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-   -   Step 1 practice Qnz - 8 (https://www.usmle-forums.com/usmle-step-1-forum/5130-step-1-practice-qnz-8-a.html)

aktorque 11-30-2010 08:33 AM

Step 1 practice Qnz - 8
 
A 68-year-old male presents to your office with exertional thigh and leg pain and decreased sexual performance. His past medical history is significant for hypertension, diabetes mellitus and myocardial infarction experienced two years ago. He smokes two packs per day and consumes alcohol occasionally. His dorsalis pedis pulses are weak in both feet. Evaluation shows moderate peripheral arterial disease of both lower extremities. This patient experiences symptomatic improvement from a drug that dilates arteries and inhibits platelet aggregation. Which of the following drugs is most likely described in this scenario?

A. Heparin
B. Argatroban
C. Warfarin
D. tPA
E. Aspirin
F. Ticlopidine
G. Abciximab
H. Cilostazol

meka 11-30-2010 09:34 AM

its cilostazol...cilostazol is a phosphodiesterase inhibitor..it decreases platelet aggregation and also causes arterial vasodilation..
its used for intermittent claudication and peripheral vascular disease..

aktorque 11-30-2010 09:52 AM

Very good Doc. You are the best Doc on board. Keep it up.

aktorque 11-30-2010 09:54 AM

Full explanation for others who didn't get this Qnz

Several molecules, including thrombin, ADP, and thromboxane A2, activate platelets by acting on cell surface receptors. Interference with post receptor signaling can alter platelet functions. Agents that increase platelet cyclic AMP decrease platelet aggregation by preventing platelet shape change and granule release.

Dipyridamole and cilostazol work by decreasing the activity of platelet phosphodiesterase, the enzyme responsible for breakdown of cyclic AMP. Cilostazol, in addition to inhibition of platelet aggregation, also is a direct arterial vasodilator. Cilostazol is approved by the FDA for the treatment of intermittent claudication (peripheral arterial disease).

step1an 11-30-2010 10:21 AM

@aktorque

Thanks for the question just want to add that symptom mentioned in this question comprise the "Leriche syndrome".


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