WBR0441
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Cardiology |
| Prompt | [[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?]] |
| Answer A | AnswerA::Digitalis |
| Answer A Explanation | 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. |
| Answer B | AnswerB::Nesiritide |
| Answer B Explanation | AnswerBExp::Nesiritide is a B-natriuretic peptide that is used effectively in 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 is a K-channel opener that hyperpolarizes and relaxes vascular smooth muscle cells. |
| Answer E | AnswerE::Fenoldopam |
| Answer E Explanation | AnswerEExp::Fenoldopam is a dopamine D1 receptor agonist that is especially used to relax renal vascular smooth muscles. |
| Right Answer | RightAnswer::B |
| Explanation | [[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.
Educational Objective: 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. |
| Approved | Approved::No |
| Keyword | WBRKeyword::Nesiritide, WBRKeyword::decompensated, WBRKeyword::heart, WBRKeyword::failure, WBRKeyword::natriuretic, WBRKeyword::peptide |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |