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€)

You must be logged in to vote!
Retired NBME 22 Answers

nbme22/Block 4/Question#35 (reveal difficulty score)
Nicotinic acid acts at which of the following ...
Pathway labeled โ€˜Cโ€™ ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +17  upvote downvote
submitted by โˆ—btl_nyc(72)
get full access to all contentpick a username

A: cholestryramine and other bile acid resins prevent the reuptake of bile acids from the gut.

B: Statins inhibit HMG-CoA reductase, preventing the liver from making mevalonic acid, a precursor to cholesterol.

C: Niacin (nicotinic acid) reduces hepatic VLDL synthesis and also inhibits lipolysis in adipose tissue by inhibiting hormone sensitive lipase.

D&E: Fibrates upregulate lipoprotein lipase (LPL), increasing triglyceride clearance (VLDL and chylomicrons are full of triglycerides) and also activate peroxisome proliferator-activated receptor- alpha (PPAR-alpha) to induce HDL synthesis.

get full access to all contentpick a username
icrieeverytiem  My dumbass thought nicotinic acid=something to do with smoking smh +2
chaosawaits  @icrieeverytiem me toooo +
kani  me 3 +


You must be logged in to vote!

 +13  upvote downvote
submitted by โˆ—mattnatomy(46)
get full access to all contentpick a username

Answer = C. (Decreased hepatic VLDL synthesis)

Nicotinic acid = Niacin. Niacin works by:

  1. Inhibiting lipolysis (hormone sensitive lipase) in adipose tissue)

  2. Reducing hepatic VLDL synthesis

get full access to all contentpick a username
johnthurtjr  Well color me surprised. I was completely thrown off here. +34
miriamp3  @almondbreeze go to the cardiovascular pharmacology you will see a draw of lipid lowering agents and you will find niacin en two places ++one on the adipose tissue and the second one in the liver by the vldl production. in the text in the same page is also mention it FA 2018 pg 313. +
djeffs1  I still don't quite see how C corresponds to those 2 processes... +

The only place where FA2019 talks about - pg. 67, on Hartnup dz: pellagra-like symptoms. Treat with high- protein diet and nicotinic acid.

well, great


You must be logged in to vote!

 +3  upvote downvote
submitted by โˆ—btl_nyc(72)
get full access to all contentpick a username

A: cholestryramine and other bile acid resins prevent the reuptake of bile acids from the gut. B: Statins inhibit HMG-CoA reductase, preventing the liver from making mevalonic acid, a precursor to cholesterol. C: Niacin (nicotinic acid) reduces hepatic VLDL synthesis and also inhibits lipolysis in adipose tissue by inhibiting hormone sensitive lipase. D&E: Fibrates upregulate lipoprotein lipase (LPL), increasing triglyceride clearance (VLDL and chylomicrons are full of triglycerides) and also activate peroxisome proliferator-activated receptor- alpha (PPAR-alpha) to induce HDL synthesis.

get full access to all contentpick a username


You must be logged in to vote!

 +1  upvote downvote
submitted by โˆ—gh889(154)
get full access to all contentpick a username

Could someone please explain which drugs (if any) are at D and E?

get full access to all contentpick a username
usmleuser007  1) label D (VLDL -->ILD --> LDL) = anything that increased LPL = Fibrates which use PPAR-alpha (Rx) are good at reducing [VLDL]; therefore, less VLDL means more ILD. 2) VLDL --> fatty acid oxidation = using fats (TAGs) for energy production Here PPAR-gamma plays a role= which are Thiazolidinediones (also called glitazones) are a class of medicines that may be used for the treatment of type 2 diabetes. They are also good at reducing serum TAGs Note VLDL are very rich in TAGs +2


You must be logged in to vote!

 +0  upvote downvote
submitted by โˆ—usmleuser007(464)
get full access to all contentpick a username

1) label D (VLDL -->ILD --> LDL) = anything that increased LPL = Fibrates which use PPAR-alpha (Rx) are good at reducing [VLDL]; therefore, less VLDL means more ILD.

2) VLDL --> fatty acid oxidation = using fats (TAGs) for energy production Here PPAR-gamma plays a role= which are Thiazolidinediones (also called glitazones) are a class of medicines that may be used for the treatment of type 2 diabetes. They are also good at reducing serum TAGs

Note VLDL are very rich in TAGs

get full access to all contentpick a username


You must be logged in to vote!

 +0  upvote downvote
submitted by โˆ—psaucy(2)
get full access to all contentpick a username

I miss so many questions on NBME exams not knowing the common names for things lol fuck me

get full access to all contentpick a username
psaucy  only knowing the common names* +


You must be logged in to vote!

Must-See Comments from nbme22

sacredazn on Unrearranged immunoglobulin gene
seagull on Decreased binding of RNA polymerase
seagull on Anticholinergic
mcl on Area labeled โ€˜Dโ€™
liverdietrying on Release of stored thyroid hormone from a ...
kernicterusthefrog on Displacement
keycompany on Negative nitrogen balance
joha961 on Displacement
imgdoc on Area labeled โ€˜Cโ€™ (Abducens nucleus, right)
alwaysanonymous on 25 mL/cm H2O
drdoom on 1 in 600
seagull on Glutamine
yotsubato on Phase variation
bubbles on Acute retroviral infection

search for anything NEW!