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Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
• Cushing’s syndrome ... Pre-Eclampsia Renal ... Acute/Chronic renal ... failure • Renal ... • Scleroderma renal
Complications of Portal Hypertension
 • Hepatic Encephalopathy
 • Pulmonary: Hepatopulmonary syndrome, Portopulmonary hypertension, Hepatic hydrothorax
 •
Complications of Portal Hypertension ... Hepatopulmonary syndrome ... Portopulmonary hypertension ... Pancytopenia • Renal ... : Hepatorenal syndrome
Primary and Secondary Causes of Hypertension - Differential Diagnosis Algorithm
Primary (Essential) (95%) - Onset between age
Medications - Renal ... • Renal parenchymal ... and bilateral renal ... excess (Cushing syndrome ... Secondary #HTN #Cardiology
Pharmacologic Treatment of Hypertensive Emergencies in Pregnancy
Drug - Dose range - Onset/oeak/duration - Side effects
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Pharmacologic Treatment ... , fetal bradycardia ... bronchospasm; fetal ... , lupus-like syndrome ... Obstetrics #OBGyn #HTN #Pharmacology
Evaluation of Secondary Hypertension
 • Primary aldosteronism - PRA, PAC
 • Renal artery stenosis - Renal
Evaluation of Secondary Hypertension ... - PRA, PAC • Renal ... artery stenosis - Renal ... fT4 • Cushing syndrome ... PAC #Secondary #Hypertension
Localization of Renal Tubular Defects
Fanconi Syndrome: Proximal tubule
Bartter Syndrome: Thick ascending loop of Henle
Gitelman Syndrome: Distal
Localization of Renal ... Defects Fanconi Syndrome ... tubule Bartter Syndrome ... : Distal convoluted ... Nephron #Defects #Pathophysiology
Secondary Causes of Hypertension - Differential Diagnosis Algorithm
Hypertension - BP > 140/90 (>130/80 for DM)
Hypertensive urgency
Secondary Causes of Hypertension ... multi-drug resistance) Renal ... • Nephritic syndrome ... Excess: • Conn's syndrome ... Licorice • Liddle's syndrome
Pulmonary Renal Syndromes and Mimics - Differential Diagnosis Framework
Diffuse alveolar hemorrhage + rapidly progressive glomerulonephritis
90%:
 -
Pulmonary Renal ... Syndromes and Mimics ... Levels: Scleroderma Renal ... disease, Malignant hypertension ... AnnKumfer #Pulmonary #Renal
Cardiorenal Syndrome (CRS) Types
 • Type 1 - Acute CRS: Alteration of renal perfusion is the
Alteration of renal ... - Chronic CRS: Renal ... considered drug induced renal ... and VAD induced renal ... #CRS #Types #cardiology
Renal Effect of NSAIDs Inhibition of Prostaglandin Synthesis

 - Renal disease, Cardiovascular disease -> Decreased renal
Renal Effect of ... Synthesis - Renal ... disease -> Decreased renal ... Prostaglandins #Pharmacology ... #Pathophysiology