Secondary Hyperaldosteronism Causes Explained
Secondary hyperaldosteronism occurs when the overproduction of aldosterone is stimulated by factors external to the adrenal glands, typically involving the Renin-Angiotensin-Aldosterone System (RAAS).
Option Analysis for Hyperaldosteronism
- Option 1: Adrenal adenoma secreting aldosterone
This is a condition where the adrenal tumor itself produces excess aldosterone, making it a cause of Primary Hyperaldosteronism (Conn's syndrome), not secondary. - Option 2: Idiopathic bilateral adrenal hyperplasia
Similar to an adenoma, this condition involves the adrenal glands themselves, leading to excess aldosterone production. It is classified as Primary Hyperaldosteronism. - Option 3: 11-deoxycorticosterone secreting adrenal tumour
While this tumor causes mineralocorticoid excess, the primary issue originates within the adrenal gland, making it a form of Primary Hyperaldosteronism, though the hormone involved is not solely aldosterone. - Option 4: Inadequate renal perfusion due to renal artery stenosis
This is the correct cause of Secondary Hyperaldosteronism. Renal artery stenosis reduces blood flow to the kidneys. The kidneys respond by releasing renin, activating the RAAS pathway. This increased activity subsequently stimulates the adrenal glands to produce more aldosterone. The root cause (renal artery stenosis) is outside the adrenal gland.
Conclusion on Secondary Hyperaldosteronism
Inadequate renal perfusion, specifically due to renal artery stenosis, triggers the RAAS system, leading to increased aldosterone secretion, which defines secondary hyperaldosteronism.
Important Questions from Adrenal Disorders
Which of the following are correct regarding Cortisol?
1. Levels are highest in the morning on waking.
2. Cortisol falls dramatically during an illness.
3. More than 95% circulating cortisol is protein bound.
4. It is the major glucocorticoid in humans and can also activate mineralocorticoid receptors.
Select the answer using the code given below :
- A 50-year lady, who is a known case of rheumatoid arthritis, presents with obesity, moon facies, abdominal striae and hypertension. Overnight dexamethasone suppression test shows serum cortisol is greater than 50 nmol/L, serum ACTH is less than 1.1 pmol/L. The adrenal imaging and brain CT/MRI imaging studies are unremarkable. The likely diagnosis is
- Hirsutism is seen in which of the following ?
1. Polycystic ovarian syndrome
2. Congenital adrenal hyperplasia
3. Hypothyroidism
4. Ovarian tumour
Select the correct answer using the code given below: - A patient presents with circulatory shock, nausea, vomiting and diarrhoea. A diagnosis of acute adrenal crisis is considered. A blood sample is stored for measurement of serum cortisol and treatment started without delay. Which of the following are appropriate interventions?
1. IV normal saline
2. IV hydrocortisone 100 mg stat
3. IV 10% glucose
4. IV KCl as infusion
Select the correct answer using the code given below: - Escape behaviour with paroxysmal occurrence is seen in:
