NBME 23 Answers ↦
nbme23/Block 3/Question#15
A 45-year-old woman comes to the physician ...
Myopathy🔍
A 45-year-old woman comes to the physician ...
Myopathy🔍
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why does treatment of hypothyroid (with levothyroxine I'm assuming) increase risk for myopathy? I chose it simply bc its a common adverse effect of statins but I don't really understand how treating hypothyroidism at the same time would have anything to do with it ??? help please!
ususmle
statins cause both hepatotoxic and mypopathy so I want for hepatotoxic:( I thought usmle expects different stuff
+1
drzed
Statins don't cause 'toxic hepatitis' they just cause a mild asymptomatic rise in LFTs that is reversible with discontinuation of the drug. The more worrisome side effect is of course, myopathy
+1
tyrionwill
statins cause both liver injury and myopathy in a dose related, so kidney failure increases their dose, which leads both liver and muscle risk elevated;
Pravastatin is said less liver concerns but the myopathy, so choose myopathy when renal failure.
+
I believe since both statins and hypothyroidism can cause myopathy; so thus myopathy will be the answer.
both statins and hypothyroidism can cause myopathy, one of the musculoskeletal effect of hypothyroidism is myopathy with inc ck.
submitted by sajaqua1(389), 2019-06-05T01:44:43Z
Pravastatin is the only statin drug not metabolized by the P450 system in the liver. Because of this, pravastatin is also unique in that more of it is excreted by the kidneys than any other statin, In addition to hypothyroidism this patient has mild renal failure. This will impair excretion of pravastatin, leading to increased pravastatin and its metabolites, increasing its potential for causing myopathy.
B) Nephrolithiasis- while the patient is hypercalcemic, pravastatin does not increase the incidence of kidney stones. C) Pancreatitis- I do not know of any significant interactions between the pancreas and pravastatin. D) Toxic hepatitis- while statins can cause mildly elevated liver function test scores, they are generally not associated with hepatotoxicity. E) Type 2 Diabetes mellitus- I do not know of any effect that pravastatin has on diabetes or diabetes medications.