ABFM HYPERTENSION EXAM
1. 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: B
,This patient's clinical findings are consistent with Cushing
syndrome, or hypera- drenocorticism. 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 of adipose tissue in the interscapular area
("buffalo hump"), and glucose intolerance.
2. You diagnose stage 2 hypertension in a 54-year-old 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
,²-Blockers
Calcium channel blockers Direct vasodilators Thiazide
diuretics: 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 ²-blockers, with
the most consistent reduction achieved with ACE inhibitors and
the least with ²-blockers. Regression of left ventricular hypertrophy
has not been demonstrated with direct vasodilators such as
hydralazine and minoxidil.
, 3. According to currently 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: D
In children and adolescents, hypertension is defined as blood
pressure at or above the 95th percentile for age, sex, and height,
on repeated measurements.
4. Which one of the following conditions is associated with
isolated systolic hypertension?
Aortic stenosis Hypothyroidism Paget's disease
Renovascular hypertension
1. 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: B
,This patient's clinical findings are consistent with Cushing
syndrome, or hypera- drenocorticism. 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 of adipose tissue in the interscapular area
("buffalo hump"), and glucose intolerance.
2. You diagnose stage 2 hypertension in a 54-year-old 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
,²-Blockers
Calcium channel blockers Direct vasodilators Thiazide
diuretics: 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 ²-blockers, with
the most consistent reduction achieved with ACE inhibitors and
the least with ²-blockers. Regression of left ventricular hypertrophy
has not been demonstrated with direct vasodilators such as
hydralazine and minoxidil.
, 3. According to currently 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: D
In children and adolescents, hypertension is defined as blood
pressure at or above the 95th percentile for age, sex, and height,
on repeated measurements.
4. Which one of the following conditions is associated with
isolated systolic hypertension?
Aortic stenosis Hypothyroidism Paget's disease
Renovascular hypertension
