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  #1  
Old 08-03-2011
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Question Smaller kidney

A 39-year-old woman is found to have a blood pressure of 160/105 mm Hg while at a free health screening clinic. She feels fine and has had no major medical problems in her life. An abdominal ultrasound reveals that the left kidney is smaller than the right, but that neither is cystic and no masses appear to be present. MR angiography reveals focal narrowing with thickening and beading of the left main renal artery. A urinalysis reveals no abnormal findings. She has an elevated plasma renin. Which of the following is the most likely diagnosis?

A Diabetes mellitus

B Antiphospholipid syndrome

C Fibromuscular dysplasia

D Thrombotic thrombocytopenic purpura

E Cholesterol emboli syndrome
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  #2  
Old 08-03-2011
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I would go with C
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Old 08-03-2011
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Quote:
Originally Posted by usmle2011 View Post
A 39-year-old woman is found to have a blood pressure of 160/105 mm Hg while at a free health screening clinic. She feels fine and has had no major medical problems in her life. An abdominal ultrasound reveals that the left kidney is smaller than the right, but that neither is cystic and no masses appear to be present. MR angiography reveals focal narrowing with thickening and beading of the left main renal artery. A urinalysis reveals no abnormal findings. She has an elevated plasma renin. Which of the following is the most likely diagnosis?

A Diabetes mellitus

B Antiphospholipid syndrome

C Fibromuscular dysplasia

D Thrombotic thrombocytopenic purpura

E Cholesterol emboli syndrome
fibromuscular dysplasia focal sclerosis
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  #4  
Old 08-04-2011
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yes C cuz of beading pattern and focal narrowin!
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  #5  
Old 08-04-2011
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definitely c
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  #6  
Old 08-04-2011
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fibromuscular dysplasia-c
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Old 08-04-2011
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Default Explanation

(C) CORRECT. Fibromuscular dysplasia is an uncommon but surgically treatable cause for hypertension. Beading pattern and focal narrowing are the pointers.The abnormal segment of artery can be treated with angioplasty or removed and replaced with a graft.
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