Tuesday, August 25, 2015

Nursing Stuff: Conn's Syndrome

01. The answer is: d. Increased aldosterone levels suppress the excretion of renin by the cells of the juxtaglomerular apparatus of the kidney Secretion of aldosterone increases plasma volume and blood pressure.  The rise in blood pressure suppresses the excretion of renin.  If there is a primary hyperaldosteronism, then decreased renin (and subsequent decreased angiotensin II) will not lead to a decrease in aldosterone levels (a very helpful clinical tool in diagnosis of primary hyperaldosteronism).

02. The answer is: a. Spironolactone and Eplerenone.  B. Lisinopril (Zestril) is and ACI and Losartan (Cozaar) is and ARB.  C. Hydrochlorothiazide (Microzide) is a loop diuretic and Chlorthalidone (Thalitone) is a thiazide diuretic.  D. Nifedipine (Procardia) and Amlodipine (Norvasc) are both calcium channel blockers.

03. The answer is: c. Mevacor.  Mevacor (Lovastatin) is used to treat elevated cholesterol.  The others: a. Valsartan (Diovan), b. Olmesartan (Benicar) and d. Irbesartan (Avapro) are all examples of ARBS.

04. The answer is: b. Cortrosyn.  Cortrosyn is a corticotropic agent that is mimics the effects of ACTH.  ACTH is a hormone produced in the anterior pituitary gland that stimulates the adrenal glands to release cortisol and aldosterone. 

05. The answer is: d. Aldosterone levels over 10 ng/dL.  Post infusion plasma aldosterone levels less than 5 ng/dL make the diagnosis of PA unlikely.  Plasma aldosterone values higher than 10 ng/dL confirm primary hyperaldosteronism, and levels 5-10 ng/dL may be considered borderline. The increase in the intravascular volume and the additional sodium should suppress further release of aldosterone by the adrenal glands.  A continued elevation in the aldosterone levels suggest hypersecretion primary source. 

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