A 34-year-old woman with no prior medical history presents to clinic with fatigue and muscle weakness. She was found to be hypertensive (BP 162/98 mmHg) during a routine visit. Physical examination is notable for mild lower extremity edema but no other findings. Laboratory studies show: Serum sodium: 142 mEq/L Serum potassium: 2.8 mEq/L Serum chloride: 102 mEq/L Serum bicarbonate: 32 mEq/L Plasma renin activity: 0.2 ng/mL/hr (normal 0.5-4.0) Plasma aldosterone: 28 ng/dL (normal <15) Aldosterone-to-renin ratio: 140 Abdominal imaging shows a 1.2 cm left adrenal nodule with smooth margins and low lipid content. Which of the following is the most likely diagnosis?
- A)Secondary hyperaldosteronism due to renal artery stenosis
- B)Hypokalemic periodic paralysis presenting with incidental hypertension
- C)Primary hyperaldosteronism due to an aldosterone-secreting adenomaGABARITO
- D)Licorice-induced apparent mineralocorticoid excess
- E)Cushing syndrome with secondary hypokalemia
Explicação
This patient has the classic triad of primary hyperaldosteronism: (1) hypertension with hypokalemic metabolic alkalosis, (2) suppressed plasma renin activity with elevated aldosterone (aldosterone-to-renin ratio >20), and (3) an aldosterone-secreting adrenal a... Ver explicação completa e trilha adaptativa →