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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Pharmacology
|MainCategory=Pharmacology
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|MainCategory=Pharmacology
|MainCategory=Pharmacology
|SubCategory=Cardiology
|SubCategory=Cardiology
|Prompt=A 78 year old patient with heart failure is brought to the emergency department with severe shortness of breath at rest. Upon evaluation, the patient is diagnosed with decompensated heart failure and is started on a recombinant B-type natriuretic peptide.  Which of the following medications has been most likely prescribed in this patient?
|Prompt=A 78-year-old male with heart failure is brought to the emergency room with complaints of severe shortness of breath at rest. Upon evaluation, the patient is diagnosed with decompensated heart failure and is administered a recombinant B-type natriuretic peptide.  Which of the following medications is most likely administered to this patient?
|Explanation=[[Nesiritide]] is an effective medication in reducing symptoms and left ventricular ([[LV]]) filling pressures in patients with acute [[decompensated heart failure]]. Nesiritide is a recombinant B-type natriuretic peptide.
|Explanation=[[Nesiritide]], a recombinant B-type natriuretic peptide, is frequently administered to reduce symptoms and left ventricular ([[LV]]) filling pressure in patients with acute [[decompensated heart failure]].
|EducationalObjectives= [[Nesiritide]], a recombinant B-type natriuretic peptide, is frequently administered to patients with [[decompensated heart failure]].


Educational Objective:
|References= Weeks SG. Nesiritide: the clinical experience.  Can J Cardiol. 2008;24(Suppl B):19B-21B.
Nesiritide is a recombinant B-type natriuretic peptide that is useful in decompensated heart failure.
 
Reference:
Weeks SG. Nesiritide: the clinical experience.  Can J Cardiol. 2008;24(Suppl B):19B-21B.


|AnswerA=Digitalis
|AnswerA=Digitalis
 
|AnswerAExp=[[Digitalis]], an inhibitor of Na/K/ATPase, indirectly causes accumulation intracellular Calcium by inactivating the Na/Ca exchanger, which requires an Na gradient to function.
|AnswerAExp=Digitalis is an inhibitor of Na/K/ATPase that indirectly causes accumulation intracellular Calcium by indirectly inactivating the Na/Ca exchanger that requires Na gradient to function.
|AnswerB=Nesiritide
|AnswerB=Nesiritide
 
|AnswerBExp=[[Nesiritide]], a B-natriuretic peptide, is frequently administered to elderly patients with [[decompensated heart failure]].  
|AnswerBExp=Nesiritide is a B-natriuretic peptide that is used effectively in elderly patients with decompensated heart failure.  
|AnswerC=Sodium Nitroprusside (SNP)
|AnswerC=Sodium Nitroprusside (SNP)
 
|AnswerCExp=[[Nitroprusside]] is a short-acting drug that increases the intracellular production of cGMP and nitrous oxide (NO).
|AnswerCExp=Nitroprusside is a short-acting drug that increases the intracellular production of cGMP and nitrous oxide (NO).
|AnswerD=Diazoxide
|AnswerD=Diazoxide
|AnswerDExp=Diazoxide is a K-channel opener that hyperpolarizes and relaxes vascular smooth muscle cells.
|AnswerDExp=[[Diazoxide]], a K-channel opener, hyperpolarizes and relaxes vascular smooth muscle cells.
|AnswerE=Fenoldopam
|AnswerE=Fenoldopam
|AnswerEExp=Fenoldopam is a dopamine D1 receptor agonist that is especially used to relax renal vascular smooth muscles.
|AnswerEExp=[[Fenoldopam]], a dopamine D1 receptor agonist, is frequently used to relax renal vascular smooth muscles.
|RightAnswer=B
|RightAnswer=B
|WBRKeyword=Nesiritide, decompensated, heart, failure, natriuretic, peptide
|WBRKeyword=Nesiritide, decompensated heart failure, natriuretic peptide, cardiovascular, cardiology, elderly, Left ventricular, heart
|Approved=No
|Approved=Yes
}}
}}

Revision as of 14:34, 23 July 2014

 
Author [[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Alison Leibowitz)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pharmacology
Sub Category SubCategory::Cardiology
Prompt [[Prompt::A 78-year-old male with heart failure is brought to the emergency room with complaints of severe shortness of breath at rest. Upon evaluation, the patient is diagnosed with decompensated heart failure and is administered a recombinant B-type natriuretic peptide. Which of the following medications is most likely administered to this patient?]]
Answer A AnswerA::Digitalis
Answer A Explanation [[AnswerAExp::Digitalis, an inhibitor of Na/K/ATPase, indirectly causes accumulation intracellular Calcium by inactivating the Na/Ca exchanger, which requires an Na gradient to function.]]
Answer B AnswerB::Nesiritide
Answer B Explanation [[AnswerBExp::Nesiritide, a B-natriuretic peptide, is frequently administered to elderly patients with decompensated heart failure.]]
Answer C AnswerC::Sodium Nitroprusside (SNP)
Answer C Explanation [[AnswerCExp::Nitroprusside is a short-acting drug that increases the intracellular production of cGMP and nitrous oxide (NO).]]
Answer D AnswerD::Diazoxide
Answer D Explanation [[AnswerDExp::Diazoxide, a K-channel opener, hyperpolarizes and relaxes vascular smooth muscle cells.]]
Answer E AnswerE::Fenoldopam
Answer E Explanation [[AnswerEExp::Fenoldopam, a dopamine D1 receptor agonist, is frequently used to relax renal vascular smooth muscles.]]
Right Answer RightAnswer::B
Explanation [[Explanation::Nesiritide, a recombinant B-type natriuretic peptide, is frequently administered to reduce symptoms and left ventricular (LV) filling pressure in patients with acute decompensated heart failure.

Educational Objective: Nesiritide, a recombinant B-type natriuretic peptide, is frequently administered to patients with decompensated heart failure.
References: Weeks SG. Nesiritide: the clinical experience. Can J Cardiol. 2008;24(Suppl B):19B-21B.]]

Approved Approved::Yes
Keyword WBRKeyword::Nesiritide, WBRKeyword::decompensated heart failure, WBRKeyword::natriuretic peptide, WBRKeyword::cardiovascular, WBRKeyword::cardiology, WBRKeyword::elderly, WBRKeyword::Left ventricular, WBRKeyword::heart
Linked Question Linked::
Order in Linked Questions LinkedOrder::