CHS Diagnosis and Evaluation 3

Question 1

Which test is the preferred initial screening for primary aldosteronism in a hypertensive patient?

Accepted Answer

Plasma aldosterone-to-renin ratio (ARR)

Answer

The plasma aldosterone-to-renin ratio (ARR) is the recommended first-line screening test for primary aldosteronism.

Question 2

A 35-year-old man has severe hypertension, hypokalemia, and metabolic alkalosis. Serum aldosterone is elevated and plasma renin activity is suppressed. The most likely diagnosis is:

Accepted Answer

Primary aldosteronism

Answer

Primary aldosteronism presents with high aldosterone, suppressed renin, hypokalemia, and metabolic alkalosis.

Question 3

Which renal artery imaging modality is preferred for screening renovascular hypertension in a patient with normal renal function?

Accepted Answer

Duplex ultrasound

Answer

Renal duplex Doppler ultrasound is the preferred non-invasive, radiation-free initial screen for renovascular hypertension.

Question 4

A 62-year-old diabetic with BP 145/88 mmHg has a urine albumin-to-creatinine ratio of 180 mg/g. This finding signifies:

Accepted Answer

Microalbuminuria indicating early kidney damage

Answer

A urine ACR of 30–300 mg/g defines moderately increased albuminuria (formerly microalbuminuria), indicating early hypertensive or diabetic kidney damage.

Question 5

The ankle-brachial index (ABI) is used in hypertension evaluation primarily to assess:

Accepted Answer

Peripheral arterial disease and atherosclerotic burden

Answer

ABI detects peripheral arterial disease, which reflects systemic atherosclerosis and elevates cardiovascular risk in hypertensive patients.

(CHS) Certified Hypertension Specialist Practice Test

(CHS) Certified Hypertension Specialist Practice Test

CHS Diagnosis and Evaluation 3