病例讨论及习题.docVIP

病例讨论及习题 Chapter（1） Drug-Receptor Interactions Objectives Understand the molecular basis for drug-receptor interactions and their subsequent cellular effects. Case 1 Intent on enjoying his newly found retirement, Mr. B. has made a point of playing tennis as often as possible during the past year. For the past 3 months, however, he has noted increasing fatigue. Moreover, he is now unable to finish a meal despite being an avid lifelong eater. Worried and wondering what these nonspecific symptoms mean, Mr. B. schedules an appointment with his doctor. On physical examination, the physician notes that Mr. B. has an enlarged spleen, extending approximately 10 cm below the left costal margin; the physical examination is otherwise within normal limits. Blood tests show an increased total white blood cell count (70,000 cells/mm3), with an absolute increase in neutrophils, band forms, metamyelocytes, and myelocytes, but no blast cells (undifferentiated precursor cells). Cytogenetic analysis of metaphase cells demonstrates that 90% of Mr. B.s myeloid cells possess the Philadelphia chromosome (indicating a translocation between chromosomes 9 and 22), confirming the diagnosis of chronic myeloid leukemia. The physician initiates therapy with imatinib.  Questions 1. How does the BCR-Abl receptor tyrosine kinase affect intracellular signaling pathways? A. This kinase phosphorylates steroid hormones, causing them to upregulate growth transcriptional regulators of cell growth. B. This kinase phosphorylates the tyrosine residue on the cytoplasmic tail of the receptor and opens plasma membrane channels to allow the entry of growth regulators. C. This kinase removes phosphate groups from G protein receptors, allowing the adenylyl cyclase signaling pathway to become activated. D. This kinase removes phosphate groups from DNA, allowing transcriptional regulators access to specific genes. E. This kinase phosphorylates cytosolic proteins, leading to dysregulated cell growth. Hide Answer 1