L********r
发帖数: 37 | 1 2. 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
What is the answer? Why? | S******9
发帖数: 2837 | | h**s
发帖数: 1757 | 3 i would like to pick C.
I do not think this girl is essential HTN. She could be secondary HTN.
cushing's syndrome is the best diagnosis (She is at the 50th percentile for
height and
95th percentile for weight). so you'd better check cortisol.
refer: FA P63. | S******9
发帖数: 2837 | 4 great ！
for
【在 h**s 的大作中提到】
: i would like to pick C.
: I do not think this girl is essential HTN. She could be secondary HTN.
: cushing's syndrome is the best diagnosis (She is at the 50th percentile for
: height and
: 95th percentile for weight). so you'd better check cortisol.
: refer: FA P63.
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