• ClipSaver
ClipSaver
Русские видео
  • Смешные видео
  • Приколы
  • Обзоры
  • Новости
  • Тесты
  • Спорт
  • Любовь
  • Музыка
  • Разное
Сейчас в тренде
  • Фейгин лайф
  • Три кота
  • Самвел адамян
  • А4 ютуб
  • скачать бит
  • гитара с нуля
Иностранные видео
  • Funny Babies
  • Funny Sports
  • Funny Animals
  • Funny Pranks
  • Funny Magic
  • Funny Vines
  • Funny Virals
  • Funny K-Pop

The Blood Pressure Creatinine Spiral in Renovascular Hypertension скачать в хорошем качестве

The Blood Pressure Creatinine Spiral in Renovascular Hypertension 2 года назад

скачать видео

скачать mp3

скачать mp4

поделиться

телефон с камерой

телефон с видео

бесплатно

загрузить,

Не удается загрузить Youtube-плеер. Проверьте блокировку Youtube в вашей сети.
Повторяем попытку...
The Blood Pressure Creatinine Spiral in Renovascular Hypertension
  • Поделиться ВК
  • Поделиться в ОК
  •  
  •  


Скачать видео с ютуб по ссылке или смотреть без блокировок на сайте: The Blood Pressure Creatinine Spiral in Renovascular Hypertension в качестве 4k

У нас вы можете посмотреть бесплатно The Blood Pressure Creatinine Spiral in Renovascular Hypertension или скачать в максимальном доступном качестве, видео которое было загружено на ютуб. Для загрузки выберите вариант из формы ниже:

  • Информация по загрузке:

Скачать mp3 с ютуба отдельным файлом. Бесплатный рингтон The Blood Pressure Creatinine Spiral in Renovascular Hypertension в формате MP3:


Если кнопки скачивания не загрузились НАЖМИТЕ ЗДЕСЬ или обновите страницу
Если возникают проблемы со скачиванием видео, пожалуйста напишите в поддержку по адресу внизу страницы.
Спасибо за использование сервиса ClipSaver.ru



The Blood Pressure Creatinine Spiral in Renovascular Hypertension

How to recognize patients who truly need a workup and who might have a more advanced case? https://www.medscape.com/viewarticle/... -- TRANSCRIPT -- Matthew F. Watto, MD: Welcome back to The Curbsiders. I'm Dr Matthew Watto, here with my great friend, Dr Paul Nelson Williams. We are going to be talking about renovascular hypertension. I don't know that I had a great grasp of what exactly this was before we talked with Dr Matt Luther about it on a recent podcast. How about you? Paul N. Williams, MD: Same. I have a much more concrete understanding of it, and it's more directly applicable to more patients than I previously recognized. Watto: Many textbooks give the impression that we should do a shotgun workup in every patient with resistant hypertension, with some sort of imaging for renal artery stenosis. A main take-home point from this discussion with Dr Luther is that you should not just go looking for it in every patient because most of these patients are not going to benefit from a revascularization procedure; you're just going to treat them medically. How would we recognize patients who truly need that workup, who might have a more advanced case? Williams: An example he gave was a patient whose hypertension had been imperfectly controlled with an ARB or calcium channel blocker, but then their blood pressure goes off a cliff — flash pulmonary edema, an acute hypertensive crisis that manifests as hypertensive encephalopathy, which is not common but can happen. If the patient had been reasonably well managed on the right medications, the dramatic episode of hypertension should prompt you to think about atherosclerotic renal artery stenosis rather than the fibromuscular dysplasia type. Watto: Those are probably the two big buckets that you should think of, at least from our perspective: the patient with risk factors for cardiovascular disease, such as atherosclerosis, or somebody without those risk factors who might have fibromuscular dysplasia. Dr Luther mentioned the "blood pressure and creatinine spiral." What's that about? Williams: It's a terrifying phenomenon and I will be reaching out to my friendly neighborhood nephrologist quickly. This happens when every time you escalate a patient's antihypertensive management, their creatinine level goes up. You're chasing the blood pressure and the creatinine worsens. You can't stop the antihypertensive because the blood pressure keeps climbing. That might be a tip that this is someone who has bilateral renal artery stenosis from atherosclerotic disease specifically. This might be one of the few instances when you would do something procedurally to fix the stenosis because everything seems to be going in the wrong direction, even though you're doing all the right things. Watto: Most of us think of the other type — fibromuscular dysplasia — as something seen primarily in young women. It can happen at any age, but classically it is a younger patient, often a younger woman. Think of this in a woman with early-onset hypertension, especially if it's accelerated, malignant, or resistant. It can also develop in someone with a single small kidney. Imaging might show a single small kidney without any other known uropathy. You might hear arterial bruits on exam. Dr Luther said he listens everywhere: brachial, carotid, abdominal. The patient might have fibromuscular dysplasia, and it's often treated with angioplasty, not even stenting, which can have a good outcome. We talked about treatment. Let's say you have someone with the blood pressure-creatinine spiral and you think maybe this is bilateral renal artery stenosis. It's been hard to prove that those patients benefit from revascularization, especially with mild cases. You definitely could be working with specialists and referring anyone like this. Let's talk about imaging. We think we have a case. We want to know what imaging to order. How do we go about that? Williams: I feel better about this after the conversation with Dr Luther. My typical approach previously was to start with ultrasonography because it's noninvasive and you're not worrying about the use of contrast. But he said he's been fooled by ultrasonography before, and renal disease can progress relatively quickly. You can have interval changes that might be missed with duplex ultrasonography. He likes CT angiography because you can get better definition, and there is also a role for MRI angiography. But if these patients have advanced kidney disease, these are off the table because you need contrast. In a certain subset of patients you can pass "go" and send them right for angiography as opposed to just imaging. https://www.medscape.com/viewarticle/...

Comments

Контактный email для правообладателей: [email protected] © 2017 - 2025

Отказ от ответственности - Disclaimer Правообладателям - DMCA Условия использования сайта - TOS



Карта сайта 1 Карта сайта 2 Карта сайта 3 Карта сайта 4 Карта сайта 5