2nd HTN

Question 1

2nd HTN definition

Answer 1

A correctable form of htn a/s w/ several modifiable risk factors

Question 2

2nd HTN clinical presentation

Answer 2

• acute BP increase
• < 30 YO
• nonobese, nonblack
• abnormal labDx

Question 3

2nd HTN principle forms

Answer 3

• Renovascular
• Intrinsic
• Primary aldosteronism
• Obstruictive Sleep Apnea

Question 4

RV HTN

• S/S
• A/S
• LabDx
• Tx

Answer 4

• S/S: Flash Pulmonary edema; renal dysfunction; Hypokalemia; Abdoiminal bruit
• A/S: RAS, FM dysplasia, PAD, Hyperlipidemia/atherosclerosis,
• LabDx: INC Renin + aldosterone
• Tx: ARB/ACEi unless critical

Question 5

Primary Hyperaldosteronism

- LabDx:

Answer 5

• ## LabDx: INC Aldosterone; suppressed Renin; User Alodosterone suppression test; Hypokalemia, metabolic alkalosis; after positive ARR, order adrenal CT;

Question 6

Cushing syndrome Tx

Answer 6

• surgical
• until then, tx medically w/ adrenal enzyme inhibitors (ketoconzaole, etomidate, metapyrone), adrenolytics (mitotane), + Dopamine agonist (cabergoline)

Question 7

Coarcation of aorta LabvDx

Answer 7

INC brachial-femoral ration; Hx congenital heart disease

Question 8

liddle syndrome

• Genetics
• EPI
• Eti
• S/S
• LabDx
• Tx

Answer 8

• G: AD disease
• EPI: childhood
• Eti: INC ENaC in dfsital tubule
• S/S: Hypernatremia, Volume overload, HTN,
• Lab Dx: Hypokalemic metabolic alkalosis; Suppressed aldosterone _ Renin
• Tx: K-sparing dureitcs (Amiloride or Triameterene)