ABFM HYPERTENSION
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ABFM HYPERTENSION 2024
Expected Questions and Answers
(Verified by Expert)
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
1/
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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
Hemochromatosi
s
Pheochromocyto
ma
Primary hyperaldosteronism ANS 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,
2/
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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 ANS D
3/
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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.
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