BOF: 119
Your junior asks for advice regarding blood results on a
45-year-old female who is a known hypertensive and is complaining of polyuria,
polydypsia and muscle weakness. Blood pressure 170/110.
The results are:
Potassium 2.5 mmol/l
Arterial pH 7.49
The next question you would ask is:
a)
Is there a family history of hypertension
b)
Does the patient have a bruit over the renal artery
c)
Is the patient on a diuretic
d)
What is the ratio of aldosterone to plasma rennin activity
e)
Does the patient have papilloedema
Answer:
c)
Hypertension, hypokalaemia and alkalosis should make one
suspect Conn’s syndrome if the patient is not on diuretics. Hence this is
the most important question to answer.
Renal artery stenosis also causes hypertension with
hypokalaemia and is a more common cause of refractory hypertension with low
potassium.
Secondary hyperaldosteronism may be due to
Renal artery stenosis
Accelerated hypertension
Diuretics
Heart failure
Liver failure
Revision Tip
Revise primary hyperaldosteronism
KEYS to SUCCESS in Medicine page 52-53
