ABFM - HYPERTENSION Questions With Verified Solutions

ABFM - HYPERTENSION Questions With
Verified Solutions
A 39-year-old male sees you for evaluation of high blood pressure.
His past medical history is unremarkable. On examination he has a
BMI of 32 kg/m2 and you note that he has a round face and a plethoric
complexion. His blood pressure is 150/98 mm Hg, his pulse rate is 88
beats/min, and his respiratory rate is 16/min. Other notable findings
include a prominent dorsal cervical fat pad and supraclavicular fat
pads, as well as violaceous striae on his trunk. Laboratory findings
are notable only for a fasting glucose level of 114 mg/dL.Which one of
the following is the most likely cause of his hypertension?
Addison's disease
Cushing syndrome
Hemochromatosis
Pheochromocytoma
Primary hyperaldosteronism - ANSWER B
This patient's clinical findings are consistent with Cushing syndrome,
or hyperadrenocorticism. This is a clinical syndrome and metabolic
disorder resulting from chronic excess of glucocorticoids. The most
common cause is corticosteroid use, but adrenal neoplasms account
for 20%-25% of cases. Findings include general weakness,
osteoporosis, moon facies, facial plethora, ecchymoses, truncal
obesity, violaceous striae of the abdomen, deposition of adipose
tissue in the interscapular area ("buffalo hump"), and glucose
intolerance.
You diagnose stage 2 hypertension in a 54-year-old male. His past
medical history is otherwise unremarkable and a physical
examination is notable for mild AV nicking on funduscopic
examination. A baseline EKG reveals evidence of left ventricular
hypertrophy.Which one of the following classes of antihypertensive
agents has NOT been shown to produce a regression of left
ventricular hypertrophy?
ACE inhibitors
β-Blockers
Calcium channel blockers
Direct vasodilators
Thiazide diuretics - ANSWER D
In patients with left ventricular hypertrophy, studies have shown a
reduction in left ventricular mass in those treated with ACE inhibitors,
diuretics, calcium channel blockers, and β-blockers, with the most
consistent reduction achieved with ACE inhibitors and the least with
β-blockers. Regression of left ventricular hypertrophy has not been
demonstrated with direct vasodilators such as hydralazine and
minoxidil.
According to currently accepted criteria, hypertension in children is
defined as repeated blood pressure measurements at or above a
threshold of which one of the following percentiles for age, sex, and
height?
80th
85th
90th
95th
99th - ANSWER D
In children and adolescents, hypertension is defined as blood
pressure at or above the 95th percentile for age, sex, and height, on
repeated measurements.
Which one of the following conditions is associated with isolated
systolic hypertension?
Aortic stenosis
Hypothyroidism
Paget's disease
Renovascular hypertension
Severe osteoporosis - ANSWER C
Isolated elevation of systolic blood pressure can be secondary to
conditions associated with elevated cardiac output, such as anemia,
Paget's disease, hyperthyroidism, arteriovenous fistula, and aortic
insufficiency.
A 59-year-old African-American male with a histo