Hyperaldosteronism/Cushing Syndrome

Question 1

Low Renin
High Aldosterone
HTN/Hypokalemia

Answer 1

Primary Hyperaldosteronism

• Adrenal Hyperplasia (17 OHase def.)
• Aldosterone tumor (Conn syndrome)

Question 2

Muscle Weakness/ Paresthesias
HTN at a young age
Hypokalemia
Alkalosis

Answer 2

Primary Hyperaldosteronism

*Muscle Weakness/ Paresthesias = electrolyte or acid-base disturbance

Question 3

primary Hyperaldosteronism has 2 etiologies :

Answer 3

aldosterone-producing adenoma (Conn syndrome)

Bilateral Adrenal Hyperplasia– 17OHase def. (60%)

Question 4

Hyperaldosteronism is characterized by increased Na+ reabsorption in the renal collecting tubulesleading to increased urinary excretion of __ & __

which promotes bicarbonate production and increased activity of the baso-lateral HCO3−/Cl- exchanger which releases Cl- to neutralize causing alkalemia

Answer 4

K+ and H+

Question 5

How does Hyperaldosteronism affect:
Renal Blood Flow
GFR
ANP

Answer 5

All of them are elevated

Question 6

High Aldosterone
High Renin
HTN Hypokalemia

Answer 6

Secondary Hyperaldosteronism

• Renal Vascular HTN
• Malignant HTN
• Renin Secreting tumor in Kidney
• Diuretic overuse

Question 7

Low Renin
Low Aldosterone
HTN/Hypokalemia

Answer 7

Non-Aldosterone cause

• Congenital Adrenal Hyperplasia (11OHase def.)
• Cushing syndrome (elevated cortisol)
• Exogenous Mineralocorticoids (Prednisone)

Question 8

Cushing Syndrome + Low ACTH levels

Causes (2)

Answer 8

Adrenal Adenoma

Exogenous glucocorticoid use (Prednisone)

Question 9

Cushing Syndrome + normal/High ACTH + Dexamethasone able to lower ACTH/cortisol levels

Answer 9

Pituitary adenoma

Question 10

Cushing Syndrome + normal/High ACTH + Dexamethasone UNABLE to lower ACTH/cortisol levels

Answer 10

Ectopic ACTH production

• Lung/ Kidney/ Brain tumor possibly

Question 11

Glucose intolerence 
HTN
Amenorrhea
Low Libido
Hirsutism

Answer 11

Cushing Syndrome

-Moon face, fat neck, fat gut, muscle weakness, bruisability