Welcome. My name is Divine. This is episode 529 of the Divine Intervention Podcasts.

In today's podcast, we're going to be continuing the series on the Step 2CK Free 120.

This is the 20241, the one that's on the website right now.

And this is going to be part 10. We've done 70 questions so far in the series. So we're going to go ahead and pick up from where we stopped. So let's get right into it. So question 71. A 22 year old man comes to the office for a health maintenance examination. He feels well and has not noticed any health issues. He is in the U.S. Army.

Two months ago, he returned from a 10-month deployment to Southwest Asia, during which he started

smoking one pack of cigarettes daily. The patient says he is happy to be home and has been celebrating with his friends and family.

He has been consuming an average of six beers daily since returning to the United States.

He has no history of major medical illness. He does not use any medications or other substances.

His mother has type 2 diabetes militus. The patient is 180 centimeters,

that's 5.11 inches tall and weighs 72 kilograms. That's 160 pounds. His BMI is 22 kilograms per

meter squared. His first blood pressure reading is 156 over 95 millimeters of mercury. Repeat

reading is 160 over 92 millimeters of mercury. He says he remembers his blood pressure being normal

when he had checked in the past. Physical examination discloses no other abnormalities,

which of the following is the most likely cause of this patient's increased blood pressure.

Option A says cigarette smoking.

Option B says essential hypertension.

Option C says excessive alcohol use.

Option D says feochromosytomaoma option E says Rinal artery stenosis so what factor that's present in the Q-STEM tells you that this

tells you why this person's blood pressure may be elevated well option E says cigarette smoking

well here's the thing this person was also smoking when he was out of the country. And it doesn't seem like he had high blood pressure when it was out of the country. So I think I'd rule out option A. Option B says essential hypertension. Essential hypertension is usually going to be usually probably the most likely

cause of hypertension in most people. But that's typically going to be in the person that is unhealthy,

you know, obesity, which this person is not obese, obesity, metabolic syndrome kind of deal.

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