1. Geography Student with Hypertension
CASE 3
Geography Student with Hypertension

2. C.P. is a 31-year-old student with a four year history of hypertension.
Upon initial evaluation, her K was 2.9 mEq/L, and the possibility of primary aldosteronism was considered.
Random serum renin and aldosterone levels were normal, however, and the issue was dropped.
Her hypertension was not controlled during treatment with metoprolol, but she did respond favorably to treatment with Aldactazide.
She later discontinued medications, her hypertension persisted and K was 3.0 mEq/L.

3. Physical examination, except for a BP of 185/102, was unremarkable.
She did not have a cushingoid habitus.

4. Laboratory data: Laboratory data:
Na 146 ( mEq/L) Cr 0.7 (<1.2 mg/dL)
K 3.0 (3.5-5 mEq/L)
C1 107 ( mEq/L)
CO2 27 (22-29 mEq/L)
EKG nonspecific ST changes, strain
Your Diagnosis ?
Most probably a cortical adenoma
Most probably a cortical carcinoma
Most probably a pheochromocytoma

5. Cortical Adenoma CT adrenals -- 2 cm homogeneous mass R adrenal
The postoperative course was uncomplicated, and her BP and serum K on follow-up were normal.