Hyperaldosteronism

Question 1

describe renin-angiotensin system

Answer 1

low BP sensed by juxtaglomerular cells in afferent kidney arteriole – secretion of renin
liver secretes angiotensinogen – renin converts angiotensinogen to angiotensin I
ACE secreted by lungs converts angiotensin I to angiotensin II
Angiosin II stimulates secretion of aldosterone from adrenals

Question 2

what cells secrete renin in response to what?

Answer 2

juxtaglomerular cells in afferent kidney arteriole in response to low BP

Question 3

what does renin do

Answer 3

converts angiotensinogen to angiotensin I

Question 4

what secretes angiotensinogen

Answer 4

the liver

Question 5

what converts angiotensin I to angiotensin II

Answer 5

ACE

Question 6

what does angiotensin II do

Answer 6

stimulates aldosterone release from adrenals

Question 7

effects of aldosterone

Answer 7

increases sodium reabsorption

increases potassium excretion

Question 8

what is primary hyperaldosteronism

Answer 8

adrenal glands are directly responsible for producing too much aldosterone

Question 9

what is primary hyperaldosteronism known as

Answer 9

Conns syndrome

Question 10

what is the most common cause of Conns

Answer 10

adrenal adenoma secreting aldosterone

Question 11

what are the causes of Conns

Answer 11

adrenal adenoma
bilateral adrenal hyperplasia
adrenal carcinoma (rare)
familial hyperaldosteronism (rare)

Question 12

what will serum renin be like in Conns syndrome

Answer 12

Low renin as BP is high

Question 13

what is secondary hyperaldosteronism

Answer 13

excess renin stimulates adrenals to secrete high aldosterone

Question 14

causes of secondary hyperaldosteronism

Answer 14

renal artery stenosis
renal artery obstruction
HF

Question 15

What will serum renin levels be like in renal artery stenosis

Answer 15

High

Question 16

screening test for hyperaldosteronism

Answer 16

renin/aldosterone ration

Question 17

high aldosterone low renin

Answer 17

Conns syndrome (primary)

Question 18

high aldosterone high renin

Answer 18

secondary hyperaldosteronism

Question 19

electrolytes in hyperaldosteronism

Answer 19

High sodium

Low potassium

Question 20

symptoms of high aldosterone

Answer 20

HTN
polyuria 
polydipsia
muscle weakness + cramps
headaches

Question 21

investigations for hyperaldosteronism

Answer 21

CT/MRI of adrenals
Renal angiogram for stenosis
2L saline – if aldosterone levels don’t fall by 50% then there is a primary cause

Question 22

treatment of bilateral adrenal hyperplasia

Answer 22

spironolactone

Question 23

treatment of adrenal adenoma

Answer 23

surgical removal

Question 24

ABG result in conns

Answer 24

metabolic alkalosis