Question of the Week # 336

336) A 21 year old hispanic woman is evaluated in your office for recently diagnosed Hypertension. On previous two visits, her blood pressure was 150/90 mm HG. She denies any family history of Hypertension.  Her Past medical history is significant for multiple Urinary tract infections and enuresis as a child. She has no other complaints. On examination, her repeat blood pressure is 148/92 mm HG. There are no abdominal bruits. Ultrasonography reveals scarring of  both kidneys. Which of the following is an important feature of this condition?

A) Positive Anti-DsDNA

B) Strong Genetic Pre-disposition

C) Association with Berry aneurysms

D) Postural Hypotension

E) Abdominal Striae

14 Responses

  1. a

  2. might be b..this is not polycystic kidney..child has multiple UTI due to vesico ureteral reflux..lead to scarring of kidney..which lead to hytn now..

  3. ans c

  4. A

  5. b

  6. C) Association with Berry aneurysms

    • ADPKD does not present in chilhood.
      ARPKD that presents in childhood with recurrent UTI and Hypertention does not have extra renal manifestations nor does it have strong genetic predisposition since half the people with PKD have spontaneous genetic mutations.
      So its

      B) Strong Genetic Pre-disposition – VUR

  7. aa

  8. B-strong genetic predisposition.
    its not enlarge kidney polycystic for berry anurysm,neither cushingoid feature for abdominal striae,No feature of SLE

  9. The women with age of 21 yrs has repeated UTI and elivation of BP may be due to involment of kidneys(both) .The cause of thease infectious condition may be due to primarily with Prerenal conditon like Aneurysm secondaryay be due to immunological causes leads to renal disease.

  10. whats da right answer….Admin plz reply

  11. Answer is B. <30 years with HTN is most likely secondary htn. ho of repeated UTI with bilateral renal scar indicates that she probably has VUR that has strong genetic predisposition.
    A. is not correct. she does not have feature of SLE.
    C. Berry aneurysm is associated with Polycystic kidney disease. and USG exclude that condition.
    D. is not correct. Postural hypertension with hypertension can be occured in pheochromocytoma. but there is no history of episodic hypertension, flushing, sweating, pallor.
    E. Abdominal striae are feature of cushing syndrome. There is no other feature of cushing and it cannot explain renal scaring.

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