10-27-2008, 08:54 PM
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recent CCS- young age pt Htn due to adrenal hyperp - jayhind
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10-27-2008, 08:54 PM
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10-27-2008, 09:08 PM
PE
CBC BMP ECG UA EKG CXR PULSE OXY VITALS BP MONITOR CHECK BP MONITOR sent home followup in 1 wk interval h/o PE vitals renin aldosterone bmp ct abd 24 hr urine cortisol 24 hr VMA follow up with results ACEI low salt diet 5min screen counsel age related screening
10-27-2008, 11:36 PM
PE
CBC BMP serum cortisole VMA/metanephrin EKG CHEST X-TAY HOME BP MONITOR 5 day appointment 24 hr-serum cortisole dexa suppression test renin aldosterone ACTH 17-hydroxyprogestron 11-hydroxylase urine -17alpha ketosteroids abdominal CT ENDOCRINOLIGY CONSULTATION TX COETICOSTERON low salt diet FOLLOW UP
10-27-2008, 11:41 PM
sorry sorry typo
11-deoxycortisole tx HYDROCORTISONE
10-28-2008, 12:18 PM
pe
cbc bmp urinary metanephrines if hypokalemia and hypernatremia do renin: angiotensin ratio if reduced- do ct abdomen conn's syndrome- admit, correct hypokalemia, contrl bp with spironolactone for 1-2 weeks , then laparoscopic adrenalectomy. phaeochromocytoma- control bp with phentolamine, then laparoscopic adrenalectomy.
10-28-2008, 07:36 PM
any idea how this case presented? jayhind??? anyone???
10-28-2008, 07:38 PM
25 yr old pt 160/90 with previous 2 high BP readings...
10-28-2008, 07:48 PM
full physical
Pulse oxy CBC BMP EKG CXR lipid profile LFTs UA diet exercise send home call after 1 week results shows-- low K+ interval history BP check renin aldo dexa supression test urin VMA renin/ald ratio is >20 start spironolactone CT abd educate CT shows adrenal mass surgery consult adrenelectomy
10-28-2008, 08:17 PM
hey jay..how ar eyou holding up? you will do more than fine...good luck
thanks for responding to my q... as i was looking at "goodnew's " hard work on this ccs and got all confused...goodnews's workup is more for Congenital Adrenal Hyperplasia....right? that case shoul d have some mention of ambigous genitalia..i think! and should be a child....anyway. but this case is basically about Primary hyperaldosteronisim or CONN's syndorme.. and our differential is pheo, Conn's and Cushing's here.
10-28-2008, 08:25 PM
Exactly..!!!!!
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