Answer:
Mayo Foundation for Medical Education and Research
38-Year-Old Woman With Hypertension, Headaches, and Abdominal Bruit
Mira T. Keddis, MD and Vesna D. Garovic, MD
Additional article information
A 38-year-old woman presented to her local clinic for recurrent episodes of headache of several weeks' duration. Evaluation revealed a blood pressure of 202/136 mm Hg. The patient was prescribed 37.5 mg of triamterene with 25 mg of hydrochlorothiazide (1 tablet) twice daily and 50 mg of atenolol once daily.
Her blood pressure remained elevated, and her headaches persisted. She was referred to the hypertension clinic for further management.
The patient's medical history was remarkable for preeclampsia during her second pregnancy 9 years previously. She smoked half a pack of cigarettes per day for 15 years. Her alcohol use was limited to social gatherings and consisted of 1 to 2 drinks monthly. She exercised regularly and had a balanced low-salt diet. Essential hypertension was common on her maternal side.
On physical examination, the patient's blood pressure was 172/100 mm Hg (both arms), and her heart rate was 90 beats/min. Findings on funduscopic examination were normal. Cardiac examination revealed a grade 2/6 systolic ejection murmur at the right upper sternal border. Abdominal examination was remarkable for a systolic-diastolic bruit present over the right midabdomen without palpable masses. No evidence of pitting edema was observed, and findings on lung examination were normal.
Initial work-up included the following (reference ranges shown parenthetically): hemoglobin, 14.1 g/dL (12.0-15.5 g/dL); creatinine, 0.8 mg/dL (0.7-1.2 mg/dL); sodium, 139 mEq/L (135-145 mEq/L); potassium, 4.2 mmol/L (3.6-4.8 mmol/L); bicarbonate, 29 mEq/L (22-29 mEq/L), and calcium, 9.5 mg/dL (8.9-10.1 mg/dL). Findings on electrocardiography were normal.
On the basis of this patient's clinical context, which one of the following is the most likely diagnosis?
Anxiety
Essential hypertension
Secondary renovascular hypertension due to atherosclerotic renal artery stenosis
Secondary renovascular hypertension due to fibromuscular dysplasia (FMD)
Hypertension associated with renal insufficiency
Anxiety can be associated with episodes of dramatic but temporary elevations in blood pressure. This patient's hypertension appears to be persistently elevated, which argues against this diagnosis.
Essential hypertension commonly occurs in middle-aged people who are usually asymptomatic with normal findings on physical examination.1 Secondary hypertension, defined as the presence of a specific condition known to cause hypertension, may affect up to 10% of hypertensive patients. It commonly presents as resistant hypertension, defined as an inability to control blood pressure despite the concurrent use of 3 antihypertensive agents, one of which is a diuretic.2 Our patient's severe stage 2 hypertension (defined as a systolic blood pressure ≥160 mm Hg and/or a diastolic blood pressure ≥100 mm Hg), young age, and inadequate response to blood pressure therapy argued against essential hypertension and raised suspicion for secondary causes.
Renovascular hypertension results from critical stenosis of the renal arteries. When the stenosis is sufficiently severe (ie, causing ≥75% diameter reduction), renal hypo perfusion ensues, leading to up-regulation of renin in the affected kidney. Consequent stimulation of angiotensin II and aldosterone leads to vasoconstriction and salt retention, respectively, which play a central role in the development of renovascular hypertension. Abdominal bruits, particularly those that have a diastolic component and lateralize to the renal areas, are suggestive of renal artery stenosis. Our patient's clinical presentation was highly suggestive of renal artery stenosis. Although atherosclerotic renal artery stenosis usually occurs in elderly patients with cardiovascular comorbid conditions such as hyperlipidemia and coexisting atherosclerotic vessel disease, fibromuscular dysplasia commonly affects young women with a history of smoking.3 Considering our patient's age, sex, and history of smoking, renovascular hypertension due to renal artery stenosis secondary to fibromuscular dysplasia was the most likely diagnosis. Hypertension associated with renal insufficiency was less likely given the negative findings on physical examination, normal kidney function, and absence of significant proteinuria on urinalysis.
Why would it be important for a leader to be open-minded
Answer:
Being open-minded allows leaders to see things from a different perspective or how things can be applied in new and novel ways.
how does hand sanitizer kill germs?
Answer:
Often used on the go, hand sanitizers contain ethyl alcohol, isopropyl alcohol or both to kill bacteria and viruses on your hands. Alcohols have long been known to kill germs by denaturing the protective outer proteins of microbes and dissolving their membranes.
Explanation:
Answer:
Hand sanitiser is mostly made of alcohol and alcohols destroy disease-causing agents, or pathogens, by breaking apart proteins, splitting cells into pieces or messing with a cell's metabolism.
Explanation:
HELP PLS!! I WILL GIVE U THE TOP COMMENT!!!
Answer:
False
Explanation:
Fruit is healthy but so are vegetables. they have different nutrients and other things that our body needs.
Help pls!! QUESTION 5 HELP PLS!! I WILL MARK YOU THE TOP COMMENT!! TANK YOUU!
the answer is true I promise
How long should a typical warm-up last
05 to 7 minutes
05 to 15 minutes
10 to 25 minutes
15 to 45 minutes
Answer:
10-25 minutes
Explanation:
I think this is a healthy amount of time to get all the exercise you need in, it may also depend on the types of exersices you are doing. Some exersices you may want to take more time on because they are more effective than others.
________are one celled organisms like bacteria.
Answer:
Protists and yeast
Explanation:
Answer:
UNICELLULAR ORGANISM
Explanation:
unicellular organism are one celled organism like bacteria
6.
b) cell-tissue-organs-organ systems-organism
What is the correct order of organization
a) tissues-cells-organs-organ systems-
organism
c) organism-cells-tissues-organ systems-
organism
d) tissues-cells-organs-organ sytems-
organism
Answer:
Cells -> tissues -> organs -> organ systems -> organisms
The correct order of organization is cell-tissue-organs-organ systems-organism.
In biological organization, cells are the basic structural and functional units of life. Cells combine to form tissues, which are groups of similar cells working together to perform specific functions. Tissues then come together to form organs, which are structures made up of different types of tissues performing specialized functions. Organs further integrate and interact to create organ systems, which are groups of organs working together to carry out specific physiological functions. Lastly, all the organ systems combine to form a complete organism, such as a human or an animal. Therefore, the correct order is cell-tissue-organs-organ systems-organism.
learn more about organs here:
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physical activity influences the calories in" side of the energy balance equation true or false
People can look for appropriate ways to deal with their emotions while following a nutritious diet true or false?
Answer:
False
True
Explanation:
The energy balance equation is defined as the equation that involves energy consumed and energy expended. Physical activity highly influence the calories "out" or energy expending and do not influence the calories "in" . Physical activity burn more calories and if person is having less food or energy "in", it leads to weight loss.
It is true that, nutritious diet can help to deal with emotions. It is recently proven that good food makes good mood, which means a healthy diet keeps a person mentally healthy and strong.
Hence, the correct answer is:
"False
True"
if sin a=-4/5 find cos a
Answer:
sin a=-4/5
we have sina=perpendicularp/hypotenuseh=-4/5
let p=-4k
h=5k
by Pythagoras theorem
h²=p²+b²
(5k)²=(-4k)²+b²
25k²-16k²=b²
(3k)²=b²
b=√(3k)²=3k
now
cos a =b/h=3k/5k=3/5
If it is more than a day beyond the best-by date, it is not safe to eat the food.
True
False
Answer:
True
Explanation:
Hope this helps you
Answer:
true
Explanation:
got it right on a test
Which organelles best fits to each of these descriptions
Answer:
Explanation:
1) cell membrane
2) lysosomes
3)mitochondria
4)Golgi apparatus
5) secretory vesicles
6)ribosomes
7)peroxisomes
8)smooth ER
9)Ribosomes
10)rough ER
11)mitochondria
What best describes the act of advocacy?
A. Supporting a meaningful action or cause
B. Calling attention to a particular product and Service
C. Reducing internal and external risks
D. Practicing health-enhancing behavior
Antibiotics are uesd to treat ______ infection.
Answer:
Antibiotics are used to treat or prevent some types of bacterial infections.
Your appetite is learned and shaped by factors in your environment and by your emotions.
True or False?
True
False
True!
When some people have an environment that makes them upset it is actually very common for them to not want to eat whereas they are not feeling happy. Also I know this is true because the term (stress eating) rises from this, meaning that somebody could literally become hungry just because they are stressed out. It is sadly a very common problem too because it is bad for health and nutrition to just skip out on a meal, of which this same process confuses the bodily system, possibly even resulting in either more stress or even anger.
Hope this helps.
。 . . 。 ඞ ඞ ඞ ඞ ඞ ඞ ඞ 。 . • . [Northstar] was ejected. . . 。 . 。 ﾟ . . , . . .. 。 • ﾟ 。 . . . 。。 • ﾟ 。 . . . 。。 • ﾟ 。 . . . 。。 • ﾟ 。 . . . 。
Select the phrase that correctly completes the statement.
An adult woman who has a (an)
v of 27
Blood flows from the aorta into smaller _________, which carry it to all body organs and tissues.
There are laws that protect patients from poor treatments by health care professionals such as negligence and malpractice.
Question 1 options:
True
False
A doctor can't do a procedure or extra procedure without a patient's consent.
Question 2 options:
True
False
HIPPA protects patient confidentiality.
Question 3 options:
True
False
Answer:
number 1 is false
number 2 is false
number 3 is false
One of the differences between labeling an individual with a medical disease or labeling them with a mental illness is that
A. many mental illnesses are used to define an individual
B. many medical diseases are seen as patient caused
C. there are no known cures for mental illnesses
D. there are more cures for medical diseases
Please select the best answer from the choices provided
Answer:
I think c because there aren't any cures for mental illnesses, but diseases there are
Explanation:
The differences between labeling an individual with a medical disease should be that various mental illness should be used for defining an individual.
What is mental illness?The mental illness should refer to the health condition that include the changes in emotion, thinking or the behavior, It should be associated with the distress or the problem where it should be functioned in the social work or even the family activities.
Therefore, based on the above explanation, we can say that the first option is correct.
learn more about illness here: https://brainly.com/question/13371930
Connie is satisfied with her weight but would like to improve her eating habits. She typically has several slices of toast and a large coffee for breakfast, a turkey sandwich and chips or sausage pizza for lunch, and a pasta dish with baked chicken or pork chops for supper. She often has an evening snack of fat-free pudding or yogurt. She drinks unsweetened iced tea, regular colas, water, and an occasional glass of milk. Connie's current diet is most likely to be adequate in which of the following nutrients?
A. Vitamin B12.
B. Potassium C.
C. Vitamin C.
D. Folic acid.
Answer:
B. Potassium C
Explanation:
Toast has 54mg of potassium
Your weight should be on the heels of your feet.
A. true
B. false
Answer/Explanation: true
Answer:
A. true
Explanation:
Yes, our weight should be on the heels and the toes of your feet.
Explain the consequences that both positive and negative influences from peers can have on a teen's life.
Answer:
Look below!
Explanation:
Peers can make a huge influence on a teens life so who they surround themselves with is important. Some of the negative influences are lowering their self worth, pressuring them, or can lead them down a dangerous path. If teens surround themselves with the wrong people who cause a negative infuence on their lives, it could cause them to do things they wouldn't normally. However, the same could be said for a positive influence on a teens life but in a more positive light. A more positive influence from peers can help push the teen out of their comfort zone in a better way. They can encourage them and support their ideas and endavours which would lead to them becoming more self-confident.
Why is it important to wash your hands? (At least 5 sentences)
Answer:
it is important to wash your hands !
Explanation:
it is important to wash your hands due to passing around an abundant amount of germs ! especially in this pandemic we are in it is more important to wash your hands . it is also important to wash your hands because you don't want your hands to smell !
Explain how the respiratory system and the circulatory system work together to keep the body alive and well. Must be at least 3 sentences.
Answer:
The human respiratory and circulatory systems work together to supply the body with oxygen and get rid of waste carbon dioxide. While the former deals with air and the latter with blood, they work together seamlessly by coordinating the functions of the many parts of each system. Other systems in the body, such as the digestive system and the nervous system, are important too, but the circulatory and respiratory systems have to work continuously, usually without pausing even for a few minutes.
Explanation:
Sexual reproduction happens when the __ material from two different sex cells combine.
A. offspring
B. Mutations
C. Genetic
B .offspring (the product of the reproductive processes of an animal or plant : young, progeny The disease can be transmitted from parent to offspring. b : child a mother of numerous offspring.)
Nine-month-old Susan has a fear of sound and a fear of heights. In which domain do these
characteristics belong?
Answer:
maybe put her down...
Explanation:
end her mysery...
Where do you start play in the game of golf?
Independent (or individual) practice associations (IPAs) are based on
A. MCO contracts established with physicians.
B. HMO service contracts with organized groups of physicians.
C. IPO policy benefits established for new patients.
D. PPO service contracts with groups of hospitals.
Answer:
D. PPO service contracts with groups of hospitals.
Explanation:
Individual Practices which is a situation whereby the medical personnel are practicing in a hospital on an individual basis with one or two group of of hospital is based on service contracts which exist between them. IF the PPO service contracts is good, the would take up the individual practice with the said group of hospital.
which of the following do play an important role in maintaining balance?
Although Laura is working in a group with others, her tendency to engage in social loafing will likely decrease if __________. A. individual productivity of group members is not evaluated by others B. the group encourages task involvement C. the group is large and incohesive D. Laura has low achievement motivatio
Answer:
The answer is B
Explanation:
Laura's tendency to engage in social loafing will likely decrease if the group encourages task involvement (Option B).
What is social loafing?The expression 'social loafing' makes reference to a psychological process that occurs when persons work less in a group environment.
This attitude (social loafing) may lead to a significant decrement in productivity.In conclusion, Laura's tendency to engage in social loafing will likely decrease if the group encourages task involvement (Option B).
Learn more about social loafing here:
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A radioactive iodine uptake test (RAIU) tests for a disorder of what gland?
thymus
thyroid
pituitary
adrenal
Answer:
Explanation:
https://uxmag.com/articles/seven-ux-best-practices-of-community-design
and yes this possible. I am just trying to see if we can add a link as an Answer in Brainly.
