ENDOCRINOLOGY- ADRENAL DISORDERS Flashcards
What is the clinical presentation of primary aldosteronism ?
Hypertension with hypokalaemia
What is the the most common causes of primary aldosteronism ?
Bilateral Adrenal Hyperplasia
2nd: Aldosterone producing adenoma
In Primary Aldosteronism , who do you want to screen ?
Hypertension < 40years of age
Drug resistant hypertension (on 3 anti hypertensive )
Hypertension + hypokalemia
What is the screening investigations for primary aldosteronism ?
What is your expected findings ? Negative ? Positive ?
Aldosterone / Renin ratio
-elevated ~ confirmation test
-normal ~ rule out PA
After the A/R ratio is elevated , how you want to further confirm ?
Fludrocortisone suppression test
Saline Infusion Test
-non suppressed ~ PA
For PA , what is the localization investigation ?
CT adrenal
Adrenal Vein Sampling (unilateral /bilateral)
For PA , what is the complication ? and How you want to screen ?
Heart failure - ECG
Kidney failure - Renal profile
What is the treatment for PA ?
Unilateral - adrenalectomy
Bilateral - MRA
Explanation:
-Unilateral PA can be treated with adrenalectomy, a surgery to remove the affected adrenal gland.
-Bilateral PA is more difficult to treat, as it is not possible to remove both adrenal glands. The main treatment for bilateral PA is mineralocorticoid receptor antagonists (MRAs), which are medications that block the effects of aldosterone.
What is the symptoms of phaeochromocytoma ?
Paroxysmal triad of pounding - headache , profuse sweating , palpitations
screening investigations of Phaeochromocytoma ? What findings did you suspect ?
24 hours catecholamine
Plasma metanephrine
-Raised
Localization investigation for Phaeochromocytoma
CT adrenal
Complication screening for phaeochromocytoma
ECG
RP
Peri operative medical management
Alpha blockade
Beta blockers
Calcium channel blockers
IV Drip
Excess salt and fluid
