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Kaplan Qbank USMLE



Author9 Posts
  #1

The amount of force produced by a skeletal muscle can be increased
by
a. Increasing extracellular Mg2+
b. Decreasing extracellular Ca2+
c. Increasing the activity of acetylcholine esterase
d. Decreasing the interval between contractions
e. Increasing the preload beyond 2.2 μm

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  #2

Is it D?

  #3

A?

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  #4

D sounds good to me. I dont understand what E means....2.2 Micro metres?

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  #5

E reffers to the optimal length of sarcomere (2.2 micrometers) which corresponds to optimal contractility - it's the Frank Starling mechanism

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  #6

d

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  #7

I don't think it's D because it's the same answer as C till one point -> increasing the activity of ACE will produce a shortened activity of Ach. Now, if you decrease the time between contractions you end up with a tetanus which in my understanding will increase the length (in time) of the contraction and just secondary the force.

I think, I'll do an elimination and end up with A which doesn't sound good eather confused

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  #8

its E

  #9

well the max force any muscle can generate is dependent on the no. of actin-myosin sites tht are in cycling which in turn depends on the conc. of Ca++ intracellularly! which in turn depends on no. of action potentials each and every muscle fibers gets in the whole bulk, thus if one decrease the interval b/w action potentials, the major effect wud be, tht Ca++ will get more and more concentrated in the cytoplasm as the mitochondria and ER won't hv enuff time to clear up all the Ca++. This high Ca++ wud then be responsible for the saturation of all the available actin-myosin sites and keep them in cycling! [this last part i.e inc. contractility due to high Ca++ is analagous to how digitalis acts on cardiac muscle fiber]

secondly, the strength tht a muscle fiber can generate depends on the no. of actin/myosin sites that are in cycling, therefore increasing the pre-load beyond Lo will reduce the interaction between the two and thus reduce the max.force that can be generated!

answer is D


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