ARJ
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A 41-year-old woman comes for a follow-up examination. Two weeks ago, her blood pressure was 149/93 mm Hg during a routine visit. Her blood pressure today is 151/93 mm Hg, pulse is 77/min, and respirations are 13/min. Examination shows no other abnormalities. Serum studies show:
Na+ 141 mEq/L
Cl– 104 mEq/L
K+ 5 mEq/L
HCO3– 27 mEq/L
Urea nitrogen (BUN) 11 mg/dL
Glucose 99 mg/dL
Creatinine 0.7 mg/dL
An ECG shows no abnormalities. Which of the following is the most appropriate next step in management?
A ) Measurement of plasma renin activity
B ) Serum lipid studies
C ) 24-Hour urine collection for measurement of metanephrine level
D ) Echocardiography
E ) Captopril renal scan
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| DrS
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B ) Serum lipid studies
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| mani
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B..
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| lucky
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A ?
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| chemamr
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B?
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| att
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E.
hypetension in young women .seconday cause.rule out fibromuscular dysplasia
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| DrS
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41 isnt very young is it?
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| phuluong2k
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ARJ what is the answer ?
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| icefires
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E ) Captopril renal scan ,
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| ckdoc5
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should be E ..SOMEONE POST AN EXPLANATION
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| alenka
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ARJ,what's the answer?
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| webjeee
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anyone explain it?
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| doyoudig
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I would do B 1st before going to something more expensive, n also there is nothing in on P/E that would suggest Fibromuscular Dysplasia, even though she is young.
Lets R/o Essential HTN 1st
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| doyoudig
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give us n answer pls. thx
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| usmle12
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none of physicals point to underlying cause of htn so essential htn and lipid level is ifne way to start with....other wise if we are searching for underlying cause then allof these test would be needed
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| dr19
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B)--->we need it for stratification of the patient.
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| doc_clotaire
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I will go with B too 
B ) Serum lipid studies
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| drhouse
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i will go for E... fibromuscular dyplasia should always be suspected in young women with HT
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| stony_meadow
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B, there's no indication for the other tests. 41 is not too young for essential htn.
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| dr.wad
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( B ) is the ans..
IN RAS there will be high NA and low K ....in this case they r normal >> so not E.
FMD is a cause of RAS so there will be these electrolytes changes...
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