A 53-Year-Old Man Comes to the Emergency Department with Shortness

question 499

Multiple Choice

A 53-year-old man comes to the emergency department with shortness of breath and chest tightness.  The patient was playing in a poker tournament when his symptoms first began.  He has a history of hypertension and is not compliant with his medications.  His last medical follow-up was a year ago.  Blood pressure is 195/115 mm Hg and pulse is 90/min and regular.  Lung examination reveals bibasilar crackles.  Nitroglycerin infusion is started and results in significant symptomatic improvement.  Repeat blood pressure is 165/90 mm Hg.  Which of the following intracellular events is most likely responsible for the beneficial effects of this patient's treatment?

• A)Actin phosphorylation
• B)Calcium release from sarcoplasmic reticulum
• C)Enhanced cyclic mononucleotide degradation
• D)Inositol triphosphate accumulation
• E)Myosin dephosphorylation
• F)Tyrosine kinase activation

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