Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is a contraindication for using alpha 1 antagonists?

1. Severe renal insufficiency

2. History of allergy to sulfa drugs

3. Cardiac arrhythmias

4. Pregnancy

The correct answer is: Severe renal insufficiency

The correct choice identifies a contraindication for using alpha-1 antagonists as severe renal insufficiency. Alpha-1 antagonists can lead to a reduction in blood pressure by blocking the action of norepinephrine on alpha-1 adrenergic receptors, causing vasodilation. In patients with severe renal insufficiency, there may be concerns about the hemodynamic changes induced by the medication, particularly regarding renal perfusion and function. This could exacerbate underlying kidney problems or lead to complications, especially in those requiring careful blood pressure control and kidney protection. In contrast, the other situations presented do not typically represent direct contraindications for the use of alpha-1 antagonists. A history of allergy to sulfa drugs primarily relates to sulfonamide antibiotics or diuretics, and does not impact alpha-1 antagonist safety. Cardiac arrhythmias may warrant caution, but they are not an outright contraindication. Pregnancy, while requiring careful clinical consideration, does not universally contraindicate the use of these medications but rather depends on a risk-benefit analysis.