Cardio Symposium Secondary Hypertension

Question 1

Conn’s Syndrome (primary hyperaldosteronism) Pathology

Answer 1

Excessive secretion of aldosterone of the adrenal gland

Question 2

Conn’s Syndrome (primary hyperaldosteronism) Signs and Symptoms

Answer 2

Musclular weakness due to hypokalaemia, hypertension due to salt and water retention

Question 3

Conn’s Syndrome (primary hyperaldosteronism) Tests

Answer 3

Function of the renin-angiotensin-aldosterone system.

→ CT scan to help localise the adenoma

Question 4

Conn’s Syndrome (primary hyperaldosteronism) Treatment

Answer 4

Surgical removal

Spironoacetone (Potassium-sparing diuretic)

Question 5

Renal artery stenosis Pathology

Answer 5

Stenosis of the renal artery may be caused by atherosclerotic plaques. It results in activation of the renin-angiotensin-aldosterone system

Question 6

Renal artery stenosis Signs and Symptoms

Answer 6

Symptoms and signs of atherosclerosis e.g. bruit over affected artery
ACE inhibitors may reduce renal perfusion and precipitate renal failure

Question 7

Renal artery stenosis Tests

Answer 7

Angiography

Question 8

Renal artery stenosis Treatment

Answer 8

Angioplasty and stenting or surgery

Question 9

Pre-eclampsia Pathology

Answer 9

Placental ischaemia results in release of agents that cause endothelial dysfunction.

Question 10

Pre-eclampsia Signs and Symptoms

Answer 10

Hypertension proteinuria +/- oedema occurring after week 20 of pregnancy

Question 11

Pre-eclampsia Tests

Answer 11

Liver function, renal function, platelet count and uric acid

Question 12

Pre-eclampsia Treatment

Answer 12

Antihypertensives, magnesium.

May required urgent delivery

Question 13

Phaeochromocytoma Pathology

Answer 13

Catecholamine secreting tumour often located in the adrenal medulla

Question 14

Phaeochromocytoma Signs and Symptoms

Answer 14

Paroxysmal (episodic) hypertension, pallor, palpitations, anxiety and abdominal pain

Question 15

Phaeochromocytoma Tests

Answer 15

24hr collection of urine to screen or elevated levels of catecholamine metabolites CT scan to help locate tumour.

Question 16

Phaeochromocytoma Treatment

Answer 16

Treatment with alpha- and beta adrenoceptor antagonists.

Surgical removal

Question 17

Cushing’s Syndrome Pathology

Answer 17

Inappropriate elevation of free corticosteroids e.g. by and adrenal tumour

Question 18

Cushing’s Syndrome Signs and Symptoms

Answer 18

Moon face, acne, hirsutism, buffalo hump, centra obesity and striaeMoon face, acne, hirsutism, buffalo hump, centra obesity and striae

Question 19

Cushing’s Syndrome Tests

Answer 19

Cortisol levels, urinary cortisol and dexamethasone suppression test CT scanning to help locate tumour.

Question 20

Cushing’s Syndrome Treatment

Answer 20

Surgical removal

Question 21

Coarctation of the aorta Pathology

Answer 21

Narrowing of the aorta most commonly where the ductus arteriosus joins aorta

Question 22

Coarctation of the aorta Signs and Symptoms

Answer 22

Raised blood pressure in upper limbs.
Systolic mumur heard posteriorly.
Weak femoral pulses and delayed in comparison to the radial pulses

Question 23

Coarctation of the aorta Tests

Answer 23

Notching of under surface of ribs due to collaterals

Question 24

Coarctation of the aorta Treatment

Answer 24

Surgical correction