Cardiovascular Drugs USMLE Step 1 Practice Question
A 64-year-old man with acute aortic dissection presents with severe hypertension (BP 210/120 mmHg, HR 110/min, RR 22/min). He receives intravenous nitroprusside for blood pressure control. Several hours later, he becomes confused and agitated. Laboratory studies reveal severe lactic acidosis (pH 7.18, lactate 12 mmol/L) and elevated cyanide levels. He has no prior renal disease or cyanide exposure. Which of the following toxicities best explains this clinical deterioration?
Answer choices
- ASalicylate poisoning
- BAcetaminophen induced hepatic necrosis
- CCyanide accumulationCorrect answer
- DMethemoglobinemia from dapsone
- ELead chelation failure
- FThiocyanate accumulation from prolonged nitroprusside use
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