USMLE Question of the Week

Pathophysiology Of Acute Heart Failure for USMLE

In the premier Episode 1 of Med School Question of the Week for USMLE, Leigh Finnegan examines the following:

A 67-year-old man with a history of hypertension, type II diabetes, hyperlipidemia, and a myocardial infarction treated with coronary artery stenting presents to the emergency department with worsening dyspnea and orthopnea. On exam, his heart rate is 125 bpm, his respiratory rate is 31/breaths/minute, and his blood pressure is 106/65. On echocardiogram, his left ventricle is dilated and has an ejection fraction of 35%. As a result of the increased volume of fluid in the left ventricle, his heart releases a substance that promotes natriuresis, diuresis, and vasodilatation, and counteracts with myocardial fibrosis. Which of the following enzymes is responsible for degrading this substance?

  • Bradykinin
  • Angiotensin
  • CYP19
  • Neprilysin
Click to Reveal the Correct Answer


Leigh Finnegan

Leigh received her B.A. from Georgetown University with a degree in English and mathematics, and received her Doctor of Medicine from the Perelman School of Medicine at the University of Pennsylvania in 2019. She enjoys cooking vegetarian food and running on the Schuylkill River Trail.

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