prasannakumar
Forum Senior
Topics: 24
Posts: 55
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A 72-year-old retired attorney presents for his annual physical examination. He has not had any medical illnesses over the past year. He formerly drank several cocktails before dinner for many years and has a history of a variceal bleed 2 years ago, but has not re-bled since. His only medications are aspirin and metoprolol. On physical examination, he is afebrile. His blood pressure is 122/68 mm Hg, pulse is 60/min, and respirations are 14/min. He is anicteric and has no stigmata of chronic liver disease. His liver edge is 9 cm in the midclavicular line by percussion, and no spleen tip is palpable. There is no evidence of ascites or peripheral edema. Which of the following medications should the patient most likely avoid?
a)Ciprofloxacin
b)Ibuprofen
c)Lorazepam
d)Losartan
e) Prednisone
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| sprint123
Forum Guru
Topics: 129
Posts: 870
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ibuprofen have a higher incidence of gasto-. intestinal bleeding.
Ans : B
Lorazepam is one of the benzo with metabolism outside the liver.
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| usmlestud
Forum Junior
Topics: 6
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| Ivonne
Find a way or make one
Topics: 57
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C. It's lorazepam (more risk for hepatic encephalopathy)
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| hanwin
Forum Senior
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Posts: 157
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Step 2 Q are not easy at all.
For me this pt has no stigmata of chronic liver diseaseTherefore, u can use lorazepam..Metabolize outside liveras well.
Given the h/o previous GI bleed, NSAID should be best avoided.
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| cirus
Forum Guru
Topics: 108
Posts: 740
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I know this quest, just solved it a couple of days in Kaplan Q Bank, the ans is Ibuprofen
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| dr in trouble
Forum Guru
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Posts: 601
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| prasannakumar
Forum Senior
Topics: 24
Posts: 55
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ans is lorazepam.....bcoz of the risk of ehcephalopathy(as given in kap q bank)
i'm also not convenced with it.....ehcephalopathy without any signs of liver cell failure???
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