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anne Forum Elite Topics: 41 Posts: 348	Apr 01, 2004 - 8:01 AM       #1 A 50-year-old African American male presents to your clinic with a 10-year history of hypertension. Each of his two kidneys has one renal artery. One renal artery is shown, by angiography, to have 80% stenosis. The other renal artery is completely normal. His electrolytes are also normal. Which of the following scenarios best conforms with these findings? A. ADH levels will increase B. The plasma renin activity is suppressed because of the high blood pressure C. The serum potassium concentration is elevated because of potassium retention by the kidney with narrowed renal artery D. Sodium excretion by the contralateral (nonstenotic) kidney is increased E. Sodium excretion by the ipsilateral (stenotic) kidney is increased
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usmleasr Forum Guru Topics: 105 Posts: 970	Apr 01, 2004 - 8:37 AM       #2 A.??
anne Forum Elite Topics: 41 Posts: 348	Apr 01, 2004 - 9:50 AM       #3 its D. i guess its bec stenosis of the artery leads to activation of RAA system of ipsilat kidney,and thus inc Na absorption by ipsilat kidney.so to compensate for this,the contralateral kidney allows more Na loss. do correct me please if i am wrong.
asmi Forum Hero Topics: 1049 Posts: 4620	Apr 01, 2004 - 11:03 AM       #4 yep since the normal kidney has to work twice to compensate for the stenosed one .
mistral92 Forum Senior Topics: 4 Posts: 185	Apr 01, 2004 - 12:38 PM       #5 excellent and great explanation !!!! thanks a lot anne...
sudipto1973 Forum Newbie Topics: 4 Posts: 31	Apr 01, 2004 - 12:47 PM       #6 How about A as answer. This is a case of high renin hypertension due to stenosed renal artery. Activated RAA system will lead to high AII levels which causes release of ADH from posterior pituitary. Correct me if I am wrong please.
anne Forum Elite Topics: 41 Posts: 348	Apr 01, 2004 - 8:51 PM       #7 but how could Angiotensin-II directly stimulate ADH?it has a direct effect on Aldosterone(as far as i know).
usmleasr Forum Guru Topics: 105 Posts: 970	Apr 02, 2004 - 5:30 AM       #8 yes anne, ang-2 stimulates ADH release...i was thinking of A as ans becos... in renal artery stenosis...R-A-A axis stimulated and aldosterone increases sodium retention in both kidneys(endocrine action)...if it will be compensated by other kidney then U/L renal artery stenosis cases won't have hypertension at all :? users.rcn.com/jkimball.ma.u.../KidneyHormones.html#renin
sudipto1973 Forum Newbie Topics: 4 Posts: 31	Apr 02, 2004 - 7:10 AM       #9 AII stimulates ADH release from posterior pituitary - I read it in First aid. Renal Physiology chapter.
anne Forum Elite Topics: 41 Posts: 348	Apr 02, 2004 - 11:08 AM       #10 thanx all for correcting me.
asmi Forum Hero Topics: 1049 Posts: 4620	Apr 02, 2004 - 11:12 AM       #11 anne , Then whats the correct answer ?? I think i have seen this Q in Q bank..was that from it / other source ? Do explain it anne :roll: iam all confused .Thanks
asmi Forum Hero Topics: 1049 Posts: 4620	Apr 02, 2004 - 11:23 AM       #12 decreased renal artery diameter-->decreased arterial pressure with in kidneys-->decreased GFR and Pg(hyderostatic pressure in glomeruli)-->increased renin and increased angiotensin II-->compensation is constriction of efferent arterioles--->increased glomerular hydrostatic pressure and increase GFR. :roll: thats what i can remember
anne Forum Elite Topics: 41 Posts: 348	Apr 02, 2004 - 1:46 PM       #13 asma i found this question in blackwell online questions,with the answer given as D,so i thought of a probable explanation to it :?

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