USMLE · Question #616
A 55-year-old female comes to the physician with a dry cough of three weeks' duration. The cough is not associated with sputum or blood production and she is afebrile. She has a medical history of…
The correct answer is D. lisinopril. ACE inhibitors such as lisinopril block the conversion of angiotensin I to angiotensin II which leads to decreased arteriolar resistance, decreased aldosterone levels, decreased glomerular filtration rates and increased renin levels. They are used to treat hypertension…
Question
A 55-year-old female comes to the physician with a dry cough of three weeks' duration. The cough is not associated with sputum or blood production and she is afebrile. She has a medical history of rheumatoid arthritis, peptic ulcer disease and hypertension for which is receiving treatment. The most likely cause of her chief complaint is:
Options
- Aaspirin
- Bhydrochlorothiazide
- Cinfliximab
- Dlisinopril
- Emetronidazole
How the community answered
(21 responses)- A10% (2)
- D86% (18)
- E5% (1)
Explanation
ACE inhibitors such as lisinopril block the conversion of angiotensin I to angiotensin II which leads to decreased arteriolar resistance, decreased aldosterone levels, decreased glomerular filtration rates and increased renin levels. They are used to treat hypertension, diabetic nephropathy and heart failure. Inhibition of the angiotensin converting enzyme (ACE) also prevents inactivation of bradykinin which can cause a persistent dry cough and angioedema due to elevated bradykinin levels. Other side effects of ACE inhibitors include teratogenesis, increased creatinine, hyperkalemia and hypotension. They are contraindicated in patients with bilateral renal stenosis and C1 esterase inhibitor deficiency. This patient who has developed a cough due to lisinopril use should be switched to an angiotensin II receptor blocker such as
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