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NBME 21 Answers

nbme21/Block 1/Question#48 (36.5 difficulty score)
A 44-year-old man is admitted to the hospital ...
Increasing cGMP🔍,📺
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 +8 
submitted by divya(63),
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ineearsc ni MPcA ()sG - bat2e - dnlovaiiosta

csadeere in cAPM Gi() - 2lahap - otsavtrocincnios

creaenis in 3PI GAD )Gq( - hlpa1a - itrvoioncncsasot

sniraeec in GcMP - 3M - NO ceniddu inoalsdtvioa

cytotoxict  Alpha 2 agonists do not cause vasoconstriction b/c they lead to negative feedback of norepi and thus decrease sympathetic response +  
payingforthisisdumb  FA20 p317 α2-agonists increase NO/cGMP and vasodilate +  
sarahs  why is decreasing cAMP wrong? +  
hiroshimi  @sarahs: you want to increase cAMP because it would lead to vasodilation and help to decrease his blood pressure. Decreasing cAMP would make his BP worse. +  



 +1 
submitted by vi_capsule(14),
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HTN ,eegnmycer mSoudi u.Nitoedprsris Uilken zyerlaiadnh a alebndac odasairolvt ine(v = at)ierlro

sympathetikey  Well then, I guess we should just forget about our old pals the Alpha-2 agonists. Good call. I didn't even see that this was hypertensive emergency. Dumb on my part. +  
zup  so yea clonidine would be used for hypertensive urgency, but this guy is over 180 (210) so they have to use something like hydralazine or nitroprusside both will increase cGMP +  
whoissaad  Drugs used to treat HTN emergency: Nitroprusside Labetolol Nicardipine Clevidpine Fenoldapam Clonidine +16  
lola915  Hydralazine actually vasodilates arteries>veins and Nitroprusside vasodilates arteries = veins. Both increase cGMP. +10