Answer:
Mayo Foundation for Medical Education and Research
38-Year-Old Woman With Hypertension, Headaches, and Abdominal Bruit
Mira T. Keddis, MD and Vesna D. Garovic, MD
Additional article information
A 38-year-old woman presented to her local clinic for recurrent episodes of headache of several weeks' duration. Evaluation revealed a blood pressure of 202/136 mm Hg. The patient was prescribed 37.5 mg of triamterene with 25 mg of hydrochlorothiazide (1 tablet) twice daily and 50 mg of atenolol once daily.
Her blood pressure remained elevated, and her headaches persisted. She was referred to the hypertension clinic for further management.
The patient's medical history was remarkable for preeclampsia during her second pregnancy 9 years previously. She smoked half a pack of cigarettes per day for 15 years. Her alcohol use was limited to social gatherings and consisted of 1 to 2 drinks monthly. She exercised regularly and had a balanced low-salt diet. Essential hypertension was common on her maternal side.
On physical examination, the patient's blood pressure was 172/100 mm Hg (both arms), and her heart rate was 90 beats/min. Findings on funduscopic examination were normal. Cardiac examination revealed a grade 2/6 systolic ejection murmur at the right upper sternal border. Abdominal examination was remarkable for a systolic-diastolic bruit present over the right midabdomen without palpable masses. No evidence of pitting edema was observed, and findings on lung examination were normal.
Initial work-up included the following (reference ranges shown parenthetically): hemoglobin, 14.1 g/dL (12.0-15.5 g/dL); creatinine, 0.8 mg/dL (0.7-1.2 mg/dL); sodium, 139 mEq/L (135-145 mEq/L); potassium, 4.2 mmol/L (3.6-4.8 mmol/L); bicarbonate, 29 mEq/L (22-29 mEq/L), and calcium, 9.5 mg/dL (8.9-10.1 mg/dL). Findings on electrocardiography were normal.
On the basis of this patient's clinical context, which one of the following is the most likely diagnosis?
Anxiety
Essential hypertension
Secondary renovascular hypertension due to atherosclerotic renal artery stenosis
Secondary renovascular hypertension due to fibromuscular dysplasia (FMD)
Hypertension associated with renal insufficiency
Anxiety can be associated with episodes of dramatic but temporary elevations in blood pressure. This patient's hypertension appears to be persistently elevated, which argues against this diagnosis.
Essential hypertension commonly occurs in middle-aged people who are usually asymptomatic with normal findings on physical examination.1 Secondary hypertension, defined as the presence of a specific condition known to cause hypertension, may affect up to 10% of hypertensive patients. It commonly presents as resistant hypertension, defined as an inability to control blood pressure despite the concurrent use of 3 antihypertensive agents, one of which is a diuretic.2 Our patient's severe stage 2 hypertension (defined as a systolic blood pressure ≥160 mm Hg and/or a diastolic blood pressure ≥100 mm Hg), young age, and inadequate response to blood pressure therapy argued against essential hypertension and raised suspicion for secondary causes.
Renovascular hypertension results from critical stenosis of the renal arteries. When the stenosis is sufficiently severe (ie, causing ≥75% diameter reduction), renal hypo perfusion ensues, leading to up-regulation of renin in the affected kidney. Consequent stimulation of angiotensin II and aldosterone leads to vasoconstriction and salt retention, respectively, which play a central role in the development of renovascular hypertension. Abdominal bruits, particularly those that have a diastolic component and lateralize to the renal areas, are suggestive of renal artery stenosis. Our patient's clinical presentation was highly suggestive of renal artery stenosis. Although atherosclerotic renal artery stenosis usually occurs in elderly patients with cardiovascular comorbid conditions such as hyperlipidemia and coexisting atherosclerotic vessel disease, fibromuscular dysplasia commonly affects young women with a history of smoking.3 Considering our patient's age, sex, and history of smoking, renovascular hypertension due to renal artery stenosis secondary to fibromuscular dysplasia was the most likely diagnosis. Hypertension associated with renal insufficiency was less likely given the negative findings on physical examination, normal kidney function, and absence of significant proteinuria on urinalysis.
Although Laura is working in a group with others, her tendency to engage in social loafing will likely decrease if __________. A. individual productivity of group members is not evaluated by others B. the group encourages task involvement C. the group is large and incohesive D. Laura has low achievement motivatio
Answer:
The answer is B
Explanation:
Laura's tendency to engage in social loafing will likely decrease if the group encourages task involvement (Option B).
What is social loafing?The expression 'social loafing' makes reference to a psychological process that occurs when persons work less in a group environment.
This attitude (social loafing) may lead to a significant decrement in productivity.In conclusion, Laura's tendency to engage in social loafing will likely decrease if the group encourages task involvement (Option B).
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Professor Devine and her colleagues are interested in assessing whether active versus passive play causes a preference for sweet or salty foods in toddlers. They assign groups of children to either an active play, passive play, or no play group and record their food choices when presented with a variety of sweet and salty foods. In this study, ________ is the independent variable and ________ is the control group.
Answer:
type of play, no play
Explanation:
In a study, the independent variable is the variable that isn't changed by the other variables during the experimental procedure. On the other hand, the dependent variable is the variable being tested/measured during the experiment (in this case, children's food choice), and therefore this variable is 'dependent' on the independent variable. Finally, the control group is the group where the independent variable is not manipulated, i.e., the group where participants do not receive the experimental treatment. A control group enables the establishment of causal-effects relationships by isolating the effects of the independent variable.
Professor Devine and her colleagues are interested in assessing whether active versus passive play causes a preference for sweet or salty foods in toddlers. They assign groups of children to either an active play, passive play, or no play group and record their food choices when presented with a variety of sweet and salty foods. In this study on health, active play and passive play is the independent variable and no play is the control group.to understand more about the subject.....
VariableA variable represents a measurable attribute that changes throughout an experiment, verifying the results. These attributes have different measures, depending on the variables, the context of the study or the limits that the researchers consider.
With this information, we can conclude that the active play and passive play group will be variables in Health, and the no play group will be the control group, because it will be in normal conditions.
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which of the following do play an important role in maintaining balance?
Which activity is an unhealthy way of easing the emotional pain of depression?
Which phase is shown in the picture below?
A) Prophase I
B) Metaphase II
C) Anaphase I
D) Anaphase II
You can use dish soap to wash your hands if hand soap is not available.
True
False
Answer:
true
Explanation:
Help pls!! QUESTION 7 HELP PLS!! I WILL MARK YOU THE TOP COMMENT!! TANK YOUU!
Answer:
I think it would be False
Answer:
True
Explanation:
By taking control and saying that you don't want to smoke a cigarette is stress management. Cigarettes were proven to increase stress and anxiety.
One of the stress management techniques is to learn how to say no – both on a professional and personal level. You should never take on more than you can handle as this will be a definite recipe for stress.
Describe the kinds of peer pressure likely to most strongly influence your decisions about substance abuse
MATCH THESE PLS!! Help pls!! QUESTION HELP PLS!! I WILL MARK YOU THE TOP COMMENT!! TANK YOUU!
Answer:
1.c
2.e
3.b
4.a
5.d
Explanation:
just trust me
cut your cloth according to your size explain it
Answer:
do what you want to do what you deserve it.do not ask for impossible.enjoy in what you have.
Many teen have more control over what they eat then children do. True or false?
Many teens from habits of eating foods that are low in fat and calories true or false?
Answer:
1. True
2. False
Explanation:
Teens do have a bigger ability to choose what they eat, since they are more independent because they become a teen. Also, they can also make their own food or shop for their own food, so the answer to this question is True.
Teens are more likely to eat unhealthy, and they do not form good habits over eating. They are more likely to consume foods that are high in fat and calories. So, the answer to this question has to be false.
The answers are 1. True, and 2. False.
50 POIINTS PLEASE JUST WRITE A SHORT ESSAY ABOUT THIS
Assignment Summary
For this assignment, you will construct a personal dietary plan that is reflective of your current diet in terms of its nutritional value. Before creating this plan, you will conduct research to explore current dietary guidelines. You will also evaluate personal barriers, and internal and external influences, to setting nutritional goals, and making food choices. You will use a food log to monitor the progress of meeting these goals. This log will help track your eating habits over the course of five days. After your entire dietary plan is constructed, you will evaluate whether healthy daily nutritional values are being met. You will then participate in a small group discussion.
Answer:
1. good diets: A good nutritional diet that I would recommend would be drinking lots of green juices, taking supplement pills like fish oil, cod liver and so on. Some goals that I would set to doing this would be waking up early meditating, finishing school early eating LOTS of veggies. I really hope this helps sorry for such a late response :)
Green, fresh fruits and vegetables, as well as freshly cooked foods with no usage of processed and refined products, should be included in the diet plan to maintain a healthy body.
What are the benefits of eating a fresh and healthy diet?It is recommended by the health sector organization to eat clean and safe foods such as fresh fruits and vegetables and freshly prepared meals with least or no use of refined oil, and physical exercise should be added to the daily routine to boost the metabolism rate. Trans fats and processed foods should be avoided because they increase the risk of heart and blood vessel disease, and along with all these, the daily food intake should be controlled too.
Hence, green, fresh fruits and vegetables, as well as freshly cooked foods with no usage of processed and refined products, should be included in the diet plan to maintain a healthy body.
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who is more likely to develop type 1 diabetes 35yr old 70yr old 10yr old 50yr old
Answer:
10 year old
Explanation:
Type 1 diabetes is normally diagnosed before the age of 40 but most diagnoses occur in children between the ages of 4 and 14 years old.
hope it helps
Social settings and time of day are examples of hereditary factors that influence weight status true or false?
Parents have great influence over a child’s eating habits true or false?
Answer:
1. false
2. true
Explanation:
1. Hereditary factors refer to things that can be passed from parents to their offspring. An example of these are the "genes." Social settings and time of the day cannot be passed from parents to offspring, therefore, these are not hereditary factors.
2. Parents play a major role in influencing their kids' eating habits since children are great imitators. If they see their parents eating junk foods all the time, then they'd surely do the same way.
Prompt
The unit has several recommendations for organizing and storing food. How could you apply one of these to your family? Or
give examples of how your family organizes your kitchen that works well.
Write at least 80 words please
Answer:
label cabnits
Explanation:
first first we start by separating everything canned goods we can good separate them down to veggies can meat fruit and stack them neatly on the shelf the label the outside the cabinet then we move on to the cups place balls together put them in one stock all the place together all the bowls together all the cups together label the cabinet then we go over to the upper cabinets and we do all of our bag drives bag beans anything that say if a mouse cut in could get into it we put in the forecast and label them
Answer: bro on top right
Explanation:
:)
HELL FAST PLEASE
4. What does it mean if someone has a predisposition for asthma?
That person lives in an environment with polluted air, tobacco smoke, or animal dander.
That person is more likely than the average individual to develop asthma.
That person is guaranteed to develop asthma at some time in his or her life.
That person has a natural Immunity to asthma and will not develop it.
Answer:
the answer is That person is more likely than the average individual to develop asthma.
Explanation:
I got it right on my quiz.
If someone has a predisposition for asthma, it means that they are more likely than the average individual to develop asthma. It does not guarantee that they will definitely develop asthma, but it indicates an increased susceptibility or risk for developing the condition.
The options provided in your question can be clarified as follows:
1. That person lives in an environment with polluted air, tobacco smoke, or animal dander: Living in an environment with these factors can contribute to the development or exacerbation of asthma symptoms. However, it does not necessarily mean that someone with a predisposition for asthma will definitely live in such an environment.
2. That person is more likely than the average individual to develop asthma: This statement accurately reflects the concept of a predisposition. Individuals with a predisposition for asthma have a higher likelihood of developing the condition compared to those without such a predisposition.
3. That person is guaranteed to develop asthma at some time in his or her life: Having a predisposition for asthma does not guarantee that someone will develop asthma. It means they have an increased risk, but other factors, such as environmental triggers or genetic predisposition, may also influence the development of the condition.
4. That person has a natural immunity to asthma and will not develop it: A predisposition for asthma implies an increased susceptibility or risk for developing asthma, not immunity. Having a predisposition indicates a higher likelihood, rather than an absence, of developing the condition.
It's important to note that asthma is a complex condition influenced by various genetic and environmental factors. While a predisposition may increase the likelihood of developing asthma, it does not determine the certainty or timeline of its development.
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Your appetite is learned and shaped by factors in your environment and by your emotions.
True or False?
True
False
True!
When some people have an environment that makes them upset it is actually very common for them to not want to eat whereas they are not feeling happy. Also I know this is true because the term (stress eating) rises from this, meaning that somebody could literally become hungry just because they are stressed out. It is sadly a very common problem too because it is bad for health and nutrition to just skip out on a meal, of which this same process confuses the bodily system, possibly even resulting in either more stress or even anger.
Hope this helps.
。 . . 。 ඞ ඞ ඞ ඞ ඞ ඞ ඞ 。 . • . [Northstar] was ejected. . . 。 . 。 ﾟ . . , . . .. 。 • ﾟ 。 . . . 。。 • ﾟ 。 . . . 。。 • ﾟ 。 . . . 。。 • ﾟ 。 . . . 。
Reducing, reusing, and recycling in your office is likely to _______.
a.
increase pollution
b.
conserve energy
c.
sustain greenhouse gas levels
d.
damage the environment
Please select the best answer from the choices provided
Answer:
B
Explanation:
Which activity is an unhealthy way of easing the emotional pain of depression?
Answer:
Watch Anime.
Explanation:
just watch anime.
the jones household has a net income of 4,000 each month. There are two adults and three school aged children in the household, so they spend 15 percent of their net income on groceries. How much do the jones spend each month?
Answer:
$3,000
Explanation:
The computation of the jones spend each month is as follows:
Net income is $4,000
Two adults, three school aged children i.e. 5 people
Each spend 15% so for all it would be 75%
Now the spending amount would be
= $4,000 × 0.75
= $3,000
Choose the three priority healthy lifestyle choices that are important in helping you prevent disease, get and remain fit, and enjoy a good quality of life.
Question 6 options:
Heredity
Effective Stress Management
Regular Physical Activity
Sound Nutrition
Affordable Health Care
The three priority healthy lifestyle choices that are important in helping you prevent disease, get and remain fit, and enjoy a good quality of life are Regular Physical Activity, Sound Nutrition, and Affordable Health Care. Hence options C, D, and E are correct.
Regular physical activity. Physical activity helps to keep your body strong and healthy. It can help to lower your risk of heart disease, stroke, type 2 diabetes, and some types of cancer. It can also help to improve your mood, sleep, and energy levels.
Sound nutrition. Eating a healthy diet is essential for good health. A healthy diet includes plenty of fruits, vegetables, and whole grains. It also includes lean protein and healthy fats.
Eating a healthy diet can help to lower your risk of chronic diseases, such as heart disease, stroke, type 2 diabetes, and some types of cancer. It can also help you to maintain a healthy weight.
Effective stress management. Stress can take a toll on your physical and mental health. Effective stress management techniques can help you to reduce stress and improve your overall health.
Some effective stress management techniques include yoga, meditation, deep breathing, and spending time in nature.
Therefore, options are C) Regular Physical Activity, D) Sound Nutrition, and E) Affordable Health Care are correct.
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why does cheese have holes???
How common is Anorexia in the US?
Answer:
The incidence of anorexia is around eight per 100,000 persons per year. Hope this helps! =)
A radioactive iodine uptake test (RAIU) tests for a disorder of what gland?
thymus
thyroid
pituitary
adrenal
Answer:
Explanation:
https://uxmag.com/articles/seven-ux-best-practices-of-community-design
and yes this possible. I am just trying to see if we can add a link as an Answer in Brainly.
What is the link between IBS and mental conditions?
Answer:
IBS is a painful condition associated with significant psychological distress and psychiatric comorbidities, like higher levels of anxiety or depression and suicidal idealization, with negative impact on quality of life
Explanation:
Why is it important for us that we identify the proper posture, body position and the mechanics in executing the "set" skill in volleyball.
"A volleyball set is an over the head pass to a hitter so they are able to spike the volleyball over the volleyball net. A hitter wants a setter they can trust to put the ball where it needs to be when it is supposed to be there."
source: myosource.com
What is not one of the seven health skills that will help achieve maintain and protect physical health?
A. dieting
B. Self-management
C. Advocacy
D. Goal setting
Answer:
A. dieting
Explanation:
The seven health skills are the following: Accessing Information, Analyzing Influences, Making Healthy Decisions, Goal Setting, Interpersonal Communication, Self-Management and Advocacy.
Clearly, dieting is not part of it because not all diets are good for the health. An example of this is too restrictive dieting, which prevents a person from taking in essential nutrients in the body. This, therefore, doesn't help protect a person's health.
Answer:
A. dieting
Explanation:
Have a great day
26. A good exercise program is one that conforms to the intent of the saying, "No pain, no gain." Do you agree or disagree? Defend your answer.
Answer:
Yes
Explanation:
If you don't feel any pain or burning then it's not really working.
A good exercise program should prioritize safety, sustainability, and individual needs, rather than embracing pain as a measure of success.
I respectfully disagree with the notion that a good exercise program should adhere to the saying, "No pain, no gain." While it is true that some level of discomfort or effort is often necessary for progress, the idea of embracing pain as a measure of success can be misleading and potentially harmful. A well-designed exercise program should prioritize safety, sustainability, and individual needs.
Pushing beyond one's limits to the point of pain can lead to injuries, burnout, and discouragement. It's more beneficial to focus on progressive overload, proper form, and gradual improvements. By listening to our bodies, finding a balance between challenge and enjoyment, and incorporating rest and recovery, we can achieve long-term results without unnecessary pain. Ultimately, sustainable gains come from a program that respects our physical and mental well-being.
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a patient must take 120 miligrams of medication per day each pill contains 30 miligrams of medication how many oills should the patient take
Select the phrase that correctly completes the statement.
An adult woman who has a (an)
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