Secondary Hypertension

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| By Ashley_work_2002

Ashley_work_2002

Community Contributor

Quizzes Created: 2 | Total Attempts: 2,630

Questions: 8 | Attempts: 1,721 | Updated: Mar 22, 2023

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Questions and Answers

1.

The most common cause of secondary hypertension
- A.
  
  Primary aldosteronism
- B.
  
  Renal parenchymal disease (kidney disease)
- C.
  
  Renovascular disease
- D.
  
  Sleep apnea
Correct Answer
B. Renal parenchymal disease (kidney disease)

Explanation
Renal parenchymal disease, also known as kidney disease, is the most common cause of secondary hypertension. This condition affects the functioning of the kidneys, leading to high blood pressure. The kidneys play a crucial role in regulating blood pressure by filtering waste products and excess fluid from the body. When they are damaged or not functioning properly, it can result in the accumulation of fluid and an increase in blood pressure. Therefore, renal parenchymal disease is a common underlying cause of secondary hypertension.

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2
0
2.

Your new patient's brachial BP is 155/92. You then check your patient's pulses simultaneously at radial and femoral sites, and there is a radio-femoral delay. What is causing their hypertension?
- A.
  
  Thyroid disease
- B.
  
  Atherosclerosis
- C.
  
  Coarctation of the aorta
- D.
  
  Pheochromocytoma
Correct Answer
C. Coarctation of the aorta

Explanation
The presence of a radio-femoral delay suggests that there is an obstruction or narrowing in the aorta, specifically in the area known as coarctation. This narrowing restricts blood flow to the lower extremities, causing an increase in blood pressure in the upper extremities. This explains the elevated brachial blood pressure reading. Therefore, the correct answer is Coarctation of the aorta.

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3.

Your preceptor tells you, "You have to come and see this patient - I have never had a patient with this disorder before, and you might never either, so now's your chance to see it." The patient has elevated blood pressure, and is complaining of episodic headache, sweating, and palpitations. The family hx reveals that the patient's father had this condition as well. What are you thinking?
- A.
  
  Coarctation of the aorta
- B.
  
  Familial hypercholesteremia
- C.
  
  Hyperchylomicronemia
- D.
  
  Pheochromocytoma
Correct Answer
D. pHeochromocytoma

Explanation
The patient's symptoms of elevated blood pressure, episodic headache, sweating, and palpitations, along with the family history of the same condition in the father, suggest a diagnosis of pheochromocytoma. Pheochromocytoma is a rare tumor that arises from the adrenal glands and causes the release of excessive amounts of catecholamines, leading to symptoms such as high blood pressure and episodic symptoms. The mention of the preceptor never having seen this disorder before and the suggestion that the student may never see it again further supports the likelihood of pheochromocytoma as the correct answer.

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4.

Your patient is a 62 year old banker complaining of weakness, fatigue, cold intolerance, constipation, weight gain, thinning hair, and depression. Your MA reported her BP as 152/90. What is the likeliest explanation for this elevated BP?
- A.
  
  Hypothyroid
- B.
  
  Pheochromocytoma
- C.
  
  CHF
- D.
  
  Sleep apnea
Correct Answer
A. Hypothyroid

Explanation
The likeliest explanation for the elevated blood pressure in this patient is hypothyroidism. Hypothyroidism can cause a decrease in metabolic rate, leading to weight gain, fatigue, constipation, and depression. It can also cause cold intolerance, thinning hair, and weakness. Elevated blood pressure can be a result of hypothyroidism due to increased peripheral vascular resistance.

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5.

Most hypertension can be classified as secondary hypertension.
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
95% of hypertension is essential hypertension and not secondary hypertension (secondary hypertension is attributable to one specific cause such as hyperaldosteronism or coarctation of the aorta).

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6.

Your patient is a 71 year old male with a BMI of 32. His partner reports that he snores and seems to "take a long break" between breaths sometimes during the night. When you take his blood pressure, you find it to be 158/92. What might explain this elevated blood pressure?
- A.
  
  CHF
- B.
  
  Lung cancer
- C.
  
  Obstructive sleep apnea
- D.
  
  Fatigue
Correct Answer
C. Obstructive sleep apnea

Explanation
Obstructive sleep apnea can explain the elevated blood pressure in this patient. Obstructive sleep apnea is a condition where the airway becomes partially or completely blocked during sleep, leading to pauses in breathing. These pauses can cause a decrease in oxygen levels and an increase in carbon dioxide levels, leading to increased sympathetic activity and elevated blood pressure. The patient's snoring and long breaks between breaths during the night are consistent with obstructive sleep apnea. Additionally, the patient's BMI of 32, which indicates obesity, is a risk factor for developing obstructive sleep apnea.

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7.

Your patient with elevated BP complains of polyuria and nocturia, muscle weakness, and palpitations. What do you suspect is the cause of the elevated BP?
- A.
  
  Primary hyperaldosteronism
- B.
  
  Diabetes mellitus
- C.
  
  Muscular dystrophy
- D.
  
  Paroxysmal supraventricular tachycardia
Correct Answer
A. Primary hyperaldosteronism

Explanation
Excess aldosterone leads to excess fluid retention, causing polyuria, and excess potassium secretion, leading to hypokalemia, causing weakness and palpitations.

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2
1
8.

Which of the following are reasonable next steps if your suspect your patient has obstructive sleep apnea?
- A.
  
  Ask them to do a CPAP trial
- B.
  
  Suggest they sleep on their side, not on their back
- C.
  
  Assess them using the Friedman Palate Scale
- D.
  
  All of the above
Correct Answer
D. All of the above

Explanation
The correct answer is "all of the above." If a healthcare professional suspects that a patient has obstructive sleep apnea, it would be reasonable to ask them to do a CPAP trial, suggest they sleep on their side instead of their back, and assess them using the Friedman Palate Scale. These steps can help confirm the diagnosis and determine the appropriate treatment plan for the patient.

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Current Version
Mar 22, 2023

Quiz Edited by
ProProfs Editorial Team
Jan 27, 2014

Quiz Created by
Ashley_work_2002

Secondary Hypertension

The most common cause of secondary hypertension

Your new patient's brachial BP is 155/92. You then check your patient's pulses simultaneously at radial and femoral sites, and there is a radio-femoral delay. What is causing their hypertension?

Your patient is a 62 year old banker complaining of weakness, fatigue, cold intolerance, constipation, weight gain, thinning hair, and depression. Your MA reported her BP as 152/90. What is the likeliest explanation for this elevated BP?

Most hypertension can be classified as secondary hypertension.

Your patient is a 71 year old male with a BMI of 32. His partner reports that he snores and seems to "take a long break" between breaths sometimes during the night. When you take his blood pressure, you find it to be 158/92. What might explain this elevated blood pressure?

Your patient with elevated BP complains of polyuria and nocturia, muscle weakness, and palpitations. What do you suspect is the cause of the elevated BP?

Which of the following are reasonable next steps if your suspect your patient has obstructive sleep apnea?