A 19-year-old woman presents with progressive muscle cramps and weakness. Vital signs: BP 104/64 mmHg, HR 92/min, RR 16/min, temp 37°C. Labs reveal serum potassium 2.8 mEq/L, pH 7.48, HCO3- 32 mEq/L, magnesium 1.4 mg/dL, and 24-hour urinary calcium 45 mg/day. Urinalysis shows no proteinuria. She denies diarrhea or diuretic use. Which of the following is the most likely diagnosis?
- A)Type 4 renal tubular acidosis
- B)Bartter syndrome
- C)Gitelman syndromeGABARITO
- D)Liddle syndrome
- E)Primary hyperaldosteronism
Explicação
Gitelman syndrome is correct. This inherited defect of the thiazide sensitive Na Cl cotransporter in the distal convoluted tubule causes hypokalemic metabolic alkalosis, hypomagnesemia, and hypocalciuria with normal or low blood pressure. It is physiologically... Ver explicação completa e trilha adaptativa →