nbme 12 q - carso

[ArchivalUser]

A 41 year old woman comes to the physician for a follow up examination 6 weeks after the diagnosis of hypertension was made. Her blood pressure today is 162/ 104 mm hg. A right abdominal bruit is heard. Physical examination shows no other abnormalities . Serum studies show :
na+ 135
k+ 3.2
cl- 105
hco3 28
urea nitrogen 9
creatine 0.9

on renal arteriography, sampling shows a left renal vein activity of 5 mu/ml( n 5-97) and renal vein renin activity of 176 mu/ml ( N 9-97). the systemic hypertension in the patient is directly mediated by a vasoconstrictor that emerges from which of the following ?

a- adrenal medullary chromafin cells
b- glomerular afferent arteriole
c- glomerular efferent arteriole
d- pulmonary vasculature
e- renal juxtaglomerular cells

explain the ans please.

[ArchivalUser]

Angiotensin released from the lungs so dd.

[ArchivalUser]

thanx img87 .

[ArchivalUser]

ACE (Angiotensin converting enzyme) that converts angiotensin I to II, which then vasoconstricts. ACE enzyme is released by the lungs (endothelial cells)

[ArchivalUser]

DD..ACE formed by endothelial of lung vasculature

[ArchivalUser]

But the question is a bit confusing. It asks where the vasoconstrictor ( which is angiotensin 2 ) arises from, not the enzyme that forms it.

[ArchivalUser]

@cadet99. ur right ,,renin is also enzyme and secreted by juxta......i think this one may be right one becouse angiotensin 2 that is the vasoconstrictor derives from renin...

any one has beeter explanation

[ArchivalUser]

renin converts angiotensinogen to angiotensin I. Angiotensin II is the vasoconstrictor and it forms when ACE converts AgI to AgII

yes this question is confusing in a way cuz angiotensin II comes from angiotensin I via conversion by ACE. Angiotensinogen comes from the liver.

[ArchivalUser]

My answer was E and that was incorrect according to NBME self assessment test.

[ArchivalUser]

hey was the diagnosis for the RENAL ARTERY STENOSIS?