Scenario number two: Discussant-Scott

Scott Soames’ Two-Dimensionalism

Principal Discussant

Renovascular hypertension has its experimental counterpart in the two-kidney, one clip model (Goldblatt hypertension). From the study of this model, a general pathophysiological scheme has evolved suggesting that temporal stages in the development and maintenance of hypertension are regulated by complicated hormonal and neural interrelations. The central roles played by the renin-angiotensin sy...

Clinical Conference Pseudopheochromocytoma Principal Discussant

A 52-year-old man was admitted to the Brigham and Women's Hospital (BWH) on August 21, 1984, for evaluation of a possible pheochromocytoma. He was first told of his hypertension at age 43 and was treated with /3-blockers, most recently nadolol (40 mg p.o q.d.) with "good control." On August 12, 1984, he was awakened from sleep with spasmotic midepigastnc pain, strong pulsations in his head, a f...

Acute myeloma kidney Principal discussant :

A 42-year-old man, who previously had been well, presented to his family doctor feeling ill after a business trip to India, where he had had an episode of diarrhea. There were no abnormal findings on examination apart from a blood pressure of 180/110 mm Hg. The urine had 3 + protein on dipstick testing, and a biochemical screen and full blood count were performed. The plasma creatinine was 264 ...

T \ imor - Dependent Hypertension Principal Discussant

First Admission The patient's blood pressure was found to be 150/ 110 mm Hg, and pelvic exam revealed a large pelvic mass. Intravenous pyelogram showed normal kidneys and collecting system; a pelvic soft tissue mass indented the bladder. Serum potassium was 2.8 mEq/liter, random peripheral plasma renin activity (PRA) was 52 ng angiotensin I (ANG I)/ml/hr (normal upper limit on a low salt diet =...