Secondary Causes of Hypertension....GO!

24 year old Japanese male, admitted for HTN. In a guy his age, has to be a secondary cause.

DDx was as follows:

• Renal Artery Stenosis - ruled out: BUN & Creatinine were wnl
• Hyperaldosteronism
• Phaeochromocytoma - abdominal CT orderdered, as well a 24hr urine for VMA
• Coarctation of the aorta - ruled out w/ CXR
• a couple others that I can't remember

Patient also had raised ICP (papilloedema), secondary to a Colloid cyst; Dr. M was thining possible Benign intracranial hypertension (formerly known as Pseudotumor cerebri.)

So, as it turns out, the guy is just from Guam, where everyone seems to have high blood pressure. Pt's father died @ 40yrs from MI, all siblings also have HTN. So it was a simple familial/environmental thing, but as Dr. M put it, this is "real internal medicine; none of that 'when can we send them back to the nursing home?' stuff". I found it quite the interesting case. Didn't enjoy being pimped on the causes though (was one of our SAQs back in first sememster when we did CVS - didn't do so well then either lol).

Today's pimp question from Dr. A: Name the 6 classes/types of Cardio-protective drugs/agents:

1. ACE-I/ARBs
2. Beta-blockers
3. Statins
4. Heparin/Lovenox (LMWH)
5. TPA/Thrombolytics
6. ASA/Aspirin

(I was going to put links to all of them...then realized that I use wikipedia for everything, so you can look them up yourselves, if interested :-D)

In other news, ACLS class is tomorrow and Saturday. I should go prepare for that...O:-)

-AMiB