A 23-year-old woman with a 2-year history of progressive hirsutism, moderate inflammatory acne, and irregular menstrual cycles occurring every 45–60 days presents to her gynecologist for follow-up. Laboratory workup confirms hyperandrogenism with an elevated free testosterone of 42 pg/mL (normal 1–8.5 pg/mL) and a normal DHEA-sulfate level, consistent with ovarian rather than adrenal origin. She is started on spironolactone 100 mg daily for symptom management. Her baseline vital signs are stable (BP 118/76 mmHg, HR 82/min, RR 16/min, temperature 98.6°F), and her baseline serum potassium is 4.1 mEq/L with normal renal function. Three weeks later, repeat laboratory testing reveals a serum potassium of 5.8 mEq/L (normal 3.5–5.0 mEq/L), while free testosterone has appropriately decreased to 9 pg/mL. She reports no nausea, palpitations, muscle weakness, or dietary changes. Her BMI is 26 kg/m² and she takes no other medications. Which mechanism best explains her laboratory abnormality?

  1. A)Flutamide
  2. B)Finasteride
  3. C)Eplerenone
  4. D)Clomiphene
  5. E)SpironolactoneGABARITO

Explicação

Spironolactone antagonizes aldosterone receptors and also has antiandrogen effects, making it useful in hirsutism and hyperaldosteronism. Hyperkalemia is a predictable consequence of its potassium sparing mineralocorticoid receptor blockade. Ver explicação completa e trilha adaptativa →

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