FN: Hyperaldosteronism

Question 1

Primary Hypoeraldosteronism

Answer 1

Excess aldosterone, independent of RAS

Question 2

Primary Hypoeraldosteronism Features of

Answer 2

1. Hypokalaemia: weakness, hypotonia, hyporeflexia, cramps
2. Parasthesia
3. Raised BP

Question 3

Primary Hypoeraldosteronism: Causes

Answer 3

1. Bilateral adrenal hyperplasia (70%)

2. Adrenocortical adenoma (30%): Conns syndrome

Question 4

Primary Hypoeraldosteronism: Investigations

Answer 4

1. U+E: raised Sodium, reduced K, alkalosis
2. Aldosterone: renin ratio: raised with primary
3. ECG: flat/inverted T waves, U waves, depressed ST
4. Adrenal CT/MRI

Question 5

Primary Hypoeraldosteronism: treatment

Answer 5

1. Conn’s: laparoscopic adrenelectomy

2. Hyperplasia: spironalactone, eplerenon or amiloride

Question 6

Secondary Hyperaldosteronism:

Answer 6

Due to increased renin from decreased renal perfusion

Question 7

Secondary Hyperaldosteronism: causes

Answer 7

RAS
Diuretics
CCF
Hepatic Failure
Nephrotic syndrome

Question 8

Secondary Hyperaldosteronism: Investigations

Answer 8

Aldosterone: renin ratio: normal

Question 9

Secondary Hyperaldosteronism: Bartters syndrome

Answer 9

1. Autosomal recessive
   Blockage of NaCL reabsorption in loop of Henle (as if taking frusemide)
2. Congenital salt wasting –> RAS activation –> hypokalaemia and metabolic alkalosis
3. Normal BP