This varies among states but in most of the states a 1-2 year free seizure period is required for epileptic patients to get their license

Just a rant - i hate this f*cking picture it's been on 3 NBMEs now and every time I've gotten it wrong.

COPD is usually associated with Pulmonary Hypertension. The examiner tells you that there is a loud pulmonary component of S2 ie: P2 (Loud S2/P2= Pulmonary Hypertension). Fev1:FVC is just related to COPD. The question is asking what is DECREASED in the pulmonary VASCULAR SMOOTH MUSCLE. do not get confused with the line stating there is decreased diffusing capacity for CO. the question isn't asking about that.

In pulmonary hypertension there is an imbalance between vasodilation substances and vasoconstrictors. therefore our vasodilators would be decreased eg: Nitric Oxide

if it asked increased, you could go with Endothelin (remember the endothelin antagonists used for t/t of Pulm HTN ie: bosentan sorry gave some extra info but all of it is important because they can ask this concept in many ways

Costanzo Physiology 6th E p456

Regulation of Vitamin D Synthesis Whether the renal cells produce 1,25- dihydroxycholecalciferol (the active metabolite) or 24,25-dihydroxycholecalciferol (the inactive metabolite) depends on the “status” of Ca2+ in the body. When Ca2+ is sufficient, with an adequate dietary intake of Ca2+ and normal or increased plasma Ca2+ concentration, the inactive metabolite is preferentially synthesized because there is no need for more Ca2+. When Ca2+ is insufficient, with a low dietary intake of Ca2+ and decreased plasma Ca2+ concentration, the active metabolite is preferentially synthesized to ensure that additional Ca2+ will be absorbed from the gastrointestinal tract.