skip to main content

Medication-induced cough — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateInternal Medicine (chronic management)Medication-induced coughUSMLE Step 3

A 55-year-old man started lisinopril 6 weeks ago. Blood pressure improved, but he has a persistent dry cough. Chest x-ray is normal and he has no fever, wheeze, or reflux symptoms. Which of the following is the most likely explanation for this patient's findings?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Bradykinin-mediated ACE inhibitor adverse effect

ACE inhibitors can cause dry cough through bradykinin accumulation; switching to an ARB is reasonable when bothersome.

Reference: 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM High Blood Pressure Guideline