Question

About a year later, Mr. Smith suddenly began to experience increasing muscle weakness, cramping and tingling, palpitations, generalized fatigue and recurrent headaches. One day he felt very uneasy and asked his coworkers to take him to the emergency room. On physical examination the only significant findings were a documented blood pressure of 210/120 mmHg, a heart rate of 110 bpm and moderate peripheral edema. e rest of his evaluation at the ER revealed the following: Mr. Smith Na = 149 mEq/L K = 2.8 mEq/L Cl = 108 mEq/L CO2 = 16 mmol/L Blood urea nitrogen = 27 mg/dL Creatinine = 2.1 mg/dL Glucose = 123 mg/dL Mg = 1.3 mEq/L Normal Values 135-145 mEq/L 3.5 - 5.0 mEq/L 98-108 mEq/L 20 to 29 mmol/L 7-20 mg/dL 0.8 to 1.4 mg/dL 64 to 128 mg/dL 1.5-2.0 mEq/L Additional routine tests which included a complete blood count (CBC), a chest X-ray and a 12 lead EKG were all unremarkable. An arterial blood gas (ABG) analysis was consistent with a mild metabolic alkalosis with some degree of compensation. An abdominal ultrasound study revealed a suspicious small mass at the level of the right adrenal cortex. Further imaging evaluation with high-resolution CT scan confirmed an adrenal adenoma of the right adrenal cortex. Based on the CT scan results Mr. Smith underwent surgery for removal of the adrenal tumor. Post-operatively, Mr. Smith recovered well without complications and with significant improvement of all his symptoms. His blood pressure began to normalize gradually and after just a few weeks, his doctor was able to completely discontinue all blood pressure medications with no further complaints. Questions 1. What is the proper name for this medical diagnosis? List some of the possible causes. 2. Describe the renin-angiotensin-aldosterone pathway IN YOUR OWN WORDS. 3. List some common signs and symptoms of hyperaldosteronism. 4. What is the main pathophysiologic process responsible for this patient's symptoms? 5. Would you classify this type of hypertension as primary (essential) or secondary? Utilizing your notes and the background information, provided (not an internet source!), please answer the following questions in your own words.

About a year later, Mr. Smith suddenly began to experience increasing muscle weakness, cramping and tingling, palpitations, generalized fatigue and recurrent headaches. One day he felt very uneasy and asked his coworkers to take him to the emergency room. On physical examination the only significant findings were a documented blood pressure of 210/120 mmHg, a heart rate of 110 bpm and moderate peripheral edema. e rest of his evaluation at the ER revealed the following:

Mr. Smith
Na = 149 mEq/L
K = 2.8 mEq/L
Cl = 108 mEq/L
CO2 = 16 mmol/L
Blood urea nitrogen = 27 mg/dL
Creatinine = 2.1 mg/dL
Glucose = 123 mg/dL
Mg = 1.3 mEq/L

Normal Values
135-145 mEq/L
3.5 - 5.0 mEq/L
98-108 mEq/L
20 to 29 mmol/L
7-20 mg/dL
0.8 to 1.4 mg/dL
64 to 128 mg/dL
1.5-2.0 mEq/L

Additional routine tests which included a complete blood count (CBC), a chest X-ray and a 12 lead EKG were all unremarkable. An arterial blood gas (ABG) analysis was consistent with a mild metabolic alkalosis with some degree of compensation. An abdominal ultrasound study revealed a suspicious small mass at the level of the right adrenal cortex. Further imaging evaluation with high-resolution CT scan confirmed an adrenal adenoma of the right adrenal cortex.

Based on the CT scan results Mr. Smith underwent surgery for removal of the adrenal tumor. Post-operatively, Mr. Smith recovered well without complications and with significant improvement of all his symptoms. His blood pressure began to normalize gradually and after just a few weeks, his doctor was able to completely discontinue all blood pressure medications with no further complaints.

Questions
1. What is the proper name for this medical diagnosis? List some of the possible causes.
2. Describe the renin-angiotensin-aldosterone pathway IN YOUR OWN WORDS.
3. List some common signs and symptoms of hyperaldosteronism.
4. What is the main pathophysiologic process responsible for this patient's symptoms?
5. Would you classify this type of hypertension as primary (essential) or secondary?

Utilizing your notes and the background information, provided (not an internet source!), please answer the following questions in your own words.

About a year later, Mr. Smith suddenly began to experience increasing muscle weakness, cramping and tingling, palpitations, generalized fatigue and recurrent headaches. One day he felt very uneasy and asked his coworkers to take him to the emergency room. On physical examination the only significant findings were a documented blood pressure of 210/120 mmHg, a heart rate of 110 bpm and moderate peripheral edema. e rest of his evaluation at the ER revealed the following:

Mr. Smith
Na = 149 mEq/L
K = 2.8 mEq/L
Cl = 108 mEq/L
CO2 = 16 mmol/L
Blood urea nitrogen = 27 mg/dL
Creatinine = 2.1 mg/dL
Glucose = 123 mg/dL
Mg = 1.3 mEq/L

Normal Values
135-145 mEq/L
3.5 - 5.0 mEq/L
98-108 mEq/L
20 to 29 mmol/L
7-20 mg/dL
0.8 to 1.4 mg/dL
64 to 128 mg/dL
1.5-2.0 mEq/L

Additional routine tests which included a complete blood count (CBC), a chest X-ray and a 12 lead EKG were all unremarkable. An arterial blood gas (ABG) analysis was consistent with a mild metabolic alkalosis with some degree of compensation. An abdominal ultrasound study revealed a suspicious small mass at the level of the right adrenal cortex. Further imaging evaluation with high-resolution CT scan confirmed an adrenal adenoma of the right adrenal cortex.

Based on the CT scan results Mr. Smith underwent surgery for removal of the adrenal tumor. Post-operatively, Mr. Smith recovered well without complications and with significant improvement of all his symptoms. His blood pressure began to normalize gradually and after just a few weeks, his doctor was able to completely discontinue all blood pressure medications with no further complaints.

Questions
1. What is the proper name for this medical diagnosis? List some of the possible causes.
2. Describe the renin-angiotensin-aldosterone pathway IN YOUR OWN WORDS.
3. List some common signs and symptoms of hyperaldosteronism.
4. What is the main pathophysiologic process responsible for this patient's symptoms?
5. Would you classify this type of hypertension as primary (essential) or secondary?

Utilizing your notes and the background information, provided (not an internet source!), please answer the following questions in your own words.

Added by Thomas K.

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