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nbme htn

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doyoudig
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Topics: 144
Posts: 613

07/11/07 - 05:33 PM

25. An asymptomatic 57-year-old man comes to the physician for a routine health maintenance examination. He has smoked one pack of cigarettes daily for 37 years. His blood pressure is 180/112 mm Hg, and pulse is 82/min. Abdominal examination shows a bruit in the right upper quadrant and no masses. His hematocrit is 42%, serum urea nitrogen (BUN) level is 23 mg/dL, and serum creatinine level is 1.4 mg/dL. Which of the following is the most likely cause of this patient's bruit?

A
) Accumulation of lipids in the arterial wall

B
) Hypertrophy of the arterial wall media

C
) Infiltration of arterial wall by giant cells

D
) Infiltration of round cells in the arterial wall

E
) Reflex vasodilation

I know it will either be A or B but can somone pls explain how they would pick btw them in this specific case? thx

dr in trouble
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07/11/07 - 07:13 PM

choice B represents Arteriosclerosis while choice A represents atherosclerosis and what I know that atherosclerosis is responsible for Renal A stenosis and sec hypertension in old pts.

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cirus
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07/11/07 - 11:57 PM

A for sure..

khorshid
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Topics: 32
Posts: 592

07/12/07 - 06:31 AM

A is right, because it is atheroscelrosis. I guess if the pt was a young lady it could be B, due it the fibroplasia seen in fibromuscular dysplasia, but I am not sure, any idea?

elitoki
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07/12/07 - 07:16 AM

A. Atherosclerosis nod

Justice
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07/12/07 - 10:04 AM

A) Accumulation of lipids in the arterial wall
I recall a similar Q in UW and association of smoking and Atherosclerosis

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the_holy_man
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Topics: 6
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07/18/07 - 02:54 AM

Justice wrote:
A) Accumulation of lipids in the arterial wall
I recall a similar Q in UW and association of smoking and Atherosclerosis

Agree.

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cirus
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07/18/07 - 03:31 AM

aother tricky one on UW is which will cause a decrease in bl pr in a pt who is a heavy smoker & an Alcoholic?..

Smoking cessation?

Alcohol moderation?

the ans is alc moderation as both of them cause HTN & ofcourse the advice is to stop both but stopping smoking doesn't reverse its effect on bl pr, it only decreases risk of CVD, on the other hand, alcohol abstinance or even moderation can reverse its effect on bl pr, thus the bl pr will decrease

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