Cardiovascular Drugs USMLE Step 1 Practice Question
A 52-year-old woman with hypertension initiated on lisinopril presents 2 weeks later with a persistent dry cough. Vital signs show BP 128/82 mmHg, HR 76/min, RR 18/min, and normal temperature. Laboratory studies reveal hyperkalemia (K+ 5.8 mEq/L) and normal renal function. She denies dyspnea, orthopnea, or recent infections. The cough is most likely due to which of the following mechanisms?
Answer choices
- ADirect bronchial irritation from drug crystallization
- BACE inhibition decreasing bradykinin metabolismCorrect answer
- CReflex cough from sudden blood pressure reduction
- DPulmonary edema from hyperkalemia-induced cardiac dysfunction
- EIncreased airway reactivity from angiotensin II deficiency
- FInhibition of neutral endopeptidase leading to substance P accumulation
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