ABFM HYPERTENSION
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
A 39-year-old male sees you of adipose tissue in the interscapular area ("buffalo hump"),
for evaluation of high blood and glucose intolerance.
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
, ABFM HYPERTENSION
D
In patients with left ventricular hypertrophy, studies have
shown a reduction in left ventricular mass in those treated
with ACE inhibitors, diuretics, calcium channel blockers, and
β-blockers, with the most consistent reduction achieved with
ACE inhibitors and the least with β-blockers. Regression of
You diagnose stage 2 left ventricular hypertrophy has not been demonstrated with
hypertension in a 54-year-old direct vasodilators such as hydralazine and minoxidil.
male. His past medical history
is otherwise unremarkable
and a physical examination is
notable for 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
, ABFM HYPERTENSION
D
In children and adolescents, hypertension is defined as blood
pressure at or above the 95th percentile for age, sex, and
According to currently height, on repeated measurements.
accepted criteria,
hypertension in children is
defined as repeated blood
pressure measurements at or
above a threshold of which
one of the following
percentiles for age, sex, and
height?
80th
85th
90th
95th
99th
C
Isolated elevation of systolic blood pressure can be
Which one of the following secondary to conditions associated with elevated cardiac
conditions is associated with output, such as anemia, Paget's disease, hyperthyroidism,
isolated systolic arteriovenous fistula, and aortic insufficiency.
hypertension?
Aortic stenosis
Hypothyroidism
Paget's disease
Renovascular hypertension
Severe osteoporosis
, ABFM HYPERTENSION
B
The JNC 8 panel recommends the initiation of
pharmacologic treatment to lower blood pressure in patients
≥18 years of age with a systolic blood pressure ≥140 mm Hg
or a diastolic blood pressure ≥90 mm Hg if they have chronic
kidney disease (CKD), defined as an estimated or measured
glomerular filtration rate (GFR) <60 mL/min/1.73 m2.
Treatment is recommended for patients of any age with these
A 59-year-old African- blood pressure values who also have albuminuria, defined as
American male with a history >30 mg of albumin/g of creatinine regardless of GFR (SOR
of hypercholesterolemia and C).Although a thiazide diuretic or a calcium channel blocker
gout sees you for a health is generally recommended as first-line antihypertensive
maintenance visit. A physical therapy in African-Americans, for patients ≥18 years of age
examination is notable only who have CKD, the JNC 8 panel recommends initial (or add-
for a blood pressure of 144/85 on) antihypertensive treatment with an ACE inhibitor or
mm Hg.Laboratory angiotensin receptor blocker to improve kidney outcomes,
FindingsLDL- regardless of ethnicity or diabetes status (SOR B).The 2017
cholesterol............82 American College of Cardiology/American Heart
mg/dLHDL- Association hypertension guidelines similarly recommend
cholesterol............47 use of an ACE inhibitor in patients with stage 3 CKD, as well
mg/dLSerum as in patients who have stages 1 or 2 CKD with albuminuria
triglycerides............134 >300 mg/day.
mg/dLLiver
panel............normalSerum
creatinine............1.7 mg/dL
(N 0.7-1.3)Estimated
glomerular filtration
rate............56 mL/min/1.73
m2Which one of the
following does the JNC 8
panel recommend as initial
management of this patient's
blood pressure elevation?
Lifestyle measures only
An ACE inhibitor
A calcium channel blocker
Hydralazine
Hydrochlorothiazide
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
A 39-year-old male sees you of adipose tissue in the interscapular area ("buffalo hump"),
for evaluation of high blood and glucose intolerance.
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
, ABFM HYPERTENSION
D
In patients with left ventricular hypertrophy, studies have
shown a reduction in left ventricular mass in those treated
with ACE inhibitors, diuretics, calcium channel blockers, and
β-blockers, with the most consistent reduction achieved with
ACE inhibitors and the least with β-blockers. Regression of
You diagnose stage 2 left ventricular hypertrophy has not been demonstrated with
hypertension in a 54-year-old direct vasodilators such as hydralazine and minoxidil.
male. His past medical history
is otherwise unremarkable
and a physical examination is
notable for 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
, ABFM HYPERTENSION
D
In children and adolescents, hypertension is defined as blood
pressure at or above the 95th percentile for age, sex, and
According to currently height, on repeated measurements.
accepted criteria,
hypertension in children is
defined as repeated blood
pressure measurements at or
above a threshold of which
one of the following
percentiles for age, sex, and
height?
80th
85th
90th
95th
99th
C
Isolated elevation of systolic blood pressure can be
Which one of the following secondary to conditions associated with elevated cardiac
conditions is associated with output, such as anemia, Paget's disease, hyperthyroidism,
isolated systolic arteriovenous fistula, and aortic insufficiency.
hypertension?
Aortic stenosis
Hypothyroidism
Paget's disease
Renovascular hypertension
Severe osteoporosis
, ABFM HYPERTENSION
B
The JNC 8 panel recommends the initiation of
pharmacologic treatment to lower blood pressure in patients
≥18 years of age with a systolic blood pressure ≥140 mm Hg
or a diastolic blood pressure ≥90 mm Hg if they have chronic
kidney disease (CKD), defined as an estimated or measured
glomerular filtration rate (GFR) <60 mL/min/1.73 m2.
Treatment is recommended for patients of any age with these
A 59-year-old African- blood pressure values who also have albuminuria, defined as
American male with a history >30 mg of albumin/g of creatinine regardless of GFR (SOR
of hypercholesterolemia and C).Although a thiazide diuretic or a calcium channel blocker
gout sees you for a health is generally recommended as first-line antihypertensive
maintenance visit. A physical therapy in African-Americans, for patients ≥18 years of age
examination is notable only who have CKD, the JNC 8 panel recommends initial (or add-
for a blood pressure of 144/85 on) antihypertensive treatment with an ACE inhibitor or
mm Hg.Laboratory angiotensin receptor blocker to improve kidney outcomes,
FindingsLDL- regardless of ethnicity or diabetes status (SOR B).The 2017
cholesterol............82 American College of Cardiology/American Heart
mg/dLHDL- Association hypertension guidelines similarly recommend
cholesterol............47 use of an ACE inhibitor in patients with stage 3 CKD, as well
mg/dLSerum as in patients who have stages 1 or 2 CKD with albuminuria
triglycerides............134 >300 mg/day.
mg/dLLiver
panel............normalSerum
creatinine............1.7 mg/dL
(N 0.7-1.3)Estimated
glomerular filtration
rate............56 mL/min/1.73
m2Which one of the
following does the JNC 8
panel recommend as initial
management of this patient's
blood pressure elevation?
Lifestyle measures only
An ACE inhibitor
A calcium channel blocker
Hydralazine
Hydrochlorothiazide
