ABFM KSA HYPERTENSION Latest Update 2024-
2025 Actual Exam from Credible Source with 60
Questions and 100% Verified Detailed Correct
Answers Guaranteed A+ Approved by Professor
A 14-year-old female is diagnosed with stage 1 hypertension. Her previous medical
history and family history are unremarkable. A physical examination is notable for a
height of 160 cm (63 in), a weight of 75 kg (165 lb), a BMI of 29 kg/m2, and a blood
pressure of 134/84 mm Hg.Which one of the following studies is not routinely obtained
in this situation?
A urinalysis
A fasting lipid profile
Serum creatinine
Hemoglobin A1c
Renal ultrasonography - CORRECT ANSWER: E
For children >13 years of age, the American Academy of Pediatrics (AAP) defines stage
1 hypertension as a blood pressure of 130-139/80-89 mm Hg and stage 2 hypertension
as a blood pressure ≥140/90 mm Hg. The AAP recommends that all pediatric patients
with hypertension be evaluated with a urinalysis, a chemistry panel (including
electrolyte, BUN, and creatinine levels), and a lipid profile.Renal ultrasonography is
recommended for patients <6 years of age with hypertension, as well as those with
abnormal findings on a urinalysis or renal function studies. For adolescents and
pediatric patients who have obesity and hypertension, recommended tests also include
hemoglobin A1c, aspartate transaminase (AST) and alanine transaminase (ALT), and a
fasting lipid panel. Echocardiography is recommended to assess for cardiac target
organ damage if pharmacologic treatment of hypertension is being considered.An
extensive evaluation for secondary causes of hypertension is not recommended for
children older than 6 years if they have a family history of hypertension, or if they are
overweight or obese, and the history and physical examination do not suggest a
secondary cause for their hypertension.
A 19-year-old male college student sees you for follow-up of an emergency department
(ED) visit. He says he was told that his symptoms were due to a panic attack. His past
medical history is notable only for migraine headaches. On the day of his ED visit he
,was started on propranolol for the headaches. The initial physical examination in the ED
was notable for a blood pressure of 198/114 mm Hg supine, dropping to 150/98 mm Hg
on standing, and a heart rate of 112 beats/min. He reports that his symptoms improved
after a couple hours in the ED and the record from the visit notes that his blood
pressure was 140/90 mm Hg at the time of discharge.The patient says that he has
always been an anxious person but has never experienced a similar attack in the past.
He notes that his blood pressure has always been on the "high side" and his blood
pressure in your office today is 144/86 mm Hg.Which one of the following should be c -
CORRECT ANSWER: D
Pheochromocytomas are catecholamine-producing neuroendocrine tumors, and the
majority arise from the adrenal medulla. They are a rare but important secondary cause
of hypertension, whether sustained or paroxysmal. Paroxysmal hypertension with
sweating, headaches, and palpitations is the usual presentation of pheochromocytoma.
Other clinical clues to its presence include unexplained tachycardia, weight loss,
episodic diaphoresis, unexplained orthostatic hypotension with a background of
paroxysmal or refractory hypertension, and feelings of anxiety or panic attacks. β-
Adrenergic blockers have been implicated in precipitating adverse reactions in patients
with pheochromocytoma. The mechanism for β-blocker-associated adverse events is
generally ascribed to inhibition of β2-adrenoceptor-mediated vasodilation, leaving
adrenoceptor-mediated vasoconstriction unopposed. If a hypertensive crisis occurs in a
patient taking β-blockers, the presence of a pheochromocytoma should be suspected.
Furthermore, the Hypertension Canada 2017 guidelines recommend that the possibility
of pheochromocytoma be considered in patients with hypertension triggered by β-
blockers as well by monoamine oxidase inhibitors, micturition, changes in abdominal
pressure, surgery, or anesthesia.
A 24-year-old male comes to the emergency department with chest pain an hour after
using cocaine. A physical examination is notable for a blood pressure of 190/110 mm Hg
and tachycardia. An EKG reveals sinus tachycardia with a rate of 116 beats/min and
nonspecific ST- and T-wave changes.Which one of the following agents can be safely
prescribed?
Labetalol (Trandate)
Lorazepam (Ativan)
Metoprolol tartrate (Lopressor)
Short-acting nifedipine (Procardia)
Propranolol - CORRECT ANSWER: B
,In patients with cocaine-induced chest pain and hypertension, initial management with
an intravenous benzodiazepine can relieve chest pain and produce beneficial cardiac
hemodynamic effects. In addition, by reducing the central stimulatory effects of cocaine,
benzodiazepines also reduce anxiety, which often leads to resolution of the
hypertension and tachycardia. Administration of sublingual or intravenous nitroglycerin
and intravenous or oral calcium channel blockers is recommended for patients with ST-
segment elevation or depression that accompanies ischemic chest discomfort after
cocaine use.By blocking only β-receptors, resulting in an unopposed α-adrenergic
effect, β-blockers can exacerbate vasoconstriction and should therefore be avoided.
Although labetalol is both an α- and β-blocker, because it blocks β-receptors
substantially more it is thought to offer no advantages over a β-blocker.
A 32-year-old female who works as an administrative assistant is referred to you for
evaluation of high blood pressure. Her past medical history is unremarkable, and she
does not take any prescribed or over-the-counter medications. A review of systems
reveals only a chronic history of mild fatigue and episodic muscle cramping. A physical
examination is normal except for a blood pressure of 156/100 mm Hg in both arms
without significant orthostatic changes.Laboratory
FindingsCBC............normalSodium............145 mEq/L (N 135-145)Potassium............2.9
mEq/L (N 3.5-5.0)Chloride............100 mEq/L (N 100-108)Bicarbonate............25 mEq/L
(N 22-26)Creatinine............0.7 mg/dL (N 0.6-1.5)BUN............10 mg/dL (N 8-
25)Glucose............90 mg/dLUrinalysis............normalWhich one of the following is the
most likely cause of her hypertension?
Addison's disease
Bartter syndrome
Chronic licorice ingestion
Pr - CORRECT ANSWER: D
Primary hyperaldosteronism, also known as Conn's syndrome, is associated with
hypersecretion of aldosterone, a mineralocorticoid. It is twice as common in women as
in men, and usually occurs between 30 and 50 years of age. In the past, it was
estimated that approximately 1% of unselected hypertensive patients had
hyperaldosteronism, but more recent data indicates that the prevalence is around 6% in
patients with uncomplicated hypertension and as high as 20% in those with resistant
hypertension. Symptoms are largely related to the associated hypertension,
hypokalemia, or alkalosis, and include headaches, polyuria, polydipsia, muscle
weakness and fatigue, and intermittent paresthesias.
, A 38-year-old male with a chronic history of nocturia sees you for a 2-day history of
gross hematuria. His past medical history is unremarkable. His father is on hemodialysis
for an unknown kidney problem and he believes his brother has kidney problems as
well. A physical examination reveals a blood pressure of 150/102 mm Hg. His serum
creatinine level is 2.4 mg/dL (N 0.6-1.2).Which one of the following is the most likely
diagnosis?
Chronic glomerulonephritis
Chronic pyelonephritis
Membranous nephropathy
Medullary sponge kidney
Polycystic kidney disease - CORRECT ANSWER: E
Autosomal polycystic kidney disease has a prevalence of 1:300 to 1:1000 and accounts
for approximately 10% of end-stage renal disease in the United States. Significant
findings include renal pain, enlarged kidneys, nocturia, gross and microscopic
hematuria, elevated serum creatinine, and low urine specific gravity. The disease can
present at any age, but most frequently causes symptoms in the third or fourth decade
of life.
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 - CORRECT ANSWER: B
2025 Actual Exam from Credible Source with 60
Questions and 100% Verified Detailed Correct
Answers Guaranteed A+ Approved by Professor
A 14-year-old female is diagnosed with stage 1 hypertension. Her previous medical
history and family history are unremarkable. A physical examination is notable for a
height of 160 cm (63 in), a weight of 75 kg (165 lb), a BMI of 29 kg/m2, and a blood
pressure of 134/84 mm Hg.Which one of the following studies is not routinely obtained
in this situation?
A urinalysis
A fasting lipid profile
Serum creatinine
Hemoglobin A1c
Renal ultrasonography - CORRECT ANSWER: E
For children >13 years of age, the American Academy of Pediatrics (AAP) defines stage
1 hypertension as a blood pressure of 130-139/80-89 mm Hg and stage 2 hypertension
as a blood pressure ≥140/90 mm Hg. The AAP recommends that all pediatric patients
with hypertension be evaluated with a urinalysis, a chemistry panel (including
electrolyte, BUN, and creatinine levels), and a lipid profile.Renal ultrasonography is
recommended for patients <6 years of age with hypertension, as well as those with
abnormal findings on a urinalysis or renal function studies. For adolescents and
pediatric patients who have obesity and hypertension, recommended tests also include
hemoglobin A1c, aspartate transaminase (AST) and alanine transaminase (ALT), and a
fasting lipid panel. Echocardiography is recommended to assess for cardiac target
organ damage if pharmacologic treatment of hypertension is being considered.An
extensive evaluation for secondary causes of hypertension is not recommended for
children older than 6 years if they have a family history of hypertension, or if they are
overweight or obese, and the history and physical examination do not suggest a
secondary cause for their hypertension.
A 19-year-old male college student sees you for follow-up of an emergency department
(ED) visit. He says he was told that his symptoms were due to a panic attack. His past
medical history is notable only for migraine headaches. On the day of his ED visit he
,was started on propranolol for the headaches. The initial physical examination in the ED
was notable for a blood pressure of 198/114 mm Hg supine, dropping to 150/98 mm Hg
on standing, and a heart rate of 112 beats/min. He reports that his symptoms improved
after a couple hours in the ED and the record from the visit notes that his blood
pressure was 140/90 mm Hg at the time of discharge.The patient says that he has
always been an anxious person but has never experienced a similar attack in the past.
He notes that his blood pressure has always been on the "high side" and his blood
pressure in your office today is 144/86 mm Hg.Which one of the following should be c -
CORRECT ANSWER: D
Pheochromocytomas are catecholamine-producing neuroendocrine tumors, and the
majority arise from the adrenal medulla. They are a rare but important secondary cause
of hypertension, whether sustained or paroxysmal. Paroxysmal hypertension with
sweating, headaches, and palpitations is the usual presentation of pheochromocytoma.
Other clinical clues to its presence include unexplained tachycardia, weight loss,
episodic diaphoresis, unexplained orthostatic hypotension with a background of
paroxysmal or refractory hypertension, and feelings of anxiety or panic attacks. β-
Adrenergic blockers have been implicated in precipitating adverse reactions in patients
with pheochromocytoma. The mechanism for β-blocker-associated adverse events is
generally ascribed to inhibition of β2-adrenoceptor-mediated vasodilation, leaving
adrenoceptor-mediated vasoconstriction unopposed. If a hypertensive crisis occurs in a
patient taking β-blockers, the presence of a pheochromocytoma should be suspected.
Furthermore, the Hypertension Canada 2017 guidelines recommend that the possibility
of pheochromocytoma be considered in patients with hypertension triggered by β-
blockers as well by monoamine oxidase inhibitors, micturition, changes in abdominal
pressure, surgery, or anesthesia.
A 24-year-old male comes to the emergency department with chest pain an hour after
using cocaine. A physical examination is notable for a blood pressure of 190/110 mm Hg
and tachycardia. An EKG reveals sinus tachycardia with a rate of 116 beats/min and
nonspecific ST- and T-wave changes.Which one of the following agents can be safely
prescribed?
Labetalol (Trandate)
Lorazepam (Ativan)
Metoprolol tartrate (Lopressor)
Short-acting nifedipine (Procardia)
Propranolol - CORRECT ANSWER: B
,In patients with cocaine-induced chest pain and hypertension, initial management with
an intravenous benzodiazepine can relieve chest pain and produce beneficial cardiac
hemodynamic effects. In addition, by reducing the central stimulatory effects of cocaine,
benzodiazepines also reduce anxiety, which often leads to resolution of the
hypertension and tachycardia. Administration of sublingual or intravenous nitroglycerin
and intravenous or oral calcium channel blockers is recommended for patients with ST-
segment elevation or depression that accompanies ischemic chest discomfort after
cocaine use.By blocking only β-receptors, resulting in an unopposed α-adrenergic
effect, β-blockers can exacerbate vasoconstriction and should therefore be avoided.
Although labetalol is both an α- and β-blocker, because it blocks β-receptors
substantially more it is thought to offer no advantages over a β-blocker.
A 32-year-old female who works as an administrative assistant is referred to you for
evaluation of high blood pressure. Her past medical history is unremarkable, and she
does not take any prescribed or over-the-counter medications. A review of systems
reveals only a chronic history of mild fatigue and episodic muscle cramping. A physical
examination is normal except for a blood pressure of 156/100 mm Hg in both arms
without significant orthostatic changes.Laboratory
FindingsCBC............normalSodium............145 mEq/L (N 135-145)Potassium............2.9
mEq/L (N 3.5-5.0)Chloride............100 mEq/L (N 100-108)Bicarbonate............25 mEq/L
(N 22-26)Creatinine............0.7 mg/dL (N 0.6-1.5)BUN............10 mg/dL (N 8-
25)Glucose............90 mg/dLUrinalysis............normalWhich one of the following is the
most likely cause of her hypertension?
Addison's disease
Bartter syndrome
Chronic licorice ingestion
Pr - CORRECT ANSWER: D
Primary hyperaldosteronism, also known as Conn's syndrome, is associated with
hypersecretion of aldosterone, a mineralocorticoid. It is twice as common in women as
in men, and usually occurs between 30 and 50 years of age. In the past, it was
estimated that approximately 1% of unselected hypertensive patients had
hyperaldosteronism, but more recent data indicates that the prevalence is around 6% in
patients with uncomplicated hypertension and as high as 20% in those with resistant
hypertension. Symptoms are largely related to the associated hypertension,
hypokalemia, or alkalosis, and include headaches, polyuria, polydipsia, muscle
weakness and fatigue, and intermittent paresthesias.
, A 38-year-old male with a chronic history of nocturia sees you for a 2-day history of
gross hematuria. His past medical history is unremarkable. His father is on hemodialysis
for an unknown kidney problem and he believes his brother has kidney problems as
well. A physical examination reveals a blood pressure of 150/102 mm Hg. His serum
creatinine level is 2.4 mg/dL (N 0.6-1.2).Which one of the following is the most likely
diagnosis?
Chronic glomerulonephritis
Chronic pyelonephritis
Membranous nephropathy
Medullary sponge kidney
Polycystic kidney disease - CORRECT ANSWER: E
Autosomal polycystic kidney disease has a prevalence of 1:300 to 1:1000 and accounts
for approximately 10% of end-stage renal disease in the United States. Significant
findings include renal pain, enlarged kidneys, nocturia, gross and microscopic
hematuria, elevated serum creatinine, and low urine specific gravity. The disease can
present at any age, but most frequently causes symptoms in the third or fourth decade
of life.
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 - CORRECT ANSWER: B
