Hyperaldosteronism Flashcards Preview

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Flashcards in Hyperaldosteronism Deck (15):
1

what is primary

excess production aldosterone independent of RAAS

2

what does primary cause

incr sodium and water retention, decr renin release

3

when would you consider primary

hypertension, hypokalaemia, alkalosis

4

symptoms primary

asymptomatic or signs of hypokalaemia- weakness, cramps, paraesthesiae, polyuria, polydipsia. bp incr but not always

5

causes

2/3- solitary aldosterone producing adenoma (Conns). 1/3 due to bilateral adrenocortical hyperplasia

6

what is GRA

glucorticoid remediable aldosteronism

7

tests

U&E, renin and aldosterone (not on diuretics, hypotensives, steroids, K+ or laxatives)

8

what is Conns

solitary aldosterone secreting adenoma

9

treatment of Conns

lap adrenalectomy. spironolocatone

10

treatment hyperplasia, GRA, adrenal carcinoma

hyperplasia- spironolactone, amiloride, eplerenone. GRA- dexamethasone. adrenal carcinoma- surgery +- post op adrenolytic therapy

11

what is secondary

due to high renin from renal underperfusion eg in renal artery stenosis, accelerated hypertension, diuretics, CCF or hepatic failure.

12

what is Bartters syndrome

major cause congenital salt wasting- sodium and chloride leak in loop of Henle- defective channel. in childhood presents failure to thrive, polyuria, polydipsia. bp normal

13

treatment in Bartters syndrome

K+ replacement, NSAIDS, ACEi

14

when should you consider Conns

1) hypertension associated with hypokalaemia. 2) refractory hypertension despite 3 or more antihypertensives. 3) hypertension before 40 years of age.

15

what is a more common cause of refractory incr in bp and decr in K+ (compared to Conns)

renal artery stenosis