conn's syndrome

Question 1

etiology?

Answer 1

solitary adenoma or bilateral hyperplasia

Question 2

define and give pathophysiology?

Answer 2

primary hyperaldosteronism

unsuppressed aldosterone (part of RAAS) causes reuptake of sodium -> seronegative lumen -> K+ secretion

this causes hypernatremia, hypertension, hypokalemia, metabolic alkalosis

Question 3

symotoms?

Answer 3

resistant hypertension to 3 antihypertensive drugs

hypokalemia: muscle weakness and cramps, fatigue, headaches

Question 4

screening and confirmatory tests?

Answer 4

screening test is aldosterone: renin ratio. High means positive screening

confirmatory is normal saline infusion test or fludrocortisone intake -> unsuppressed aldosterone

or

high sodium intake for 3 days then do urine aldosterone measurement. will be high if positive

do adrenal CT to determine etiology

Question 5

treatment?

Answer 5

adenoma: resection

bilateral hyperplasia: ARB (spironolactone/ eplrenone)