A 67-year-old man with severe atherosclerotic disease and type 2 diabetes presents with refractory hypertension despite lisinopril and amlodipine. Vital signs show BP 178/102 mmHg, HR 88/min, RR 16/min, temperature 37.2°C. Laboratory studies reveal markedly elevated plasma renin activity and elevated aldosterone levels. Serum creatinine is 1.3 mg/dL. A systolic abdominal bruit is appreciated on examination. No lower extremity edema is noted. Which of the following is the most likely underlying cause?
- A)Autoimmune destruction of the adrenal cortex
- B)Primary polydipsia
- C)Bilateral renal artery stenosisGABARITO
- D)Pituitary ACTH excess
- E)Adrenal adenoma producing aldosterone
Explicação
Secondary hyperaldosteronism is driven by excess renin production, often from decreased renal perfusion. An abdominal bruit in an older patient with diffuse atherosclerosis suggests renal artery stenosis, which activates the renin angiotensin aldosterone syste... Ver explicação completa e trilha adaptativa →