pathophys Ques... - dr...b

[ArchivalUser]

A 56 yrs old person with right renal art. Occlusion 85%, lab values that best predict whether an operation that relieves the obstruction will reduce BP to normal is increase rennin activity in the

A- Left renal art vs right renal art.
B- Left renal vein vs right renal vein
C- right renal art vs. Left renal art
D- right renal vein vs Left renal vein

plz explain the ques. and answer, also what happens if right kidney is atrophy, will renin level increase than left or decrease... thanks

[ArchivalUser]

i think the concept here is that because Right renal artery is 85%occluded, so this kidney is making more renin which flows out through right renal vein, so now this renin would stimulate the whole renin angitensin aldosterone system n will cause increase in BP, this increase in BP would cause the normally perfused left kidney to produce low renin, so left renal vein has low renin......
so i think the answer is increased renin activity in right renal vein vs left renal vein ( where its low)..........D
probably with prolonged stenosis, the rt kidney wd undergo atrophy n may no longer produce renin

[ArchivalUser]

Goljan explains this in his audio 3, with atrophy, and i am confused a lot, if someone plz listen or read and explain, this will be nice.. i think he says that atrophy kidney has more renin than hypertrophy kidney... .. EXPLAIN plz... thanks

[ArchivalUser]

bb
right renal vein has already increased renin due to stenosis...

[ArchivalUser]

D
renin will be increase in the Rt renal Vein and decrease in the left renal vein

[ArchivalUser]

the question states...
...lab values that best PREDICT!!!
whether an OPERATION THAT RELIEVES THE OBSTRUCTION will reduce BP to normal is increase rennin activity in the

[ArchivalUser]

i know u guys are very helpful .. BUT i need more output on it, this is question from NBME forum 1 sec. 1, # 29,..............

thanks for ur time, plz explain..

[ArchivalUser]

hi dr b dr aa explained very well . ... i dont know why still u are not understanding need more explanation

[ArchivalUser]

my question now is that the after the surgery, Renin level will decrease in right renal vein...

[ArchivalUser]

after sugical correction of RRA's occlusion, renin levels in RRV will come back to normal, n of course there is no hyperreninemia so no HTN n hence the renin levels in LRV will also come back to normal