Short Answers (50 points) Please answer questions concisely…

Short Answers (50 points) Please answer questions concisely and write clearly.   A 55-year-old female was admitted to the hospital due to “pounding” in her chest, nausea, and diaphoresis (sweating) that persisted for 40 minutes after a routine jog. The heart rate was 65 beats per minute, and the blood pressure 138/72 mm Hg. Doctors noted that her blood troponin I level was elevated and continued to rise 11 hours later (from 0.055 ng/ml to 0.415 ng/ml; normal range, 0 to 0.045). All other tests were normal with the left ventricular end-diastole pressure, 5 mmHg, and she was discharged with aspirin and a beta-blocker for presumed exercise-related supraventricular tachycardia. Four months later, while she was on a downhill-skiing trip in Vermont, she experienced acute nausea and emesis (vomiting) followed by chest pain and dyspnea (difficulty breathing). The heart rate was 111 beats per minute, the blood pressure was 115/81 mm Hg, the troponin I level was 11 ng/ml, and the white-cell count was 36,100 per cubic millimeter (normal range, 4500 to 11,000). Intravenous infusions of heparin and furosemide (diuretics) were administered at a local emergency department then transferred to the local hospital via helicopter. On the patient’s arrival, the heart rate was 143 beats per minute, the blood pressure was 96/72 mm Hg, and the troponin I level was 4.790 ng/ml (normal range,

Early in her care, she was treated to lower the heart rate….

Early in her care, she was treated to lower the heart rate. Discuss three drug mechanisms to lower the heart rate, based on three different types of receptors which influence heart rate. Justify the administration of norepinephrine following an episode of hypotension. Specifically, state how the drug impacts contractility, stroke volume, and mean arterial pressure. Be sure to do the following; a) Identify the type of receptor to which norepinephrine binds on a myocardial (contractile) cell. b) Predict intracellular calcium levels after receptor-ligand binding (increase/decrease) and identify two resulting mechanisms that lead to those changes.

A 49-year-old woman was admitted to the hospital after exper…

A 49-year-old woman was admitted to the hospital after experiencing recurrent episodes of shortness of breath, severe headache, sweating, and abdominal pain. These episodes occurred primarily during physical exertion. Vitals were taken and included a BP recording of 160/95 mm Hg. She underwent a series of exams including imaging studies that showed a tumor on her adrenal medulla. When this tumor suddenly releases a large amount of epinephrine into the circulation, the patient’s heart rate would be expected to