dr_jojo
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2. A 15-year-old girl is brought to the physician 3
months after she had a blood pressure of 150/95 mm Hg at a routine
examination prior to participation in school sports. She is asymptomatic
and has no history of serious illness. Twelve months ago, she was
diagnosed with a urinary tract infection and treated with oral
trimethoprim-sulfamethoxazole.
She currently takes no medications. Subsequent blood
pressure measurements on three separate occasions since the
last visit have been: 155/94 mm Hg, 145/90 mm Hg, and 150/92 mm Hg. She is at the
50th percentile for height and 95th percentile for weight. Her blood
pressure today is 150/90 mm Hg confirmed by a second measurement, pulse
is 80/min, and respirations are 12/min. Examination shows no other
abnormalities. Her hematocrit is 40%. Urinalysis is within normal limits.
Cardiac and renal ultrasonography shows no abnormalities. Which
of the following is the most appropriate next step in management?
A
) Exercise and weight reduction program
B
) Measurement of urine catecholamine levels
C
) Measurement of urine corticosteroid levels
D
) Captopril therapy
E
) Hydrochlorothiazide therapy
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
|
B
) Measurement of urine catecholamine levels
in the real exam, look for renin/aldosterone first.
___________________
The Key to Succeed is Patience.
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| Aashi
Forum Moderator
Topics: 113
Posts: 1,058
|
C) Measurement of urine corticosteroid levels
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"Obstacles are those frightful things you see when you take your EYES off your goal."
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
|
yes C is better
I picked C when did NBME2
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The Key to Succeed is Patience.
|
| huyniid
Forum Elite
Topics: 9
Posts: 199
|
weight :95 percentile ---> mild obesity ---> Ess HTN? --> Thiazide Rx
Urinalysis N, in spite of Hx of UTI ---> rarely renal cause
Hypogonad is not mentioned, is there any adult type of 17OH hydroxylase def?
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| MAGY17
Forum Elite
Topics: 30
Posts: 234
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please, what the correct ans and explain
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