Repeated USMLE Questions Step 1 Review-167- Pharmacology

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Q- A patient treated with vancomycin develops acute kidney injury. Which concurrent medication increases this risk most significantly?

A- Amoxicillin

B- Azithromycin

C- Gentamicin

D- Metronidazole

C- Gentamicin- Both vancomycin and aminoglycosides are nephrotoxic; concurrent use significantly increases the risk of acute tubular injury.

 

Q- A patient who is taking a high dose of niacin for hyperlipidemia develops hyperglycemia. What explains this effect?

A- Decreased insulin secretion

B- Decreased peripheral glucose uptake

C- Increased hepatic gluconeogenesis

D- Increased pancreatic glucagon release

C- Increased hepatic gluconeogenesis- Niacin can impair glucose tolerance by increasing hepatic glucose production and reducing insulin sensitivity, leading to hyperglycemia.

 

Q- A patient with metastatic prostate cancer is treated with leuprolide. Shortly after therapy begins, his bone pain temporarily worsens. What explains this phenomenon?

A- Direct androgen receptor activation

B- Initial surge in luteinizing hormone and testosterone

C- Inhibition of adrenal steroid synthesis

D- Increased prolactin secretion

B- Initial surge in luteinizing hormone and testosterone- GnRH agonists like leuprolide initially stimulate LH and FSH release, causing a temporary rise in testosterone before receptor downregulation suppresses hormone production.

 

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Dr Ray Makar
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