S*****4
发帖数: 153 | 1 【 以下文字转载自 Pre_Resident_Club 俱乐部 】
发信人: Sahara4 (ninimomo), 信区: Pre_Resident_Club
标 题: CK NBME form 2 block 3 Q2
发信站: BBS 未名空间站 (Tue May 31 15:24:20 2011, 美东)
A or C? CK super cow, would you please help for some expaination?
A 15-year-old girl is brought to the physician 3 months after she had a
blood pressure of 150/95 mm Hg at a routine examination prior to
participation in school sports. She is asymptomatic
and has no history of serious illness. Twelve months ago, she was
diagnosed with a urinary tract infection and treated with oral
trimethoprim-sulfamethoxazole. She currently takes no medications.
Subsequent blood
pressure measurements on three separate occasions since the
last visit have been: 155/94 mm Hg, 145/90 mm Hg, and 150/92 mm Hg. She is
at the
50th percentile for height and 95th percentile for weight. Her blood
pressure today is 150/90 mm Hg confirmed by a second measurement, pulse
is 80/min, and respirations are 12/min. Examination shows no other
abnormalities. Her hematocrit is 40%. Urinalysis is within normal limits.
Cardiac and renal ultrasonography shows no abnormalities. Which
of the following is the most appropriate next step in management?
A) Exercise and weight reduction program
B) Measurement of urine catecholamine levels
C) Measurement of urine corticosteroid levels
D) Captopril therapy
E) Hydrochlorothiazide therapy |
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