Medfags report in
28 y/o woman with familial history of arterial hypertension (father) & persistent headache, arterial blood pressure was 220/130mmHg and stays over 180/110 despite a two week anti-hypertensive therapy, dipstick urinalysis was positive for proteins and negative for leukocytes, erythrocytes and nitrates. Endocrinologist said everything is normal, she was referred back to me with the diagnosis of essential hypertension, do you agree with this diagnosis?
Veeky Forums used to be full of decent tier medfags... it's now an autistic STEM meme board I see
What did the Endo actually do? PRA results? Any abnormals on the CMP?
Take a creatinine and electrolytes. Also ask about licorice consumption. Ultrasound renal arteries for fibromuscular dysplasia.
220? Doesn't that mean she's just about dead?
220 is definively possible, seen it multiple times. Some people dont even have symptoms with that blood pressure.
It's definitely enough to cause severe damage all over, though, right?
(We wikipedia MD now)
have the pt see cardio asap. she probably has persistent ischemia
Yes, it will cause kidney failure in a few months/years.
Electrolytes are normal, serum creatinine is 1.1 and clearence is normal
And how about her renal arteries?
No excertional dyspnea or any clinical/ECG indication for that you dumb cuck
No bruits, no stenosis, nada
>the diagnosis of essential hypertension
restating the symptoms basically
lmao
medfags are pathetic
why does she have protein in the urine
is it because of the hypertension
How about drugs and alcohol?
Yes
That's what I'm trying to figure out
>Yes
how does that mess her filtration up exactly
is it because the pressure is so high in the glomeural vessels that proteins just get pushed through even though it's technically not permeable for them
Probably this.
Non-smoker, occasional alcohol, no drugs, liver function and enzymes are normal, nothing abnormal on physical exam
Well, since persistent ischemia is ruled out, renal arteries are normal and there's no history of smoking and drug use, I'd agree with the diagnosis.
Have you tried wearing a different colored coat
I hope you fix her OP
>28 y/o woman
My diagnosis is:
You are either too fat
or you were too slutty
or your vagina has been invaded by terrorists
or the guy you friendzoned casted a curse on you.
Can't you drain some of the blood out of her to lower the pressure
This guy knows something.
Redo the plasma renin activity:
Primary hyperaldosteronism.
you can make her pee more
Because it's not being properly digested in her small intestine and is being pushed through her kidneys.
Black?
I would prescribe a dose of Tits or GTFO
it happens where it is very intermittent . at least have them run a pharmacological stress test with myocardial perfusion imaging
Haematology and blood biochemistry?
Man I really would not like to be in the position of that woman. If even my doctor has to go to Veeky Forums for medical advice, things must be very bad.
RIP
But he said her electrolytes were normal.
just because you have high bp doesn't mean you'll have protein in the urine
at some point it happens, and im guessing you know at what values of bp the gradient is enough and you know those values by heart
im asian
>"med fags"
>no one asks about the anti hypertensive drugs
>no one asks about diagnoses in other members of the family
>no one asks about onset of symptoms
HAEMATOLOGY AND BLOOD BIOCHEMISTRY REEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
lmao
It's lupus.
THATS WHAT ATTENDINGS DO.
>Wants full chart
>never heard of HIPAA
RRRRREEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
Turned out to be lupus
SLE?
I see, I was wondering where the homework threads were. Looks like you graduated.
Laughed a bit.
If you have no primary cause for the hypertension it's marked essential.
I have seen two cases were similar symptoms were due to haemoconcentration
Positive for cardiac enzymes or just creatinine
>tfw your doctor is so shit at his job he has to ask an anonymous anime imageboard to help him out
LMAO
?