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Retired NBME 21 Answers

nbme21/Block 1/Question#48 (reveal difficulty score)
A 44-year-old man is admitted to the hospital ...
Increasing cGMP ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +9  upvote downvote
submitted by โˆ—divya(75)
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scareien ni PMAc )Gs( - a2teb - dvitaanlsoio

arceeeds ni MAPc ()Gi - 2alpha - ronittaocivnocss

eairnces ni 3PI GAD (G)q - h1alap - nrostcoiocvitans

acesirne in PMcG - 3M - ON iudcnde tivosoiadanl

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cytotoxict  aplhA 2 gisnsato od nto ucsae troovnsoatncsici /cb eyth dael to eventiag cfakbede of iropen nad thus eecdarse yacihsptmet npeseors +1
payingforthisisdumb  2F0A p173 2saฮฑniso-tg sreneaci GNO/McP dna sdvaitoeal +
sarahs  hwy si rgedcinase PMcA wn?ogr +1
hiroshimi  ahss@:ra you atwn ot ecaenisr AMPc auebcse it oduwl ldea to vaniooltdisa dna hlep to sedracee ihs dolob euespr.rs Dgnceeirsa MAPc dulwo akme shi PB .oesrw +
fatboyslim  plah2a utotiamslin sueacs saalonitidov abeuces it is ptimycyalsht.o +

simple rule of thumb is

Calcium --> vasoconstriction (smooth muscle constriction) -- > must be Gq (alpha 1, v1)

rise in cAMP and cGMP both vasodilation (cAMP by inhibiting MLCK, cGMP by activating MLCP) so whoever causes vasodialation must increase either. cGMP is niche (NO, ANP) so most of the time it is rise in cAMP --> must be Gs (beta 2)

only exception is M3 it rises calcium (Gq) but in endothelial cells , not vascular smooth m. cells, so NO produced and causes vasodialation via rise in cGMP (again!)



 +2  upvote downvote
submitted by โˆ—vi_capsule(21)
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HNT g,ryecenem imuodS e.rNrdtspiiuos elkiUn ldnazhryiae a dcabelan iaalovostdr niv(e = letria)or

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sympathetikey  lWle nh,te I sguse ew ohsldu stju oetrfg ubota ruo dol lpsa teh 2lpaAh- .s osgaGntoodi ac.ll I tdid'n even ese htta siht swa tipneryvshee negecrym.e bmDu on ym a.rpt +
zup  so eay ninloecid wuold be dseu fro iyshereptevn yr,cgune btu hsti ugy is revo 081 21()0 so etyh eahv ot seu nesgoithm keil dzhaleraniy or dirtprnusiseo tobh wlil secnriea GPMc +
whoissaad  Drugs euds to terat NHT ldcFedeereoa aoboNdis slideiemdapnnorl ipprv tci tymneia lepLiriu:CenneClgoinN +18
lola915  aynzaliredH uclltaay sstoveadail esreti;nsagret&iv nda roirNtuseidps isaodtasevl iaesrter = isenv. thBo aesncrei cGPM. +12
vi_capsule  OS ihts teis oegs ftear nemoy nw!o at etasl my omsmcetn are'nt bdacmselr lol +2



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