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Retired NBME 23 Answers

nbme23/Block 4/Question#13 (reveal difficulty score)
A 65-year-old man comes to the physician ...
Smooth muscle cells of the deep artery ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +8  upvote downvote
submitted by โˆ—drschmoctor(137)
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I got thrown off thinking about nitric oxide synthesis occurring in the endothelial cells and NO diffusing to nearby smooth muscle cells. This does occur, though the cGMP the question asks about is a downstream effect of the NO in the smooth muscle cell.

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mdmikek89  Its the action of PDE inhibitors. They inhibit PDE = increase cyclic compounds. Doesn't effect NO. +3
an1  @mdmikek89 actually, FA makes it seem like PDE5 also play a role with NO. They increase NO release in the lungs (which would be endothelial cells) --> pulm vasodilation --> increased blood flow to penis. because the q was asking about the penis, endothelial cells didn't fit, but they do play a role Pg 246, FA'20 +



 +7  upvote downvote
submitted by โˆ—lfsuarez(160)
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The patient is prescribed Sildenafil which caused increased cGMP levels are therefore SMOOTH MUSCLE relaxation. In this case you would want to vasodilate the deep artery to increase blood flow into the corpora cavernosa.

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sugaplum  aka cavernous artery, that is what I was looking for. Did not realize it was also called the deep artery +9



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