Renal - 08 - Secondary Hypertension

Front 1

ABCDEs of 2ndary Hypertension

Back 1

A - Apnea, alodsteronism

B - bruits (renal artery stenosis), bad kidneys (renal parenchymal disease)

C - catecholamines, coarctation of aorta

D - drugs

E - endocrine - hypercalcemia, cushings, hypothyroid, hyperthyroid

Front 2

T/F secondary hypertension is more common than essential hypertension

Back 2

False secondary hypertension represents only 10% of all hypertension

Front 3

renal and renovascular disease account for how much of all secondary htn

Back 3

50%

Front 4

hyperaldosterone state

Back 4

look for triad of hypokalemia, hypertension, and metabolic alkalosis

renin is supressed in primary hyperaldosteronism

CT is useful for localization of aldosterone produce adenoma - but not spcific

aldosterone inhibitors for treatment or surgery

Front 5

pheochromocytoma

Back 5

neuroendocrine tumor in adrenal gland - secretes lots of catcecholamines

look for headache, sweating, tachycardia, anxiety abdominal pain, nausea/vomit, dyspnea, visal issues, dizzy

diagnosi with measure MN and NMN

rule of 10:
10% malignant
10% bilateral
10% extra adrenal
10% genetic - MEN1, MEN2, von hippel lindau, von recklinghusen (NF1)

Front 6

T/F never give unopposed beta blockade for pheochromocytoma

Back 6

true - use alpha blockers

Front 7

T/F resistive index < .8 preducts interventional success

Back 7

True

Front 8

Doppler useage on RAS

Back 8

good for measuring kidney size and blood velocity

higher velocity means larger stenosis

measures resistive index which measure small vessels
-higher numbers suggest small vessel disease (RI > .8)
-if RI < .8 then probably bigger vessel and easier intervention

Front 9

T/F ACE-I are okay for unilateral renal artery stenosis

Back 9

True

Front 10

T/F Renal artery stenosis usually has less benign urinary sediment than dose renal disease

Back 10

false - more benign urinary sediment