Question of the Week # 156

156) A 25 year old woman presents to your office with complaints of muscle cramps and weakness. On examination, she is afebrile,  heart rate is 88/min and blood pressure is 150/98.  Ophthalmoscopic examination shows the following :

Laboratory investigations reveal a Sodium of 144 meq/L, potassium of 3.0meq/L, Chloride 98meq/L , Bicarbonate of 34meq/L and Creatinine of 0.8mg%. Urinary chloride is 45meq/L. The most likely diagnosis that explains this patient’s clinical features :

A) Gitelman’s syndrome

B) Chronic Laxative abuse

C) Diuretic Abuse

D) Primary Hyperaldosteronism

E) Bartter’s syndrome

3 Responses

  1. its primary hyperaldosteronism,triad of HTN,hypokalemia, and met alkalosis,and eye ex showing hypertensiv retinopathy.In Bartter bp will be normal,in diuretic there will be history of intakeso ans is D

  2. hypokalemia wil cause weakness n cramps,it will hv increase aldo and low renin

  3. D.

    The only HTA with Metabolic alkalosis list in the answer is primery hyperaldosteronism

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