Secondary HTN

Question 1

Chronic kidney disease

Answer 1

HTN is common due to impaired autoregulation and hypervolemia

Question 2

Renal artery stenosis

Answer 2

One clinical hallmark is falling renal function (rise in creatinine >30%) after starting ACE-inhibitors or angiotensin receptor blockers.

May have abdominal bruit

Question 3

Nephritic syndrome

Answer 3

HTN
Raised creatinine
Haematuria
Proteinuria
Oliguria

Question 3

Pregnancy HTN?

Answer 3

Spectrum of pregnancy-related HTN ranges from pregnancy induced HTN to pre-eclampsia to eclampsia

Question 4

Cushing’s syndrome?

Answer 4

Central obesity with dorsocervical and supraclavicular fat pads, thin skin, proximal muscle weakness

Question 5

Obstructive sleep apnea

Answer 5

Usually overweight pt with night-time snoring. Can have morning headaches.
Sleep apnea is a/w HTN, arrhythmias, adverse CVS conditions.

Question 6

Renal artery stenosis?

Answer 6

Creatinine can be normal, especially if ACE-inhibitors have not been administered.

Question 7

Phaeochromocytoma?

Answer 7

Paroxysmal episodes of HTN, headache, tachycardia and diaphoresis.

Question 8

Aortic coarctation?

Answer 8

Upper limb HTN with LL normotension.
Will have radial-femoral pulse delay, interscapular systolic murmur.