renal phys ?

[patuit79]

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a 52 year old man is found to have HTN on a routine exam. a systolic bruit is heard over the left renal artery. angiography shows 95% obstructive lesion in the left renal artery, right renal artery is normal. the right kidney is 11cm and the left kidney is 8.5 cm. which of the following describes the most likely response to treatment?

A) decreased plasma renin and decreased aldosterone following administration of loop diuretic
B) decreased plasma renin following administration of ACE inhibitor
C) increased plasma renin and decreased AG1 following administration of loop diuretic
D) increased plasma renin following ACEI

i picked D because the renal artery stenosis will cause increased renin.

 

[Flobber]

a 52 year old man is found to have HTN on a routine exam. a systolic bruit is heard over the left renal artery. angiography shows 95% obstructive lesion in the left renal artery, right renal artery is normal. the right kidney is 11cm and the left kidney is 8.5 cm. which of the following describes the most likely response to treatment?

A) decreased plasma renin and decreased aldosterone following administration of loop diuretic
B) decreased plasma renin following administration of ACE inhibitor
C) increased plasma renin and decreased AG1 following administration of loop diuretic
D) increased plasma renin following ACEI

i picked D because the renal artery stenosis will cause increased renin.

I would agree with that... diuretics won't fix the stenosis, the reduced renal blood flow to the stenosed kidney is going to continue pissing it off, hence the elevated renin. Then, you piss it off more by rendering the renin useless (ACEI) ----> more renin.

 

[OSUdoc08]

a 52 year old man is found to have HTN on a routine exam. a systolic bruit is heard over the left renal artery. angiography shows 95% obstructive lesion in the left renal artery, right renal artery is normal. the right kidney is 11cm and the left kidney is 8.5 cm. which of the following describes the most likely response to treatment?

A) decreased plasma renin and decreased aldosterone following administration of loop diuretic
B) decreased plasma renin following administration of ACE inhibitor
C) increased plasma renin and decreased AG1 following administration of loop diuretic
D) increased plasma renin following ACEI

i picked D because the renal artery stenosis will cause increased renin.

Note that ACE inhibitors increase renin in a healthy patient, as well.