Renal

Question 1

Hypertension Ix?

Answer 1

• Bedside: 4 limb BP, fundoscopy, urine analysis protein creatinine ratio, ECG, Echo
  
  • Pathology: FBE UEC CMP, albumin, bicarb, TFT, cortisol, catecholamines/metanephrines, 17 OHP (CAH)
  • Imaging: renal US and dopplers, ECHO (LVH, coarct), DMSA< MAG3
    Special: 24 hour BP monitoring, renal biopsy, genetic

Question 2

Hypertension DDx?

Answer 2

Essential/primary
* > 6, risk factors obesity + FHx
Situational
* Pain, anxiety

Secondary
Cardiac
* Coarctation
Renal
* Renal artery stenosis
* Parenchymal
* Structural (CAKUT)
* Scarring recurrent UTIs
Endo
* Adrenal - hyperadrenalism, CAH, phae
* Cushing’s
* Hyperthyroidism
Drugs
* Steroids, stimulants, tacro, cyclo, OCP
Syndromes
* NF, Williams, Turners
Neuro
* Increased ICP
Resp
CLD, OSA

Question 3

HTN Mx?

Answer 3

• Cease offending agents, treat cause
  
  • Low salt diet
    Antihypertensives (calcium channel blocker, ACEi)