2ry Hypertension

Question 1

What is the most appropriate hypertensive drug used to treat ptn with Adult polycystic kidney?

Answer 1

ACE inhibitors ( captopril,  lisinopril, ect. ) 
.or angiotensin 2 receptor antagonist blockers  ( losartan, ect. )

Question 2

In treatment of congestive heart failure, What drug is given in combination with loop diuretic to prevent potassium depletion?

Answer 2

Amiloride or triamterene ( slow effect it takes a week to work )

Question 3

What is fibroelastic hyperplasia mean? And where it happens?

Answer 3

On biopsy it shows as republication of the elastic lamina and fibrosis of the media

It can affect the media of larger interlobular and arcuate arteries

Question 4

In which ptn you might see benign nephrosclerosis ( fibroelastic nephrosclerosis ) ?

Answer 4

In hypertensive ptn

Question 5

A-What are the changes seen in benign nephrosclerosis?

Answer 5

Fibroelastic hyperplasia

Hyaline arteriosclerosis

Patchy ischemic atrophy

Question 6

What is the best drug given in an emergency case with SLE with malignant HTN and papillodema and history of asthma ?

Answer 6

ACE inhibitors as oral enalpril

Question 7

Q.young ptn with family history of renal disease is found to have hypertension. What the most likely cause?

Answer 7

Renal artery stenosis ( usually asymptotic until long time ) a bruit might be heard over the renal arteries.

Question 8

A. How to diagnose renal artery stenosis?

Answer 8

History + Examination + Renal imaging with duplex ultrasonography, radionuclide imaging, or magnetic resonance angiography

Question 9

Q. What’s the preferred anti hypertensive for ptn with adult polycystic kidney disease?

Answer 9

ACEI and maybe angiotensin 2 receptor antagonist blockers

Question 10

Q. Asymmetric kidney size + mild proteinuria. what’s your diagnosis ? And what’s the next step in diagnosis?

Answer 10

Arteriosclerotic renal artery stenosis , MRA or captopril renoghraphy