Question

A 44-year-old woman is found to have a blood pressure
of 150/100 mm Hg on a routine physical examination following
a transient ischemic attack (TIA). Laboratory studies show
normal serum potassium, sodium, and natriuretic peptide
levels but increased plasma renin activity. Her urinary fractional
excretion of sodium is normal. Which of the following
vascular abnormalities is most likely to be seen on renal arterial
angiography?

Answer 1

Answer ) Fibromuscular Dysplasia

Old age woman around 45-50 yrs with Hypertension following TIA ( transient Iscahemic attack ) with High Plasma Renin activity but Normal FeNA ( Fractional excretional of Sodium ) all point towards Fibromuscular Dysplasia .

It is the vascular disease affecting Carotid artery and Renal Artery .Abnormal growth of the lining of arteries resulting in narrowing of arteries resulting in Hypertension .Radiologically seen as strings of beads appearance .High Blood pressure is because of increased RAAS(Renin Angiotensin Aldosterone Axis ) hence high Plasma Renin activity .Duplex ultrasound detect the diagnosis .Treatment is by Ballon Angioplasty .