q

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum

Author

5 Posts

som
Forum Guru

Topics: 59
Posts: 308

08/10/06 - 03:18 PM

50 yr old h/o HTN, has now bp of 160/95 evne after 3rd agent is added to his anti htnive regimen. PE is normal electrolytes are normal, and he is not any OTC meds. next helpful step for this pt is:

chk pill count

evaluate for cushing's syndr

obtain cxr for corctation

obtain renal angio

obtain adrenal ct

frank100
Forum Guru

Topics: 48
Posts: 586

08/10/06 - 05:39 PM

The real answer is: check for treament compliance. but it is not in the question so...

hits guy has a very high blood presure, normally you fo wok up for secondary hypertension when you add a second drug and SBP>160 or DBP>110. and this gentleman is using 3 drugs, this is hardcore!!! baby...

I do not understand the first option "check pill count", perhaps this is the answer, because the rest of the options are done to rule out secondary Hypertension, but in the question there is not enough info to go for one or the other specifically.

It depends of your country, in some european countries and in America they check compliance with ELECTRONIC PILL BOXES (but this option is too chic at this time), they monitore wether patients take their medication over 4 weeks, if the patient takes 80% or more of the prescribed doses, he or she is considered compliant.

before someone KILL ME, what i´ve just said is extra information supporting my answer, not a completely no no to the rest of options

my answer is (a?) or first option.

achilles
Forum Guru
avatar

Topics: 90
Posts: 1,228

08/10/06 - 08:55 PM

agree with frank... check the compliance of the patient.

all others are causes of secondary htn and the question, although doesn't give much info, says that PE is normal and electrolytes are normal and does not give the presentation characteristic of the other causes of htn.

___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "

GDS2008
Forum Elite

Topics: 9
Posts: 144

08/10/06 - 08:55 PM

Absolutely right and appreciate the extra infomration smiling face

MILF
Forum Newbie

Topics: 0
Posts: 4

08/11/06 - 03:55 PM

som wrote:
50 yr old h/o HTN, has now bp of 160/95 evne after 3rd agent is added to his anti htnive regimen. PE is normal electrolytes are normal, and he is not any OTC meds. next helpful step for this pt is:

chk pill count

evaluate for cushing's syndr

obtain cxr for corctation

obtain renal angio

obtain adrenal ct

check pill count to see if the patient comply with taking the medication

You don't have permission to post.