sandra
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Posts: 426
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A 42-year-old woman comes for a follow-up examination.
Two weeks ago,
her blood pressure was 152/94 mm Hg during a routine
visit. Her blood
pressure today is 150/94 mm Hg, pulse is 76/min, and
respirations are
14/min. Examination shows no other abnormalities.
Serum studies show:
Na+ 142 mEq/L
Cl– 105 mEq/L
K+ 4 mEq/L
HCO3– 26 mEq/L
Urea nitrogen (BUN) 12 mg/dL
Glucose 101 mg/dL
Creatinine 0.8 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
a or e?
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| dr.wad
Forum Senior
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B
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| sandra
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r u sure? y?
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| dr.wad
Forum Senior
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yes .
-this is not hyperaldosteronism coz electrolytes are normal ...so not ( A )
_ not pheochromcytoma coz BP is satble and glucose is normal....in pheo the BP is variable from time to time and glucose is high coz catecholamine have anti- insulin effect.....so not ( C ).
- the pt is not in heart failure , no signs of coarctation of aorta , no signs of aortic regurge ( note in aortic regurge there is diastolic hypertension )....so not ( D ).
-this is not renal artery stenosis coz serum electrolytes are normal .....in RAS there is secondary hyperaldosteronsim .....so not ( E )
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| sandra
Forum Guru
Topics: 180
Posts: 426
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k.thanks!
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