Difference between revisions of "SECONDARY HYPERTENSION-PRIMARY HYPERALDOSTERONISM"
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==Reference(s)== | ==Reference(s)== | ||
Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. | Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. [https://amzn.to/3YHrI6K Get it on Amazon.] | ||
<br/>Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. [https://amzn.to/3k7WSW0 Get it on Amazon.] | |||
<br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy. | <br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy. | ||
<br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021]. | <br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021]. | ||
Latest revision as of 20:03, 13 March 2023
SUMMARY
1. In the patient with hypokalemia and hypertension, screen for hyperaldosteronism: early morning aldosterone:renin ratio (ratio > 30 is considered positive).
2. Causes: adrenal adenomas (70%; AKA "Conn syndrome"), idiopathic bilateral adrenal hyperplasia (25%), adrenal carcinoma (rare).
3. Investigate positive screening test with IV NS (salt & fluid loading) over 3-4 hours and check aldosterone levels. Alternatively, give oral salt load over 3-4 days.
4. Subsequently investigate with CT abdomen.
5. Initial management: salt & fluid restriction, potassium-sparing diuretic.
6. Unilateral adrenal adenomas are surgically removed with excellent results, whereas patients with bilateral adrenal hyperplasia are managed with diuretics alone.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
