Could someone please explain this QBank question- My Gd...

[Phloston]

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I've read the explanation here, and I don't understand why choice E is correct but choice A is wrong (I didn't have room to fit the explanation for choice A here, but all it literally said was "choice E is correct and choice A isn't.")

Could someone please explain why choice A is not correct?

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[lrkoehle]

Apparently corticosteroids decrease COX2 activity now? I have never heard this, but that's what the answer choice says. I think it is incorrect though. Answer choice A would make the most sense to me...plus, if it was aspirin, wouldn't that help his heart problems too?

I think it's pretty clear why only 15% of people chose E...

 

[AndyRSC]

Choice A is incorrect because, of the COX1 and 2 drugs, NSAIDs elevate cardiovascular risk and aspirin lowers it. The question asks for a drug that does not affect it.

 

[Phloston]

Choice A is incorrect because, of the COX1 and 2 drugs, NSAIDs elevate cardiovascular risk and aspirin lowers it. The question asks for a drug that does not affect it.

Could you please be more specific and elaborate on what you've just said?

As far as I'm aware, NSAIDs don't elevate CV risk.

The reason they say choice E is correct is because NSAIDs / aspirin IMPROVE CV health, whereas steroids neither improve nor exacerbate it.

 

[Morsetlis]

The important point is that the vascular endothelium has more PGI2 synthase, and the platelets have more TXA2 synthase, and that COX-2 isn't present in platelets. So, by inhibiting PLA2, you inhibit inflammatory PG's (treats RA) and reduce TXA2 which reduces TXA2 effects (platelet aggregation), but by also selectively inhibiting COX-2, you reduce PGI2 effects (antiplatelet).

It's like, less of both, less of one, and less of the other...

It's not A, because if you inhibit both COX-1 and COX-2, the endothelium will resynthesize new COX-1, but the platelets are screwed.