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Cardiac tumors

Cardiac tumors






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USMLE® Step 1 style questions USMLE

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A 55-year-old man is brought to the emergency department due to the acute onset of diffuse headache, blurry vision, and nausea that started 2 hours ago. His partner states that the patient has not visited a physician in several years. Medical history is significant for type 2 diabetes mellitus, hypertension and smoking 1 pack of cigarettes daily for 30 years. Temperature is 37.7°C (99.8°F), pulse is 90/min, respirations are 20/min, and blood pressure is 189/130 mmHg. On physical examination, the patient is confused and dyspneic. No neck pain or stiffness is noted. Lung auscultation reveals bilateral crackles without wheezing. Fundoscopic examination reveals bilateral blurring of the optic disc margins. The rest of the physical examination is within normal limits. Which of the following is the most likely diagnosis?

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ACE inhibitors p. 634

hypertension p. 323

Alcoholism p. 595

hypertension and p. 306

Angiotensin II receptor blockers p. 634

hypertension p. 323

Antihypertensive drugs

hypertension in pregnancy p. 667

Aortic aneurysm p. 308

hypertension p. 306

Aortic dissection p. 309

hypertension p. 306

Asthma p. 698

hypertension treatment with p. 323

Atrial fibrillation

hypertension as cause p. 306

β -blockers p. 247

hypertension p. 324

Calcium channel blockers p. 325

hypertension p. 325

Chronic kidney disease

hypertension and p. 306

Coronary artery disease

hypertension and p. 308

Diabetes mellitus p. 352-360

hypertension and p. 307, 323


hypertension treatment p. 323

Geriatric patients

isolated systolic hypertension p. 290

Heart failure p. 318

hypertension p. 306

hypertension treatment in p. 323

pulmonary hypertension p. 703

Hyperaldosteronism p. 356

hypertension with p. 306

Hypertension p. 306

ACE inhibitors for p. 634

alcohol withdrawal p. 595

aliskiren for p. 634

α-blockers for p. 245

angiotensin II receptor blockers for p. 634

aortic dissection and p. 309, 728

atherosclerosis and p. 308

atrial fibrillation and p. 298

autosomal recessive polycystic kidney disease p. 628

β -blockers for p. 247

Charcot-Bouchard microaneurysms p. 533

Cushing syndrome p. 354

ecstasy intoxication p. 595

endometrial cancer p. 665

episodic p. 345

Guillain-Barré syndrome p. 542

heart failure p. 323

hyperaldosteronism p. 356

immunosuppressants p. 118

intraparenchymal hemorrhage p. 532

isolated systolic p. 292

leflunomide p. 499

local anesthetics p. 571

loop diuretics for p. 632

MDMA p. 595

microangiopathic anemia p. 417

minoxidil p. 682

nephritic syndrome and p. 622

PCP p. 595

pheochromocytomas p. 345

placental abruption p. 664

polyarteritis nodosa p. 482

preeclampsia p. 667

in pregnancy p. 244

pregnancy p. 667

pseudoepherine/phenylephrine p. 711

renal cyst disorders p. 628

renal failure p. 626

sleep apnea p. 703

thiazides for p. 633

thoracic aortic aneurysms and p. 308

treatment for p. 323

tyramine p. 245

tyramine ingestion p. 599

Hypertensive urgency p. 306, 325

Isolated systolic hypertension p. 292

Kidney disease

hypertension p. 306

Labetalol p. 246

gestational hypertension p. 667

hypertension in pregnancy p. 323


hypertension in pregnancy p. 323


hypertension and p. 306


hypertension risk factors p. 306

Pregnancy p. 657

hypertension in p. 667

hypertension treatment in p. 244, 323

Primary hyperaldosteronism p. 356

hypertension with p. 306

Primary hypertension p. 323

Refractory hypertension p. 682


hypertension p. 306

Stroke p. 529

hypertension p. 306

Thiazide diuretics

hypertension p. 323


Over a billion people around the world have hypertension, or high blood pressure, so that pretty much means it’s pretty common. 

Let’s start by defining it. Typically, it’s represented by two numbers: the top number is the systolic blood pressure, which is the arterial pressure when the heart’s contracting; and the lower number is the diastolic blood pressure, which is the arterial pressure when the heart’s relaxing or refilling. Most of the time, blood pressure is taken in the brachial artery in your upper arm, because if the pressure is high there, it’s probably high throughout all of the arteries.

The guidelines for categorizing blood pressure have recently changed to reflect a growing body of evidence that shows that even moderately high blood pressures can significantly increase your risk for developing heart disease. Now, ‘normal’ systolic blood pressure is defined as less than 120 mmHg, and a normal diastolic pressure is less than 80 mmHg. Elevated systolic blood pressure is considered between 120 and 129 mmHg and less than 80 mmHg on the diastolic side. Stage 1 hypertension is between 130 and 139 mmHg on the systolic side, and between 80 and 89 mmHg on the diastolic side. Stage 2 hypertension is defined as anything that is 140 mmHg or higher on the Systolic side and 90 mmHg or higher on the diastolic side.

Typically, both systolic and diastolic pressures tend to climb or fall together, but that’s not always the case. Sometimes, you can have systolic or diastolic hypertension, when one number is normal and the other is really high. This is referred to as isolated systolic hypertension or isolated diastolic hypertension


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  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "Arterial hypertension" Hellenic J Cardiol (2013 Sep)
  5. "Arterial hypertension in the light of current recommendations" Terapevticheskii arkhiv (2018)
  6. "Gender-specific therapeutic approach in arterial hypertension – Challenges ahead" Pharmacological Research (2019)

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