A 60-year-old man presents with dizziness, nausea and severe shoness of breath of several months’ duration. Physical examination shows hepatomegaly, ascites and anasarca. His blood pressure is 200/115 mm Hg. An X-ray film of the chest demonstrates cardiomegaly and mild pulmonary edema. Although different mechanisms may have contributed to the pathogenesis of hypeension in this patient, the common end result for all of them is which of the following?
A 60-year-old man presents with dizziness, nausea and severe shoness of breath of several months’ duration. Physical examination shows hepatomegaly, ascites and anasarca. His blood pressure is 200/115 mm Hg. An X-ray film of the chest demonstrates cardiomegaly and mild pulmonary edema. Although different mechanisms may have contributed to the pathogenesis of hypeension in this patient, the common end result for all of them is which of the following?
💡 Explanation
**Core Concept**
The patient's symptoms and physical examination findings are indicative of severe, end-stage congestive heart failure (CHF) and severe hypertension. The question asks about the common end result of different mechanisms contributing to the pathogenesis of hypertension in this patient. The correct answer lies in understanding the pathophysiology of hypertension and its effects on the cardiovascular system.
**Why the Correct Answer is Right**
The common end result of different mechanisms contributing to the pathogenesis of hypertension is vasoconstriction and increased peripheral resistance leading to cardiac remodeling and hypertrophy. This is because increased blood pressure causes the heart to work harder, leading to increased wall tension and eventually, cardiac hypertrophy and fibrosis. The increased workload on the heart also leads to remodeling of the left ventricle, which can result in heart failure. The patient's symptoms of dizziness, nausea, and shortness of breath are likely due to the cardiac component of heart failure, while the physical examination findings of hepatomegaly, ascites, and anasarca are indicative of right-sided heart failure.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not relevant to the question and does not describe a common end result of hypertension.
* **Option B:** While cardiac hypertrophy is a common end result of hypertension, it is not the most accurate answer. Cardiac hypertrophy is a compensatory mechanism that allows the heart to adapt to increased workload, but it can eventually lead to heart failure.
* **Option D:** This option is not a direct consequence of hypertension and is not a common end result of its pathogenesis.
**Clinical Pearl / High-Yield Fact**
In patients with severe hypertension, it is essential to consider the possibility of cardiac hypertrophy and eventual heart failure. The J-shaped curve, which describes the relationship between blood pressure and cardiovascular mortality, highlights the increased risk of cardiovascular events at both low and high blood pressure levels.
**Correct Answer: C. Cardiac hypertrophy**
✓ Correct Answer: D. Increased peripheral vascular resistance
📤 Share this MCQ
Share Card Preview
👆 1080x1080 square card — fills the full width in WhatsApp and Telegram