doyoudig
Forum Guru
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1. A Young Pt w/ Renovascular HTN d/t Fibromuscular Dyspl
and HTN
how is the Pt managed
- is it--> decr Bp 1st (what meds??) then percutaneous angio w/ stent placement or
do we go straight to stenting??
2. In which cases do you do surgery instead?? Is it elderly Pt w/ athersclerotic renovascular HTN??
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| doyoudig
Forum Guru
Topics: 144
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can someone help me out and let me know order of Mx (i.e Anti-HTN drusg vs Stenting ...) and when to use surgery, thx
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| doc_clotaire
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1 .- NSIM in RVHT due to Fibromuscular dysplasia
ACE inhibitors ( contraindicated in bilateral renovascular disease )
If ACE inhibitors failed the NSIM.....
Percutaneous angio w/ stent placement ( that 's the definitive Tx and has better outcome )
2.- In which cases do you do surgery instead?
Elderly Pt w/ athersclerotic renovascular with advanced atherosclerosis in multiple vessels
Any more input is WELCOME
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The elevator to succes is broke ,you must take the stairs
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| doyoudig
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also does anyone know details about what is done in surgery exactly
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| doyoudig
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Topics: 144
Posts: 613
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doclaire, a UW question relating to Fibromuscular HTN w/ BP 160/90 and recent onset of headaches in a Young Female gave Angio-Stenting as the Rx of choice (ACE- was also an answer choice, that's why I am a bit confused aboyt the order??)
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| doc_clotaire
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What did the question stem said ?
Next SIM or Best SIM ?
It would be better to post the whole question to figure it out better !
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The elevator to succes is broke ,you must take the stairs
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| doyoudig
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It said -- Which one of the following is the most appropriate Rx for this Pt?
pls tell me what on earth I should remeber when they word the questions?
Only once in a while I see NISM or Best??
But how do we interpret the "most approriate"?
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| doc_clotaire
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Topics: 159
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I understand your feeling doyoudig . Some qs in UW are so tricky and so easy to get misundertood . I guess those dudes are trying to simulate the real thing since most people who already took CK say the question are so VAGUE .
Anyway like my favorite teacher Dr Goljan would say : WE ' VE GOTTA PLAY THE GAME SOMETIMES
Which one of the following is the most appropriate Rxthis Pt ?
Sound like what the best treatment for this patient ?
Answer : Percutaneous angio w/ stent placement
it 's because it 've been proved in clinical trials that Percutaneous angio w/ stent placement has better outcome in patient in young woman with fibromuscular dysplasia and it should be the definitive treatment .
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The elevator to succes is broke ,you must take the stairs
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| doyoudig
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thx doc, I really hate these vague questions n honestly this is a stupid game we have to play, but hey whatever floats their boat I am along for the ride
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