PAEA Surgery End Of Rotation (EOR) Practice Exam

Which condition is characterized by diastolic hypertension and requires an angiogram for diagnosis?

1. Raynaud's phenomenon

2. Subclavian steal syndrome

3. Renal artery stenosis

4. Takayasu's arteritis

The correct answer is: Renal artery stenosis

The condition characterized by diastolic hypertension that requires an angiogram for diagnosis is renal artery stenosis. This condition involves the narrowing of one or both renal arteries, which supply blood to the kidneys. The reduction in blood flow triggers the kidneys to release renin, leading to secondary hypertension, often with a noticeable diastolic component. An angiogram is a critical diagnostic tool in this instance, as it allows for direct visualization of the renal arteries and can reveal the extent and severity of the stenosis. This imaging helps confirm the diagnosis and aids in evaluating the need for potential interventions, such as angioplasty or surgical revascularization. In contrast, while the other options may present with various symptoms related to vascular conditions or hypertension, they are not primarily associated with diastolic hypertension or might not require an angiogram for diagnosis. For example, Raynaud's phenomenon mainly involves peripheral vascular issues and is diagnosed clinically. Subclavian steal syndrome involves collateral circulation due to blockages but does not exclusively lead to diastolic hypertension. Takayasu's arteritis, an inflammatory condition affecting the large vessels, may present with hypertension but typically requires additional clinical criteria for diagnosis rather than directly indicating an angiogram for renal artery evaluation.