Repeated USMLE Questions Step 1 Review-165- Pharmacology

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Q- A patient with heart failure is started on sacubitril/valsartan. What is the primary pharmacologic action of sacubitril?

A- Angiotensin II receptor blockade

B- Inhibition of neprilysin

C- Inhibition of renin release

D- Stimulation of natriuretic peptide receptors

B- Inhibition of neprilysin- Sacubitril inhibits neprilysin, the enzyme that degrades natriuretic peptides, leading to increased vasodilation, natriuresis, and reduced cardiac remodeling. It is combined with valsartan to block RAAS activation.

 

Q- A patient taking linezolid develops thrombocytopenia after prolonged therapy. What is the underlying mechanism?

A- Direct platelet destruction

B- Immune complex deposition

C- Mitochondrial protein synthesis inhibition

D- Vitamin K antagonism

C- Mitochondrial protein synthesis inhibition- Linezolid inhibits the 50S ribosomal subunit but can also affect mitochondrial ribosomes, leading to bone marrow suppression and thrombocytopenia with long-term use.

 

Q- A patient with atrial fibrillation is prescribed sotalol. Which additional pharmacologic property does this drug possess?

A- Alpha-1 blockade

B- Beta-adrenergic blockade

C- Calcium channel blockade

D- Sodium channel blockade

B- Beta-adrenergic blockade- Sotalol is both a nonselective beta blocker and a Class III antiarrhythmic that prolongs repolarization by blocking potassium channels.

 

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Dr Ray Makar
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