ABFM HYPERTENSION EXAM BOARD REVIEW QUESTIONS AND ANSWERS

ABFM HYPERTENSION EXAM BOARD REVIEW QUESTIONS AND ANSWERS 

A 39-year-old male sees you for evaluation of high blood pressure. His past
medical history is unremarkable. On examination he has a BMI of 32 kg/m2
and you note that he has a round face and a plethoric complexion. His blood
pressure is 150/98 mm Hg, his pulse rate is 88 beats/min, and his
respiratory rate is 16/min. Other notable findings include a prominent
dorsal cervical fat pad and supraclavicular fat pads, as well as violaceous
striae on his trunk. Laboratory findings are notable only for a fasting
glucose level of 114 mg/dL.Which one of the following is the most likely
cause of his hypertension?
Addison's disease
Cushing syndrome
Hemochromatosis
Pheochromocytoma
Primary hyperaldosteronism - ANS:--B
This patient's clinical findings are consistent with Cushing syndrome, or
hyperadrenocorticism. This is a clinical syndrome and metabolic disorder
resulting from chronic excess of glucocorticoids. The most common cause is
corticosteroid use, but adrenal neoplasms account for 20%-25% of cases.
Findings include general weakness, osteoporosis, moon facies, facial
plethora, ecchymoses, truncal obesity, violaceous striae of the abdomen,
deposition of adipose tissue in the interscapular area ("buffalo hump"), and
glucose intolerance.
You diagnose stage 2 hypertension in a 54-year-old male. His past medical
history is otherwise unremarkable and a physical examination is notable for
 lOMoAR cPSD|3013804
mild AV nicking on funduscopic examination. A baseline EKG reveals
evidence of left ventricular hypertrophy.Which one of the following classes
of antihypertensive agents has NOT been shown to produce a regression of
left ventricular hypertrophy?
ACE inhibitors
β-Blockers
Calcium channel blockers
Direct vasodilators
Thiazide diuretics - ANS:--D 

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