Consider the steps the renin-angiotensin-aldosterone system [RAAS] goes through when there is a decrease in circulation or a drop in blood pressure, ordered from the earliest to the latest. What is the step directly after angiotensin I is produced?

The kidney senses decreased perfusion

Renin is released and cleaves angiotensinogen.

Blood volume is raised and blood pressure is increased.

Angiotensin-converting enzyme helps to produce angiotensin II in the lungs and to stimulate the adrenal gland to release aldosterone

Answer and Explanation

The Correct Answer is D

A. The kidney senses decreased perfusion:

This occurs earlier in the RAAS sequence, triggering the release of renin — not the immediate next step after angiotensin I is produced.

B. Renin is released and cleaves angiotensinogen:

This precedes the production of angiotensin I, not after.

C. Blood volume is raised and blood pressure is increased:

This is the final result of RAAS activation, not the step immediately following angiotensin I production.

D. Angiotensin-converting enzyme helps to produce angiotensin II in the lungs and to stimulate the adrenal gland to release aldosterone:

After angiotensin I is produced, it travels to the lungs where ACE converts it into angiotensin II, a potent vasoconstrictor that also triggers aldosterone release.

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Correct Answer is D

Explanation

A. Mitral stenosis:

Mitral stenosis is narrowing of the mitral valve, often due to rheumatic heart disease, not IV drug use or infection.

B. Angina pectoris:

Angina is chest pain due to ischemia, not infection or vegetation on heart valves.

C. Aortic insufficiency:

Aortic insufficiency is leakage of the aortic valve, leading to volume overload, not typically associated with infection and petechiae.

D. Infective endocarditis:

IV drug users are at high risk for infective endocarditis. Symptoms include fever, chills, weakness, petechiae, and vegetations seen on echocardiogram.

A. Seizures and dilated (fixed) pupils B. Double-vision and disorientation C. Tinnitus and Diarrhea D. Clear speech and 2 + deep tendon reflex response

Correct Answer is B

Explanation

A. Seizures and dilated (fixed) pupils:

These findings suggest severe neurological injury, such as brain herniation, not a TIA.

B. Double-vision and disorientation:

TIA often presents with neurological deficits like visual disturbances (double vision), disorientation, weakness, and slurred speech, which resolve within 24 hours.

C. Tinnitus and Diarrhea:

These symptoms are not typical for TIA; tinnitus relates to ear problems, and diarrhea relates to GI issues.

D. Clear speech and 2+ deep tendon reflex response:

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Consider the steps the renin-angiotensin-aldosterone system [RAAS] goes through when there is a decrease in circulation or a drop in blood pressure, ordered from the earliest to the latest. What is the step directly after angiotensin I is produced?

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Explanation

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