Hyperaldosteronism

Question 1

What is Primary Hyperaldosteronism?

Answer 1

Increase in Aldosterone independent of Renin angiotensin aldosterone system

Question 2

What are the features of Primary Hyperaldosteronism?

Answer 2

Hypokalaemia - Weakness, Hypotonia, Hyporeflexia
Parasthesia
Increased BP

Question 3

What are the causes of Primary Hyperaldosteronism?

Answer 3

Bilateral adrenal hyperplasia

Adrenocortical adenoma - Conn’s syndrome

Question 4

What investigations can be done in a patient with suspected Primary Hyperaldosteronism?

Answer 4

U+E: ↑/↔ Na, ↓K, alkalosis
Aldosterone:renin ratio: ↑
ECG - May show signs of Hypokalaemia
Adrenal CT/MRI

Question 5

What are the signs of Hypokalaemia on ECG?

Answer 5

Flattened/Inverted T waves
Depressed ST segment
Prolonged PR interval
Pseudoprolonged QT interval
U waves present

Question 6

What is the management of Primary Hyperaldosteronism?

Answer 6

Conn’s - Laparoscopic adrenelectomy

Adrenal hyperplasia - Spironolactone - aldosterone antagonist or amiloride causes ENaC to insert (Both K+ sparing)

Question 7

Define Secondary Hyperaldosteronism

Answer 7

↑ Aldosterone due to ↑ renin from ↓ renal perfusion

Question 8

What are the cause of Secondary Hyperaldosteronism?

Answer 8

Renin Angiotensin Aldosterone system
Diuretics
Congestive cardiac failure
Hepatic failure
Nephrotic syndrome
Bartter’s Syndrome (Activagtes RAAS)

Question 9

What investigations can be done to differentiate between Primary and Secondary Hyperaldosteonism?

Answer 9

Aldosterone:Renin ratio normal