A 27-year-old male has had a hard to control hypeension for 2 years. He is taking clonidine, hydrochlorothiazide, verapamil, and lisinopril. His blood pressure is 170/105 mmHg, pulse 90 beats/min, and respirations 16/min. The cardiopulmonary exam is normal. Pedal pulses are intact and there is no edema or mis-distribution of fat. Laboratories show potassium of 2.7 mEq/L, BUN 20 mg/dL, creatinine 1.2 mg/dL, bicarbonate 33 mg/dL, and fasting glucose 98 mg/dL. What is the most likely diagnosis?
Presentation: K+|| RFT= N HCO3(22-26) here || so alkalosis present Therefore, Hypokalemic alkalosis with HTN Option A- characterized by ||BP as aldosterone is elevated which also l/t urinary loss of K+ and hydrogen causing Hypokalemic alkalosis. Option B- In renal vasculature hypeension there is |RFT Option C- presents with weight gain in patients, HTN as coisol can stimulate aldosterone receptors l/t hypokalemic alkalosis. Option D- carcinoid syndrome doesn't lead to hypeension because metabolites produced may cause bronchospasm and Histamine/Serotonin release which will cause vasodilation not HTN. 1ST likely diagnosis= CONN syndrome
Conn syndrome
Renal vascular hypeension
Cushing syndrome
Carcinoid syndrome
Disorders of Adrenal Gland