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Practice sessionHEALTHCARE & MEDICAL EXAMSMEDICAL LICENSING

USMLE (United States Medical Licensing Examination) Practice Exam 16

Practice exam for USMLE (United States Medical Licensing Examination).

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Question 1 of 110%
Time remaining180:00
Attempts allowedUnlimited
Difficulty mixE • M • H
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Question 1

MEDIUM

A 62-year-old man with long-standing hypertension is started on a medication that lowers blood pressure by increasing intracellular cGMP in vascular smooth muscle. Two weeks later, he reports facial flushing and a throbbing headache shortly after taking the medication. Which of the following best describes the primary mechanism that increases cGMP in vascular smooth muscle?

Nitric oxide activates soluble guanylate cyclase in vascular smooth muscle, increasing cGMP and causing relaxation; this is the key pathway for nitrates and related vasodilators. PDE3 inhibition increases cAMP (not cGMP) and is more relevant to inotropy/vasodilation with agents like milrinone.

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