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11- Primary Hyperaldosteronism

Terms in this set (21)

Describe renin levels in terms of primary and secondary hyperaldosteronism?
primary= suppressed
secondary= high
Which secretes +aldosterone due to activation of the RAAS? = primary or secondary hyperalosteronism?
secondary
Conn Syndrome is a --------- and is classified as primary/secondary hyperaldosteronism.
aldosterone producing adrenal adenoma; primary
Patients who do not have Conn Syndrome but do have primary hyperaldosteronism are likely to present with ----------------------------
bilateral cortical nodular hyperplasia (MC in men)
(no tumor - idiopathic hyperaldosteronism)
CYP11B2 refers to the enzyme -------- and CYP11B1 refers to -------------.
aldsterone synthase; 11B hydroxylase
Name 3 factors that help secrete aldosterone? inhibit aldosterone?
1. Secrete= Ag2, K+, AcTH
2. Inhibit= Dopa, ANP, heparin
Aldosterone binds to what cells?

Hint= -----------cells in the -----------
principal cells in the renal cortical collecting duct
** Why does edema not occur in hyperaldosteronism?
Escape phenomenon (counter regulation)
Escape phenomenon can be attributed to the effects of what hormone?
ANP (natriuresis & diuresis)

(note NO escape from hypokalemia)
Primary aldosterone secreting adrenal adenomas will present with eosinophilic inclusions knwon as ------------.
These appear after tx w/ antihypertensive drugs
spironolactone bodies
Mode of inheritance for the familial hyperaldosteronisms (1&2)
a. dominant
FH type 1 is characterized by -------------. (Clinical presentation) and is caused by unequal crossover of ------ &----------
bilateral adrenal hyperplasia;
11B hydroxylase & aldosterone synthase (chimeric/hybrid)
Which is the glucocorticoid remediable familial hyperaldosteronism? (type 1or2?)
1
Type 2 familial hyperaldosteronism is due to ------------
an adrenal adenoma that secretes aldosterone
What is the test to confirm primary hyperaldosteronism?
NaCl loading test
** What is the mc cause of secondary hyperaldosteronism?
Renal artery stenosis (RAS - renovascular HTN)
** How to differentaiate primary from secondary causes of hyperaldosteronism?
ARR to PRA ratio (plasma aldosterone : plasma renin activity)
Juxtaglomerular cell tumors of the kidney are also known as ---------- and can cause --- hyperaldosteronism
reninoma (secrete +renin); secondary
2 MC sx of Primary hyperaldosteronism?
1. refractory HTN
2. hypokalemia
Pts w/ refractory HTN d/t primary hyperaldosteronism are at higher risk of -----
end organ damage
Subtype studies to distinguish causes of primary hyperaldosteronism are based on response to ---
adrenalectomy
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