Lipid Biochemistry USMLE Step 1 Practice Question
A 51-year-old man with metabolic syndrome takes a fibrate for hypertriglyceridemia. Two weeks later, he develops myalgia and dark urine. Serum creatinine rises to 2.1 mg/dL from baseline of 0.9 mg/dL, and CK is 3,200 U/L. Which of the following best explains the mechanism of fibrate-induced myotoxicity in this patient?
Answer choices
- AIncreased binding of drugs to muscle protein causing direct cytotoxicity
- BPPAR-α activation increasing fatty acid oxidation and mitochondrial uncoupling in myocytesCorrect answer
- CDirect activation of lipoprotein lipase causing muscle fatty acid overload
- DAccumulation of oxidized triglycerides in muscle tissue
- EInhibition of HMG-CoA reductase similar to statin mechanism
- FPPAR-alpha activation in skeletal muscle causing fatty acid oxidation overload
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