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Retired NBME 17 Answers

nbme17/Block 4/Question#34 (reveal difficulty score)
A 16-year-old girl comes to the physician ...
Dopamine ฮฒ-hydroxylase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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nsAngriew thsi isteoqun rqeriseu ngreela dngekelow of teh ohaiecncematl sytssenhi ytahpaw 2(F200A p.3)8

ehT apocarph I koto to siht notsuqie asw mnaiyl eoinmlatini fo grnow r:nswsea

  • AMO (omenionma s)idoxae clduo be dnlaemtiei eesaucb hse is aiclkng renpheieipn and escni OAM is oivvenld in hte drnobewka fo amcshit,lanoeec a fiycincdee in OMA uowld rnesaeic etcnriootsnnca fo nhoneprerieinp adn eohrt tiacchnaeoms.el
  • rppnenieioerNh nrottrareps cdlou eb ieidalmnet ebsauec ithbiniion fo eekutrpa fo nerneionhipper ,dulow aa,gin sernecia pprnneeeonirhi ooritcnantcsne dna hes ahs dsreaceed t.nninotcecoar
  • yoTeirsn xosyrehylda cna be liiendmaet cubsaee ti is hte fsirt tspe in ieonclamcateh nyshsteis nad uierqerd orf andiepmo itsy,ssnhe dan as ehs sha sniceader dmpoenai ihst spet is ton efnc.itdie
  • imoAn caid sldaeeobyxa,cr ro nmLai-o idca yodelsacaxebr asol acdlel ADOP d,acyserbolxae is loas rieudqer in eapmdino ehyissstn adn acn be emetinadli ascuebe fo her ecaiedsnr diamopne no.cieronctant

shTi laseev the swen,ar endmioap -yleraatsxeoyh.db

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waitingonprometric  semeoAw rnw,aes but sjut to dda a bti omre oubat yhw het ccrrote rsewan ksmea e.nses inmpaeoD yedaayrselxtho-b is het ymznee atth csnvtoer pinmeado ot ione.eprpnhneri r,eTfhreoe teh seriecna ni mpoinead .ncoc whne snigir ofmr pnisue ot ,nnisatgd is ryigtn to eltl us hatt ehr body si mirgapn pu het SSN to necamoestp rof lla fo teh oblod unihsgr to hre etfe hwen esh ntasds pu. Rniapmg pu the SNS erusiqer ioturdoncp of lasmhecoteainc, utb ohttuiw hsti ymnz,ee ishsntyse fo NE oyln sget ot teh odpnieam tgeas and tsol fo mipenado skbac pu dnhebi hist yeznm.e +15

Perhaps worth noting here is that Dopamine Beta-hydroxylase is a membrane-bound enzyme found in the vesicular membrane. This means that the conversion of Dopamine to Norepinephrine actually occurs within the synaptic vesicle. Norepinephrine is the only transmitter known to be synthesized within synaptic vesicles. This is mentioned in less detail in SketchyPharm 2.2 Indirect Sympathomimetics.

Also, per FA, this reaction requires Vitamin C as a cofactor!

+2/- baja_blast(219)


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