Hyperaldosteronism Sequence of Management - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-13-2012
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 246
Threads: 18
Thanked 142 Times in 86 Posts
Reputation: 152
Question Hyperaldosteronism Sequence of Management

is that the right sequence in mgm of a pt with hyperaldosteronism
Aldo/Renin ratio --> Abd CT --> Sample of venous blood draining the adrenal or Surgery

i think if the Abd is negative we proceed with sampling (like in pituitary adenoma)

correct me if i'm wrong :sorry:
Reply With Quote Quick reply to this message
The above post was thanked by:
pakigal (05-14-2012)



  #2  
Old 05-14-2012
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 239
Threads: 3
Thanked 48 Times in 37 Posts
Reputation: 58
Default

well.. I think, it's not like that. it should be > first, Aldo/Renin ratio then > venous blood sampling > CT scan.
CT should be done after biochemical testing confirms > low plasma renin level, low potassium, high aldosterone despite a high salt diet.
__________________
I'm Predictable In The Unpredictable Future !
Reply With Quote Quick reply to this message
The above post was thanked by:
pakigal (05-14-2012)
  #3  
Old 05-14-2012
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 246
Threads: 18
Thanked 142 Times in 86 Posts
Reputation: 152
Default

yea exactly, but mtb2 mention that sampling is the most accurate test to confirm the presence of UNILATERAL adenoma, but what if the cause is bilateral hyperplasia then Sampling result would ambiguous maybe.
and serum aldo, renin are the biochemical test that establish the dx (right)
Reply With Quote Quick reply to this message
 
  #4  
Old 05-14-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 17
Threads: 5
Thanked 4 Times in 4 Posts
Reputation: 14
Default

Quote:
Originally Posted by bisho View Post
is that the right sequence in mgm of a pt with hyperaldosteronism
Aldo/Renin ratio --> Abd CT --> Sample of venous blood draining the adrenal or Surgery

i think if the Abd is negative we proceed with sampling (like in pituitary adenoma)

correct me if i'm wrong :sorry:
you are right....

according to emedicine:Adrenal venous sampling probably has its greatest utility in the setting of either totally normal adrenal imaging despite biochemical evidence for PH(primary hyperaldosteronism) or settings in which bilateral adrenal pathology is present on imaging, with the biochemistry suggesting the presence of a functional aldosteronoma. The test also has utility in resolving the exact etiology in cases of PH in which discordance exists between the biochemical findings and the radiologic findings with regard to whether the PH is due to IAH or an aldosteronoma.

Also according to Ferri's clinical advisor:Bilateral adrenal venous sampling may be done to localize adenoma when adrenal CT scan is equivocal.
Reply With Quote Quick reply to this message
The above post was thanked by:
bisho (05-14-2012)
  #5  
Old 05-11-2013
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 821 Times in 434 Posts
Reputation: 831
Send a message via Yahoo to venky2600
Post

guys, i knew it's old post but i gotta doubt

according to mtb2 ---most accurate is adrenal venous sampling

according to uworld---most accurate is giving IV/oral NS and measuring aldosterone level in plasma or urine....

are they both same..? if not which one is correct...?


thanks
Reply With Quote Quick reply to this message
The above post was thanked by:
MerryM (06-07-2016)



Reply

Tags
Endocrinology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Primary Hyperaldosteronism and Sodium Escape? Dr.Binish USMLE Step 1 Forum 1 04-24-2012 10:11 AM
The pathophysiology of edema & hypertension in hyperaldosteronism chienpolska USMLE Step 2 CK Forum 3 01-23-2012 06:05 AM
Chronic Renal Failure as cause of Secondary Hyperaldosteronism? Triquetrum USMLE Step 1 Forum 0 08-14-2011 08:47 AM
Sequence of Management of Suspected Infantile Meningitis! Kais_MD USMLE Step 2 CK Forum 15 08-08-2011 10:28 AM
Primary vs. secondary hyperaldosteronism; how to differentiate schiwei USMLE Step 1 Forum 5 12-01-2010 11:34 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)