Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 100539

In scope icon M 3 E
QID 100539 (Type "100539" in App Search)
A 50-year-old man with congestive heart failure (CHF) was started on an experimental analog of atrial natriuretic peptide. Which of the following would he expect to experience?

Increased water reabsorption by the renal collecting ducts

1%

4/284

Vasoconstriction, increased blood pressure, aldosterone release

8%

22/284

Increased glomerular filtration rate, restricted aldosterone release, vascular smooth muscle dilation

82%

232/284

Increased renal absorption of sodium and water

6%

16/284

Increased plasma calcium and decreased renal reabsorption of phosphate

1%

4/284

Select Answer to see Preferred Response

bookmode logo Review TC In New Tab

Atrial natriuretic peptide (ANP) is a polypeptide secreted by atrial cardiomyocytes in response to increased intravascular pressure (determined by atrial volumetric stretch). ANP secretion leads to peripheral vasodilation, natriuresis and diuresis, ultimately lowering blood pressure and increasing glomerular filtration rate (GFR)).

ANP binds to the natriuretic peptide receptor A (NPR-A) on cell membranes, activating guanylate cyclase and forming cyclic GMP. The NPR-A receptor is present in the following tissues:
1. Kidney: ANP dilates afferent atrioles preferentially, leading to an increase of GFR. ANP also binds along the nephron, limiting the reabsorption of sodium and restricting renin secretion.
2. Vasculature: ANP relaxes smooth muscle in arterioles and venules
3. Adrenal: Restricts the release of aldosterone

Doust et al. review the use of BNP testing clinically in patients with suspected heart failure. Brain natriuretic peptide (BNP) levels are simple and objective measures of cardiac function. Elevated BNP measurements can be used to diagnose heart failure. The high negative predictive value of BNP tests is particularly helpful for ruling out heart failure.

Daniels et al. provide a review of the function of natriuretic peptides. Natriuretic peptides (NPs) are released from the heart in response to pressure and volume overload. The NP level reflects a compilation of systolic and diastolic function, as well as right ventricular and valvular function. NP levels have important prognostic value in multiple clinical settings, including in patients with stable coronary artery disease and with acute coronary syndrome. Troughton et al report that NP-guided heart failure (HF) therapy has recently been given a recommendation in US HF guidelines to achieve guideline-directed medical therapy and possibly improve outcomes.

Illustration A depicts a flowchart of the end-organ effects of atrial natriuretic peptide.

Incorrect Answers:
Answer 1: Increased water reabsorption by the renal collecting ducts results from the effects of antidiuretic hormone (vasopressin).
Answer 2: Vasoconstriction, increased blood pressure, and aldosterone release result from action of angiotensin II.
Answer 4: Increased renal absorption of sodium and water results from the effects of aldosterone.
Answer 5: Increased plasma calcium and decreased renal reabsorption of phosphate result from the effects parathyroid hormone (PTH).

ILLUSTRATIONS:
REFERENCES (3)
Authors
Rating
Please Rate Question Quality

4.8

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(9)

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options