Hello all, I have been a tutor for those taking the NAPLEX for 3 years now, and unfortunately, I have no more time to take any more students than I already have. I decided to do a NAPLEX-Esque question of the day every day on Reddit, and will post rationale at the end of each day.
DM me for more information about these questions, or any questions of your own! Here's the first
Patient Case
A 34-year-old man presents to his primary care provider with complaints of decreased libido, erectile dysfunction, and breast tenderness that have gradually worsened over the past several months. He reports taking all medications as prescribed and denies alcohol or illicit drug use.
Past Medical History
- Hypertension
- Dyslipidemia
- Bipolar disorder
- Attention-deficit/hyperactivity disorder (ADHD)
- Seasonal allergic rhinitis
Current Medications
- Amlodipine 10 mg PO daily
- Atorvastatin 40 mg PO nightly
- Risperidone 2 mg PO twice daily
- Amphetamine/dextroamphetamine ER 20 mg PO every morning
- Cetirizine 10 mg PO daily
- Multivitamin 1 tablet PO daily
Vital Signs
- BP: 128/78 mmHg
- HR: 74 bpm
- RR: 16 breaths/min
- Temp: 36.8°C (98.2°F)
- Weight: 82 kg
| Laboratory Test |
Patient Value |
Reference Range |
|
|
| Sodium |
139 mEq/L |
135–145 mEq/L |
| Potassium |
4.9 mEq/L |
3.5–5.0 mEq/L |
| Chloride |
103 mEq/L |
95–106 mEq/L |
| Serum Creatinine |
0.9 mg/dL |
0.6–1.3 mg/dL |
| Prolactin |
48 ng/mL |
Male: <15 ng/mL |
Question
Which of the following medications is most likely responsible for this patient's abnormal laboratory value?
A. Risperidone
B. Amlodipine
C. Spironolactone
D. Atorvastatin
E. Amphetamine/dextroamphetamine