USMLE Step 1

USMLE Step 1 QUESTION of the DAY!

You have a 46 year-old patient come into the office. He complains that he has noticed that his breasts are getting bigger. He currently is being treated for high blood pressure and GERD. Which of the patients’ medications could have caused his gynecomastia?

A) Minoxidil
B) Propranolol
C) Sucralfate
D) Chlorothiazide
E) Cimetidine

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Answer: E) Cimetidine. Cimetidine is an H2 Blocker used to treat GERD and peptic ulcers. Side effects of Cimetidine include gynecomastia (most common), headaches, vertigo, fatigue, and reduced sperm count. The other choices do not cause gynecomastia. Sucralfate is an anti-ulcer agent. Minoxidil, Propranolol, and Chlorothiazide are all drugs used to treat hypertension.



USMLE Step 1 D.O.C. of the DAY!

Drug of choice for

Klebsiella causing pneumonia

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Any 3rd generation cephalosporin i.e. ceftriaxone, cefotaxime


Fact of the DAY!

Bug Profile: Giardia lamblia
- most common intestinal protozoa
- fecal-oral transmission of cysts- form trophozoites in duodenum
- cyst: 4 nuclei; trophozoite: 2 nuclei, 4 pairs of flagella (clown appearance)
- causes giardiasis- non-bloody, foul smelling diarrhea (don’t invade wall of duodenum)
- Dx by visualization of organism in stool or string test.
- Tx: metronidazole