USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

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Which condition presents with hypertension, hypernatremia, and hypokalemia with no edema due to the Aldosterone escape mechanism?

2° Aldosteronism
Addison disease
Primary hyperparathyroidism
1° Aldosteronism

The correct answer is: 1° Aldosteronism

This condition presents with hypertension, hypernatremia, and hypokalemia due to increased levels of aldosterone in the body. However, unlike in secondary aldosteronism (A), where there is an underlying issue causing the increase in aldosterone levels, in primary aldosteronism, the issue lies with the adrenal gland itself. This can be due to an adenoma (growth) on the adrenal gland or hyperplasia (enlargement) of the adrenal gland. Addison's disease (B) is a disorder where the adrenal gland does not produce enough hormones, including aldosterone, leading to hypotension and low sodium levels. Primary hyperparathyroidism (C) is a condition where the parathyroid gland produces too much hormone, leading to increased calcium levels and potential hypertension, but it does not affect aldosterone levels. Thus, the correct answer is 1° Aldosteronism (D).