Inflammation and repair: bradykinin and ACE inhibitors: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Inflammation and repair: bradykinin and ACE inhibitors

Sample item

A 55-year-old hypertensive man taking an angiotensin-converting enzyme inhibitor develops a persistent dry cough and an episode of lip swelling. Accumulation of which mediator is responsible?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Bradykinin

Angiotensin-converting enzyme also degrades bradykinin, so its inhibition allows bradykinin to accumulate. Bradykinin increases vascular permeability, causes vasodilation and stimulates pain and cough. This explains the cough and angioedema seen with ACE inhibitors.

Option by option

  • A. Serotonin

    Serotonin is released from platelets and is not metabolised by ACE.

  • B. Leukotriene C4

    Leukotriene C4 is a lipoxygenase product that is not degraded by ACE.

  • C. Bradykinin (correct)

    Correct. ACE normally breaks down bradykinin, so inhibition lets it accumulate.

  • D. Platelet-activating factor

    Platelet-activating factor is a phospholipid mediator and not an ACE substrate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Bradykinin. Angiotensin-converting enzyme also degrades bradykinin, so its inhibition allows bradykinin to accumulate.

Why is "Serotonin" not the answer?

Serotonin is released from platelets and is not metabolised by ACE.

Why is "Leukotriene C4" not the answer?

Leukotriene C4 is a lipoxygenase product that is not degraded by ACE.

Why is "Platelet-activating factor" not the answer?

Platelet-activating factor is a phospholipid mediator and not an ACE substrate.

What concept does this question test?

It tests Inflammation and repair: bradykinin and ACE inhibitors in Pathology. Bradykinin increases vascular permeability, causes vasodilation and stimulates pain and cough. This explains the cough and angioedema seen with ACE inhibitors.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Inflammation and repair: bradykinin and ACE inhibitors?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.