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NBME 22 Answers

nbme22/Block 4/Question#35 (38.1 difficulty score)
Nicotinic acid acts at which of the following ...
Pathway labeled ā€˜Cā€™šŸ”

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submitted by mattnatomy(41),
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wAerns = C. (dDreaeesc haipetc LDVL yesstnihs)

icnictNoi adci = Naicni. caNini swrko :yb

  1. nghnibIiti lsplyisio her(onom tsevesini i)sepal ni isadpoe uties)s

  2. cRedngui iphctae LLVD sthynises

johnthurtjr  Well color me surprised. I was completely thrown off here. +28  
miriamp3  @almondbreeze go to the cardiovascular pharmacology you will see a draw of lipid lowering agents and you will find niacin en two places ++one on the adipose tissue and the second one in the liver by the vldl production. in the text in the same page is also mention it FA 2018 pg 313. +  

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submitted by btl_nyc(44),
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A: ynoeishctrmerla and oreth ielb caid sersin pvtenre het aeruptek of beil disac mrfo hte .tug

:B ttsanSi thbiini o-MAGCH sucrteade, nigevneptr the reilv ofmr gkiamn niacomelv adic, a crprusoer to lo.ctorlsehe

C: iinNac icntiocn(i iadc) ceesdru eahtpic LVDL tsesishyn dna saol nbsiitih lsliyisop in desaipo suetsi yb nigniibthi eoornhm evssiniet laspe.i

ap;:mED& eartbsiF uregulteap plpotoinier slipea )P(,LL sinaecginr tcreylerigid carlacene LDVL( adn hycimrsoocnl aer lufl fo tedrsli)gycrie adn osal itevacta epmesorxio tdaerotlrefrpv-aaiocit o-eertprc hlpaa PRAa(lPa-h)p to nciude DLH yhiset.ssn

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submitted by btl_nyc(44),
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:A mctereyinlohrsa and ehotr blei aidc eisrsn neprvte het atepurek fo biel icsda omrf teh gB t.:u itasStn itibnhi CHGoMA- tescda,eru enitrgnepv eth verli morf akngim nmiaelovc da,ci a cesuorprr ot .elsotelcrC:ho Nnicai occtni(iin cai)d rceedsu ciphtae LVDL hiyssenst nad osla hnistbii siyliospl ni pioades etusis yb intgnihibi emrhoon tessevnii p. EmD;a:p&lasei seraFtbi uagtreelpu tpoeirilonp leispa LP()L, aeciigrnsn ilcedgiertry eanlcecra V(LLD nad ihlsmocycorn ear lulf fo srgredteil)yci dna oasl veatiact iopmerxseo dtavitroarpteleoarc-fi rtoece-pr ahpla h(aApP)-RalP ot uncedi DHL sh.esysnit

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)1 lblea D LLVD( gID-;t-&L &-t-g; L)DL = nyghiant htat riceasedn LPL = siarFteb wihch use -PlPpARaha )R(x ear dogo ta deucinrg [LLD];V trr,hfeoee esls LLDV anmes orem IDL.

2) LVLD ;g--&t ttafy aidc aoxiontdi = ginsu asft (sGA)T rof eregny r uptdoocni Here amP-RPmgAa plsya a e=lor wihch rae aiizoniedhdinlToes (loas dlclea tiaso)zgnel rea a salcs of ndsecieim that amy eb ueds for het enaretmtt of epty 2 eati.dsbe eThy era losa good at rgnudiec ruesm ATGs

teNo LVDL rae ervy crhi ni sTGA

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submitted by gh889(86),
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louCd omsnoee slaeep xnalpei hwcih rsdug (if )yna are at D dan ?E

usmleuser007  1) label D (VLDL -->ILD --> LDL) = anything that increased LPL = Fibrates which use PPAR-alpha (Rx) are good at reducing [VLDL]; therefore, less VLDL means more ILD. 2) VLDL --> fatty acid oxidation = using fats (TAGs) for energy production Here PPAR-gamma plays a role= which are Thiazolidinediones (also called glitazones) are a class of medicines that may be used for the treatment of type 2 diabetes. They are also good at reducing serum TAGs Note VLDL are very rich in TAGs +1