A 35-year-old female with a history of poorly controlled hypertension presents with paraesthesia and weakness. Her blood results are shown below:
|
Parameter |
Patient Value |
Normal Adult Range |
|
Sodium |
145 mmol/L |
135 – 145 |
|
Potassium |
1.8 mmol/L* |
3.5 – 5.0 |
|
Chloride |
85 mmol/L* |
95 – 105 |
|
Bicarbonate |
40 mmol/L* |
24 – 32 |
|
Urea |
3.4 mmol/L |
3.0 – 8.5 |
|
Creatinine |
80 micromol/L |
70 – 110 |
|
Parameter |
Patient Value |
Normal Adult Range |
|
|
pH |
7.56* |
7.35 – 7.45 |
|
|
pO2 |
85 mmHg (11.3 kPa) |
||
|
pCO2 |
46 mmHg* (6.1 kPa)* |
35 – 45 mmHg (4.6 – 5.9 kPa) |
|
|
Bicarbonate |
40 mmol/L* |
24 – 32 |
|
|
FiO2 |
0.21 |
||
a) Interpret these results.
b) List two likely diagnoses.
c) Give two drugs used to treat this condition.
a)
Metabolic alkalosis with partial respiratory compensation and severe hypokalaemia.
b)
Primary Hyperaldosteronism most likely secondary to an aldosterone producing adenoma (Conn's syndrome – 50 – 60%) or adrenal hyperplasia (40 – 50%).
Licorice ingestion.
Liddle's syndrome.
Excessive diuretic use.
c)
Aldosterone antagonist (spirinolactone or eplerenone).
Amiloride.
This question is identical to Question 18.2 from the first paper of 2011.