Chronic Kidney Disease USMLE Step 1 Practice Question
A 70 year old man with severe systolic heart failure presents with progressive dyspnea, bibasilar crackles, and lower extremity edema. He is being considered for an osmotic diuretic to reduce intracranial pressure after a recent head injury. Which of the following is the strongest reason to avoid this medication in this patient?
Answer choices
- AIt produces antiandrogen effects with gynecomastia
- BIt causes severe hyperkalemia by blocking aldosterone receptors
- CIt irreversibly injures the proximal tubule
- DIt causes nephrogenic diabetes insipidus
- EIt can worsen pulmonary edema by transiently expanding extracellular fluid volumeCorrect answer
- FIt inhibits carbonic anhydrase, leading to metabolic alkalosis and increased intracranial pressure
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