Sem3-Block11 Nine's Lecture Question Stems

Front 1

45-year-old black man with hypertension. No medical history, no medications. Family history of hypertension.

Back 1

ESSENTIAL HYPERTENSION (no cause)

Front 2

54-year-old white man with Conn syndrome (hyperaldosteronism) and hypertenstion.

Back 2

SECONDARY HYPERTENSION (has a cause)

Front 3

67-year-old white man with severe atherosclerosis has cardiomegaly with left ventricular hypertrophy.

Back 3

CARDIOVASCULAR CAUSE of SECONDARY HYPERTENSION (atherosclerosis - rigid aorta)

Front 4

51-year-old woman with hypertension and renal artery stenosis.

Back 4

SECONDARY HYPERTENSION (Goldblatt kidney)

Front 5

51-year-old woman with hypertension and renal artery stenosis. No history of atherosclerosis or other vascular disease.

Back 5

SECONDARY HYPERTENSION (Goldblatt kidney)
Fibromuscular dysplasia

Front 6

67-year-old woman with hypertension and hyperaldosteronism.

Back 6

SECONDARY HYPERTENSION (hyperaldosteronism)
CAUSES? Adrenal cortical hyperplasia, adenoma

Front 7

Any patient that has "cardiomegaly with left ventricular hypertrophy"

Back 7

HYPERTENSION
Others: Aortic stenosis, hypertrophic cardiomyopathy

Front 8

78-year-old man, sudden death. Autopsy shows granular contracted kidneys. Microscopic findings?

Back 8

HYPERPLASTIC ARTERIOLARSCLEROSIS
Sclerotic glomeruli (ischemic damage)
Chronic, benign hypertension

Front 9

56-year-old man, sudden death. Autopsy shows "flea-bitten" kidneys and cerebral hemorrhagic infarct (stroke).

Back 9

HYPERTENSIVE CRISIS
Malignant hypertension

Front 10

Staging of Hypertension based on BP

Back 10

Systolic/Diastolic
Normal <120 and <80
Pre-HTN 120-139 or 80-89
Stage I HTN 140-159 or 90-99
Stage II HTN >160 or >100

Front 11

68-year-old man with diabetes mellitus (type 2), now has peripheral vascular disease.

Back 11

Atherosclerosis (atheromatous plaques)

Front 12

61 year-old woman with essential hypertension, increasing BUN and creatinine (developing signs of renal insufficiency).

Back 12

Arteriolosclerosis (hyperplastic or hyaline)
Some study books link hyperplastic -> malignant and hyaline -> benign

Front 13

56-year-old man found to have calcification of his radial artery during an x-ray for a forearm injury. No vascular symptoms.

Back 13

Mönckeberg medial sclerosis (aka medial calcific sclerosis)

Front 14

70-year-old woman with systemic atherosclerosis and "carotid bruit" now has symptoms of a cerebral infarct (stroke).

Back 14

Embolism (from carotid atheroma)

Front 15

74-year-old man with pulsatile abdominal mass on physical exam suddenly becomes hypotensive and develops hemodynamic collapse.

Back 15

Ruptured abdominal aortic aneurysm

Front 16

68-year-old woman with essential hypertension experiences sudden onset of excruciating chest pain radiating to the middle of her back. She collapses and becomes unresponsive.

Back 16

Dissection of thoracic aorta
Hemopericardium?

Front 17

35-year-old man with Marfan's syndrome experiences sudden onset of excruciating chest pain radiating to the middle of his back.

Back 17

Dissection of thoracic aorta
Cystic medial degeneration (or necrosis)

Front 18

43-year-old man with recent recurring low-grade headaches experiences the "worst headache of his life" then suddenly collapses.

Back 18

Rupture of cerebral berry aneurysm (recent "leakage")

Front 19

69-year-old woman with Stage IV cancer of the right lung experiences gradual swelling and edema of her right arm, jugular venous distention and capillary congestion of her head and neck.

Back 19

Superior vena cava syndrome