Question

Q1:

What are the typical changes in these laboratory parameters in primary hyperaldosteronism? Serum K ______; Urine K _______; Plasma Renin ______.

Q2:

An alcoholic presents to a local emergency department in a confused state and has an epileptic seizure. Alcohol withdrawal and hypoglycemia are certainly likely causes, but in this case, a plasma pyridoxal 5’ -phosphate level is decreased. What vitamin deficiency explains these findings?

Q3:

A test for a particular disease has a sensitivity of 95% and a specificity of 95%. Calculate the percent predictive value of both a positive and negative test result in a population in which the prevalence of the disease is 1 in 5000.

Answer 1

1) Primary hyperaldosteronism is a diseased condition in which the adrenal gland(s) make too much aldosterone resulting in low renin level which leads to hypertension and low blood potassium levels. It can be caused by either hyperactivity in one adrenal gland or in both.

The typical changes in laboratory parameters are as follows:-

Serum potassium ( K) is lower than the normal range ( 3.5 - 5.1 mmol/ L)

Urine potassium ( K) is higher than the normal range ( 25 - 125 mmol/ d)

Plasma Renin is very low then the normal value ( 0.6 to 4.3 ng/ ml/ hour)

2) Vitamin B6 is a water soluble vitamin with the active form being pyridoxal 5- phosphate. Deficiency of vitamin B6 may result in this neurological disorder of epileptic seizure in adult with chronic alcoholism.