CNS Pharmacology USMLE Step 1 Practice Question
A 41-year-old woman with systemic lupus erythematosus has taken high-dose prednisone for 6 months. She presents with proximal muscle weakness, easy bruising, and recurrent oral candidiasis. Vital signs show BP 158/92 mmHg, HR 88, RR 16, temp 37°C. Labs reveal fasting glucose 186 mg/dL and 24-hour urine cortisol elevated. Skin striae are noted. She denies fever or weight loss. Which mechanism best explains prednisone's anti-inflammatory therapeutic action?
Answer choices
- ASuppression of calcineurin mediated IL-2 transcription only in T cells
- BDirect blockade of cyclooxygenase by irreversible acetylation
- CCompetitive antagonism of leukotriene receptors only
- DInhibition of phospholipase A2 via increased lipocortin expressionCorrect answer
- EInhibition of folate synthesis in activated lymphocytes
- FDirect inhibition of 5-lipoxygenase to prevent leukotriene synthesis
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