Hyperaldosteronism (conn's) Flashcards

1
Q

What is hyperaldosteronism?

A

High levels of aldosterone

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2
Q

What are the main causes of hyperaldosteronism?

A

Unilateral benign adrenal adenoma
Or
Bilateral adrenal hyperplasia

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3
Q

What is the most common cause of hyperaldosteronism?

A

Bilateral adrenal hyperplasia

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4
Q

What is another term for primary hyperaldosteronism?

A

Conn’s syndrome

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5
Q

What are the 2 main presenting features of hyperaldosteronism?

A

Hypokalaemia
Hypertension
Metabolic alkalosis

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6
Q

What is Conn’s syndrome?

A

An adrenal adenoma producing too much aldosterone

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7
Q

What symptoms can present in primary aldosteronism due to hypertension?

A

Headaches and retinopathy

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8
Q

What symptoms can present in primary hyperaldosteronism due to hypokalaemia?

A

Paraesthesia
Muscle weakness
Cardiac arrhythmias

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9
Q

What does an excess of aldosterone cause?

A

Excessive aldosterone production causes
-Renal sodium retention
which is balanced by the loss of potassium and hydrogen ions in the distal convoluted tubule of the kidney.

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10
Q

What type of hormone is aldosterone?

A

Mineralocorticoid steroid hormone

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11
Q

What are the mian investigations for primary hyperaldosteronism?

A
  • plasma aldosterone
  • U&Es
  • High resolution CT abdomen
  • adrenal venous sampling
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12
Q

What would you see with plasma aldosterone: renin ratio in someone with hyperaldosteronism?

A

High aldosterone and low renin levels

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13
Q

What might you find in the U&E’s of someone with hyperaldosteronism?

A

Hyperkalaemia

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14
Q

Why might you do a CT abdomen in someone with hyperaldosteronism?

A

To differentiate between adrenal adenoma or bilateral adrenal hyperplasia

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15
Q

What is the function of adrenal venous sampling in someone with hyperaldosteronism?

A

Confirms if a unilateral adrenal adenoma is responsible for excess production of aldosterone

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16
Q

What is the management if the adrenal adenoma is causing the hyperaldosteronism?

A

Surgery- unilateral adrenalectomy

17
Q

What is the management if it is bilateral adrenal hyperplasia is causing the hyperaldosteronism?

A

Aldosterone antagonist- spironolactone

18
Q

What effect does aldosterone have on the nephrons of the kidneys in someone with hyperaldosteronism?

A

Increase sodium reabsorption from the distal tubule
Increase potassium secretion from the distal tubule
Increase hydrogen secretion from the collecting ducts

19
Q

What is secondary hyperaldosteronism caused by?

A

Excessive renin stimulating the release of excessive aldosterone.

20
Q

What causes the release of excessive renin?

A

Disproportionately lower blood pressure in the kidneys

21
Q

What is the low blood pressure in the kidneys usually due to?

A

Renal artery stenosis
Heart failure
Liver cirrhosis and ascites

22
Q

What aldosterone: renin ration would indicate secondary hyperaldosteronism?

A

High aldosterone and high renin indicate secondary hyperaldosteronism

23
Q

What could be used in the management of renal artery stenosis?

A

Percutaneous renal artery angioplasty via the femoral artery to treat renal artery stenosis