{"id":6016,"date":"2025-05-21T00:01:00","date_gmt":"2025-05-21T08:01:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=6016"},"modified":"2025-10-01T11:38:25","modified_gmt":"2025-10-01T19:38:25","slug":"usmle-step-1-question-of-the-day-coronary-angiography","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\/#Major_Takeaway\" >Major Takeaway&nbsp;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\/#References\" >References&nbsp;<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em><strong>Can you determine the most likely diagnosis for a 55-year-old man who&#8217;s experienced a ST-segment myocardial infarction and is admitted for coronary angiography with stent placement in the left anterior descending artery<\/strong><\/em><strong><em>? Let&#8217;s learn more about the case!<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 55-year-old man experiences a ST-segment myocardial infarction and is admitted for coronary angiography with stent placement in the left anterior descending artery. On day four of hospitalization, he has sudden sharp chest pain that radiates to his neck and shoulders. The pain is exacerbated by coughing and deep breathing. Vitals are within normal limits. Physical examination shows a restless man whose symptoms improve when sitting forward from a supine position. There is a loud rubbing sound upon cardiac auscultation when he leans forward. Lungs are clear to auscultation bilaterally. An ECG is shown below. The patient is treated with an antiplatelet drug. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Which of the following is a common adverse effect of the antiplatelet medication administered to this patient?<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"975\" height=\"486\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/image_cce2fa.png\" alt=\"\" class=\"wp-image-6018\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/image_cce2fa.png 975w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/image_cce2fa.png?resize=300,150 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/image_cce2fa.png?resize=768,383 768w\" sizes=\"auto, (max-width: 975px) 100vw, 975px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Gastric ulcers<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Neutropenia<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Osteoporosis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Skin necrosis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Hypotension<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Gastric ulcers<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Correct:<\/strong> See Main Explanation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Neutropenia<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Neutropenia is a rare but serious adverse effect of the ADP receptor inhibitor, ticlopidine. It prevents platelet aggregation by irreversibly blocking ADP (P2Y12) receptor and inhibiting the expression of glycoproteins IIb\/IIIa on the platelet surface. Although it is indicated in managing acute coronary syndrome and coronary stenting, this patient\u2019s symptoms indicate post-MI pericarditis, usually treated with aspirin.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Osteoporosis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Osteoporosis is a common adverse effect of heparin therapy. An anticoagulant (not antiplatelet) activates antithrombin in the coagulation pathway, which decreases the action of factor IIa (thrombin) and factor Xa. Although heparin is indicated in patients with coronary stent placement, it cannot alleviate the symptoms of pericarditis.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Skin necrosis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Skin and tissue necrosis are serious adverse effects of warfarin therapy and are thought to result from small vessel microthrombosis. Warfarin is an anticoagulant (not antiplatelet), usually administered in patients requiring chronic anticoagulation (e.g., venous thromboembolism prophylaxis and stroke prevention in atrial fibrillation). It is not indicated in the treatment of pericarditis.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Hypotension<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Incorrect: Hypotension is a common adverse effect of phosphodiesterase inhibitors (e.g., cilostazol), which inhibit the breakdown of cyclic guanosine monophosphate in the vascular smooth muscle cells, preventing vasoconstriction. They are usually used to treat peripheral artery disease and coronary artery disease and can be combined with aspirin for secondary prevention of ischemic stroke. They are, however, not indicated in the treatment of acute pericarditis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This patient with sharp and pleuritic chest pain on the 4th day of hospitalization following an acute ST-elevation myocardial infarction, in combination with ECG findings of diffuse ST-elevation, is suggestive of peri-infarction pericarditis. It is usually managed with aspirin, which risks developing gastric ulcers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with an antiplatelet effect. It irreversibly inhibits the activity of cyclooxygenase enzymes (COX-1 and COX-2) via acetylation, thereby preventing the formation of thromboxane A2, which usually helps in platelet adhesion. It is used in several clinical situations to prevent clots from worsening or provide anti-inflammatory effects:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A dose of 325 mg is used as a loading dose to treat acute strokes and myocardial infarction. A dose of 81 mg tablets is used as the maintenance therapy<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A dose of 650 mg &#8211; 1 g every 8 hours is indicated for the treatment of pericarditis, followed by gradual taper after resolution of symptoms.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Common adverse effects of its use include increased risk of bleeding and gastric ulcers.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with an antiplatelet effect. It irreversibly inhibits the activity of cyclooxygenase enzymes (COX-1 and COX-2), preventing the formation of thromboxane A2. It is indicated in treating stroke, myocardial infarction, and pericarditis. Common adverse effects include an increased risk of bleeding and the formation of gastric ulcers.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Read this Osmosis Answer page:&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Antiplatelet_medications\">Antiplatelet medications<\/a><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Imazio, M., &amp; Hoit, B. D. (2013). Post-cardiac injury syndromes. An emerging cause of pericardial diseases. International journal of cardiology, 168(2), 648-652.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/create\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/09\/Blog_Display_Ads_MD1_2023.png?w=700\" alt=\"\" class=\"wp-image-5904\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/09\/Blog_Display_Ads_MD1_2023.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/09\/Blog_Display_Ads_MD1_2023.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis by Elsevier today! Access your&nbsp;<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>&nbsp;and discover why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Delve into today&#8217;s USMLE\u00ae Step 1 question on a post-MI patient with chest pain and uncover the common adverse effects of antiplatelet therapy.<\/p>\n","protected":false},"author":202,"featured_media":6019,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,16,1366,1369,44],"tags":[735,736,733,737,265,84,366,149,738,185],"class_list":["post-6016","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-do","category-questions","category-step-1-questions","category-step-1","tag-antiplatelet-therapy","tag-cardiovascular-disease","tag-clinical-case","tag-gastric-ulcers","tag-healthcare-training","tag-medical-education","tag-myocardial-infarction","tag-patient-care","tag-pericarditis","tag-usmle"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Delve into today&#039;s USMLE\u00ae Step 1 question on a post-MI patient with chest pain and uncover the common adverse effects of antiplatelet therapy.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\" \/>\n<meta property=\"og:site_name\" content=\"Osmosis Blog\" \/>\n<meta property=\"article:published_time\" content=\"2025-05-21T08:01:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-10-01T19:38:25+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1080\" \/>\n\t<meta property=\"og:image:height\" content=\"1080\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Marina Horiates Kerekes, MD &amp; Team\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":[\"Article\",\"BlogPosting\"],\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\"},\"author\":{\"name\":\"Marina Horiates Kerekes, MD &amp; Team\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/#\/schema\/person\/c7e60a94ecf3ec6e6cfe4855957afafc\"},\"headline\":\"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography\",\"datePublished\":\"2025-05-21T08:01:00+00:00\",\"dateModified\":\"2025-10-01T19:38:25+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\"},\"wordCount\":733,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png\",\"keywords\":[\"antiplatelet therapy\",\"cardiovascular disease\",\"clinical case\",\"gastric ulcers\",\"healthcare training\",\"medical education\",\"myocardial infarction\",\"patient care\",\"pericarditis\",\"USMLE\"],\"articleSection\":[\"Allopathic Medicine (MD)\",\"Exam Prep\",\"Osteopathic Medicine (DO)\",\"Questions of the Day\",\"USMLE Step 1\",\"USMLE\u00ae Step 1\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\",\"url\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\",\"name\":\"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography - Osmosis Blog\",\"isPartOf\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png\",\"datePublished\":\"2025-05-21T08:01:00+00:00\",\"dateModified\":\"2025-10-01T19:38:25+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage\",\"url\":\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png\",\"contentUrl\":\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png\",\"width\":1080,\"height\":1080,\"caption\":\"USMLE Step 1 Question of the Day Coronary angiography\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.osmosis.org\/blog\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/#website\",\"url\":\"https:\/\/www.osmosis.org\/blog\/\",\"name\":\"Osmosis Blog\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.osmosis.org\/blog\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/#organization\",\"name\":\"Osmosis Blog\",\"url\":\"https:\/\/www.osmosis.org\/blog\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/OsmosisElsevierStacked.png\",\"contentUrl\":\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/OsmosisElsevierStacked.png\",\"width\":1276,\"height\":596,\"caption\":\"Osmosis Blog\"},\"image\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/#\/schema\/logo\/image\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/#\/schema\/person\/c7e60a94ecf3ec6e6cfe4855957afafc\",\"name\":\"Marina Horiates Kerekes, MD &amp; Team\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.osmosis.org\/blog\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/c4eaddbf095676223204097f8973e0eed2b2b435a8c32f8f6b8c06da77819aa6?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/c4eaddbf095676223204097f8973e0eed2b2b435a8c32f8f6b8c06da77819aa6?s=96&d=mm&r=g\",\"caption\":\"Marina Horiates Kerekes, MD &amp; Team\"},\"description\":\"Authors: Marina Horiates Kerekes, MD &amp; Osmosis Question Writing Team\",\"url\":\"https:\/\/www.osmosis.org\/blog\/author\/marinahoriateskerekesandteam\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography - Osmosis Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography","og_locale":"en_US","og_type":"article","og_title":"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography - Osmosis Blog","og_description":"Delve into today's USMLE\u00ae Step 1 question on a post-MI patient with chest pain and uncover the common adverse effects of antiplatelet therapy.","og_url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography","og_site_name":"Osmosis Blog","article_published_time":"2025-05-21T08:01:00+00:00","article_modified_time":"2025-10-01T19:38:25+00:00","og_image":[{"width":1080,"height":1080,"url":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png","type":"image\/png"}],"author":"Marina Horiates Kerekes, MD &amp; Team","twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":["Article","BlogPosting"],"@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#article","isPartOf":{"@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography"},"author":{"name":"Marina Horiates Kerekes, MD &amp; Team","@id":"https:\/\/www.osmosis.org\/blog\/#\/schema\/person\/c7e60a94ecf3ec6e6cfe4855957afafc"},"headline":"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography","datePublished":"2025-05-21T08:01:00+00:00","dateModified":"2025-10-01T19:38:25+00:00","mainEntityOfPage":{"@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography"},"wordCount":733,"commentCount":0,"publisher":{"@id":"https:\/\/www.osmosis.org\/blog\/#organization"},"image":{"@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage"},"thumbnailUrl":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png","keywords":["antiplatelet therapy","cardiovascular disease","clinical case","gastric ulcers","healthcare training","medical education","myocardial infarction","patient care","pericarditis","USMLE"],"articleSection":["Allopathic Medicine (MD)","Exam Prep","Osteopathic Medicine (DO)","Questions of the Day","USMLE Step 1","USMLE\u00ae Step 1"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#respond"]}]},{"@type":"WebPage","@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography","url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography","name":"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography - Osmosis Blog","isPartOf":{"@id":"https:\/\/www.osmosis.org\/blog\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage"},"image":{"@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage"},"thumbnailUrl":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png","datePublished":"2025-05-21T08:01:00+00:00","dateModified":"2025-10-01T19:38:25+00:00","breadcrumb":{"@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#primaryimage","url":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png","contentUrl":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png","width":1080,"height":1080,"caption":"USMLE Step 1 Question of the Day Coronary angiography"},{"@type":"BreadcrumbList","@id":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.osmosis.org\/blog"},{"@type":"ListItem","position":2,"name":"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography"}]},{"@type":"WebSite","@id":"https:\/\/www.osmosis.org\/blog\/#website","url":"https:\/\/www.osmosis.org\/blog\/","name":"Osmosis Blog","description":"","publisher":{"@id":"https:\/\/www.osmosis.org\/blog\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.osmosis.org\/blog\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/www.osmosis.org\/blog\/#organization","name":"Osmosis Blog","url":"https:\/\/www.osmosis.org\/blog\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.osmosis.org\/blog\/#\/schema\/logo\/image\/","url":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/OsmosisElsevierStacked.png","contentUrl":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/OsmosisElsevierStacked.png","width":1276,"height":596,"caption":"Osmosis Blog"},"image":{"@id":"https:\/\/www.osmosis.org\/blog\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/www.osmosis.org\/blog\/#\/schema\/person\/c7e60a94ecf3ec6e6cfe4855957afafc","name":"Marina Horiates Kerekes, MD &amp; Team","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.osmosis.org\/blog\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/c4eaddbf095676223204097f8973e0eed2b2b435a8c32f8f6b8c06da77819aa6?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/c4eaddbf095676223204097f8973e0eed2b2b435a8c32f8f6b8c06da77819aa6?s=96&d=mm&r=g","caption":"Marina Horiates Kerekes, MD &amp; Team"},"description":"Authors: Marina Horiates Kerekes, MD &amp; Osmosis Question Writing Team","url":"https:\/\/www.osmosis.org\/blog\/author\/marinahoriateskerekesandteam"}]}},"jetpack_featured_media_url":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png","jetpack-related-posts":[{"id":3010,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-acute-chest-pain-with-diabetes-and-hypertension","url_meta":{"origin":6016,"position":0},"title":"USMLE\u00ae Step 1 Question of the Day: Acute Chest Pain with Diabetes and Hypertension","author":"Marina Horiates Kerekes, MD &amp; Team","date":"January 20, 2021","format":false,"excerpt":"A 60-year-old with chest pain and ECG changes shows LAD artery occlusion. Learn why endothelial cell injury is the first step in atherosclerosis causing myocardial infarction.","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"USMLE\u00ae Step 1 Question of the Day: Acute Chest Pain with Diabetes and Hypertension","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-hypertension.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-hypertension.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-hypertension.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-hypertension.webp 2x"},"classes":[]},{"id":8924,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-class-i-antiarrhythmics","url_meta":{"origin":6016,"position":1},"title":"USMLE\u00ae Step 1 Question of the Day:\u00a0Class I antiarrhythmics","author":"Rowan Bell, MD &amp; Marina Horiates Kerekes, MD","date":"December 24, 2025","format":false,"excerpt":"A patient with arrhythmia after myocardial infarction receives a medication that alters phase 0 depolarization. Explore how this drug modulates cardiac electrical activity.","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"USMLE Step 1 Question of the Day: Class 1 Antiarrhythmics","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/12\/Step-1-Question-of-the-Day-Class-I-Antiarrhythmics.jpg","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/12\/Step-1-Question-of-the-Day-Class-I-Antiarrhythmics.jpg 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/12\/Step-1-Question-of-the-Day-Class-I-Antiarrhythmics.jpg 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/12\/Step-1-Question-of-the-Day-Class-I-Antiarrhythmics.jpg 2x"},"classes":[]},{"id":2302,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain","url_meta":{"origin":6016,"position":2},"title":"USMLE\u00ae Step 2 CK Question of the Day: Chest Pain","author":"Marina Horiates Kerekes, MD &amp; Team","date":"November 3, 2021","format":false,"excerpt":"We're back with a USMLE\u00ae Step 2 CK Question of the Day!\u00a0Today's case involves a 66-year-old man with sharp chest pain. What would be the most appropriate definitive treatment for this patient\u2019s condition? A 66-year-old man presents to the emergency department with sudden onset sharp chest pain radiating to the\u2026","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"USMLE\u00ae Step 2 CK Question of the Day: Chest Pain","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T163840.555.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T163840.555.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T163840.555.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T163840.555.webp 2x"},"classes":[]},{"id":7931,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-vascular-ischemia","url_meta":{"origin":6016,"position":3},"title":"USMLE\u00ae Step 1 Question of the Day:\u00a0Vascular ischemia","author":"Rowan Bell, MD &amp; Marina Horiates Kerekes, MD","date":"October 27, 2025","format":false,"excerpt":"Explore a clinical case of acute neurological deficits in an elderly patient, focusing on identifying the affected brainstem vascular territory.","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"Step 1 Question of the Day Vascular ischemia","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/10\/Step-1-Question-of-the-Day-Vascular-ischemia.png","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/10\/Step-1-Question-of-the-Day-Vascular-ischemia.png 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/10\/Step-1-Question-of-the-Day-Vascular-ischemia.png 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/10\/Step-1-Question-of-the-Day-Vascular-ischemia.png 2x"},"classes":[]},{"id":1690,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-syncopal-episode","url_meta":{"origin":6016,"position":4},"title":"USMLE\u00ae Step 1 Question of the Day: Syncopal Episode","author":"Marina Horiates Kerekes, MD &amp; Team","date":"April 27, 2022","format":false,"excerpt":"This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.\u00a0Today's case involves a 65-year-old man who suddenly collapsed when crossing the street. An electrocardiogram is demonstrated below.\u00a0Can you figure out which pathophysiologic process is likely the result of this cardiac activity? A\u2026","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-syncopal-episode.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-syncopal-episode.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-syncopal-episode.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-syncopal-episode.webp 2x"},"classes":[]},{"id":2246,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-av-block","url_meta":{"origin":6016,"position":5},"title":"USMLE\u00ae Step 1 Question of the Day: AV Block","author":"Marina Horiates Kerekes, MD &amp; Team","date":"December 8, 2021","format":false,"excerpt":"Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today's case involves a 20-year-old male patient with a seemingly abnormal ECG reading.\u00a0Can you figure it out? A 20-year-old male college student comes to the clinic with an ECG obtained at a health\u2026","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"USMLE\u00ae Step 1 Question of the Day: AV Block","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T144607.920.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T144607.920.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T144607.920.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T144607.920.webp 2x"},"classes":[]}],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/6016","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/users\/202"}],"replies":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/comments?post=6016"}],"version-history":[{"count":3,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/6016\/revisions"}],"predecessor-version":[{"id":6833,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/6016\/revisions\/6833"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media\/6019"}],"wp:attachment":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media?parent=6016"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/categories?post=6016"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/tags?post=6016"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}