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Medicine

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Cardiology

Question
20 out of 36
 

Most common cause of renal artery stenosis in young adults in India is: (AIIMS Nov 2012)



A Atherosclerosis

B Non-specific aorto-arteritis

C Fibro muscular dysplasia

D None of the above

Ans. B

Nonspecific aorto-arteritis

Causes of secondary hypertension

1. Renal disease:The most common Qsecondary cause.

a. Glomerulonephritis, (Acute & Chronic)

b. Chronic pyelonephritis,

c. Renovascular disease (Renal artery stenosis) most frequently atheromatous (elderly, cigarette smokers with periphery vascular disease) or fibro muscular dysphasia Q in young patients.

d. RAS, can occur in Takayasu disease but it does not occur in PAN. (LQ, AIPG 2012)

e. Polycystic kidneys.

f. Renin secreting tumor.

Extra Edge:

1. Best screening test for RAS is Gadollium enhanced MRI angiography. (PNQ) (Previously it used to be HRCT). 2. Most confirmatory test for RAS is conventional angiography. (MCQ)(Ref. Hari 18th ed., pg 2049, 2376)

2. Endocrine disease: Cushing's Q, Conn's syndromes Q, pheochromocytoma Q, acromegaly Q, Hyperparathyroidism. QHypothyroid, Hyperthyroid.

3. Connective tissue disorders - PAN, systemic sclerosis, Takayasu disease.

4. Others: Coarctation Q, porphyria Q, Guillain Barre syndrome

5. Pregnancy Q

6. Drugs : steroids Q, MAOI, oral contraceptive Pill', Amphetamine, Alcohol, NSAID

Extra Edge:

Table 247–4. Example of Mendelian Forms of Hypertension (Ref. Hari-18th ed., Pg- 2051)

Autosomal recessive

Autosomal dominent

1. 17α-hydroxylase deficiency

2. 11β-hydroxylase deficiency

3. 11β-hydroxysteroid dehydrogenase deficiency (apparent mineralocorticoid excess syndrome)

1. Liddle's syndrome

2. Pseudohypoaldosteronism type II (Gordon's syndrome)

3. Polycystic kidney disease

4. Pheochromocytoma

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