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BOF: 10

A fifty-year-old patient attending the hypertension clinic has refractory hypertension. Random aldosterone: plasma renin activity has shown a ratio of greater than 750. In order to differentiate the underlying cause of primary aldosteronism, demonstrated in this patient, you arrange for the patient to have aldosterone: plasma renin activity measured in the morning (at 8 a.m.) with the patient in the supine position and again at noon with the patient in the erect position. This test helps to differentiate the causes of primary hyperaldosteronism because:

a) ACTH suppresses aldosterone secretion in adrenal adenoma

b) ACTH has no effect on glucocorticoid suppressible hyperaldosteronism

c) Erect posture increases plasma aldosterone in adrenal hyperplasia

d) ACTH levels are higher at noon

e) The supine position increases aldosterone secretion in glucocorticoid suppressible hyperaldosteronism.

 

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