39-year-old women uncontrolled HTN despite therapy on thiazide and calcium channel blocker. About a month ago lisinopril 5 mg has been added, she develops dyspnea for 3 days, orthopnea and cough productive of white sputum. Her vitals: pulse 110 regular, RR 28, BP 170/97, O2 90%. Cardiovascular exam reveals normal S1, S2, gallop 3 and bilateral abdominal bruits. Her labs reveal: K= 3.1 Urea = 12(2.5-6.6) Creatinine = 120 (60-120). Most likely cause of uncontrolled HTN is?
سؤال مجاني 3 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: E. Renal artery stenosis
A young woman with resistant HTN on 3 drugs, bilateral abdominal bruits, hypokalaemia (secondary hyperaldosteronism), flash pulmonary edema and rising urea/creatinine after an ACE inhibitor points to renal artery stenosis (fibromuscular dysplasia in young women). Pulmonary edema is a consequence, not the cause; malignant HTN needs retinopathy (papilledema/flame haemorrhages).
ليش كل خيار صح أو غلط
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A
ليش غلط
Flash pulmonary edema is listed as a cardiac complication of hypertensive crisis (end-organ dysfunction), so it is a consequence of the severe HTN, not its cause.
✓ CARDIOLOGY-HTN.pdf · p. 10 -
B
ليش غلط
Hypertensive nephrosclerosis is renal injury secondary to long-standing hypertension, so renal failure is a complication rather than the cause here.
✓ CARDIOLOGY-HTN.pdf · p. 4 -
C
ليش غلط
Rapid deterioration of kidney function after an ACEI or ARB is listed as a sign of renal artery stenosis, not as a plain medication complication.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 5 -
D
ليش غلط
Malignant hypertension is severe HTN with retinopathy (flame hemorrhages, papilledema); none is described here.
✓ CARDIOLOGY-HTN.pdf · p. 10 -
E
ليش صح
An abdominal bruit with rapid deterioration of kidney function after an ACEI or ARB is the renal artery stenosis pattern.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 5
- المصدر
- Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 5
CARDIOLOGY-HTN.pdf · p. 4 - المحاضرة
- Hypertension · Cardiology · Module B
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- Cardio bank