WBR283
| Author | PageAuthor::Gerald Chi |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Cardiology |
| Prompt | [[Prompt::A 32-year-old woman delivers a newborn at 33 weeks' gestation. The newborn has an idiopathic pulmonary arterial hypertension requiring inhaled nitric oxide therapy. Three hours later, the newborn is found to be cyanotic, lethargic, and develops a seizure. Which of the following treatment may be used as a potential therapy for the condition?]] |
| Answer A | AnswerA::Acetylcysteine |
| Answer A Explanation | [[AnswerAExp::Acetylcysteine replenishes reduced form of glutathione, which neutralizes the oxidative stress associated with acetaminophen overdose. It is also used in reducing the mucus viscosity in patients with cystic fibrosis by isolating disulfide bonds.]] |
| Answer B | AnswerB::EDTA |
| Answer B Explanation | AnswerBExp::EDTA is a chelating agent for treating heavy metal poisoning. It is also an anticoagulant for keeping blood samples. |
| Answer C | AnswerC::Ascorbic acid |
| Answer C Explanation | AnswerCExp::Ascorbic acid or methylene blue has the ability to convert ferric ion into ferrous ion in hemoglobin and restores its oxygen-binding capacity to the proper state. |
| Answer D | AnswerD::Nitrite |
| Answer D Explanation | AnswerDExp::Nitrite is used in cyanide poisoning that oxidizes iron to the ferric state and causes methemoglobinemia. |
| Answer E | AnswerE::Vitamin K |
| Answer E Explanation | AnswerEExp::Vitamin K is required for gamma carboxylation of glutamate residues and is used in warfarin overdose. |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation::Pulmonary arterial hypertension in the newborn may be idiopathic or associated with prematurity, pulmonary hypoplasia, or premature closure of the ductus arteriosus. In hypoxemic newborns with pulmonary hypertension, inhaled nitric oxide reduces pulmonary vascular resistance and decreases the need for extracorporeal membrane oxygenation therapy. Nitric oxide inhalation may result in elevations in methemoglobin. Educational Objective: |
| Approved | Approved::No |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |