Cardiovascular Drugs USMLE Step 1 Practice Question
A 66-year-old woman hospitalized for acute pulmonary edema presents with dyspnea, orthopnea, and bibasilar crackles. Vital signs: BP 168/94 mmHg, HR 118 bpm, RR 28/min, SpO2 88% on room air. Chest X-ray shows pulmonary edema. She receives aggressive intravenous furosemide therapy and subsequently develops tinnitus and bilateral high-frequency hearing loss. Serum creatinine is 1.8 mg/dL. She denies recent aminoglycoside or NSAIDs use. Which mechanism best explains this ototoxic adverse effect?
Answer choices
- ABlue gray skin discoloration from antiarrhythmic therapy
- BImmune hemolysis from central alpha 2 agonism
- CBronchospasm from muscarinic agonism
- DOtotoxicity from loop diuretic therapyCorrect answer
- EMyopathy from HMG CoA reductase inhibition
- FPeripheral neuropathy from thiazide diuretic therapy
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