Pathology USMLE Question No. 4

[Cardiac Arrest]

A 46-year-old woman presents to her doctor complaining of weakness and fatigue. On physical examination, her physician notices a 10-pound weight gain since her last visit 6 months ago. Her blood pressure is 160/100 mmHg. Blood tests reveal serum Na+ 155 mEq/L, K+ 2.8 mEq/L, and a decreased serum renin. Which of the following is the most likely diagnosis?

A. Cushing's syndrome
B. Diabetes mellitus
C. Pheochromocytoma
D. Primary aldosteronism
E. Secondary aldosteronism

[GoldenButterfly]

hmm

not DM
not pheochromocytoma (i dont think ppl gain weight in this case)

cushing sundrome (maybe)
1ry aldosteronism (this would lower the renin level but i don't really know how exactly.. is it the high blood pressure that would reduce the renin secretion or is it a feedback from aldosterone ?)

2ry aldosteronism (high renin level could be a cause )

the BP ,na, K level and low renin all point to hyperaldosteronism

so i'll choose

D -primary aldosteronism

[dr-kenzy]

salam ..

iam agree with GoldenButterfly

the answer is :

D. Primary aldosteronism

cuz from the case there are :

blood pressure is 160/100 mmHg. ( hypertention )..
serum Na+ 155 mEq ( increased )
K+ 2.8 mEq/L,( decreased )
decreased serum renin\

all the above make the diagnosis of aldosteronism
and it is primary not secondary cuz: the serum renin low in primary and high in secondary ..

[Cardiac Arrest]

Good work everybody

The correct answer is D. Primary aldosteronism
(Conn's syndrome) is a condition of hyperaldosteronism originating in the adrenal gland. The causes include an aldosterone-secreting adrenocortical adenoma, hyperplasia of the zona glomerulosa, and very rarely, an adrenal carcinoma. It is characterized by hypertension secondary to sodium retention, hypokalemia, and a decreased serum renin due to a negative feedback of increased blood pressure on renin secretion.

Cushing's syndrome (choice A) is the result of increased glucocorticoid production, particularly cortisol. Physical signs typically include "moon facies," truncal obesity, "buffalo hump," and purple abdominal striae.

Diabetes mellitus (choice B) is a condition of inadequate insulin production that presents with hyperglycemia and ketoacidosis.

Pheochromocytoma (choice C) is a rare tumor of chromaffin cells occurring most commonly in the adrenal medulla. The tumor secretes epinephrine and norepinephrine, resulting in secondary hypertension.

Secondary aldosteronism (choice E) results from an activation of the renin-angiotensin system caused by renal ischemia, edema, and renal tumors. In contrast to primary aldosteronism, secondary aldosteronism is associated with increased serum renin.

[uday]

i think its D

[f_ameer376]

thannnnnnnnx

[alva]

thanks for the explanation