TPR FL2 : B/Bc: #40

[To be MD]

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Question 40 on the B/Bc section of TPR FL 2 asks the following:

"Which of the following peptides can be expected to be found in higher amounts in the serum of a patient with acute or chronic heart failure?"

I. ANP
II. Tropomyosin
III. Aldosterone

A) III only
B) I and II only
C) I and III only
D) I, II, and III

______________________________

I picked B because ANP & Tropomyosin will be present in the serum of a failing heart.




TPR says the answer is D, but Aldosterone, while present during heart failure, isn't a peptide.... They say, "Item III is correct: activation of RAAS is also observed during heart failure." I say, "Who cares? It's still not a peptide."
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Is this a TPR mistake or am I missing something?

 

[NextStepTutor_3]

From the information you've given, I would personally assume that it's a mistake. Aldosterone certainly is not a peptide. Additionally, if this were an AAMC question, you would have approached it properly - it's very important to isolate exactly what the question is asking for, and they're asking for peptides.

It's possible that Roman numeral III previously said something else, and was changed to "Aldosterone" later in the question-writing process but never fixed. This is particularly evident as the explanation references the renin-angiotensin system, and both renin and angiotensin are peptides. But (unless I'm missing something significant) the way it's currently written, they are incorrect.

 

[theonlytycrane]

@To be MD for heart failure, how do you think about the role of each answer choice listed? ANP is released to lower bp, but if the heart is failing to pump wouldn't bp already be low? Though aldosterone isn't a peptide (wrong for this question) I would expect it to be present. I'm not sure how to reason through tropomyosin.

 

[To be MD]

@To be MD for heart failure, how do you think about the role of each answer choice listed? ANP is released to lower bp, but if the heart is failing to pump wouldn't bp already be low? Though aldosterone isn't a peptide (wrong for this question) I would expect it to be present. I'm not sure how to reason through tropomyosin.

The passage tells you that this the body has many compensatory mechanisms over a number of years for a failing heart.

The ANP acts to reduce the increased pressure during heart failure.
Tropomyosin can come from cardiac myocytes. Failing heart --> dead/dying myocytes --> tropomyosin lying around.
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Activation of RAAS (Renin-Angiotensin Aldosterone System) will get your aldosterone, but in this Q it's not a peptide.