Hi everyone, I will appreciate if somebody wants to discuss these questions with me.I know they all look like easy, but I got confused at the short time.

1.A 60y old broth to the hospital because he took 4 tablets of medication that prevent angina ( instead of usual one). His pulse is 36, and blood pressure is 100/50. After injection of Proterenol he feels good.Which of the follows best describes the mechanism of action of the drug;
1. Irreversible-dose dependent
2. Irreversible-dose independent
3. Reversible-dose dependent
4. Reversible-dose independent

First, I thought it was Digoxin, but you are not taking Dig. for angina prevention; second I thought It was Aspirin ( most possible), but I donj't know that Aspirin would make such a low pulse, Usually they are taking 81mg,
and even 3 tab. are not too high dose. Nitro is possible to make huge vassodilation ( specially 3 tab.) and this sounds like closest to the right answer, but I don't know is it reversible or not, plus Nitro you are taking
when you need it not for prevention.

2.13 y old girl is broth to the doc. because of 5 mo. history of behavioral problems. Diagnosis of bipolar disorder is made, and treatment is started with Valproate which inhibits histone deacetylase.
THis drug affect which of the following processes:

1.mRNA splicing
2.Polyadenylation
3.Post-transcriptional processing
4.Transcription
5.Translation.

I know that fact that it inhibits histone deacetylation should be a help, but i don't know the answer ( Transcription???)

3.23.y old man has a 3 mo history of a mild depressed mood, decreased energy and dry skin. His thyroid gland is not enlarged.Serum thyroxine(T4) and TSH are decreased. What is diagnose??
1. Primary hyperthyroidism
2. SEc. hyperthyroidism
3. Primary Hypothyro.
4. Sec. Hypothyro.

This Q. also confused me cause first part looks like hypothyroidism, but lab. values are saying contra. What do you guys are thinking would be the right answer.
Any input highly appreciated.
Thank you, Dusha

hey... 1 and 2 i dont know the answer... but 3 is secondary hypothyroidism... pitutary problem causing decreased tsh and t4.

No 1) not sure but i think it is revesible antagonism,dose dependent
2) definitely transcription (remember that acetylation promotes transcription while methylation prevents transcription) this deacetylation will definitely inhibit transcription
3) sec hypothyroidism both values are low.

All the best.. Do all nbmes.

1.dose dependant and reversible

2.transcription

3.sec hypothroidism

.....anwers:
1.BB....reversible and dose dependent.
2..Transcript?
3.Secondary Hypothiroidismo( hypophysis disease).

1...beta blocker.......dose dependent reversible
2.....transcription
3....sec hypothyriodism