need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)
NBME Free 120 Answers

free120/Block 1/Question#37 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
baroreceptor output ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

 Login (or register) to see more

 +1  upvote downvote
submitted by โˆ—icedcoffeeislyfe(56)

Is the decrease in baroreceptor output due to the body adapting to the hypertension?

 Login (or register) to see more
azibird  Apparently. "Baroreceptor activity is reset during sustained increases in blood pressure so that in patients with essential hypertension, baroreceptor responsiveness is maintained." "It is a universally accepted phenomenon that vascular baroreceptors reset to operate at higher pressure levels in hypertension." Okay, so they can reset to normal levels, but wouldn't this patient already have undergone their reset? Why would the receptors further decrease? I thought that eventually their LV would hypertrophy and fail, leading to decreased stroke work. +4
azibird  From Costanzo Physiology: "The sensitivity of the baroreceptors can be altered by disease. For example, in chronic hypertension (elevated blood pressure), the baroreceptors do not โ€œseeโ€ the elevated blood pressure as abnormal. In such cases, the hypertension will be maintained, rather than corrected, by the baroreceptor reflex. The mechanism of this defect is either decreased sensitivity of the baroreceptors to increases in arterial pressure or an increase in the blood pressure set point of the brain stem centers." +19
mangomango  Hypertensive heart disease causes concentric LVH - impaired diastolic function, preserved ejection fraction +2

 +1  upvote downvote
submitted by โˆ—brise(85)

Does anyone know why decreased left ventricular stroke volume work is wrong? Would'n stroke volume decrease with increased afterload?

 Login (or register) to see more
helppls  I put down stroke work because I was thinking about decompensated heart failure, could this not be a potential answer? +
madamestep  @helppls that was my thought too. But maybe the baroreceptor adaptation comes first... +

Must-See Comments from free120

sugaplum on It is a polymorphism
bwdc on Elaboration of proteases and urease with ...
bwdc on Hypercoagulability from advanced malignancy
bwdc on Ribosomal assembly
bwdc on Aspiration
bwdc on Amygdala
imnotarobotbut on von Willebrand disease
bwdc on Trinucleotide repeat expansion
bwdc on Mediation of cell entry via a fusion protein
bwdc on Metabolism
bwdc on Basement membrane
melchior on Aspiration
hungrybox on Immune complex deposition in tissues
aejinkim on Decreased activity in the enzyme that ...

search for anything NEW!