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Wouldn't nitrates be a faster acting drug here? That was my take-away anyway. One is more acute, the other for long term maintenance.
I also believe it's because CCBs have minimal effect on venous beds and would not cause a significant decrease on preload.
decrease of cardiac preload is another word of Venodilation, so Nitrates primarly venodilators. CCB dilate arteria more than veins
also, verapamil is the one that causes constipation. But Verampamil is non-dyhydropiridine, so it works more on the heart than the vessels
You should be able to rule it out by the normal Thrombin time. Abnormal fibrinogen would have increased PT/PTT but also increased Thrombin time because the entire pathway is compromised by the inability of fibrinogen to be cleaved to functioning fibrin.
Possibly Multiple Myeloma. That is classic for an older person with back pain and lytic lesions in the back.
osteolytic- multiple myeloma, Osteoblastic- Prostate; dont think beyond this for this exam, i have never seen a question in NBME or uworld they tried to fool us off on this concept so far.
I'd like to reiterate what's stated above... dx NOT MM in this question because MM is PRIMARY not METASTATIC @ bone (answer reads: metastatic carcinoma)
Hypoxia leads to pulmonary vasoconstriction and therefore pulmonary HTN. This can lead to the peripheral edema. Furthermore pulmonary HTN can present with a loud S2.