2.2.3 Clinical Case 1 - Bartter's Syndrome

Question 1

Answer 1

E. B and C

Question 2

What are four symptoms commonly identified in Bartter’s syndrome?

Answer 2

muscle weakness, polyuria, enuresis (bed wetting), polydipsia

Question 3

Answer 3

D. Tubular function is abnormal due to increased excretion rates for both Na and K

Question 4

Answer 4

C. Decreased K-conductance prolongs RT-interval and slows phase 3 depolarization to flatten T-wave

Question 5

Answer 5

A. Hypokalemia

Question 6

Answer 6

D. Kidney handling is abnormal for both sodium and potassium

Question 7

Answer 7

D. All of the Above

Question 8

Which diuretic acts to block/occupy the receptor of aldosterone?

Answer 8

Spironolactone

Question 9

Answer 9

E. B and C

Question 10

What three factors can aid in a diagnosis of Bartter’s Syndrome?

Answer 10

Renal K wasting

Metabolic alkalosis

Increased renin and aldosterone

Question 11

What is a treatment method to minimize or eliminate the muscle weakness associated with Bartter’s syndrome?

Answer 11

K+ supplementation

Question 12

Answer 12

E. A and B

Question 13

What might you expect regarding lab values if a patient is suffering from bartter’s syndrome?

Answer 13

Decreased levels on Na, Cl, K, and HCO3

Question 14

Answer 14

E. B and C

Question 15

Based on the following values, what is your assessment of the glomerular function in this patient?

Answer 15

GFR is near normal

Question 16

What are 4 treatment approaches for a patient suffering from Bartter’s syndrome?

Answer 16

K supplements and liberal salt intake to avoid electrolyte imbalances

Aldosterone antagonists and the diuretic spironolactone

ACE inhibitors to counteract the effects of ANG II and aldosterone

Nonsteriodal anti-inflammatory drugs (NSAIDs) to decrease prostaglandin excretion

Question 17

Answer 17

E. B and C

Question 18

Answer 18

D. Resorption of potassium is less than normal

Question 19

What is causing the alkalosis in this patient?

Answer 19

Increased H excretion stimulated by aldosterone in the distal and collecting tubule