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NBME 24 Answers

nbme24/Block 1/Question#47 (25.6 difficulty score)
A 35-year-old man comes to the physician 1 ...
Increased serum angiotensin II concentration🔍,📺

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submitted by xxabi(267),
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BsRA tleusr in hte looglniwf ceghnas: aeseindcr nreni, nridasece gnA I, rsncadiee nAg II, addcresee sadonloeetr adn ngecnhadu abryiknndi

famylife  ...and just to clarify, they directly inhibit the Ang II receptor (AT1) +2  
kpjk  I had a doubt- that wouldnt increased RAA lead to increased serum aldosterone as well. Now I understand that since the receptors are blocked- even the receptors to increase aldosterone secretion by Ang II would also get blocked... +3  

submitted by aoa05(30),

Renin concentration will be increased because feedback mechanism of renin release is due to angiotensis II (Ang II) on angiotensin type 1 receptor (AR1). That is, Ang II acting on AR1 will cause a negative feedback on the RAAS pathway. Since AR1 is blocked by ARB, this negative feedback is no longer active, triggering an increase in renin and increasing Ang II production (correct answer). Blocking AR1 will inhibit downstream actions (release of aldosterone and Ang II-mediated increase in sympathetic activation, triggering norepinephrine). Therefore, aldosterone and norepinephrine will be reduced.

submitted by jotajota94(14),
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A doog yaw ot tikhn uatob thsi is htta aionintsgne II si ptsener at eth AGIIN scep.rroet If you iveg na asoitiegnnn rteopecr crbelok scuh as losaar.nt iths lwil slaipecd het oaentingnis II nrpetse in eth o.septcrer uhts gaeiinnsrc het llevse fo nnonistgaie II in mrue.s