high blood pressure 2 Flashcards
Which of the following correctly describes the mechanism of action of calcium channel blockers (CCBs) in reducing blood pressure?
A. Block Gq-coupled α1 receptors to inhibit IP3 production and reduce vasoconstriction
B. Inhibit L-type voltage-gated calcium channels, reducing intracellular calcium in smooth muscle
C. Enhance the activity of Na+/K+ ATPase in vascular smooth muscle cells
D. Inhibit renin release by blocking β1 adrenergic receptors in the kidney
nhibit L-type voltage-gated calcium channels (or voltage gated channels), reducing intracellular calcium in smooth muscle
is this in b1 or b2
how do calcium channel blockers DIHYDROPYRIDINE and NON-DIHYDROPYRIDINE differ?
dihydropyridine act by vasodilating the peripheral vasculature
includes amlodipine and clevidipine
non dihydropyridine acts on calcium channels of cardiac and smoot muscles to decrease contractility
includes verapamil and diltiazemi
includes verapamil and diltiazemi, acts on calcium channels in heart cells and smooth muscles cells to reduce how hard the heart pumps
non-dihydropyridine
includes amlodipine and clevidipine that does vasodilation
dihydropyridine
Which of the following pathways correctly describes how angiotensin II (ATII) leads to aldosterone release?
A. ATII activates β2 receptors → ↑cAMP → aldosterone release
B. ATII activates AT1 receptors → Gq → IP3/DAG → Ca2+/PKC/CaMK activation
C. ATII inhibits phospholipase C → ↓DAG and IP3 → aldosterone suppression
D. ATII binds to aldosterone receptor → gene transcription → aldosterone secretion
ATII activates AT1 receptors → Gq → IP3/DAG → Ca2+/PKC/CaMK activation
an enzyme stimulated by SNS by B1 adrenergic receptors and secreted by juxtaglomerular cells in the kidneys that process angiotensinogen into ATI
renin
a hormone that mainly exists as a membrane bound glycoprotein in the pulmonary capillary endothelium converts ATI to ATII
ace
Which of the following statements about angiotensin II (ATII) is TRUE?
A. ATII acts primarily through β1 receptors to promote sodium reabsorption
B. ATII decreases aldosterone release by inhibiting adrenal cortex signaling
C. ATII exerts its effects primarily via the AT1 receptor, promoting vasoconstriction and aldosterone secretion
D. ATII activates cAMP-mediated signaling in the nephron to stimulate diuresis
ATII exerts its effects primarily via the AT1 receptor, promoting vasoconstriction and aldosterone secretion
Upon activation by angiotensin II, the AT1 receptor initiates which of the following correct intracellular signaling cascades?
A. Activates Gs protein → ↑cAMP → activation of PKA → smooth muscle relaxation
B. Activates Gi protein → ↓cAMP → inhibition of renin release
C. Activates Gq protein → ↑IP3 and DAG → ↑[Ca²⁺] and PKC activation → smooth muscle contraction and aldosterone synthesis
D. Activates tyrosine kinase pathway → PI3K-Akt signaling → vasodilation and natriuresis
ctivates Gq protein → ↑IP3 and DAG → ↑[Ca²⁺] and PKC activation → smooth muscle contraction and aldosterone synthesis
how does low calcium lead to aldosterone release
calcoum leads to the activation of CAMK, which does smooth muscle contraction
PKC and CaMK signals trigger aldosterone release
Aldosterone exerts its primary effects on the distal nephron by modulating which of the following specific membrane proteins to promote sodium reabsorption and water retention?
A. Na⁺/K⁺ ATPase and NKCC2 in the loop of Henle, proximal convoluted tubule
B. ENaC and Na⁺/K⁺ ATPase in the distal convoluted tubule and the nephron
C. ROMK and CFTR channels in the proximal tubule and the nephrone
D. Aquaporin-2 and V2 receptors in the collecting duct and distal convoluted tubule
ENaC and Na⁺/K⁺ ATPase in the distal convoluted tubule and the nephron
the main effect is promote Na+ balance and water reabsorption
what are two examples of angiotensin converting enzyme inhibitors (ACEi)
captopril and enalapril
Which of the following best describes the primary mechanism and a notable consequence of angiotensin-converting enzyme inhibitors (ACEi)?
A. ACEi block AT1 receptors, directly causing vasodilation and increased bradykinin breakdown
B. ACEi inhibit renin secretion, leading to reduced angiotensinogen cleavage and hyperkalemia
C. ACEi prevent conversion of angiotensin I to angiotensin II and decrease bradykinin breakdown, leading to vasodilation and dry cough
D. ACEi block aldosterone receptors in the nephron, reducing Na⁺ reabsorption and increasing water excretion
ACEi prevent conversion of angiotensin I to angiotensin II and decrease bradykinin breakdown, leading to vasodilation and dry cough
reduces the downstream of the RAAS system
The primary mechanism by which angiotensin receptor blockers (ARBs) reduce blood pressure involves:
A. Inhibition of renin secretion via β1 adrenergic blockade
B. Inhibition of angiotensin-converting enzyme, reducing bradykinin breakdown
C. Blocking AT1 receptors to prevent angiotensin II–mediated vasoconstriction
D. Direct inhibition of aldosterone binding to its nuclear receptor
Blocking AT1 receptors to prevent angiotensin II–mediated vasoconstriction
acti on smooth muscle and adrenal cortex, causes vasodilation and decreases aldosterone secretion
2 drug examples of ARBS (At1 blockers)
Losartan and Valsartan
Which of the following best describes the mechanism of action of aldosterone antagonists such as spironolactone and eplerenone?
A. Block the epithelial sodium channel (ENaC) directly, preventing sodium entry into nephron cells
B. Inhibit the mineralocorticoid receptor, reducing transcription of Na⁺/K⁺ ATPase and ENaC proteins
C. Inhibit angiotensin-converting enzyme, leading to decreased aldosterone synthesis
D. Block AT1 receptors, preventing aldosterone release and increasing sodium excretion
Inhibit the mineralocorticoid receptor, reducing transcription of Na⁺/K⁺ ATPase and ENaC proteins
also inhibits the actions of aldosterone
what are 2 examples of aldosterone antagonists:
spironolactone and eplerenone
