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  #1  
Old 06-26-2012
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Poison Death by a substance!

A 20-year-old star football player suddenly collapses during practice and has a cardiac arrest and cannot be resuscitated. The medical examiner is called to investigate this sudden and unexpected death. At autopsy, there is marked coronary atherosclerosis and histologic evidence of hypertension in the renal blood vessel. Use of which of the following substances is most likely to contribute to these findings?

a) amphetamine
b) barbiturate
c) benzodiazepine
d) cocaine
e) ethanol
f) heroin
g) marijuna

Please try to explain your answer
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  #2  
Old 06-26-2012
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D. Cocaine, This drug is well known to cause vasospasm of coronary vessels and can cause ischemic heart attack even in healthy individuals , obviously a patient who is predisposed to ischemic attack like the one that was described will suffer from the risk the most.
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Old 06-26-2012
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yeah the answer is COCAINE.....coronary vasospasm leading to SCD and it is an indirect sympathomimietic drug too
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  #4  
Old 06-26-2012
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@ modesty and @anomali - thanks for your posts guys - cocaine was my choice as well. unfortunately, to my surprise, it is not the correct answer. I'll wait few hours for other members to join the discussion and then give the correct answer.
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  #5  
Old 06-26-2012
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The first thing I thought of was cocaine but I don't think cociane causes chronic hypertension, as the renal artery autopsy findings seem to suggest. So I'd go for alcohol.

Awesome questions casandra :-) where are these from?

Sent from my Desire HD
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Old 06-26-2012
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i think its amphetamine......
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Old 06-26-2012
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i think it is ethanol or amphetamine.if we go thru these 2 options
being star football player could be using a lot of drugs or alcohol.alcohol causes arteriosclerosis in arteries so renal artery could have also been involved and hence chronic HTN and M.I
amphetamine causes severe vasoconstriction due to its action by increasing NE and Epi hence causing renal arteriosclerosis from chronic HTN and Coronary a.sclerosis.
ampetamine> alcohol is my ans
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Old 06-26-2012
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Im debating between benzo or barbiturate... i go with

C BENZODIAZEPINE!!!
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Old 06-26-2012
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Amphetamine , as it blocks uptake of of NE, DA and aswell causes release of amines..
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Old 06-26-2012
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What a debate!

Question to those of you who picked either amphetamine or cocaine - since the mechanism of those two is very similar what made you chose one over the other?
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Flipped my book found out Amphetamine has additional MAO inhibitory action which would contribute to hypertension and atherosclerosis..
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Old 06-27-2012
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whats the right answer??
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Old 06-27-2012
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may be heroin? because intravenous heroin abuse -focal segmental glomerulosclerosis-hypertension(20%)
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i marked this question so i can change answer -ethanol
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Old 06-28-2012
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Default correct answer

Correct answer is D) Cocaine

@modesty and @anomali - sorry about confusing you before - it wasn't intentional, just mistakened it with a different question

The explanation is that cocaine is a powerful vasoconstrictor and the cardiac comlpications of its use include arterial vasoconstriction with ischemic injury and arrhythmias. Atherosclerosis, affecting small, peripheral branches of the coronary arteries, can be marked.

Ethanol, barbiturates and benzodiazepins od would be associated with respiratory depression - here in the stem we had cardiac arrest.

My only question here is how can you distinguish amphetamine and cocaine effects? I remember that in pharma videos they said we would never be asked to differentiate between those two because it's virtually impossible based on the symptoms only. So I was wonderring if there's anything in the question that could suggest cocaine over amphetamine?
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Old 06-28-2012
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...hurray....finally.....was really confused after ur initial post casandra but anyways thanks for the answer....

And reg ur difference over symptoms between cocaine and amphetamines....there is a gross overlap in the presentation but i think the question stem will differentiate between those two ( we should be in a position to spot that minor difference---as in this case where SCD relates more to cocaine)....

i hope someone would explain it better....
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Old 05-06-2014
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I think an important point to remember about amphetamines (vs. cocaine) is its tendency to cause "prolonged wakefulness & attention" (FA 2014), hence its indication for the treatment of ADD and Narcolepsy.
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