Guess the diuretic! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 03-20-2012
bunny's Avatar
Banned
 
Steps History: Not yet
Posts: 176
Threads: 34
Thanked 117 Times in 69 Posts
Reputation: 127
Urine Sample Guess the diuretic!

An experiment is done to ascertain the effect of a drug in a healthy subject:


.................................................. ............................... (After injection of Drug)
..................................(Before Injection of Drug)........ (10 minutes) ....... (20 minutes)

Urine volume(mL/min) ............... 5 ..................................... 22 ..................... 18
Urine Osmolarity(mOsm/kg)........ 1200 ............................... 800 ................... 300
Urinary Na excretion (mEq/min) .. 0.5 ................................. 4 ....................... 3
Plasma Renin activity(ng/L/min)... 25 .................................. 90 ...................... 100


The drug injected was most likely?

A- Acetazolamide
B- Furosemide
C- Hydrochlorothiazide
D- Spironolectone
E- Triamterene
Reply With Quote Quick reply to this message



  #2  
Old 03-20-2012
LatinGeorge's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 653
Threads: 47
Thanked 409 Times in 249 Posts
Reputation: 419
Default

I would say spironolactone
Reply With Quote Quick reply to this message
The above post was thanked by:
DefeatTheBeast (03-20-2012)
  #3  
Old 03-20-2012
doxy's Avatar
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 38
Threads: 8
Thanked 9 Times in 5 Posts
Reputation: 19
Default b

y cant it be B
frusemide has a short onset of action...
whereas spironolactone has a slower one taking days to develop
Reply With Quote Quick reply to this message
 
  #4  
Old 03-20-2012
beka-CTS's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 763
Threads: 77
Thanked 1,371 Times in 349 Posts
Reputation: 1381
Default

i would go with B too.
__________________
Step 1 - 244 [✔] Step 2 CK - 246 [✔] Step 2 CS [✔] Step 3 - 228 [✔] Match [EMORY SOM] YOG: 2013, 4 Months of USCE University Hospital
Reply With Quote Quick reply to this message
  #5  
Old 03-20-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

Looks like Furosemide to me.
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message
  #6  
Old 03-20-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 96
Threads: 15
Thanked 19 Times in 18 Posts
Reputation: 29
Default

can someone please explain
Reply With Quote Quick reply to this message
  #7  
Old 03-20-2012
LatinGeorge's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 653
Threads: 47
Thanked 409 Times in 249 Posts
Reputation: 419
Default

Quote:
Originally Posted by DocSikorski View Post
Looks like Furosemide to me.
I though so too but i went with D. because of urine osm, after injection, by blocking the NA/K/CL pump, should the osm go up?.. and in this case goes down


By blocking aldosterone receptor, you block Na and Water reabsorption, in other words OSM goes down, what happened here

thats why i went with D. but still don't know
Reply With Quote Quick reply to this message
  #8  
Old 03-20-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

Quote:
Originally Posted by LatinGeorge View Post
I though so too but i went with D. because of urine osm, after injection, by blocking the NA/K/CL pump, should the osm go up?.. and in this case goes down


By blocking aldosterone receptor, you block Na and Water reabsorption, in other words OSM goes down, what happened here

thats why i went with D. but still don't know
I see the point. Might be.
This looks like it acts pretty fast, I thought of hypertensive emergency...
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message
  #9  
Old 03-20-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 457
Threads: 62
Thanked 276 Times in 186 Posts
Reputation: 286
Default

i would chose frusimide because Spironalactone is not THAT fast acting.to cause this much diuresis in 10 min, i think it should be Frusimide
Reply With Quote Quick reply to this message
  #10  
Old 03-20-2012
LatinGeorge's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 653
Threads: 47
Thanked 409 Times in 249 Posts
Reputation: 419
Default

Quote:
Originally Posted by kdm0101 View Post
i would chose frusimide because Spironalactone is not THAT fast acting.to cause this much diuresis in 10 min, i think it should be Frusimide
yep, that is correct big detail
Reply With Quote Quick reply to this message
  #11  
Old 03-20-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 457
Threads: 62
Thanked 276 Times in 186 Posts
Reputation: 286
Default

i think osmolarity is going down because in addition to losing Na, the pt is losing huge amount of water, faster than Na.so thats why urine becomes hypotonic
Quote:
Originally Posted by LatinGeorge View Post
I though so too but i went with D. because of urine osm, after injection, by blocking the NA/K/CL pump, should the osm go up?.. and in this case goes down


By blocking aldosterone receptor, you block Na and Water reabsorption, in other words OSM goes down, what happened here

thats why i went with D. but still don't know
Reply With Quote Quick reply to this message
  #12  
Old 03-20-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 457
Threads: 62
Thanked 276 Times in 186 Posts
Reputation: 286
Default

also by giving a potassium sparing like Spironalactone, we would not wanna make the patient hyperkalemic in 10 min because of the cardiac risks
Reply With Quote Quick reply to this message
  #13  
Old 03-20-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,406
Threads: 118
Thanked 647 Times in 409 Posts
Reputation: 657
Default

whats the answer?
__________________
"inflammable means flammable!? What a country."
Reply With Quote Quick reply to this message
  #14  
Old 03-20-2012
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 303
Threads: 57
Thanked 106 Times in 67 Posts
Reputation: 116
Send a message via Skype™ to usmlemydream
Default

whats the answer i too think it has to be B?????????????????
Reply With Quote Quick reply to this message
  #15  
Old 03-20-2012
bunny's Avatar
Banned
 
Steps History: Not yet
Posts: 176
Threads: 34
Thanked 117 Times in 69 Posts
Reputation: 127
Default

Source of the Question: Old USMLE Sample Question

Correct Answer is Furosemide:

- has a "SHORT Onset of Action" (2 - 5 minutes when given IV)
-is more aggressive diuretic than Thiazide
-it block the segment that reabsorb 25% of Filtered Na in comparison to Thiazide which block the segment that reabsorb 5 - 10% of Filtered Na.

Thanks for participation
Reply With Quote Quick reply to this message
The above post was thanked by:
DocSikorski (03-21-2012), Dr. Mexito (03-21-2012), Gurpreetkhakh25 (03-23-2012), Joanna (03-20-2012)






Reply

Tags
Pharmacology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Blunting of diuretic response by Ibuprofen USMLE2011m USMLE Step 1 Forum 4 12-03-2011 10:58 PM
Why we use a diuretic in nephrogenic DI! drmdshah USMLE Step 1 Forum 3 06-09-2011 02:04 PM
Can you guess which virus? aktorque USMLE Step 1 Forum 3 12-11-2010 08:27 AM
Guess what is this? mary USMLE Step 2 CK Forum 4 10-31-2009 07:27 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)