support the site ⋅ become a member ⋅ unscramble the egg
(tag_directory)
free120  nbme24  nbme23  nbme22  nbme21  nbme20  nbme19  nbme18  nbme17  nbme16  nbme15  nbme13 

NBME 21 Answers

nbme21/Block 2/Question#39 (43.9 difficulty score)
A 64-year-old man with bronchospastic ...
Enhanced action of the agonist at β-adrenergic receptors🔍
tags:

Login to comment/vote.


unscramble the site ⋅ become a member ($36/month)

iThs si hwat I htoghut tub otn ruse if tsi’ rtc.ecro eeTrh si a oUrWdl q werhe it icbseders oitcio-ndaastimnr fo triscolo adn in.ieenphper srolCito fainclgiynist hceensna hte cftfee of ipe beueasc istocolr ahs a sipevmries tfefce on maiiitnnnga hte ncregeardi ersrt.epoc

194orbust  per UWorld, "cortisol exerts a permissive effect on many hormones to help improve the response to a variety of stressors. For example, cortisol increases vascular and bronchial smooth muscle reactivity to catecholamines". FA also uses the effect of cortisol on catecholamine responsiveness as the lone example for a permissive drug interaction (FA2018 pg 229). The difference here is that we're talking about exogenous glucocorticoid and adrenergic agonist. I guess it was expected for us to assume that the mechanism is analogous for the analogous drugs +3  
maxillarythirdmolar  I'm sure it's related to the activating effect of Cortisol on phenylethanolamine-N-methyltransferase, converting NE to Epi. Sounds like a synergistic thing to me. (FA.83) +3  
feeeeeever  My logic is probably flawed, but I also thought that if cortisol has the ability inhibit COX, LOX, and NFKB you can reduce inflammation and bronchoconstrictive mediators. Therefore, the B2 agonists would have a greater effect since things like LTB4 will be reduced. +1  
feeeeeever  *LTC4, LTD4, LTE4 for bronchoconstriction, my bad +1  



unscramble the site ⋅ become a member ($36/month)

e“hT ntacmonbioi of a ggonntla-ci ebta 2 itosgan AL(BA) and na ahndlei tocooctrirdsie si rmeo aicfsiofeuc ni msaath dan DOP][C tnha ..[]. reteih eo.anl osetdCcsotoriri yam etarglue teba 2 oeercrpt nnuiotcf yb genricisna sxespnreoi fo het oreetcrp, setrginro rnatpeGbt-i/oe 2 ereoctpr nogpicl,u nad innhibigti aebt 2 peocrter gn”roiatuwdeoln.

3l/s.w5/mi/1cpn4be/.n.w1h6:pihmwdngu1tb.t3ov

sahusema  In short, cortisol upregulates adrenergic receptors and makes them more sensitive +  



 +2  upvote downvote
submitted by adong(80),

FA19 p.233 cortisol has a permissive effect on catecholamines




 +1  upvote downvote
submitted by sam1(13),
unscramble the site ⋅ become a member ($36/month)

iThs sseme to eb a enertalv eppar:/s9:97ni.7ect/n1omhmu/.gdw1bvpw.wbn8plhi9./t

sThe"e aatd niaedtic that ccsdicliogrootu olny slatenrytni hacneen e(bAR)2at egen tiipanocrtnrs nda iafl to scaeerin essdetya-tat sellve of Aa(et2Rb) epritno ni uhamn awyari hepatelili s.ellc Nsote,shnlee ucoecgdilcuocdit-rndio efectsf on hte C(a)2AA-Rtbe sseymt of nuham yarwai lpeeitialh llcse uoticentrb to the eifabneilc fecfste fo docisrosotitcer ni mhasat by ennaihcgn teh tuonlincaf esnoersp ot "(eibgntt-s.osa2a)




unscramble the site ⋅ become a member ($36/month)

I'm rsue s'ti reetlda to eht atvangciti ffcete fo rltoCosi no ,tnpnensyemaNtoaean-hhh-efemrlrltyeails tivnnercog EN ot i.pE doSsnu leik a resnsciigyt ntgih ot me. 8.F(3A)

kevin  It's permissive because without cortisol Epi wouldn't be able to attain its full effect +