Endocrinology MCQ 012

A 38-year-old black woman comes to you for renewal of her medications. She has had hypertension since her last pregnancy at age 30 and has been maintained on clonidine 0.2 mg twice a day. She gets headaches, dyspnea on exertion, swelling of her feet, and orthopnea but denies chest pain. Her father is also being treated for hypertension. She is married and does not smoke. She is five feet seven inches tall and weighs 257 pounds. Her blood pressure is 180/110 mm Hg; pulse is 92 beats/minute. The rest of her exam is remarkable for hypertensive retinopathy, bibasilar rales, and 1+ pitting edema bilaterally. Initial labs were normal except for a serum potassium of 3.0 mEq/L (normal range, 3.5- 5.0 mEq/L) and serum bicarbonate of 33 mEq/L (normal range, 22-28 mEq/L). You correct hypokalemia and obtain a random serum aldosterone level of 25 ng/dL (normal range, 5-30 ng/dL) with a plasma renin activity of 0.5 ng/mL/hour (normal range, 1.6- 7.4 ng/mL/hour) while the patient is on a normal diet. What additional tests might be appropriate?

A. Adrenal computed tomography (CT) scan
B. Adrenal vein sampling
C. 18-hydroxycorticosterone
D. Saline loading test
E. A, B, and C

Answer

Tags: MCQ, Endocrine, Aldosterone

Category: Endocrinology MCQs