PC3 Module 4.2 (Medchem Nitro)

What does NO increase in terms of cardiac function?

A. transport of O2, nutrients, and glucose

B. BP

C. cellular waste products

A. transport of O2, nutrients, and glucose

What does NO decrease in terms of cardiac function?

A. transport of O2, nutrients, and glucose

B. BP

C. cellular waste products

B. BP

What does NO remove in terms of cardiac function?

A. transport of O2, nutrients, and glucose

B. BP

C. cellular waste products

C. cellular waste products

when eNOS is bound to ______ it causes NO to lead to vasodilation

A. BH2

B. BH3

C. BH4

D. haem

C. BH4

NO diffuses into smooth muscle cells where it binds to the haem center and activates sGC to produce _______________

A. ATP

B. cGMP

C. PKG

D. GTP

B. cGMP

cGMP activates __________________

A. ATP

B. PKA

C. PKG

D. GTP

C. PKG

PKG phosphorylates several targets in regulating the intracellular Ca2+ concentration, resulting in __________

A. contraction

B. relaxation

B. relaxation

All nitrates have a nitro group on them except amyl nitrite

all organic nitrates are _____________

prodrugs

__________________ are polyol esters of nitric acid, characterized by a sequence of carbon-oxygen-nitrogen

A. synthetic nitrates

B. organic nitrates

B. organic nitrates

in smooth muscle, the net result is reduced phosphorylation of mysosin light chain, reduced Ca2+ concentration in the cytosol, and thus promotes _______________

A. relaxation

B. contraction

A. relaxation

NO reduces myocardial _____ demand by decreasing both preload and afterload

A. CO2

B. NO2

C. O2

D. H2O

C. O2

NO dilates coronary arteries, thereby _____________ coronary blood flow

A. increasing

B. decreasing

A. increasing

NO limits ___________ aggregation/adhesion

platelet

Which is a potential way to produce NO?

A. direct formation in response to interaction with ALDH2

B. formation of NOx species

C. formation of nitrite which may be reduced by the xanthine oxidase (XO) in the cytoplasm to form NO

D. all of the above

D. all of the above

low potency nitrates can be activated by ____________ in the ER directly yielding nitric oxide

Cytochrome P450 enzymes

allow nitrate free interval of ______________ to avoid nitrate tolerance

A. 1-2 hours

B. 5-10 hours

C. 10-14 hours

D. 14-15 hours

C. 10-14 hours

Within 1 day of continuous low dose GTN therapy, neurohormonal counter regulation reduces therapeutic efficacy

A. vascular tolerance and cross tolerance

B. pseudotolerance

C. no tolerance

B. pseudotolerance

after 3 days, endothelial and smooth muscle dysfunction develops

A. vascular tolerance and cross tolerance

B. pseudotolerance

C. no tolerance

A. vascular tolerance and cross tolerance

Which are proposed mechanisms for endothelial dysfunction? (select all)

A. increased endothelial and smooth muscle superoxide formation from NADPH oxidase activation by PKC and from the mitochondria

B. direct inhibition of NOS activation by PKC

C. impaired bioactivation of GTN caused by inhibition of ALDH-2

D. uncoupling of endothelial NOS caused by limited BH4 availability

A. increased endothelial and smooth muscle superoxide formation from NADPH oxidase activation by PKC and from the mitochondria

B. direct inhibition of NOS activation by PKC

D. uncoupling of endothelial NOS caused by limited BH4 availability

Which are proposed mechanisms for smooth muscle dysfunction? (select all)

A. vasoconstrictor supersensitivity caused by increased smooth muscle PKC activity

B. impaired bioactivation of GTN caused by inhibition of ALDH-2

C. inhibition of smooth muscle sGC

D. increased inactivation of cGMP by PDE

A. vasoconstrictor supersensitivity caused by increased smooth muscle PKC activity

B. impaired bioactivation of GTN caused by inhibition of ALDH-2

C. inhibition of smooth muscle sGC

D. increased inactivation of cGMP by PDE

Cellular concentration of cGMP can be reduced by ______

PDE, particularly PDE5

do not take PDE-5 inhibitor within at least _________ of taking nitrate due to severe and potentially fatal hypotension

A. 12 hours

B. 24 hours

C. 36 hours

D. 48 hours

B. 24 hours

except tadalafil which is not taken within 48 hours

Tadalafil is not taken within __________ from nitrates

A. 12 hours

B. 24 hours

C. 36 hours

D. 48 hours

D. 48 hours

__________ are rich of inorganic nitrate

A. fruit

B. rice

C. vegetables

D. bread

C. vegetables