A 34-year-old woman has uncontrolled hypertension despite hydralazine, losartan, amlodipine and furosemide. She has central obesity (BMI 32) and a continuous right flank bruit. What is the diagnosis?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Renal artery stenosis
Resistant hypertension despite four drugs plus a continuous flank/abdominal bruit points to renovascular hypertension (renal artery stenosis); in a young woman, fibromuscular dysplasia is the typical cause.
- Central obesity alone does not make Cushing syndrome/disease; there are no striae or other Cushingoid features.
- Hyperaldosteronism would suggest hypokalaemia/alkalosis, not a bruit.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Hyperaldosteronism (Conn) is suggested by hypokalemia with metabolic alkalosis and muscle weakness, not by a flank bruit.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 5 -
B
ليش غلط
Cushing syndrome is suggested by rapid weight gain with abdominal striae, psychological disturbances and central obesity. Central obesity alone with a bruit is not enough.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 5 -
C
ليش غلط
Cushing disease is the ACTH-driven (pituitary microadenoma) form, with cortisol-excess features like fat redistribution and hyperpigmentation. A flank bruit is not part of it.
✓ 6• Cushing's Syndrome & Disease [Notes].pdf · p. 3 -
D
ليش صح
An abdominal/flank bruit with early-onset, treatment-resistant hypertension is the key clue for renal artery stenosis.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 5
- المصدر
- Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 5
(Y4)-(M B) Hypertension.pdf · p. 2 - المحاضرة
- Hypertension · Cardiology · Module B
- ظهر في
- MED42 ♂ EOM B