for the same drug that is used to manage this patient's condition?
|Explanation=The patient is presenting with acetaminophen (paracetamol) toxicity. When patients present with delay, awaiting the serum levels of acetaminophen may not be very helpful. As such, giving N-acetylcysteine before the serum levels of acetaminophen are available becomes necessary. Symptoms of acetaminophen overdose are generally non-specific, such as abdominal pain and nausea.  
|Explanation=The patient is presenting with acetaminophen (paracetamol) toxicity. When patients present late, awaiting the serum levels of acetaminophen is not be very helpful, and administration of N-acetylcysteine prior to the return of serum concentration of acetaminophen is necessary. Symptoms of acetaminophen overdose are generally non-specific, and typical manifestations include abdominal pain and nausea. N-acetylcysteine is an anti-oxidant that regenerates glutathione and reduces the generation of toxic reactive oxygen species (ROS). It is used to reduce the effect of acetaminophen (paracetamol) toxicity. N-acetylcysteine is also a mucolytic that is usually used to manage patients with cystic fibrosis.
 
N-acetylcysteine is an anti-oxidant that may be used to reduce the effect of acetaminophen (paracetamol) toxicity by the regeneration of glutathione and reduction of toxic reactive oxygen species (ROS). N-acetylcysteine is also a mucolytic that is usuaully use in patients with cystic fibrosis.
 
Educational Objective: N-acetylcysteine is used as an antidote to reduce the toxicity of acetaminophen (paracetamol). It is also a mucolytic used in patients with cystic fibrosis.
|AnswerA=Mucolysis
|AnswerA=Mucolysis
|AnswerAExp=N-acetylcysteine is a mucolytic that is frequently used in patients with cystic fibrosis (CF)
|AnswerAExp=N-acetylcysteine is a mucolytic agent that is frequently used to manage patients with cystic fibrosis (CF)
|AnswerB=Decongestion
|AnswerB=Nasal congestion
|AnswerBExp=N-acetylcysteine is not a decongestant.
|AnswerBExp=N-acetylcysteine is not a decongestant.
|AnswerC=Exercise-induced asthma
|AnswerC=Exercise-induced asthma
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|AnswerE=Gastoesophageal reflux disease (GERD)
|AnswerE=Gastoesophageal reflux disease (GERD)
|AnswerEExp=N-acetylcysteine is not generally used to treat GERD.
|AnswerEExp=N-acetylcysteine is not generally used to treat GERD.
|EducationalObjectives=N-acetylcysteine reduces the effect of acetaminophen (paracetamol) toxicity. It is mucolytic agent used to manage patients with cystic fibrosis.
|RightAnswer=A
|RightAnswer=A
|WBRKeyword=acetaminophen, paracetamol, toxicity, overdose, suicide, attempt, commit, N-acetylcysteine, acetylcysteine, antidote, glutathione, regeneration, repletion, depletion, reactive, oxygen, species, mucolysis, mucolytic, cystic, fibrosis
|WBRKeyword=acetaminophen, paracetamol, toxicity, overdose, suicide, attempt, commit, N-acetylcysteine, acetylcysteine, antidote, glutathione, regeneration, repletion, depletion, reactive, oxygen, species, mucolysis, mucolytic, cystic, fibrosis
|Approved=No
|Approved=Yes
}}
}}

Revision as of 16:05, 9 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::Pulmonology, SubCategory::General Principles
Prompt [[Prompt::A 27-year-old woman is brought to the emergency department (ED) with severe abdominal pain and nausea. Her temperature is 36.8 °C (98.24 °F), heart rate is 88/min, and blood pressure is 128/78 mmHg. Her husband arrives to the ED shortly and informs the physician that the patient attempted to commit suicide and ingested more than 20 tables of acetaminophen 5 hours before admission. The physician decides to administer a drug to reduce the effect of acetaminophen toxicity. What is another indication for the same drug that is used to manage this patient's condition?]]
Answer A AnswerA::Mucolysis
Answer A Explanation AnswerAExp::N-acetylcysteine is a mucolytic agent that is frequently used to manage patients with cystic fibrosis (CF)
Answer B AnswerB::Nasal congestion
Answer B Explanation AnswerBExp::N-acetylcysteine is not a decongestant.
Answer C AnswerC::Exercise-induced asthma
Answer C Explanation AnswerCExp::N-acetylcysteine is not generally used to treat exercise-induced asthma.
Answer D AnswerD::Bronchoconstriction
Answer D Explanation AnswerDExp::N-acetylcysteine is not generally used to treat bronchoconstriction.
Answer E AnswerE::Gastoesophageal reflux disease (GERD)
Answer E Explanation AnswerEExp::N-acetylcysteine is not generally used to treat GERD.
Right Answer RightAnswer::A
Explanation [[Explanation::The patient is presenting with acetaminophen (paracetamol) toxicity. When patients present late, awaiting the serum levels of acetaminophen is not be very helpful, and administration of N-acetylcysteine prior to the return of serum concentration of acetaminophen is necessary. Symptoms of acetaminophen overdose are generally non-specific, and typical manifestations include abdominal pain and nausea. N-acetylcysteine is an anti-oxidant that regenerates glutathione and reduces the generation of toxic reactive oxygen species (ROS). It is used to reduce the effect of acetaminophen (paracetamol) toxicity. N-acetylcysteine is also a mucolytic that is usually used to manage patients with cystic fibrosis.

Educational Objective: N-acetylcysteine reduces the effect of acetaminophen (paracetamol) toxicity. It is mucolytic agent used to manage patients with cystic fibrosis.
References: ]]

Approved Approved::Yes
Keyword WBRKeyword::acetaminophen, WBRKeyword::paracetamol, WBRKeyword::toxicity, WBRKeyword::overdose, WBRKeyword::suicide, WBRKeyword::attempt, WBRKeyword::commit, WBRKeyword::N-acetylcysteine, WBRKeyword::acetylcysteine, WBRKeyword::antidote, WBRKeyword::glutathione, WBRKeyword::regeneration, WBRKeyword::repletion, WBRKeyword::depletion, WBRKeyword::reactive, WBRKeyword::oxygen, WBRKeyword::species, WBRKeyword::mucolysis, WBRKeyword::mucolytic, WBRKeyword::cystic, WBRKeyword::fibrosis
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