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CASE 3

CASE 3. Geography Student with Hypertension. C.P. is a 31-year-old student with a four year history of hypertension. Upon initial evaluation, her K was 2.9 mEq/L, and the possibility of primary aldosteronism was considered.

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CASE 3

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  1. CASE 3 Geography Student with Hypertension

  2. C.P. is a 31-year-old student with a four year history of hypertension. • Upon initial evaluation, her K was 2.9 mEq/L, and the possibility of primary aldosteronism was considered. • Random serum renin and aldosterone levels were normal, however, and the issue was dropped. • Her hypertension was not controlled during treatment with metoprolol, but she did respond favorably to treatment with Aldactazide. • She later discontinued medications, her hypertension persisted and K was 3.0 mEq/L.

  3. Physical examination, except for a BP of 185/102, was unremarkable. • She did not have a cushingoid habitus.

  4. Laboratory data: Laboratory data: • Na 146 (135-145 mEq/L) Cr 0.7 (<1.2 mg/dL) • K 3.0 (3.5-5 mEq/L) • C1 107 (95-110 mEq/L) • CO2 27 (22-29 mEq/L) • EKG nonspecific ST changes, strain • Your Diagnosis ? • Most probably a cortical adenoma • Most probably a cortical carcinoma • Most probably a pheochromocytoma

  5. Cortical Adenoma • CT adrenals -- 2 cm homogeneous mass R adrenal • The postoperative course was uncomplicated, and her BP and serum K on follow-up were normal.

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