As per the JNC VIII committee recommendation, for individuals that are part of the African American population, including those with diabetes, the initial treatment should include a thiazide type diuretic or calcium channel blocker (CCB).
Which of the following thiazide type diuretic is preferred as the initial antihypertensive therapy?
Copyright © ABIM Exam World Created On: 09/20/2017 Last Modified: 10/28/2024
The ACCOMPLISH trial is the first major trial addressing the issue of combination therapy in 11,506 patients who were at high cardiovascular risk. The goal blood pressure was less than 130/80 mm Hg in the patients with diabetes or impaired renal function, and less than 140/90 mm Hg in the patients with prior cardiovascular disease.
Which of the following combinations of blood pressure medications was the best in reducing cardiovascular events and slowing the progression of nephropathy in patients with hypertension who were at high risk for such events?
Copyright © ABIM Exam World Created On: 09/20/2017 Last Modified: 01/25/2021
An 18 year-old male is brought to the renal clinic for evaluation of hypertension. There is no history of edema of the feet, puffiness of the face, hematuria, oliguria ,or recurrent urinary tract infections. He is an active football player, but lately he complains of weakness and muscle cramps. His blood pressure for the last 3-4 years has always been borderline high and during this visit was as noted below.
Physical examination shows: Pulse 100/min, all peripheral pulsations are well felt. BP 150/100 mm Hg, Temp. 37.4 degrees C. He is pale. His growth is stunted. His cognitive function is normal and no focal neurological deficits are noted. Other systems are unremarkable. Laboratory examination is as follows:
Hemoglobin 13.5 g/dL
Hematocrit 42%
Platelet Count 150,000 mm3
White Blood Cells 8,000 mm3
Urinalysis:
Protein 100 mg/24 h
Glucose None
Red Blood Cells None
White Blood Cells None
Leukocyte Esterase Negative
Nitrites Negative
Chemistry:
BUN 13.5 mg/dL
Creatinine 0.9 mg/dL
Sodium 140 mEq/L
Potassium 5.8 mEq/L
Bicarbonate 18.5 mEq/L
Chloride 112 mEq/l
Calcium 9.2 mEq/L
Phosphorus 3.2 mg/dL
Aldosterone 5 ng/mL
PRA <1.0ng/dl/hr
Glucose 100 mg/dL
HbA1C 5.30%
S. Osmolality 282 mOsmol
Uric Acid 5.3 mg/dL
ESR 9.8 mm/h
ABG:
pH 7.25
PCO2 32 mm Hg
HCO3 16 mEq/L
PO2 90 mm Hg
USG Normal size kidneys, no hydronephrosis
Considering the history and the laboratory findings, which of the following is most likely the cause of hypertension in this patient?
A 30 year-old man comes to your office for a painful rash on the neck. He has fever and malaise. He has history of HIV. He is currently taking Tenofovir, emtricitabine, and indinavir. The rash is suggestive of Herpes Zoster rash :
Physical examination does not reveal any oral cavity lesions. His current CD4 count is 250/mm3. His chemistry is normal. He is started on an intravenous medication for his rash. Two days later his chemistry is as follows:
Na 135 mEq/L
K 4.5 mEq/L
CL 100 mEq/L
HCO3 24 mEq/L
BUN 21 mg/dL
Cr 2.0 mEq/L
Glucose 95 mg/dL
Calcium 9.4 mg/dl
Urinalysis shows needle-shaped crystals in the sediment.
Which of the following is most likely the cause of his renal problem?
Copyright © ABIM Exam World Created On: 09/20/2017 Last Modified: 08/29/2018
A 20 year-old-male was at a party where after dancing he ate a lot of cake because it was “delicious”. After 2-3 hours he developed sudden onset of weakness in all 4 limbs. He has had two similar episodes in the past. He was rushed to the nearest ER. On examination: P: 88/min, BP: 140/96 mm Hg, Pallor+, No thyroid enlargement. He is alert and oriented. There is no cranial nerve involvement and no neck muscle weakness. Motor power is grade 2-3 in all extremities, reflexes sluggish to absent. Sensory exam is normal. Laboratory results reveal the following:
pH 7.4
pCO2 40 mm Hg
paO2 98 mm Hg
O2 saturation 98%
Na 140 mEq/L
K 2.2 mEq/L
Cl 103 mEq/
BUN 10 mg/dl
S.Cr 0.8 mg%
S. Ca 10.2 mg/dl
PO4 2.5 mg/dl
Mg 2.2 mg/dl
Urine Electrolytes
Urine Na 100 mEq/L
Urine K 15 mEq/L
Which of the following is the MOST likely diagnosis?
Copyright © ABIM Exam World Created On: 09/12/2017 Last Modified: 12/30/2017
In a CKD and ESRD patient, Vitamin D seems to protect against cardiovascular disease events by controlling secondary hyperparathyroidism. The OPERA trial evaluated the effect of paricalcitol Vitamin D analog in CKD stages 3-5 with left ventricular hypertrophy. The study observed the effect on left ventricular mass and function.
Which of the following statements is true about the effect of paricalcitol in CKD and ESRD patients?
Copyright © ABIM Exam World Created On: 09/20/2017 Last Modified: 08/06/2018
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