A 50-year-old male, with 2-month history of muscle cramping, associated with weakness and fatigue. BP 150/90 HR normal. Medical and surgical hx was unremarkable. Na high, K low, Cr normal What's the diagnostic test?
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الإجابة والشرح
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الإجابة: C. Plasma aldosterone:renin ratio
HTN + muscle cramps/weakness/fatigue (features of hypokalaemia) + high Na and low K = primary hyperaldosteronism. Screening test: plasma aldosterone : renin ratio. Cortisol (Cushing), metanephrines (phaeo), renal Doppler and TFTs target other causes without matching features.
ليش كل خيار صح أو غلط
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A
ليش غلط
24-hour urinary cortisol is one of the screening tests for Cushing syndrome (cortisol excess), not a test for aldosterone excess.
✓ 6• Cushing's Syndrome & Disease [Notes].pdf · p. 5 -
B
ليش غلط
Plasma metanephrines are the test for pheochromocytoma (episodic headache, sweating, palpitations), which is not this picture of cramps, weakness and low potassium.
✓ Adrenal summary.pdf · p. 7 -
C
ليش صح
The plasma aldosterone-to-renin ratio is the screening test for primary hyperaldosteronism, which shows high aldosterone with low renin; his hypertension, weakness and low potassium fit that disease.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 8 -
D
ليش غلط
Renal artery stenosis causes secondary hyperaldosteronism through ↑renin release and is assessed for with a renal artery bruit; nothing in his history or examination points to it.
✓ 7• Hyperaldosteronism [Notes].pdf · p. 2
- المصدر
- Adrenal disorders (2).pdf · p. 12
Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 8 - المحاضرة
- Primary Hyperaldosteronism · Endocrinology · Module B
- ظهر في
- Endo bank