adrenals

Question 1

what is Conn’s syndrome

Answer 1

excess aldosterone (hyperaldosteronism)

Question 2

cause of Conn’s syndrome

Answer 2

benign adrenal cortical tumour (in zona glomerulosa)

Question 3

2 clinical features of Conn’s syndrome

Answer 3

hypertension and hypokalaemia (on top of excess aldosterone)

Question 4

how to diagnose Conn’s syndrome between primary and secondary hyperaldosteronism

Answer 4

to excluse secondary hyperaldosteronism, renin-angiotensin system should be suppressed

Question 5

how is Conn’s syndrome treated

Answer 5

mineralocorticoid receptor antagonist

Question 6

2 examples of mineralocorticoid receptor antagonists used to treat Conn’s syndrome

Answer 6

spironolactone, epleronone

Question 7

mechanism of action of spironolactone to treat Conn’s syndrome

Answer 7

treats primary hyperaldosteronism by being converted to several active metabolites, including canrenone, which is a competitive agonist against mineralocorticoid receptors

Question 8

effect of spironolactone in kidney tubules

Answer 8

blocks Na+ reabsorption and K+ excretion (K+ sparing diuretic)

Question 9

2 unwanted actions of using spironolactone to treat Conn’s syndrome

Answer 9

not very specific to mineralcorticoid receptor: menstural irregularities (binds to and stimulates progesterone receptor), gynaecomastia (inhibits androgen receptor)

Question 10

mechanism of action of epleronone to treat Conn’s syndrome, and relative tolerance vs. spironolactone

Answer 10

similar to spironolactone (mineralcorticoid receptor antagonist with similar affinity), but less binding to progesterone and androgen receptors so better tolerated