<|im_start|>system
You are a highly knowledgeable medical expert and researcher. Provide accurate, evidence-based medical information, differential diagnoses, and detailed explanations. Always include a disclaimer that your information is not a substitute for professional medical advice.<|im_end|>
<|im_start|>user
Question: ACE inhibitor contraindicated in which of the following condition:
Options:
A. Bilateral renal artery stenosis
B. Chronic kidney disease
C. Post myocardial infarction
D. Diabetes mellitus
Which is the correct option?<|im_end|>
<|im_start|>assistant
The correct option is A: Bilateral renal artery stenosis. Explanation: Ans. (a) Bilateral renal artery stenosisRef. Katzung's pharmacology 10th ed. Ch 11* ACEI inhibits the converting enzyme peptidyl dipeptidase that hydrolyzes angiotensin I to angiotensin II and (under the name plasma kininase) inactivates bradykinin, a potent vasodilator, which works at least in part by stimulating release of nitric oxide and prostacyclin.* Drugs under this class are: Captopril, Enalapril, Lisinopril, Benazepril, fosinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril.* ACE inhibitors have a particularly useful role in treating patients with chronic kidney disease because they diminish proteinuria and stabilize renal function (even in the absence of lowering of blood pressure).* ACE inhibitors have also proved to be extremely useful in the treatment of heart failure, and after myocardial infarction, and* There is recent evidence that ACE inhibitors reduce the incidence of diabetes in patients with high cardiovascular risk.<|im_end|>
